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Article ; Online: Translating the COVID-19 epidemiological situation into policies and measures: the Belgian experience.

De Muylder, Géraldine / Laisnez, Valeska / Stefani, Giulietta / Boulouffe, Caroline / Faes, Christel / Hammami, Naïma / Hubin, Pierre / Molenberghs, Geert / Sans, Jasper / van de Konijnenburg, Cecile / Van der Borght, Stefaan / Brondeel, Ruben / Stassijns, Jorgen / Lernout, Tinne

Frontiers in public health

2024 Volume 12, Page(s) 1306361

Abstract: The COVID-19 pandemic led to sustained surveillance efforts, which made unprecedented volumes and types of data available. In Belgium, these data were used to conduct a targeted and regular assessment of the epidemiological situation. In addition, ... ...

Abstract	The COVID-19 pandemic led to sustained surveillance efforts, which made unprecedented volumes and types of data available. In Belgium, these data were used to conduct a targeted and regular assessment of the epidemiological situation. In addition, management tools were developed, incorporating key indicators and thresholds, to define risk levels and offer guidance to policy makers. Categorizing risk into various levels provided a stable framework to monitor the COVID-19 epidemiological situation and allowed for clear communication to authorities. Although translating risk levels into specific public health measures has remained challenging, this experience was foundational for future evaluation of the situation for respiratory infections in general, which, in Belgium, is now based on a management tool combining different data sources.
MeSH term(s)	Humans ; COVID-19/epidemiology ; Belgium/epidemiology ; SARS-CoV-2 ; Health Policy ; Public Health ; Pandemics ; Risk Assessment/methods
Language	English
Publishing date	2024-04-05
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2024.1306361
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Article: A systematic review and meta-analysis on the safety of newly adjuvanted vaccines among children

Stassijns, Jorgen / Kaatje Bollaerts / Marc Baay / Thomas Verstraeten

Vaccine. 2016 Feb. 03, v. 34, no. 6

2016

Abstract: New adjuvants such as the AS- or the MF59-adjuvants improve vaccine efficacy and facilitate dose-sparing. Their use in influenza and malaria vaccines has resulted in a large body of evidence on their clinical safety in children.We carried out a ... ...

Abstract	New adjuvants such as the AS- or the MF59-adjuvants improve vaccine efficacy and facilitate dose-sparing. Their use in influenza and malaria vaccines has resulted in a large body of evidence on their clinical safety in children.We carried out a systematic search for safety data from published clinical trials on newly adjuvanted vaccines in children ≤10 years of age. Serious adverse events (SAEs), solicited AEs, unsolicited AEs and AEs of special interest were evaluated for four new adjuvants: the immuno-stimulants containing adjuvant systems AS01 and AS02, and the squalene containing oil-in-water emulsions AS03 and MF59. Relative risks (RR) were calculated, comparing children receiving newly adjuvanted vaccines to children receiving other vaccines with a variety of antigens, both adjuvanted and unadjuvanted.Twenty-nine trials were included in the meta-analysis, encompassing 25,056 children who received at least one dose of the newly adjuvanted vaccines. SAEs did not occur more frequently in adjuvanted groups (RR 0.85, 95%CI 0.75–0.96). Our meta-analyses showed higher reactogenicity following administration of newly adjuvanted vaccines, however, no consistent pattern of solicited AEs was observed across adjuvant systems. Pain was the most prevalent AE, but often mild and of short duration. No increased risks were found for unsolicited AEs, febrile convulsions, potential immune mediated diseases and new onset of chronic diseases.Our meta-analysis did not show any safety concerns in clinical trials of the newly adjuvanted vaccines in children ≤10 years of age. An unexplained increase of meningitis in one Phase III AS01-adjuvanted malaria trial and the link between narcolepsy and the AS03-adjuvanted pandemic vaccine illustrate that continued safety monitoring is warranted.
Keywords	adjuvants ; antigens ; children ; clinical trials ; emulsions ; influenza ; malaria ; malaria vaccines ; meningitis ; meta-analysis ; monitoring ; narcolepsy ; pain ; pandemic ; risk ; seizures ; squalene ; systematic review
Language	English
Dates of publication	2016-0203
Size	p. 714-722.
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2015.12.024
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Article ; Online: A systematic review and meta-analysis on the safety of newly adjuvanted vaccines among children.

