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  1. Article ; Online: Evaluating the risk of conflict on recent Ebola outbreaks in Guinea and the Democratic Republic of the Congo.

    Charnley, Gina E C / Green, Nathan / Kelman, Ilan / Malembaka, Espoir B / Gaythorpe, Katy A M

    BMC public health

    2024  Volume 24, Issue 1, Page(s) 860

    Abstract: Background: Reducing Ebola virus transmission relies on the ability to identify cases and limit contact with infected bodily fluids through biosecurity, safe sex practices, safe burial and vaccination. Armed conflicts can complicate outbreak detection ... ...

    Abstract Background: Reducing Ebola virus transmission relies on the ability to identify cases and limit contact with infected bodily fluids through biosecurity, safe sex practices, safe burial and vaccination. Armed conflicts can complicate outbreak detection and interventions due to widespread disruption to governments and populations. Guinea and the Democratic Republic of the Congo (DRC) have historically reported the largest and the most recent Ebola virus outbreaks. Understanding if conflict played a role in these outbreaks may help in identifying key risks factors to improve disease control.
    Methods: We used data from a range of publicly available data sources for both Ebola virus cases and conflict events from 2018 to 2021 in Guinea and the DRC. We fitted these data to conditional logistic regression models using the Self-Controlled Case Series methodology to evaluate the magnitude in which conflict increased the risk of reported Ebola virus cases in terms of incidence rate ratio. We re-ran the analysis sub-nationally, by conflict sub-event type and tested any lagged effects.
    Results: Conflict was significantly associated with an increased risk of reported Ebola virus cases in both the DRC and Guinea in recent outbreaks. The effect was of a similar magnitude at 1.88- and 1.98-times increased risk for the DRC and Guinea, respectively. The greatest effects (often higher than the national values) were found in many conflict prone areas and during protest/riot-related conflict events. Conflict was influential in terms of Ebola virus risk from 1 week following the event and remained important by 10 weeks.
    Conclusion: Extra vigilance is needed following protests and riot-related conflict events in terms of Ebola virus transmission. These events are highly disruptive, in terms of access to transportation and healthcare and are often in urban areas with high population densities. Additional public health messaging around these types of conflict events, relating to the risks and clinical symptoms may be helpful in reducing transmission. Future work should aim to further understand and quantify conflict severity and intensity, to evaluate dose-response relationships in terms of disease risk.
    MeSH term(s) Humans ; Hemorrhagic Fever, Ebola/epidemiology ; Hemorrhagic Fever, Ebola/prevention & control ; Democratic Republic of the Congo/epidemiology ; Guinea/epidemiology ; Ebolavirus ; Disease Outbreaks/prevention & control
    Language English
    Publishing date 2024-03-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041338-5
    ISSN 1471-2458 ; 1471-2458
    ISSN (online) 1471-2458
    ISSN 1471-2458
    DOI 10.1186/s12889-024-18300-8
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  2. Article ; Online: COVID-19-related disruption and resiliency in immunisation activities in LMICs: a rapid review

    Hartner, Anna-Maria / Li, Xiang / Gaythorpe, Katy AM

    medRxiv

    Abstract: Objectives Rapid review to determine the extent that immunisation services in LMICs were disrupted by the COVID-19 pandemic and what factors can be considered to build resilience in future. Setting We searched PubMed on 28th Feb 2023 for studies ... ...

