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  1. Article ; Online: Invasive Bacterial Vaccine-Preventable Disease Surveillance: Successes and Lessons Learned in Bangladesh for a Sustainable Path Forward.

    Saha, Senjuti / Saha, Samir K

    The Journal of infectious diseases

    2021  Volume 224, Issue 12 Suppl 2, Page(s) S293–S298

    Abstract: We have made considerable progress in setting and scaling up surveillance systems to drive evidence-based policy decisions, but the recent epidemics highlight that current systems are not optimally designed. Good surveillance systems should be ... ...

    Abstract We have made considerable progress in setting and scaling up surveillance systems to drive evidence-based policy decisions, but the recent epidemics highlight that current systems are not optimally designed. Good surveillance systems should be coordinated, comprehensive, and adaptive. They should generate data in real time for immediate analysis and intervention, whether for endemic diseases or potential epidemics. Such systems are especially needed in low-resource settings where disease burden is the highest, but tracking systems are the weakest here due to competing priorities and constraints on available resources. In this article, using the examples of 3 large, and mostly successful, infectious disease surveillance studies in Bangladesh, we identify 2 core limitations-the pathogen bias and the vaccine bias-in the way current surveillance programs are designed for low-resource settings. We highlight the strengths of the current Global Invasive Bacterial Vaccine Preventable Disease Surveillance Network of the World Health Organization and present case studies from Bangladesh to illustrate how this surveillance platform can be leveraged to overcome its limitations. Finally, we propose a set of criteria for building a comprehensive infectious disease surveillance system with the hope of encouraging current systems to use the limited resources as optimally as possible to generate the maximum amount of knowledge.
    MeSH term(s) Bangladesh/epidemiology ; Child, Preschool ; Communicable Disease Control ; Communicable Diseases/epidemiology ; Cost of Illness ; Female ; Humans ; Infant ; Male ; Public Health Surveillance ; Sentinel Surveillance ; Vaccine-Preventable Diseases ; Vaccines ; World Health Organization
    Chemical Substances Vaccines
    Language English
    Publishing date 2021-09-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3019-3
    ISSN 1537-6613 ; 0022-1899
    ISSN (online) 1537-6613
    ISSN 0022-1899
    DOI 10.1093/infdis/jiab129
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Vaccines can save children with non-preventable diseases.

    Saha, Senjuti / Saha, Samir K

    Lancet (London, England)

    2021  Volume 397, Issue 10291, Page(s) 2250

    MeSH term(s) Child ; Humans ; Immunization Programs ; Vaccines
    Chemical Substances Vaccines
    Language English
    Publishing date 2021-05-27
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(21)01013-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Genomic Surveillance of

    Hooda, Yogesh / Tanmoy, Arif Mohammad / Saha, Samir K / Saha, Senjuti

    Open forum infectious diseases

    2023  Volume 10, Issue Suppl 1, Page(s) S53–S57

    Abstract: Salmonella ... ...

    Abstract Salmonella enterica
    Language English
    Publishing date 2023-06-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2757767-3
    ISSN 2328-8957
    ISSN 2328-8957
    DOI 10.1093/ofid/ofad077
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  4. Article ; Online: Typhoid Conjugate Vaccine: An Urgent Tool to Combat Typhoid and Tackle Antimicrobial Resistance.

    Saha, Samir K / Tabassum, Nazifa / Saha, Senjuti

    The Journal of infectious diseases

    2021  Volume 224, Issue 12 Suppl 2, Page(s) S788–S791

    Abstract: Typhoid is endemic in many countries in South Asia and sub-Saharan Africa. The high burden of this age-old, preventable disease exacerbates constraints on the health systems of these countries. Currently, most patients are treated effectively in the ... ...