Stassijns, Jorgen / Bollaerts, Kaatje / Baay, Marc / Verstraeten, Thomas

Vaccine

2015 Volume 34, Issue 6, Page(s) 714–722

Abstract: Introduction: New adjuvants such as the AS- or the MF59-adjuvants improve vaccine efficacy and facilitate dose-sparing. Their use in influenza and malaria vaccines has resulted in a large body of evidence on their clinical safety in children.: Methods! ...

Abstract	Introduction: New adjuvants such as the AS- or the MF59-adjuvants improve vaccine efficacy and facilitate dose-sparing. Their use in influenza and malaria vaccines has resulted in a large body of evidence on their clinical safety in children. Methods: We carried out a systematic search for safety data from published clinical trials on newly adjuvanted vaccines in children ≤10 years of age. Serious adverse events (SAEs), solicited AEs, unsolicited AEs and AEs of special interest were evaluated for four new adjuvants: the immuno-stimulants containing adjuvant systems AS01 and AS02, and the squalene containing oil-in-water emulsions AS03 and MF59. Relative risks (RR) were calculated, comparing children receiving newly adjuvanted vaccines to children receiving other vaccines with a variety of antigens, both adjuvanted and unadjuvanted. Results: Twenty-nine trials were included in the meta-analysis, encompassing 25,056 children who received at least one dose of the newly adjuvanted vaccines. SAEs did not occur more frequently in adjuvanted groups (RR 0.85, 95%CI 0.75-0.96). Our meta-analyses showed higher reactogenicity following administration of newly adjuvanted vaccines, however, no consistent pattern of solicited AEs was observed across adjuvant systems. Pain was the most prevalent AE, but often mild and of short duration. No increased risks were found for unsolicited AEs, febrile convulsions, potential immune mediated diseases and new onset of chronic diseases. Conclusions: Our meta-analysis did not show any safety concerns in clinical trials of the newly adjuvanted vaccines in children ≤10 years of age. An unexplained increase of meningitis in one Phase III AS01-adjuvanted malaria trial and the link between narcolepsy and the AS03-adjuvanted pandemic vaccine illustrate that continued safety monitoring is warranted.
MeSH term(s)	Adjuvants, Immunologic/adverse effects ; Adjuvants, Immunologic/chemistry ; Adolescent ; Child ; Child, Preschool ; Clinical Trials as Topic ; Drug Combinations ; Humans ; Infant ; Likelihood Functions ; Lipid A/adverse effects ; Lipid A/analogs & derivatives ; Lipid A/chemistry ; Polysorbates/adverse effects ; Polysorbates/chemistry ; Risk ; Saponins/adverse effects ; Saponins/chemistry ; Squalene/adverse effects ; Squalene/chemistry ; Vaccines/adverse effects ; Vaccines/chemistry ; alpha-Tocopherol/adverse effects ; alpha-Tocopherol/chemistry
Chemical Substances	ASO2A adjuvant ; Adjuvants, Immunologic ; Drug Combinations ; Lipid A ; MF59 oil emulsion ; Polysorbates ; Saponins ; Vaccines ; adjuvant system 01 ; Squalene (7QWM220FJH) ; AS03 adjuvant (A7YT618XBV) ; alpha-Tocopherol (H4N855PNZ1)
Language	English
Publishing date	2015-12-28
Publishing country	Netherlands
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2015.12.024
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Article ; Online: Prevalence and diagnostics of congenital malaria in rural Burundi, a cross-sectional study.

Stassijns, Jorgen / van den Boogaard, Wilma / Pannus, Pieter / Nkunzimana, Alphonse / Rosanas-Urgell, Anna

Malaria journal

2016 Volume 15, Issue 1, Page(s) 443

Abstract: Background: Congenital malaria, defined as the presence of asexual forms of malaria parasites in the peripheral blood during the first 7 days of life, remains a neglected area of research. Knowledge gaps exist about prevalence and management of malaria ... ...