    Abstract Objectives Rapid review to determine the extent that immunisation services in LMICs were disrupted by the COVID-19 pandemic and what factors can be considered to build resilience in future. Setting We searched PubMed on 28th Feb 2023 for studies published after 1st December 2019 in English that focused on LMICs. Participants Screening and data extraction were conducted by two experienced reviewers with one reviewer vote minimum per study per stage. Of 3801 identified studies, 66 met the eligibility criteria. Outcomes Routine vaccine coverage achieved; Supplementary immunisation activity timing; Vaccine doses given; Timing of vaccination; Supply chain changes; factors contributing to disruption or resilience. Results Included studies showed evidence of notable declines in immunisation activities across LMICs related to the COVID-19 pandemic. These have included reductions in achieved routine coverage, cancellation or postponement of campaigns, and underimmunised cohorts. Immunisation was most disrupted in the early months of the pandemic, particularly March to May 2020; however, the amount of recovery seen varied by country, age-group, and vaccine. Though many countries observed partial recovery beginning after lockdown policies were lifted in 2020, disruption in many countries has also continued into 2021. It has also been noted that clinician staff shortages and vaccine stock outs caused by supply chain disruptions contributed to immunisation delays but that concern over COVID transmission was a leading factor. Key resiliency factors included community outreach and healthcare worker support. Finally, whilst our search took place in February 2023, the latest dataset used across all studies was from November 2022 and many focused on 2020; as a result some of the study conclusions do not take recovery into account. Conclusions There is limited information on whether reductions in vaccination coverage or delays have persisted beyond 2021. Further research is needed to assess ongoing disruptions and identify missed vaccine cohorts.
    Keywords covid19
    Language English
    Publishing date 2023-06-12
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2023.06.12.23291133
    Database COVID19

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  3. Article ; Online: Evaluating effective measles vaccine coverage in the Malaysian population accounting for between-dose correlation and vaccine efficacy.

    Kumar, Shurendar Selva / Hartner, Anna-Maria / Chandran, Arunah / Gaythorpe, Katy A M / Li, Xiang

    BMC public health

    2023  Volume 23, Issue 1, Page(s) 2351

    Abstract: Background: Malaysia introduced the two dose measles-mumps-rubella (MMR) vaccine in 2004 as part of its measles elimination strategy. However, despite high historical coverage of MCV1 and MCV2, Malaysia continues to report high measles incidence. This ... ...

    Abstract Background: Malaysia introduced the two dose measles-mumps-rubella (MMR) vaccine in 2004 as part of its measles elimination strategy. However, despite high historical coverage of MCV1 and MCV2, Malaysia continues to report high measles incidence. This study suggests a novel indicator for investigating population immunity against measles in the Malaysian population.
    Methods: We define effective vaccine coverage (EVC) of measles as the proportion of a population vaccinated with measles-containing vaccine (MCV) and effectively protected against measles infection. A quantitative evaluation of EVC throughout the life course of Malaysian birth cohorts was conducted accounting for both vaccine efficacy (VE) and between-dose correlation (BdC). Measles vaccination coverage was sourced from WHO-UNICEF estimates of Malaysia's routine immunisation coverage and supplementary immunisation activities (SIAs). United Nations World population estimates and projections (UNWPP) provided birth cohort sizes stratified by age and year. A step wise joint Bernoulli distribution was used to proportionate the Malaysian population born between 1982, the first year of Malaysia's measles vaccination programme, and 2021, into individuals who received zero dose, one dose and multiple doses of MCV. VE estimates by age and doses received are then adopted to derive EVC. A sensitivity analysis was conducted using 1000 random combinations of BdC and VE parameters.
    Results: This study suggests that no birth cohort in the Malaysian population has achieved > 95% population immunity (EVC) conferred through measles vaccination since the measles immunisation programme began in Malaysia.
    Conclusion: The persistence of measles in Malaysia is due to pockets of insufficient vaccination coverage against measles in the population. Monitoring BdC through immunisation surveillance systems may allow for the identification of susceptible subpopulations (primarily zero-dose MCV individuals) and increase the coverage of individuals who are vaccinated with multiple doses of MCV. This study provides a tool for assessment of national-level population immunity of measles conferred through vaccination and does not consider subnational heterogeneity or vaccine waning. This tool can be readily applied to other regions and vaccine-preventable diseases.
    MeSH term(s) Humans ; Immunization Programs ; Immunization Schedule ; Measles/epidemiology ; Measles/prevention & control ; Measles Vaccine/therapeutic use ; Measles virus ; Measles-Mumps-Rubella Vaccine ; Vaccination ; Vaccine Efficacy
    Chemical Substances Measles Vaccine ; Measles-Mumps-Rubella Vaccine
    Language English
    Publishing date 2023-11-28
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2041338-5
    ISSN 1471-2458 ; 1471-2458
    ISSN (online) 1471-2458
    ISSN 1471-2458
    DOI 10.1186/s12889-023-17082-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Seasonal and inter-annual drivers of yellow fever transmission in South America.

