A5011984849- Pneumonia and Respiratory Infections
- Respiratory viral infections research
- Child Nutrition and Water Access
- Global Maternal and Child Health
- Vaccine Coverage and Hesitancy
- Iron Metabolism and Disorders
- Bacterial Infections and Vaccines
- Viral gastroenteritis research and epidemiology
- Hemoglobinopathies and Related Disorders
- Hepatitis Viruses Studies and Epidemiology
- Influenza Virus Research Studies
- Global Health and Epidemiology
- Pneumocystis jirovecii pneumonia detection and treatment
- Global Public Health Policies and Epidemiology
- Enterobacteriaceae and Cronobacter Research
- Viral Infections and Immunology Research
- Parathyroid Disorders and Treatments
- COVID-19 epidemiological studies
- Child and Adolescent Health
- Salmonella and Campylobacter epidemiology
- Antibiotic Resistance in Bacteria
- Autopsy Techniques and Outcomes
- Trace Elements in Health
- Bone health and osteoporosis research
- Disaster Response and Management
MRC Unit the Gambia
2016-2025
London School of Hygiene & Tropical Medicine
2019-2022
University of London
2019-2022
Ministry of Health
2019
University of Otago
2019
Murdoch Children's Research Institute
2019
International Centre for Diarrhoeal Disease Research
2009-2017
Medical Research Council
1970-2015
Western Infirmary
1970
Little information is available about the effect of pneumococcal conjugate vaccines (PCVs) in low-income countries. We measured these on invasive disease The Gambia where 7-valent vaccine (PCV7) was introduced August, 2009, followed by 13-valent (PCV13) May, 2011.We conducted population-based surveillance for individuals aged 2 months and older who were residents Basse Health Demographic Surveillance System (BHDSS) Upper River Region, Gambia, using standardised criteria to identify...
Pneumococcal conjugate vaccines (PCVs) are used in many low-income countries but their impact on the incidence of pneumonia is unclear. The Gambia introduced PCV7 August, 2009, and PCV13 May, 2011. We aimed to measure introduction these incidence.We did population-based surveillance case-control studies. primary endpoint was WHO-defined radiological with pulmonary consolidation. Population-based for suspected children aged 2-59 months (minimum age 3 study) between May 12, 2008, Dec 31, 2015....
Background Rotavirus vaccines are now globally recommended by the World Health Organization (WHO), but in early 2009 WHO’s Strategic Advisory Group of Experts on Immunization reviewed available data and concluded that there was no evidence for efficacy or effectiveness a two-dose schedule human rotavirus vaccine (HRV; Rotarix) given at 6 10 wk age. Additionally, programmatic vaccination, including possible indirect effects, has not been assessed low-resource populations Asia. Methods...
BackgroundThe Gambia introduced seven-valent pneumococcal conjugate vaccine (PCV7) in August 2009, followed by PCV13 May, 2011, using a schedule of three primary doses without booster dose or catch-up immunisation. We aimed to assess the long-term impact PCV on disease incidence.MethodsWe did 10 years population-based surveillance for invasive (IPD) and WHO defined radiological pneumonia with consolidation rural Gambia. The population included all Basse Health Demographic Surveillance System...
Objective To measure mortality and its risk factors among children discharged from a health centre in rural Gambia. Methods We conducted cohort study between 12 May 2008 11 2012. Children aged 2–59 months, admitted with suspected pneumonia, sepsis, or meningitis after presenting to primary secondary care facilities, were followed for 180 days discharge. developed models associating post-discharge clinical syndrome on admission factors. Findings One hundred five of 3755 (2.8%) died, 80%...
Abstract Background Pneumococcal conjugate vaccines (PCV) effectively prevent pneumococcal disease but the global impact of vaccination is hampered by cost PCV. The relevance and feasibility trials reduced dose schedules greatest in middle- low-income countries, such as Gambia, where PCV has been introduced with good control transmission vaccine-type pneumococci persists. We are conducting a large cluster-randomised, non-inferiority, field trial an alternative schedule compared to standard...
In 2012, an outbreak of Neisseria meningitidis serogroup W135 occurred in The Gambia. attack rate was highest among young children. associated risk factors were male sex, contact with meningitis patients, and difficult breathing. Enhanced surveillance facilitates early epidemic detection, multiserogroup conjugate vaccine could reduce meningococcal epidemics
Background: Iron deficiency and its associated anaemia (IDA) are the leading forms of micronutrient malnutrition worldwide. Here we describe rationale design first clinical trial evaluating efficacy safety an innovative nano iron supplement, hydroxide adipate tartrate (IHAT), for treatment IDA in young children (IHAT-GUT trial). Oral is often ineffective due to poor absorption and/or gastrointestinal adverse effects. IHAT novel since it effectively absorbed whilst remaining nanoparticulate...