Abstract	Background: Congenital malaria, defined as the presence of asexual forms of malaria parasites in the peripheral blood during the first 7 days of life, remains a neglected area of research. Knowledge gaps exist about prevalence and management of malaria in this age group. The objective of this study was to evaluate the prevalence of congenital malaria and the validity of a rapid diagnostic test (RDT) for its diagnosis in rural Burundi. Methods: A cross-sectional study was conducted in a meso-endemic malaria context in Burundi among 290 mothers, and their newborns (n = 303), who delivered at the maternity departments of Kirundo and Mukenke Hospitals during March and April 2014. Peripheral blood samples were collected from all mothers/newborns pairs in order to examine the presence of malaria parasites with two RDT (SD-Bioline HRP2 and Carestart pan-pLDH) and a blood slide. In addition, quantitative real-time polymerase chain reaction (PCR) was performed from the newborn peripheral sample. Frequencies and proportions were calculated for categorical variables. Sensitivity and specificity were calculated with a 95 % confidence interval (CI). Results: None of the newborns were found positive by PCR (0/303; 95 % CI 0.0-1.3). The prevalence in newborns born from microscopy-positive mothers was 0 % (0/44; 95 % CI 0.0-8.0). Two newborns were positive with SD-Bioline HRP2 (0.7 %, 95 % CI 0.2-2.4) but none with Carestart pan-pLDH or microscopy. Sensitivity of the diagnostic tests could not be evaluated as no congenital malaria was detected. Specificity of SD-Bioline HRP2, Carestart pan-pLDH and microscopy to detect congenital malaria was 99.3 % (95 % CI 97.6-99.8), 100.0 % (95 % CI 98.3-100.0) and 100.0 % (95 % CI 98.8-100.0), respectively. Conclusion: In Burundi or the Central African region, no recent prevalence studies for congenital malaria have been carried out. This study found that the prevalence of congenital malaria in two hospitals in Kirundo province is zero. RDT showed to have an excellent specificity and, therefore, can be used to rule out congenital malaria: the risk of overtreatment is low. However, as no cases of congenital malaria were detected, the study was not able to draw conclusions about the sensitivity of the RDT, nor about risk factors for congenital malaria. Further studies evaluating the sensitivity of RDT for diagnosis of congenital malaria are needed.
MeSH term(s)	Adult ; Burundi/epidemiology ; Cross-Sectional Studies ; Diagnostic Tests, Routine/methods ; Female ; Humans ; Immunochromatography/methods ; Infant, Newborn ; Malaria/congenital ; Malaria/diagnosis ; Malaria/epidemiology ; Pregnancy ; Prevalence ; Rural Population ; Sensitivity and Specificity ; Young Adult
Language	English
Publishing date	2016--30
Publishing country	England
Document type	Comparative Study ; Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1475-2875
ISSN (online)	1475-2875
DOI	10.1186/s12936-016-1478-0
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Article ; Online: Malaria PCR detection in Cambodian low-transmission settings: dried blood spots versus venous blood samples.

Canier, Lydie / Khim, Nimol / Kim, Saorin / Eam, Rotha / Khean, Chanra / Loch, Kaknika / Ken, Malen / Pannus, Pieter / Bosman, Philippe / Stassijns, Jorgen / Nackers, Fabienne / Alipon, SweetC / Char, Meng Chuor / Chea, Nguon / Etienne, William / De Smet, Martin / Kindermans, Jean-Marie / Ménard, Didier

The American journal of tropical medicine and hygiene

2015 Volume 92, Issue 3, Page(s) 573–577

Abstract: In the context of malaria elimination, novel strategies for detecting very low malaria parasite densities in asymptomatic individuals are needed. One of the major limitations of the malaria parasite detection methods is the volume of blood samples being ... ...

Abstract	In the context of malaria elimination, novel strategies for detecting very low malaria parasite densities in asymptomatic individuals are needed. One of the major limitations of the malaria parasite detection methods is the volume of blood samples being analyzed. The objective of the study was to compare the diagnostic accuracy of a malaria polymerase chain reaction assay, from dried blood spots (DBS, 5 μL) and different volumes of venous blood (50 μL, 200 μL, and 1 mL). The limit of detection of the polymerase chain reaction assay, using calibrated Plasmodium falciparum blood dilutions, showed that venous blood samples (50 μL, 200 μL, 1 mL) combined with Qiagen extraction methods gave a similar threshold of 100 parasites/mL, ∼100-fold lower than 5 μL DBS/Instagene method. On a set of 521 field samples, collected in two different transmission areas in northern Cambodia, no significant difference in the proportion of parasite carriers, regardless of the methods used was found. The 5 μL DBS method missed 27% of the samples detected by the 1 mL venous blood method, but most of the missed parasites carriers were infected by Plasmodium vivax (84%). The remaining missed P. falciparum parasite carriers (N = 3) were only detected in high-transmission areas.
MeSH term(s)	Cambodia ; DNA, Protozoan ; Dried Blood Spot Testing/methods ; Humans ; Malaria/blood ; Malaria/diagnosis ; Malaria/transmission ; Parasitemia ; Plasmodium/classification ; Plasmodium/genetics ; Prevalence ; Real-Time Polymerase Chain Reaction ; Serologic Tests/methods
Chemical Substances	DNA, Protozoan
Language	English
Publishing date	2015-01-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.14-0614
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Article ; Online: Plasmodium prevalence and artemisinin-resistant falciparum malaria in Preah Vihear Province, Cambodia: a cross-sectional population-based study.