    Hamlet, Arran / Gaythorpe, Katy A M / Garske, Tini / Ferguson, Neil M

    PLoS neglected tropical diseases

    2021  Volume 15, Issue 1, Page(s) e0008974

    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 ...

    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.
    MeSH term(s) Agriculture ; Climate ; Humans ; Seasons ; South America/epidemiology ; Yellow Fever/epidemiology ; Yellow Fever/transmission
    Language English
    Publishing date 2021-01-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2429704-5
    ISSN 1935-2735 ; 1935-2735
    ISSN (online) 1935-2735
    ISSN 1935-2735
    DOI 10.1371/journal.pntd.0008974
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  5. Article ; Online: Yellow fever in Asia-a risk analysis.

    Cracknell Daniels, Bethan / Gaythorpe, Katy / Imai, Natsuko / Dorigatti, Ilaria

    Journal of travel medicine

    2021  Volume 28, Issue 3

    Abstract: Background: There is concern about the risk of yellow fever (YF) establishment in Asia, owing to rising numbers of urban outbreaks in endemic countries and globalisation. Following an outbreak in Angola in 2016, YF cases were introduced into China. ... ...

    Abstract Background: There is concern about the risk of yellow fever (YF) establishment in Asia, owing to rising numbers of urban outbreaks in endemic countries and globalisation. Following an outbreak in Angola in 2016, YF cases were introduced into China. Prior to this, YF had never been recorded in Asia, despite climatic suitability and the presence of mosquitoes. An outbreak in Asia could result in widespread fatalities and huge economic impact. Therefore, quantifying the potential risk of YF outbreaks in Asia is a public health priority.
    Methods: Using international flight data and YF incidence estimates from 2016, we quantified the risk of YF introduction via air travel into Asia. In locations with evidence of a competent mosquito population, the potential for autochthonous YF transmission was estimated using a temperature-dependent model of the reproduction number and a branching process model assuming a negative binomial distribution.
    Results: In total, 25 cities across Asia were estimated to be at risk of receiving at least one YF viraemic traveller during 2016. At their average temperatures, we estimated the probability of autochthonous transmission to be <50% in all cities, which was primarily due to the limited number of estimated introductions that year.
    Conclusion: Despite the rise in air travel, we found low support for travel patterns between YF endemic countries and Asia resulting in autochthonous transmission during 2016. This supports the historic absence of YF in Asia and suggests it could be due to a limited number of introductions in previous years. Future increases in travel volumes or YF incidence can increase the number of introductions and the risk of autochthonous transmission. Given the high proportion of asymptomatic or mild infections and the challenges of YF surveillance, our model can be used to estimate the introduction and outbreak risk and can provide useful information to surveillance systems.
    MeSH term(s) Aedes ; Angola/epidemiology ; Animals ; Asia ; Cities ; Disease Outbreaks/prevention & control ; Female ; Humans ; Risk Assessment ; Travel-Related Illness ; Yellow Fever/epidemiology ; Yellow Fever/prevention & control ; Yellow Fever/transmission ; Yellow fever virus/physiology
    Language English
    Publishing date 2021-01-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 1212504-0
    ISSN 1708-8305 ; 1195-1982
    ISSN (online) 1708-8305
    ISSN 1195-1982
    DOI 10.1093/jtm/taab015
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4120: Show issues Location:
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  6. Article ; Online: Accessing sub-national cholera epidemiological data for Nigeria and the Democratic Republic of Congo during the seventh pandemic.

