Dengue is a mosquito-borne disease that threatens over half of the world’s population. Despite being endemic to more than 100 countries, government-led efforts and tools for timely identification and tracking of new infections are still lacking in many affected areas. Multiple methodologies that leverage the use of Internet-based data sources have been proposed as a way to complement dengue surveillance efforts. Among these, dengue-related Google search trends have been shown to correlate with dengue activity. We extend a methodological framework, initially proposed and validated for flu surveillance, to produce near real-time estimates of dengue cases in five countries/states: Mexico, Brazil, Thailand, Singapore and Taiwan. Our result shows that our modeling framework can be used to improve the tracking of dengue activity in multiple locations around the world.
World Health Organization (WHO) recommendations on the use of dengue vaccine
Dengue vaccination would be cost-effective in Brazil even with a relatively low vaccine efficacy in seronegative individuals
Review of articles on communication strategies for vector-borne diseases
Strengthening integrated dengue surveillance, monitoring and response systems
Evaluation of NS1 antigen assay as an alternative to RT-PCR for the early diagnosis of dengue
Analysis of potential dengue vaccine impact in Yucatán Mexico.
A study of dengue and yellow fever viruses in mosquitoes in Zaria, Nigeria
The growth of slums in the developing world's rapidly expanding cities is creating new opportunities for infectious disease to flourish and spread.
Vaccine efficacy alone is inadequate to capture the public health importance of vaccines.
Laboratory systems and diagnostic technologies are a critical pillar in the fight against malaria. The World Health Organization (WHO) recommends diagnostic testing for all people with suspected malaria before treatment is administered.
An estimate of the global economic burden of dengue by country and super-region
This paper looks at the true cost of dengue fever
Secondary analysis of clinical trial data reveals dengue burden
Vector control, surveillance, drugs, diagnostics and vaccines all hold exciting potential but none can solve the problem alone. We need an integrated approach.
Research points to a promising single antiviral for the transgenic suppression of multiple arboviruses
Scientists belive a protein may be key to new dengue drug discoveries?
U.S. efforts to combat the Zika virus in the US and abroad
The Zika virus is another wild card dealt to us by nature. It was first discovered in 1947.
With Zika infection rates now seeming to be on the increase, the Oxford Science Blog talked to Professor Lang about why it is so important to develop capacity for doing research in places where research doesn't normally happen.
Trudie Lang, Professor of Global Health at Oxford University and Head of The Global Health Network, and virologist Professor Jonathan Ball from Nottingham University discuss what we know so far.
This Week in Global Health or TWiGH presents Global Health Out Loud with Sulzhan Bali & Jessica Taaffe. This week they discuss Zika virus.
Malaria remains a major global health threat. In the last fifteen years there has been remarkable progress in reducing cases and deaths due to malaria.
A candidate tetravalent dengue vaccine is being assessed in three clinical trials involving more than 35,000 children between the ages of 2 and 16 years in Asian–Pacific and Latin American countries. This article in the New England Journal of Medicine reports the results of long-term follow-up interim analyses and integrated efficacy analyses. Abstract A candidate tetravalent dengue vaccine is being assessed in three clinical trials involving more than 35,000 children between the ages of 2 and 16 years in Asian–Pacific and Latin American countries. We report the results of long-term follow-up interim analyses and integrated efficacy analyses. We are assessing the incidence of hospitalization for virologically confirmed dengue as a surrogate safety end point during follow-up in years 3 to 6 of two phase 3 trials, CYD14 and CYD15, and a phase 2b trial, CYD23/57. We estimated vaccine efficacy using pooled data from the first 25 months of CYD14 and CYD15. Follow-up data were available for 10,165 of 10,275 participants (99%) in CYD14 and 19,898 of 20,869 participants (95%) in CYD15. Data were available for 3203 of the 4002 participants (80%) in the CYD23 trial included in CYD57. During year 3 in the CYD14, CYD15, and CYD57 trials combined, hospitalization for virologically confirmed dengue occurred in 65 of 22,177 participants in the vaccine group and 39 of 11,089 participants in the control group. Pooled relative risks of hospitalization for dengue were 0.84 (95% confidence interval [CI], 0.56 to 1.24) among all participants, 1.58 (95% CI, 0.83 to 3.02) among those under the age of 9 years, and 0.50 (95% CI, 0.29 to 0.86) among those 9 years of age or older. During year 3, hospitalization for severe dengue, as defined by the independent data monitoring committee criteria, occurred in 18 of 22,177 participants in the vaccine group and 6 of 11,089 participants in the control group. Pooled rates of efficacy for symptomatic dengue during the first 25 months were 60.3% (95% CI, 55.7 to 64.5) for all participants, 65.6% (95% CI, 60.7 to 69.9) for those 9 years of age or older, and 44.6% (95% CI, 31.6 to 55.0) for those younger than 9 years of age. Although the unexplained higher incidence of hospitalization for dengue in year 3 among children younger than 9 years of age needs to be carefully monitored during long-term follow-up, the risk among children 2 to 16 years of age was lower in the vaccine group than in the control group.