Bosman, Philippe / Stassijns, Jorgen / Nackers, Fabienne / Canier, Lydie / Kim, Nimol / Khim, Saorin / Alipon, Sweet C / Chuor Char, Meng / Chea, Nguon / Dysoley, Lek / Van den Bergh, Rafael / Etienne, William / De Smet, Martin / Ménard, Didier / Kindermans, Jean-Marie

Malaria journal

2014 Volume 13, Page(s) 394

Abstract: Background: Intensified efforts are urgently needed to contain and eliminate artemisinin-resistant Plasmodium falciparum in the Greater Mekong subregion. Médecins Sans Frontières plans to support the Ministry of Health in eliminating P. falciparum in an ...

Abstract	Background: Intensified efforts are urgently needed to contain and eliminate artemisinin-resistant Plasmodium falciparum in the Greater Mekong subregion. Médecins Sans Frontières plans to support the Ministry of Health in eliminating P. falciparum in an area with artemisinin resistance in the north-east of Cambodia. As a first step, the prevalence of Plasmodium spp. and the presence of mutations associated with artemisinin resistance were evaluated in two districts of Preah Vihear Province. Methods: A cross-sectional population-based study using a two-stage cluster sampling was conducted in the rural districts of Chhaeb and Chey Saen, from September to October 2013. In each district, 30 clusters of 10 households were randomly selected. In total, blood samples were collected for 1,275 participants in Chhaeb and 1,224 in Chey Saen. Prevalence of Plasmodium spp. was assessed by PCR on dried blood spots. Plasmodium falciparum positive samples were screened for mutations in the K13-propeller domain gene (PF3D7_1343700). Result: The prevalence of Plasmodium spp. was estimated at 1.49% (95% CI 0.71-3.11%) in Chhaeb and 2.61% (95% CI 1.45-4.66%) in Chey Saen. Twenty-seven samples were positive for P. falciparum, giving a prevalence of 0.16% (95% CI 0.04-0.65) in Chhaeb and 2.04% (95% CI 1.04-3.99%) in Chey Saen. Only 4.0% of the participants testing positive presented with fever or history of fever. K13-propeller domain mutant type alleles (C580Y and Y493H) were found, only in Chey Saen district, in seven out of 11 P. falciparum positive samples with enough genetic material to allow testing. Conclusion: The overall prevalence of P. falciparum was low in both districts but parasites presenting mutations in the K13-propeller domain gene, strongly associated with artemisinin-resistance, are circulating in Chey Saen.The prevalence might be underestimated because of the absentees - mainly forest workers - and the workers of private companies who were not included in the study. These results confirm the need to urgently develop and implement targeted interventions to contain and eliminate P. falciparum malaria in this district before it spreads to other areas.
MeSH term(s)	Adolescent ; Adult ; Antimalarials/pharmacology ; Artemisinins/pharmacology ; Cambodia/epidemiology ; Child ; Child, Preschool ; Cross-Sectional Studies ; Drug Resistance ; Female ; Humans ; Infant ; Infant, Newborn ; Malaria, Falciparum/epidemiology ; Malaria, Falciparum/parasitology ; Malaria, Falciparum/prevention & control ; Male ; Middle Aged ; Mutation ; Plasmodium falciparum/drug effects ; Plasmodium falciparum/genetics ; Prevalence ; Young Adult
Chemical Substances	Antimalarials ; Artemisinins ; artemisinin (9RMU91N5K2)
Language	English
Publishing date	2014-10-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1475-2875
ISSN (online)	1475-2875
DOI	10.1186/1475-2875-13-394
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Article ; Online: The Merits of Malaria Diagnostics during an Ebola Virus Disease Outbreak.

de Wit, Emmie / Falzarano, Darryl / Onyango, Clayton / Rosenke, Kyle / Marzi, Andrea / Ochieng, Melvin / Juma, Bonventure / Fischer, Robert J / Prescott, Joseph B / Safronetz, David / Omballa, Victor / Owuor, Collins / Hoenen, Thomas / Groseth, Allison / van Doremalen, Neeltje / Zemtsova, Galina / Self, Joshua / Bushmaker, Trenton / McNally, Kristin /

Emerging infectious diseases

2016 Volume 22, Issue 2, Page(s) 323–326

Abstract: Malaria is a major public health concern in the countries affected by the Ebola virus disease epidemic in West Africa. We determined the feasibility of using molecular malaria diagnostics during an Ebola virus disease outbreak and report the incidence of ...