    Charnley, Gina E C / Kelman, Ilan / Gaythorpe, Katy A M / Murray, Kris A

    BMC infectious diseases

    2022  Volume 22, Issue 1, Page(s) 288

    Abstract: Background: Vibrio cholerae is a water-borne pathogen with a global burden estimate at 1.4 to 4.0 million annual cases. Over 94% of these cases are reported in Africa and more research is needed to understand cholera dynamics in the region. Cholera data ...

    Abstract Background: Vibrio cholerae is a water-borne pathogen with a global burden estimate at 1.4 to 4.0 million annual cases. Over 94% of these cases are reported in Africa and more research is needed to understand cholera dynamics in the region. Cholera data are lacking, mainly due to reporting issues, creating barriers for widespread research on cholera epidemiology and management in Africa.
    Main body: Here, we present datasets that were created to help address this gap, collating freely available sub-national cholera data for Nigeria and the Democratic Republic of Congo. The data were collated from a variety of English and French publicly available sources, including the World Health Organization, PubMed, UNICEF, EM-DAT, the Nigerian CDC and peer-reviewed literature. These data include information on cases, deaths, age, gender, oral cholera vaccination, risk factors and interventions.
    Conclusion: These datasets can facilitate qualitative, quantitative and mixed methods research in these two high burden countries to assist in public health planning. The data can be used in collaboration with organisations in the two countries, which have also collected data or undertaking research. By making the data and methods available, we aim to encourage their use and further data collection and compilation to help improve the data gaps for cholera in Africa.
    MeSH term(s) Cholera/epidemiology ; Democratic Republic of the Congo/epidemiology ; Humans ; Nigeria/epidemiology ; Pandemics ; United States ; Vibrio cholerae
    Language English
    Publishing date 2022-03-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041550-3
    ISSN 1471-2334 ; 1471-2334
    ISSN (online) 1471-2334
    ISSN 1471-2334
    DOI 10.1186/s12879-022-07266-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Association between Conflict and Cholera in Nigeria and the Democratic Republic of the Congo.

    Charnley, Gina E C / Jean, Kévin / Kelman, Ilan / Gaythorpe, Katy A M / Murray, Kris A

    Emerging infectious diseases

    2022  Volume 28, Issue 12, Page(s) 2472–2481

    Abstract: Cholera outbreaks contribute substantially to illness and death in low- and middle-income countries. Cholera outbreaks are associated with several social and environmental risk factors, and extreme conditions can act as catalysts. A social extreme known ... ...

    Abstract Cholera outbreaks contribute substantially to illness and death in low- and middle-income countries. Cholera outbreaks are associated with several social and environmental risk factors, and extreme conditions can act as catalysts. A social extreme known to be associated with infectious disease outbreaks is conflict, causing disruption to services, loss of income, and displacement. To determine the extent of this association, we used the self-controlled case-series method and found that conflict increased the risk for cholera in Nigeria by 3.6 times and in the Democratic Republic of the Congo by 2.6 times. We also found that 19.7% of cholera outbreaks in Nigeria and 12.3% of outbreaks in the Democratic Republic of the Congo were attributable to conflict. Our results highlight the value of providing rapid and sufficient assistance during conflict-associated cholera outbreaks and working toward conflict resolution and addressing preexisting vulnerabilities, such as poverty and access to healthcare.
    MeSH term(s) Humans ; Cholera/epidemiology ; Nigeria/epidemiology ; Democratic Republic of the Congo/epidemiology ; Disease Outbreaks ; Poverty
    Language English
    Publishing date 2022-11-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1380686-5
    ISSN 1080-6059 ; 1080-6040
    ISSN (online) 1080-6059
    ISSN 1080-6040
    DOI 10.3201/eid2812.212398
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4778: Show issues Location:
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  8. Article ; Online: Cholera past and future in Nigeria: Are the Global Task Force on Cholera Control's 2030 targets achievable?