These findings suggest that the 2013 dengue epidemic in Angola was larger than indicated by passive surveillance data. Abstract During the 2013 dengue epidemic in Luanda, Angola, 811 dengue rapid diagnostic test-positive cases were reported to the Ministry of Health. To better understand the magnitude of the epidemic and identify risk factors for dengue virus (DENV) infection, we conducted cluster surveys around households of case-patients and randomly selected households 6 weeks after the peak of the epidemic. Of 173 case cluster participants, 16 (9%) exhibited evidence of recent DENV infection. Of 247 random cluster participants, 25 (10%) had evidence of recent DENV infection. Of 13 recently infected participants who had a recent febrile illness, 7 (54%) had sought medical care, and 1 (14%) was hospitalized with symptoms consistent with severe dengue; however, none received a diagnosis of dengue. Behavior associated with protection from DENV infection included recent use of mosquito repellent or a bed net. These findings suggest that the 2013 dengue epidemic was larger than indicated by passive surveillance data.
The SWAT and SWAR programme is identifying issues about the methods of trials and systematic reviews about which there is sufficient uncertainty to justify research to support well-informed decision making about future designs and choices.
The increasing burden of dengue, and the relative failure of traditional vector control programs highlight the need to develop new control methods. SIT using self-limiting genetic technology is one such promising method. Abstract The increasing burden of dengue, and the relative failure of traditional vector control programs highlight the need to develop new control methods. SIT using self-limiting genetic technology is one such promising method. A self-limiting strain of Aedes aegypti, OX513A, has already reached the stage of field evaluation. Sustained releases of OX513A Ae. aegypti males led to 80% suppression of a target wild Ae. aegypti population in the Cayman Islands in 2010. Here we describe sustained series of field releases of OX513A Ae. aegypti males in a suburb of Juazeiro, Bahia, Brazil. This study spanned over a year and reduced the local Ae. aegypti population by 95% (95% CI: 92.2%-97.5%) based on adult trap data and 81% (95% CI: 74.9-85.2%) based on ovitrap indices compared to the adjacent no-release control area. The mating competitiveness of the released males (0.031; 95% CI: 0.025-0.036) was similar to that estimated in the Cayman trials (0.059; 95% CI: 0.011 - 0.210), indicating that environmental and target-strain differences had little impact on the mating success of the OX513A males. We conclude that sustained release of OX513A males may be an effective and widely useful method for suppression of the key dengue vector Ae. aegypti. The observed level of suppression would likely be sufficient to prevent dengue epidemics in the locality tested and other areas with similar or lower transmission.
In this video, Professor Theonest Mutabingwa discusses the two key challenges that face developing countries to progress their malaria research.
In this video of a seminar delivered at the University of Oxford in June 2014, Professor Nicholas White talks about the challenge of antimalarial resistance.
Anders Björkman is Professor of Infectious Disease at the Karolinska Institute. In this video, Anders talks about how the efficacy of antimalarials is a major obstacle in the path towards full malaria elimination.
Are you a research scientist working in Global Health? Or an institution looking for partners to run a clinical trial? Site Finder is for you.
New Public Management (public sector reforms which draw on business ideology) are increasingly seen in African ministries of health. This talk concentrates on the effects of NPM reform on Ethiopian hospitals and how efforts to be 'more business-like' have many unintended consequences for hospitals and patients.
Professor Bongani M Mayosi from the Department of Medicine, Groote Schuur Hospital & University of Cape Town describes the transofmation of the science cohort in South Africa.
In this seminar Professor Kevin Marsh describes how knowledge of immunity to malaria in humans has developed over the past thirty years and what impact this has for future research.
Academics in Germany, the US, Singapore and Sweden ask whether Dengue is still a 'neglected tropical disease'. Abstract Dengue is currently listed as a "neglected tropical disease" (NTD). But is dengue still an NTD or not? Classifying dengue as an NTD may carry advantages, but is it justified? This review considers the criteria for the definition of an NTD, the current diverse lists of NTDs by different stakeholders, and the commonalities and differences of dengue with other NTDs. We also review the current research gaps and research activities and the adequacy of funding for dengue research and development (R&D) (2003-2013). NTD definitions have been developed to a higher precision since the early 2000s, with the following main features: NTDs are characterised as a) poverty related, b) endemic to the tropics and subtropics, c) lacking public health attention, d) having poor research funding and shortcomings in R&D, e) usually associated with high morbidity but low mortality, and f) often having no specific treatment available. Dengue meets most of these criteria, but not all. Although dengue predominantly affects resource-limited countries, it does not necessarily only target the poor and marginalised in those countries. Dengue increasingly attracts public health attention, and in some affected countries it is now a high profile disease. Research funding for dengue has increased exponentially in the past two decades, in particular in the area of dengue vaccine development. However, despite advances in dengue research, dengue epidemics are increasing in frequency and magnitude, and dengue is expanding to new areas. Specific treatment and a highly effective vaccine remain elusive. Major research gaps exist in the area of integrated surveillance and vector control. Hence, although dengue differs from many of the NTDs, it still meets important criteria commonly used for NTDs. The current need for increased R&D spending, shared by dengue and other NTDs, is perhaps the key reason why dengue should continue to be considered an NTD.