Background In low-resource settings, it is challenging to ascertain the burden and causes of under-5 mortality as many deaths occur outside health facilities. We aimed determine childhood in rural Gambia using verbal autopsies (VA). Methodology used WHO VA questionnaires conduct VAs for years age Basse Fuladu West Health Demographic Surveillance Systems (HDSS) between September 01, 2019, December 31, 2021. Using a standardized cause death list, two physicians assigned discordant diagnoses...
In 1997, The Gambia introduced three primary doses of Haemophilus influenzae type b (Hib) conjugate vaccine without a booster in its infant immunisation programme along with establishment population-based surveillance on Hib meningitis the West Coast Region (WCR). This was stopped 2002 reported elimination disease. re-established 2008 but again 2010. We aimed to re-establish WCR and continue Basse Health Demographic Surveillance System (BHDSS) east country assess any shifts epidemiology...
Staphylococcus aureus bacteremia is a substantial cause of childhood disease and death, but few studies have described its epidemiology in developing countries. Using population-based surveillance system for pneumonia, sepsis, meningitis, we estimated S. incidence the case-fatality ratio children <5 years age 2 regions eastern part The Gambia during 2008-2015. Among 33,060 with suspected or performed blood culture 27,851; 1,130 patients bacteremia, 198 (17.5%) were positive aureus. was 78...
Background Anemia is one of the most impactful nutrient deficiencies in world and disproportionately affects children low-resource settings. Point-of-care devices (PoCDs) measuring blood hemoglobin (Hb) are widely used such settings to screen for anemia due their low cost, speed, convenience. Here we present first iteration Aptus, a new PoCD which measures Hb hematocrit (HCT). Aim To evaluate accuracy Aptus HemoCue® 301 against an automated hematology analyzer (Medonic®) Gambian aged 6–35...
<ns4:p><ns4:bold>Background: </ns4:bold>Iron deficiency and its associated anaemia (IDA) are the leading forms of micronutrient malnutrition worldwide. Conventional oral iron supplements have limited efficacy been with increased infection, diarrhoea, detrimental changes to gut microbiome, particularly in young children. Here we describe rationale design first clinical trial evaluating safety a novel nano supplement, hydroxide adipate tartrate (IHAT), for treatment IDA children (IHAT-GUT...
Children with acute infectious diseases may not present to health facilities, particularly in low-income countries. We investigated healthcare seeking using a cross-sectional community survey, facility-based exit interviews, and interviews customers of private pharmacies 2014 Upper River Region (URR) The Gambia, within the Basse Health & Demographic Surveillance System. estimated access care surveillance data from 2008 2017 calculating disease incidence versus distance nearest facility. In...
Introduction Introducing pneumococcal conjugate vaccine (PCV) in many low-income countries has contributed to reductions global childhood deaths caused by Streptococcus pneumoniae . Many countries, however, will soon reach an economic status leading transition from Gavi, the Vaccine Alliance funding support and then face increased expenditure continue PCV programmes. Evaluating cost-effectiveness of inform such country decisions. Methods We used empiric data on costs delivery disease...
We investigated the pathogenesis of pneumococcal pneumonia using clinical specimens collected for surveillance in The Gambia.Lung aspirates and nasopharyngeal swabs from 31 patients were examined by culture, quantitative polymerase chain reaction (qPCR), whole genome sequencing, serotyping, reverse-transcription qPCR.Five lung cultured pneumococci, with a matching strain identified nasopharynx. Three virulence genes including ply (pneumolysin) upregulated >20-fold compared Nasopharyngeal...
Abstract Background We determined the risk factors associated with unvaccinated children in rural Gambia. Methods conducted prospective demographic surveillance and recorded immunisations real time Upper River Region, The Analysis included residents born from 1 January 2012 to 31 December 2016. Data age, sex, household members relationships, migrations, births, deaths, ethnicity, residential location birth type. Children were defined as at 10, 15 24 mo of age if they missed all primary...
The COVID-19 pandemic represents an unprecedented challenge for clinical research. Pneumococcal Vaccine Schedules (PVS) study is a non-inferiority, interventional trial in which infants resident 68 geographic clusters are randomised to two different schedules pneumococcal vaccination. From September 2019 onwards, all the area became eligible enrolment at Expanded Programme on Immunisation (EPI) clinics area. Surveillance endpoints conducted 11 health facilities PVS as collaboration between...