Abstract	Malaria is a major public health concern in the countries affected by the Ebola virus disease epidemic in West Africa. We determined the feasibility of using molecular malaria diagnostics during an Ebola virus disease outbreak and report the incidence of Plasmodium spp. parasitemia in persons with suspected Ebola virus infection.
MeSH term(s)	Coinfection ; Disease Outbreaks ; Ebolavirus ; Hemorrhagic Fever, Ebola/epidemiology ; Humans ; Malaria/diagnosis ; Malaria/parasitology ; Malaria, Falciparum/diagnosis ; Malaria, Falciparum/parasitology ; Parasite Load ; Plasmodium falciparum/classification ; Plasmodium falciparum/genetics ; Prevalence
Language	English
Publishing date	2016-02
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Intramural
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid2202.151656
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Article ; Online: Plasmodium Parasitemia Associated With Increased Survival in Ebola Virus-Infected Patients.

Rosenke, Kyle / Adjemian, Jennifer / Munster, Vincent J / Marzi, Andrea / Falzarano, Darryl / Onyango, Clayton O / Ochieng, Melvin / Juma, Bonventure / Fischer, Robert J / Prescott, Joseph B / Safronetz, David / Omballa, Victor / Owuor, Collins / Hoenen, Thomas / Groseth, Allison / Martellaro, Cynthia / van Doremalen, Neeltje / Zemtsova, Galina / Self, Joshua /

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2016 Volume 63, Issue 8, Page(s) 1026–1033

Abstract: Background: The ongoing Ebola outbreak in West Africa has resulted in 28 646 suspected, probable, and confirmed Ebola virus infections. Nevertheless, malaria remains a large public health burden in the region affected by the outbreak. A joint Centers ... ...

Abstract	Background: The ongoing Ebola outbreak in West Africa has resulted in 28 646 suspected, probable, and confirmed Ebola virus infections. Nevertheless, malaria remains a large public health burden in the region affected by the outbreak. A joint Centers for Disease Control and Prevention/National Institutes of Health diagnostic laboratory was established in Monrovia, Liberia, in August 2014, to provide laboratory diagnostics for Ebola virus. Methods: All blood samples from suspected Ebola virus-infected patients admitted to the Médecins Sans Frontières ELWA3 Ebola treatment unit in Monrovia were tested by quantitative real-time polymerase chain reaction for the presence of Ebola virus and Plasmodium species RNA. Clinical outcome in laboratory-confirmed Ebola virus-infected patients was analyzed as a function of age, sex, Ebola viremia, and Plasmodium species parasitemia. Results: The case fatality rate of 1182 patients with laboratory-confirmed Ebola virus infections was 52%. The probability of surviving decreased with increasing age and decreased with increasing Ebola viral load. Ebola virus-infected patients were 20% more likely to survive when Plasmodium species parasitemia was detected, even after controlling for Ebola viral load and age; those with the highest levels of parasitemia had a survival rate of 83%. This effect was independent of treatment with antimalarials, as this was provided to all patients. Moreover, treatment with antimalarials did not affect survival in the Ebola virus mouse model. Conclusions: Plasmodium species parasitemia is associated with an increase in the probability of surviving Ebola virus infection. More research is needed to understand the molecular mechanism underlying this remarkable phenomenon and translate it into treatment options for Ebola virus infection.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Child ; Child, Preschool ; Coinfection ; Disease Models, Animal ; Ebolavirus/genetics ; Female ; Hemorrhagic Fever, Ebola/complications ; Hemorrhagic Fever, Ebola/diagnosis ; Hemorrhagic Fever, Ebola/epidemiology ; Hemorrhagic Fever, Ebola/mortality ; Humans ; Infant ; Infant, Newborn ; Malaria/complications ; Malaria/diagnosis ; Malaria/epidemiology ; Malaria/parasitology ; Male ; Mice ; Middle Aged ; Parasite Load ; Parasitemia ; Plasmodium/genetics ; Survival Rate ; Viral Load ; Young Adult
Language	English
Publishing date	2016-08-15
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Intramural
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciw452
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