    Charnley, Gina E C / Yennan, Sebastian / Ochu, Chinwe / Kelman, Ilan / Gaythorpe, Katy A M / Murray, Kris A

    PLoS neglected tropical diseases

    2023  Volume 17, Issue 5, Page(s) e0011312

    Abstract: Background: Understanding and continually assessing the achievability of global health targets is key to reducing disease burden and mortality. The Global Task Force on Cholera Control (GTFCC) Roadmap aims to reduce cholera deaths by 90% and eliminate ... ...

    Abstract Background: Understanding and continually assessing the achievability of global health targets is key to reducing disease burden and mortality. The Global Task Force on Cholera Control (GTFCC) Roadmap aims to reduce cholera deaths by 90% and eliminate the disease in twenty countries by 2030. The Roadmap has three axes focusing on reporting, response and coordination. Here, we assess the achievability of the GTFCC targets in Nigeria and identify where the three axes could be strengthened to reach and exceed these goals.
    Methodology/principal findings: Using cholera surveillance data from Nigeria, cholera incidence was calculated and used to model time-varying reproduction number (R). A best fit random forest model was identified using R as the outcome variable and several environmental and social covariates were considered in the model, using random forest variable importance and correlation clustering. Future scenarios were created (based on varying degrees of socioeconomic development and emissions reductions) and used to project future cholera transmission, nationally and sub-nationally to 2070. The projections suggest that significant reductions in cholera cases could be achieved by 2030, particularly in the more developed southern states, but increases in cases remain a possibility. Meeting the 2030 target, nationally, currently looks unlikely and we propose a new 2050 target focusing on reducing regional inequities, while still advocating for cholera elimination being achieved as soon as possible.
    Conclusion/significance: The 2030 targets could potentially be reached by 2030 in some parts of Nigeria, but more effort is needed to reach these targets at a national level, particularly through access and incentives to cholera testing, sanitation expansion, poverty alleviation and urban planning. The results highlight the importance of and how modelling studies can be used to inform cholera policy and the potential for this to be applied in other contexts.
    MeSH term(s) Humans ; Cholera/epidemiology ; Cholera/prevention & control ; Nigeria/epidemiology ; Poverty ; Cost of Illness ; Sanitation ; Disease Outbreaks
    Language English
    Publishing date 2023-05-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2429704-5
    ISSN 1935-2735 ; 1935-2735
    ISSN (online) 1935-2735
    ISSN 1935-2735
    DOI 10.1371/journal.pntd.0011312
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  9. Article ; Online: Modeling the impact of vaccination for the immunization Agenda 2030: Deaths averted due to vaccination against 14 pathogens in 194 countries from 2021 to 2030.

    Carter, Austin / Msemburi, William / Sim, So Yoon / Gaythorpe, Katy A M / Lambach, Philipp / Lindstrand, Ann / Hutubessy, Raymond

    Vaccine

    2023  

    Abstract: Background: The Immunization Agenda 2030 (IA2030) Impact Goal 1.1. aims to reduce the number of future deaths averted through immunization in the next decade. To estimate the potential impact of the aspirational coverage targets for IA2030, we developed ...