    Abstract Typhoid is endemic in many countries in South Asia and sub-Saharan Africa. The high burden of this age-old, preventable disease exacerbates constraints on the health systems of these countries. Currently, most patients are treated effectively in the community or outpatient departments, but with rising antimicrobial resistance and the dearth of novel antimicrobials in the horizon, we risk losing our primary defense against typhoid. Extensively drug-resistant Salmonella Typhi is spreading, and azithromycin is the last oral drug to continue treating typhoid in the community. With increasing azithromycin resistance, emergence of pan-oral drug resistant Salmonella Typhi is imminent. The high burden of typhoid is also an underlying cause of the unnecessary use of antimicrobials. In addition to implementing water sanitation and hygiene interventions to prevent typhoid, it is imperative to rapidly roll out typhoid conjugate vaccines in endemic countries. This will not only reduce the burden of typhoid but will also help interrupt the trend of increasing antimicrobial resistance.
    MeSH term(s) Drug Resistance, Bacterial/drug effects ; Humans ; Salmonella typhi/drug effects ; Typhoid Fever/drug therapy ; Typhoid Fever/prevention & control ; Typhoid-Paratyphoid Vaccines ; Vaccines, Conjugate/administration & dosage
    Chemical Substances Typhoid-Paratyphoid Vaccines ; Vaccines, Conjugate
    Language English
    Publishing date 2021-09-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3019-3
    ISSN 1537-6613 ; 0022-1899
    ISSN (online) 1537-6613
    ISSN 0022-1899
    DOI 10.1093/infdis/jiab443
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Echocardiography 2020: Toward deciphering the "Rosetta stone" of left ventricular diastolic function.

    Saha, Samir K / Kiotsekoglou, Anatoli / Nanda, Navin C

    Echocardiography (Mount Kisco, N.Y.)

    2020  Volume 37, Issue 11, Page(s) 1886–1889

    Abstract: In the year 1997, nearly a quarter-century ago, Nishimura and Tajik (J Am Coll Cardiol. 1997;30:8) suggested that Doppler echocardiography was the "Rosetta stone" (a metaphor for decrypting secrets of diastole) of left ventricular diastole, based solely ... ...

    Abstract In the year 1997, nearly a quarter-century ago, Nishimura and Tajik (J Am Coll Cardiol. 1997;30:8) suggested that Doppler echocardiography was the "Rosetta stone" (a metaphor for decrypting secrets of diastole) of left ventricular diastole, based solely on transmitral E/A ratio and its progression from grade I through IV, supported by cardiac catheterization, as the filling pressure started to increase to over 15 mm Hg. Ten years later, in 2007, the same Mayo group (Nagueh et al, J Am Coll Cardiology. 2008;51:679) was searching to decipher the secrets of diastole using multiple measures such as left atrial (LA) volume, E/E' ratio, pulmonary venous flow, and mitral inflow propagation velocity. This substantial leap from E/A ratio led to the more formal recommendation proposed by the American Society of Echocardiography in 2009 (Nagueh et al, J Am Soc Echocardiogr. 2009;22:107) and, as an update, in the year 2016 (Nagueh et al, J Am Soc Echocardiogr. 2016;29:277): the later version gained popularity for the simplified approach to identify diastolic dysfunction in healthy subjects as well as in those with poorly contracting left ventricle. Despite 30 years of continuous search, we are not sure if we have been able to decipher the hidden secrets of diastolic function. With this background, the Echocardiography Journal under the leadership of Dr Navin Nanda as the Editor-in-Chief has taken this initiative to publish a theme issue on left ventricular diastolic function and when this becomes dysfunctional to diminish life.
    MeSH term(s) Diastole ; Echocardiography, Doppler ; Heart Ventricles/diagnostic imaging ; Humans ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Function, Left
    Language English
    Publishing date 2020-12-07
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 843645-9
    ISSN 1540-8175 ; 0742-2822
    ISSN (online) 1540-8175
    ISSN 0742-2822
    DOI 10.1111/echo.14830
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Prevalence and psychosocial impact of atopic dermatitis in Bangladeshi children and families.

    Pedersen, Courtney J / Uddin, Mohammad J / Saha, Samir K / Darmstadt, Gary L

    PloS one

    2021  Volume 16, Issue 4, Page(s) e0249824

    Abstract: Background: Skin conditions are the fourth leading cause of nonfatal disease globally, with atopic dermatitis (AD) a major and rising contributor. Though atopic dermatitis (AD) is rising in prevalence, little is known about its psychosocial effects on ... ...