ABRAID, new website of infectious diseases risk maps
Abstract The increasing population of Aedes aegypti mosquitoes on Madeira Island (Portugal) resulted in the first autochthonous dengue outbreak, which occurred in October 2012. Our study establishes the first genetic evaluation based on the mitochondrial DNA (mtDNA) genes [cytochrome oxidase subunit I (COI) and NADH dehydrogenase subunit 4 (ND4)] and knockdown resistance ( kdr ) mutations exploring the colonisation history and the genetic diversity of this insular vector population. We included mosquito populations from Brazil and Venezuela in the analysis as putative geographic sources. The Ae. aegypti population from Madeira showed extremely low mtDNA genetic variability, with a single haplotype for COI and ND4. We also detected the presence of two important kdr mutations and the quasi-fixation of one of these mutations (F1534C). These results are consistent with a unique recent founder event that occurred on the island of Ae. aegypti mosquitoes that carry kdr mutations associated with insecticide resistance. Finally, we also report the presence of the F1534C kdr mutation in the Brazil and Venezuela populations. To our knowledge, this is the first time this mutation has been found in South American Ae. aegypti mosquitoes. Given the present risk of Ae. aegypti re-invading continental Europe from Madeira and the recent dengue outbreaks on the island, this information is important to plan surveillance and control measures.
The Mekong Delta is vulnerable to climate change and dengue incidence. Research points to a positive association between dengue incidence and temperature and humidity. Poisson model affords the best prediction of dengue incidence for a-year period; the SARIMA model affords good prediction of dengue incidence for a 3-month period; the simple multiple model affords an inaccurate prediction of dengue incidence. Abstract The Mekong Delta is highly vulnerable to climate change and a dengue endemic area in Vietnam. This study aims to examine the association between climate factors and dengue incidence and to identify the best climate prediction model for dengue incidence in Can Tho city, the Mekong Delta area in Vietnam. We used three different regression models comprising: standard multiple regression model (SMR), seasonal autoregressive integrated moving average model (SARIMA), and Poisson distributed lag model (PDLM) to examine the association between climate factors and dengue incidence over the period 2003–2010. We validated the models by forecasting dengue cases for the period of January–December, 2011 using the mean absolute percentage error (MAPE). Receiver operating characteristics curves were used to analyze the sensitivity of the forecast of a dengue outbreak. The results indicate that temperature and relative humidity are significantly associated with changes in dengue incidence consistently across the model methods used, but not cumulative rainfall. The Poisson distributed lag model (PDLM) performs the best prediction of dengue incidence for a 6, 9, and 12-month period and diagnosis of an outbreak however the SARIMA model performs a better prediction of dengue incidence for a 3-month period. The simple or standard multiple regression performed highly imprecise prediction of dengue incidence. We recommend a follow-up study to validate the model on a larger scale in the Mekong Delta region and to analyze the possibility of incorporating a climate-based dengue early warning method into the national dengue surveillance system.
A new class of antibody found in the blood of patients with dengue fever has boosted hopes for a vaccine against the virus, which debilitates millions and kills tens of thousands each year. Cases of dengue fever have soared in the past 50 years to nearly 100 million a year as improved transport and urbanisation have brought more people into contact with the mosquito-borne virus.
Japan reported more patients with dengue fever after last week finding the country’s first domestic cases of the mosquito-borne disease since the 1940s. Nineteen people in Japan have been confirmed to have dengue fever in addition to the three cases confirmed last month, public broadcaster NHK reported today, citing the nation’s health ministry.
On the 8th of July 2014 The Global Health Network launched the Global Health Research Process Map, the first digital toolkit designed to enable researchers anywhere in the world to conduct rigorous global health research.
This good practice document of the ESSENCE on Health Research initiative is designed to provide broad guidance on how best to strengthen research capacity with the maximum possible benefit.
AuthorAid is a great online tool whose aim is to support developing country researchers in publishing their work.
A programme set up by WHO together with major publishers to provide free or very low cost online access to the major journals to local, not-for-profit institutions in developing countries.
ESSENCE on Health Research have created a good practice document on research costing. It includes a review of the funding practices related to the definition and funding of direct and indirect costs.
This guide, developed by the WHO and released in December 2013, aims to facilitate implementation research in LMICs.
This article describes a health portal developed in India aimed at providing one-stop access to efficiently search, organize and share maternal child health information relevant from public health perspective in the country.
Research reporting guidelines are standard statements that provide guidance on how to report research methodology and findings. These are in the form of checklists, flow diagrams or texts. Most of the biomedical journals require authors to comply with these guidelines. Guidelines are available for reporting various study designs:
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