    Abstract Background: The Immunization Agenda 2030 (IA2030) Impact Goal 1.1. aims to reduce the number of future deaths averted through immunization in the next decade. To estimate the potential impact of the aspirational coverage targets for IA2030, we developed an analytical framework and estimated the number of deaths averted due to an ambitious vaccination coverage scenario from 2021 to 2030 in 194 countries.
    Method: A demographic model was used to determine annual age-specific mortality estimates associated with vaccine coverage rates. For ten pathogens (Hepatitis B virus, Haemophilus influenzae type B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, Streptococcus pneumoniae, rotavirus, rubella, yellow fever), we derived single measures of country-, age-, and pathogen-specific relative risk of deaths conditional upon coverage rates, leveraging the data from 18 modeling groups as part of the Vaccine Impact Model Consortium (VIMC) for 110 countries. We used a logistic regression model to extrapolate the relative risk estimates to countries that were not modeled by VIMC. For four pathogens (diphtheria, tetanus, pertussis and tuberculosis), we used estimates from the Global Burden of Disease 2019 study and existing literature on vaccine efficacy. A future scenario defining years of vaccine introduction and scale-up needed to reach aspirational targets was developed as an input to estimate the long-term impact of vaccination taking place from 2021 to 2030.
    Findings: Overall, an estimated 51.5 million (95 % CI: 44.0-63.2) deaths are expected to be averted due to vaccinations administered between the years 2021 and 2030. With immunization coverage projected to increase over 2021-2030 an average of 5.2 million per year (4.4-6.3) deaths will be averted annually, with 4.4 million (3.9-5.1) deaths be averted for the year 2021, gradually rising to 5.8 million (4.9-7.5) deaths averted in 2030. The largest proportion of deaths is attributed to Measles and Hepatitis B accounting for 18.8 million (17.8-20.0) and 14.0 million (11.5-16.9) of total deaths averted respectively.
    Interpretation: The results from this global analysis demonstrate the substantial potential mortality reductions achievable if the IA2030 targets are met by 2030. Deaths caused by vaccine preventable diseases disproportionately affect LMICs in the African region.
    Language English
    Publishing date 2023-08-01
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 605674-x
    ISSN 1873-2518 ; 0264-410X
    ISSN (online) 1873-2518
    ISSN 0264-410X
    DOI 10.1016/j.vaccine.2023.07.033
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1930: Show issues Location:
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    Zs.MO 458: Show issues

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  10. Article ; Online: Understanding the risks for post-disaster infectious disease outbreaks: a systematic review protocol.

    Charnley, Gina E C / Kelman, Ilan / Gaythorpe, Katy / Murray, Kris

    BMJ open

    2020  Volume 10, Issue 9, Page(s) e039608

    Abstract: Introduction: Disasters have many forms, including those related to natural hazards and armed conflict. Human-induced global change, such as climate change, may alter hazard parameters of these disasters. These alterations can have serious consequences ... ...

    Abstract Introduction: Disasters have many forms, including those related to natural hazards and armed conflict. Human-induced global change, such as climate change, may alter hazard parameters of these disasters. These alterations can have serious consequences for vulnerable populations, which often experience post-disaster infectious disease outbreaks, leading to morbidity and mortality. The risks and drivers for these outbreaks and their ability to form cascades are somewhat contested. Despite evidence for post-disaster outbreaks, reviews quantifying them have been on short time scales, specific geographic areas or specific hazards. This review aims to fill this gap and gain a greater understanding of the risk factors involved in these contextual outbreaks on a global level.
    Methods and analysis: Using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 checklist and Khan's methodological framework, a systematic search strategy will be created and carried out in August 2020. The strategy will search MEDLINE, Embase and GlobalHealth electronic databases and reference lists of selected literature will also be screened. Eligible studies will include any retrospective cross-sectional, case-control or cohort studies investigating an infectious disease outbreak in a local disaster affected population. Studies will not be excluded based on geographic area or publication date. Excluded papers will include non-English studies, reviews, single case studies and research discussing general risk factors, international refugee camps, public health, mental health and other non-communicable diseases, pathogen genetics or economics. Following selection, data will be extracted into a data charting form, that will be reviewed by other members of the team. The data will then be analysed both numerically and narratively.
    Ethics and dissemination: Only secondary data will be used and there will be no public or patient involvement; therefore, no ethical approval is needed. Our findings will aim to be disseminated through a peer-reviewed journal. The authors intend to use the results to inform future mathematical modelling studies.
    MeSH term(s) Cross-Sectional Studies ; Disasters ; Disease Outbreaks ; Humans ; Meta-Analysis as Topic ; Public Health ; Retrospective Studies ; Review Literature as Topic ; Systematic Reviews as Topic
    Language English
    Publishing date 2020-09-13
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2020-039608
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