    Abstract Background: Skin conditions are the fourth leading cause of nonfatal disease globally, with atopic dermatitis (AD) a major and rising contributor. Though atopic dermatitis (AD) is rising in prevalence, little is known about its psychosocial effects on children and families in low- and middle-income countries (LMICs).
    Methods: We conducted a community-based, cross-sectional survey of 2242 under-5 children in rural Bangladesh using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire to measure AD prevalence and severity, the Patient-Oriented Eczema Measure (POEM) to measure severity, and the Infants' Dermatitis Quality of Life index (IDQoL) and Dermatitis Family Index (DFI) to measure quality of life.
    Findings: Overall AD prevalence in under-five children was 11.9% [95% confidence interval (CI) 10.6-13.3%]. Prevalence was highest in children age 30-35 months [16.2% (95% CI 11.4-21.0)]. IDQoL was significantly higher in males (2.67) vs. females (1.95, p = 0.015), the lowest (3.06) vs. highest (1.63) wealth quintile (p<0.001), and among mothers with < primary (2.41) vs. > secondary (1.43) education (p = 0.039). POEM severity was correlated with IDQoL (r = 0.77, p<0.001) and DFI (r = 0.56, p<0.001). Severe disease as rated by caretakers was correlated with POEM (r = 0.73, p<0.001), IDQoL (r = 0.82, p<0.001) and DFI (r = 0.57, p<0.001).
    Conclusions: Severe AD significantly affects quality of life for children and families in Bangladesh. As access to healthcare expands in LMICs, identification and treatment of both the medical and psychosocial morbidities associated with the disease are needed.
    MeSH term(s) Adult ; Bangladesh ; Child, Preschool ; Dermatitis, Atopic/epidemiology ; Dermatitis, Atopic/psychology ; Family/psychology ; Humans ; Infant ; Prevalence ; Psychosocial Functioning ; Quality of Life ; Rural Population/statistics & numerical data
    Language English
    Publishing date 2021-04-16
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0249824
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  7. Article ; Online: The full value of immunisation against respiratory syncytial virus for infants younger than 1 year: effects beyond prevention of acute respiratory illness.

    Feikin, Daniel R / Karron, Ruth A / Saha, Samir K / Sparrow, Erin / Srikantiah, Padmini / Weinberger, Daniel M / Zar, Heather J

    The Lancet. Infectious diseases

    2023  Volume 24, Issue 5, Page(s) e318–e327

    Abstract: Respiratory syncytial virus (RSV) is a leading cause of severe respiratory illness and death among children worldwide, particularly in children younger than 6 months and in low-income and middle-income countries. Feasible and cost-effective interventions ...

    Abstract Respiratory syncytial virus (RSV) is a leading cause of severe respiratory illness and death among children worldwide, particularly in children younger than 6 months and in low-income and middle-income countries. Feasible and cost-effective interventions to prevent RSV disease are not yet widely available, although two new products aimed at preventing RSV disease-long-acting monoclonal antibodies and maternal vaccines-have been licensed within the past 2 years. The primary target of these products is reduction of the substantial burden of RSV-associated acute lower respiratory tract infections (LRTI) in infants younger than 1 year. However, other important public health benefits might also accrue with the prevention of RSV-associated LRTI during the first year of life. Mounting evidence shows that preventing RSV-associated LRTI in infants younger than 1 year could prevent secondary pneumonia caused by other pathogens, reduce recurrent hospitalisations due to other respiratory diseases in later childhood, decrease all-cause infant mortality, ameliorate the burden of respiratory diseases on health-care systems, reduce inappropriate antibiotic use, and possibly improve lung health beyond infancy. We herein review current evidence and suggest approaches to better assess the magnitude of these potential secondary effects of RSV prevention, which, if proven substantial, are likely to be relevant to policy makers in many countries as they consider the use of these new products.
    MeSH term(s) Humans ; Respiratory Syncytial Virus Infections/prevention & control ; Respiratory Syncytial Virus Infections/epidemiology ; Infant ; Respiratory Syncytial Virus Vaccines/immunology ; Respiratory Syncytial Virus Vaccines/administration & dosage ; Respiratory Syncytial Virus, Human/immunology ; Respiratory Tract Infections/prevention & control ; Infant, Newborn
    Chemical Substances Respiratory Syncytial Virus Vaccines
    Language English
    Publishing date 2023-11-21
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2061641-7
    ISSN 1474-4457 ; 1473-3099
    ISSN (online) 1474-4457
    ISSN 1473-3099
    DOI 10.1016/S1473-3099(23)00568-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Old tools, new applications: Use of environmental bacteriophages for typhoid surveillance and evaluating vaccine impact.

