A5071031251- Viral gastroenteritis research and epidemiology
- Pneumonia and Respiratory Infections
- Vaccine Coverage and Hesitancy
- Respiratory viral infections research
- Hepatitis Viruses Studies and Epidemiology
- Child Nutrition and Water Access
- SARS-CoV-2 and COVID-19 Research
- Global Maternal and Child Health
- Viral Infections and Immunology Research
- Pneumocystis jirovecii pneumonia detection and treatment
- Influenza Virus Research Studies
- Salmonella and Campylobacter epidemiology
- COVID-19 Clinical Research Studies
- COVID-19 epidemiological studies
- Bacterial Infections and Vaccines
- Global Health Care Issues
- Animal Virus Infections Studies
- Misinformation and Its Impacts
- Escherichia coli research studies
- Viral Infections and Outbreaks Research
- Emergency and Acute Care Studies
- Vibrio bacteria research studies
- Clostridium difficile and Clostridium perfringens research
- Antibiotic Resistance in Bacteria
- SARS-CoV-2 detection and testing
World Health Organization
2024-2025
Malawi-Liverpool-Wellcome Trust Clinical Research Programme
2015-2025
Johns Hopkins University
2018-2025
University of Liverpool
2015-2025
London School of Hygiene & Tropical Medicine
2024
Kamuzu University of Health Sciences
2021-2022
University College London
2019-2022
Queen Elizabeth Central Hospital
2022
University of Malawi
2013-2021
Universidad de Murcia
2019
Bacterial bloodstream infection is a common cause of morbidity and mortality in sub-Saharan Africa, yet few facilities are able to maintain long-term surveillance. The Malawi-Liverpool-Wellcome Trust Clinical Research Programme has done sentinel surveillance bacteraemia since 1998. We report trends antimicrobial resistance from this surveillance.In study, we analysed blood cultures that were routinely taken adult paediatric patients with fever or suspicion sepsis admitted Queen Elizabeth...
Background WHO, as requested by its member states, launched the Expanded Programme on Immunization (EPI) in 1974 to make life-saving vaccines available all globally.To mark 50-year anniversary of EPI, we sought quantify public health impact vaccination globally since programme's inception. MethodsIn this modelling study, used a suite mathematical and statistical models estimate global regional 50 years against 14 pathogens EPI.For modelled pathogens, considered coverage routine supplementary...
Rotavirus is the main cause of severe acute gastroenteritis in children Africa. Monovalent human rotavirus vaccine (RV1) was added into Malawi's infant immunisation schedule on Oct 29, 2012. We aimed to assess impact and effectiveness RV1 2 years after introduction.From Jan 1, 2012, June 30, 2014, we recruited younger than 5 who were admitted Queen Elizabeth Central Hospital, Blantyre, Malawi, with gastroenteritis. assessed stool samples from these for presence use ELISA genotyped...
Background. Rotavirus vaccines have been introduced in many low-income African countries including Malawi 2012. Despite early evidence of vaccine impact, determining persistence protection beyond infancy, the utility against specific rotavirus genotypes, and effectiveness vulnerable subgroups is important. Methods. We compared prevalence diarrheal stool hospitalization incidence before following introduction Malawi. Using case-control analysis, we derived (VE) second year life for human...
Abstract There are concerns that pneumococcal conjugate vaccines (PCVs) in sub-Saharan Africa sub-optimally interrupt Streptococcus pneumoniae vaccine-serotype (VT) carriage and transmission. Here we assess PCV using rolling, prospective nasopharyngeal surveys between 2015 2018, 3.6–7.1 years after Malawi’s 2011 PCV13 introduction. Carriage decay rate is analysed non-linear regression. Despite evidence of reduction VT over the study period, there high persistent residual carriage. This...
Abstract While mortality attributable to COVID-19 has devastated global health systems and economies, striking regional differences have been observed. The Bacille Calmette Guérin (BCG) vaccine previously shown non-specific protective effects on infections, as well long-term efficacy against tuberculosis. Using publicly available data we built a simple log-linear regression model assess the association of BCG use COVID-19-attributable per 1 million population after adjusting for confounders...
Salmonella enterica serotype Typhi (S Typhi) is a major public health problem in low-income and middle-income countries. We aimed to investigate the effectiveness impact of typhoid conjugate vaccine Typbar-TCV against S among children an outbreak setting extensively drug-resistant (XDR) Pakistan.This cohort study was done from Feb 21, 2018, Dec 31, 2019. A census survey all households located Qasimabad Latifabad subdistricts Hyderabad, Pakistan, at baseline, 174 005 were registered census....
Abstract In the early months of pandemic, most reported cases and deaths due to COVID-19 occurred in high-income countries. However, insufficient testing could have led an underestimation true infections many low- middle-income As confirmed increase, ultimate impact pandemic on individuals communities countries is uncertain. We therefore propose research three broad areas as urgently needed inform responses countries: transmission patterns SARS-CoV-2, clinical characteristics disease,...