    Hooda, Yogesh / Islam, Shuborno / Kabiraj, Rathin / Rahman, Hafizur / Sarkar, Himadree / da Silva, Kesia E / Raju, Rajan Saha / Luby, Stephen P / Andrews, Jason R / Saha, Samir K / Saha, Senjuti

    PLoS neglected tropical diseases

    2024  Volume 18, Issue 2, Page(s) e0011822

    Abstract: Typhoid-conjugate vaccines (TCVs) provide an opportunity to reduce the burden of typhoid fever, caused by Salmonella Typhi, in endemic areas. As policymakers design vaccination strategies, accurate and high-resolution data on disease burden is crucial. ... ...

    Abstract Typhoid-conjugate vaccines (TCVs) provide an opportunity to reduce the burden of typhoid fever, caused by Salmonella Typhi, in endemic areas. As policymakers design vaccination strategies, accurate and high-resolution data on disease burden is crucial. However, traditional blood culture-based surveillance is resource-extensive, prohibiting its large-scale and sustainable implementation. Salmonella Typhi is a water-borne pathogen, and here, we tested the potential of Typhi-specific bacteriophage surveillance in surface water bodies as a low-cost tool to identify where Salmonella Typhi circulates in the environment. In 2021, water samples were collected and tested for the presence of Salmonella Typhi bacteriophages at two sites in Bangladesh: urban capital city, Dhaka, and a rural district, Mirzapur. Salmonella Typhi-specific bacteriophages were detected in 66 of 211 (31%) environmental samples in Dhaka, in comparison to 3 of 92 (3%) environmental samples from Mirzapur. In the same year, 4,620 blood cultures at the two largest pediatric hospitals of Dhaka yielded 215 (5%) culture-confirmed typhoid cases, and 3,788 blood cultures in the largest hospital of Mirzapur yielded 2 (0.05%) cases. 75% (52/69) of positive phage samples were collected from sewage. All isolated phages were tested against a panel of isolates from different Salmonella Typhi genotypes circulating in Bangladesh and were found to exhibit a diverse killing spectrum, indicating that diverse bacteriophages were isolated. These results suggest an association between the presence of Typhi-specific phages in the environment and the burden of typhoid fever, and the potential of utilizing environmental phage surveillance as a low-cost tool to assist policy decisions on typhoid control.
    MeSH term(s) Humans ; Child ; Typhoid Fever/epidemiology ; Typhoid Fever/prevention & control ; Bacteriophages ; Bangladesh/epidemiology ; Salmonella typhi/genetics ; Typhoid-Paratyphoid Vaccines ; Water
    Chemical Substances Typhoid-Paratyphoid Vaccines ; Water (059QF0KO0R)
    Language English
    Publishing date 2024-02-15
    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.0011822
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  9. Article ; Online: Cost-effectiveness and public health impact of typhoid conjugate vaccine introduction strategies in Bangladesh.

    Weyant, Christopher / Hooda, Yogesh / Munira, Sira Jam / Lo, Nathan C / Ryckman, Theresa / Tanmoy, Arif M / Kanon, Naito / Seidman, Jessica C / Garrett, Denise / Saha, Samir K / Goldhaber-Fiebert, Jeremy D / Saha, Senjuti / Andrews, Jason R

    Vaccine

    2024  Volume 42, Issue 11, Page(s) 2867–2876

    Abstract: Purpose: Typhoid fever causes substantial morbidity and mortality in Bangladesh. The government of Bangladesh plans to introduce typhoid conjugate vaccines (TCV) in its expanded program on immunization (EPI) schedule. However, the optimal introduction ... ...

    Abstract Purpose: Typhoid fever causes substantial morbidity and mortality in Bangladesh. The government of Bangladesh plans to introduce typhoid conjugate vaccines (TCV) in its expanded program on immunization (EPI) schedule. However, the optimal introduction strategy in addition to the costs and benefits of such a program are unclear.
    Methods: We extended an existing mathematical model of typhoid transmission to integrate cost data, clinical incidence data, and recently conducted serosurveys in urban, semi-urban, and rural areas. In our primary analysis, we evaluated the status quo (i.e., no vaccination) and eight vaccine introduction strategies including routine and 1-time campaign strategies, which differed by age groups targeted and geographic focus. Model outcomes included clinical incidence, seroincidence, deaths, costs, disability-adjusted life years (DALYs), and incremental cost-effectiveness ratios (ICERs) for each strategy. We adopted a societal perspective, 10-year model time horizon, and 3 % annual discount rate. We performed probabilistic, one-way, and scenario sensitivity analyses including adopting a healthcare perspective and alternate model time horizons.
    Results: We projected that all TCV strategies would be cost saving compared to the status quo. The preferred strategy was a nationwide introduction of TCV at 9-12 months of age with a single catch-up campaign for children ages 1-15, which was cost saving compared to all other strategies and the status quo. In the 10 years following implementation, we projected this strategy would avert 3.77 million cases (95 % CrI: 2.60 - 5.18), 11.31 thousand deaths (95 % CrI: 3.77 - 23.60), and save $172.35 million (95 % CrI: -14.29 - 460.59) compared to the status quo. Our findings were broadly robust to changes in parameter values and willingness-to-pay thresholds.
    Conclusions: We projected that nationwide TCV introduction with a catch-up campaign would substantially reduce typhoid incidence and very likely be cost saving in Bangladesh.
    MeSH term(s) Child ; Humans ; Typhoid Fever/epidemiology ; Typhoid Fever/prevention & control ; Cost-Benefit Analysis ; Vaccines, Conjugate ; Public Health ; Typhoid-Paratyphoid Vaccines ; Bangladesh/epidemiology
    Chemical Substances Vaccines, Conjugate ; Typhoid-Paratyphoid Vaccines
    Language English
    Publishing date 2024-03-25
    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.2024.03.035
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  10. Article ; Online: Young Infant Mortality Associated with Preterm and Small-for-Gestational-Age Births in Rural Bangladesh: A Prospective Cohort Study.

    Applegate, Jennifer A / Islam, Md Shafiqul / Khanam, Rasheda / Roy, Arunangshu Dutta / Chowdhury, Nabidul Haque / Ahmed, Salahuddin / Mitra, Dipak K / Mahmud, Arif / Islam, Mohammad Shahidul / Saha, Samir K / Baqui, Abdullah H

    The Journal of pediatrics

    2024  Volume 269, Page(s) 114001

    Abstract: Objective: To assess the relative risk of mortality in infants born preterm and small for gestational age (SGA) during the first and second months of life in rural Bangladesh.: Study design: We analyzed data from a cohort of pregnant women and their ... ...

    Abstract Objective: To assess the relative risk of mortality in infants born preterm and small for gestational age (SGA) during the first and second months of life in rural Bangladesh.
    Study design: We analyzed data from a cohort of pregnant women and their babies in Sylhet, Bangladesh, assembled between 2011 and 2014. Community health workers visited enrolled babies up to 10 times from birth to age 59 days. Survival status was recorded at each visit. Gestational age was estimated from mother's reported last menstrual period. Birth weights were measured within 72 hours of delivery. SGA was defined using the INTERGROWTH-21st standard. We estimated unadjusted and adjusted hazard ratios (HRs) and corresponding 95% CIs for babies born preterm and SGA separately for the first and second month of life using bivariate and multivariable weighted Cox regression models.
    Results: The analysis included 17 643 singleton live birth babies. Compared with infants born at term-appropriate for gestational age, in both unadjusted and adjusted analyses, infants born preterm-SGA had the greatest risk of death in the first (HR 13.25, 95% CI 8.65-20.31; adjusted HR 12.05, 95% CI 7.82-18.57) and second month of life (HR 4.65, 95% CI 1.93-11.23; adjusted HR 4.1, 95% CI 1.66-10.15), followed by infants born preterm-appropriate for gestational age and term-SGA.
    Conclusions: The risk of mortality in infants born preterm and/or SGA is increased and extends through the second month of life. Appropriate interventions to prevent and manage complications caused by prematurity and SGA could improve survival during and beyond the neonatal period.
    MeSH term(s) Humans ; Bangladesh/epidemiology ; Infant, Small for Gestational Age ; Infant, Newborn ; Infant Mortality ; Female ; Prospective Studies ; Rural Population/statistics & numerical data ; Male ; Infant ; Infant, Premature ; Adult ; Pregnancy ; Gestational Age ; Premature Birth/epidemiology ; Young Adult ; Cohort Studies
    Language English
    Publishing date 2024-03-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3102-1
    ISSN 1097-6833 ; 0022-3476
    ISSN (online) 1097-6833
    ISSN 0022-3476
    DOI 10.1016/j.jpeds.2024.114001
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