To combat the high burden of rotavirus gastroenteritis, multiple African countries have introduced vaccines into their childhood immunization programs. Malawi incorporated a G1P[8] vaccine (Rotarix) its schedule in 2012. Utilizing surveillance platform hospitalized gastroenteritis cases, we examined phylodynamics strains that circulated before (1998 to 2012) and after (2013 2014) introduction. Analysis whole genomes obtained through next-generation sequencing revealed all randomly selected...
Carriage of either single or multiple pneumococcal serotypes (multiple carriage) is a prerequisite for developing invasive disease. However, despite the reported high rates carriage in Malawi, no data on has been previously. Our study provides first description prevalence Malawi.The was conducted Blantyre and Karonga districts from 2008 to 2012. We recruited 116 children aged 0-13 years. These were HIV-infected (N = 44) uninfected 72). Nasopharyngeal samples collected using sterile swabs....
Pneumococcal conjugate vaccine (PCV) introduction has reduced pneumococcal meningitis incidence. The Serotype Replacement and Distribution Estimation (PSERENADE) project described the serotype distribution of remaining in countries using PCV10/13 for least 5–7 years with primary series uptake above 70%. was estimated a multinomial Dirichlet regression model, stratified by PCV product age. In PCV10-using sites (N = 8; cases 1141), PCV10 types caused 5% <5 age 15% among ≥5 years; top...
BackgroundThe population impact of pneumococcal conjugate vaccines (PCVs) depends on direct and indirect protection. Following Malawi's introduction the 13-valent PCV (PCV13) in 2011, we examined its vaccine non-vaccine serotype invasive disease among vaccine-eligible-age vaccine-ineligible-age children adults.MethodsWe did a prospective observational time-series analysis case-control study. We used data from between Jan 1, 2006, Dec 31, 2018, laboratory-based surveillance at government...
Background. We documented bacterial meningitis trends among adults and children presenting to a large teaching hospital in Malawi during introduction of Haemophilus influenzae type b (Hib) vaccination the rollout antiretroviral therapy (ART).
Background The pneumococcal conjugate vaccine's (PCV) impact on childhood pneumonia during programmatic conditions in Africa is poorly understood. Following PCV13 introduction Malawi November 2011, we evaluated the case burden and rates of pneumonia. Methods Findings Between January 1, 2012-June 30, 2014 conducted active surveillance children <5 years at seven hospitals, 18 health centres, with 38 community workers two districts, central Malawi. Eligible had clinical per guidelines, defined...
Remote dwelling Aboriginal infants from northern Australia have a high burden of disease and frequently use health services. Little is known about the quality infant care provided by remote This study describes adherence to guidelines for anaemia growth faltering staff barriers effective service delivery in settings.
Background Malawi introduced pneumococcal conjugate vaccine (PCV13) and monovalent rotavirus (RV1) in 2011 2012 respectively, is planning the introduction of a second-dose measles (MV). We assessed predictors availability, uptake timeliness these vaccines rural Malawian setting. Methods Commencing on first date PCV13 eligibility we conducted prospective population-based birth cohort study 2,616 children under demographic surveillance Karonga District, northern who were eligible for PCV13, or...
Background. Salmonella Typhimurium (STm) remain a prominent cause of bacteremia in sub-Saharan Africa. Complement-fixing antibodies to STm develop by 2 years age. We hypothesized that STm-specific CD4+ T cells alongside this process. Methods. Eighty healthy Malawian children aged 0–60 months were recruited. producing interferon γ, tumor necrosis factor α, and interleukin quantified using intracellular cytokine staining. Antibodies measured serum bactericidal activity (SBA) assay, anti-STm...
Abstract Background In November 2011, Malawi introduced the 13-valent pneumococcal conjugate vaccine (PCV13) into routine infant schedule. Four to 7 years after introduction (2015–2018), rolling prospective nasopharyngeal carriage surveys were performed in city of Blantyre. Carriage Streptococcus pneumoniae serotypes (VT) remained higher than reported high-income countries, and impact was asymmetric across age groups. Methods A dynamic transmission model fit survey data using a Bayesian...
Despite rotavirus vaccination, diarrhea remains a leading cause of child mortality. We collected stool specimens from 684 children <5 years age hospitalized with (cases) and 527 asymptomatic community controls for 4 after vaccine introduction in Malawi. Specimens were tested 29 pathogens, using polymerase chain reaction analysis. Three or more pathogens detected 71% cases 48% controls. Pathogens significantly associated included (in 34.7% 1.5% controls), enteric adenovirus 29.1% 2.7%,...
Rotavirus is a major contributor to child mortality. The effect of rotavirus vaccine on diarrhoea mortality has been estimated in middle-income but not low-income settings, where high and effectiveness reducing admissions hospital lower. Empirical population-based studies have done any setting. Malawi introduced monovalent (RV1) October, 2012. We aimed investigate the impact RV1 diarrhoea-associated infants aged 10-51 weeks.
Background The mortality impact of pulse oximetry use during infant and childhood pneumonia management at the primary healthcare level in low-income countries is unknown. We sought to determine outcomes infants children diagnosed referred using clinical guidelines with or without Malawi. Methods findings conducted a data linkage study prospective health facility community case data. matched prospectively collected worker (CHW) centre (HC) outpatient hospital community-based surveillance...