2671 research outputs found
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Contexts, Facilitators, and Barriers to Integrating Portable Genomic Sequencing in Outbreak Response: A Qualitative Study from Coastal Kenya
No full textThis data was collected during a stakeholders' engagement meeting which aimed at exploring the context of outbreak response in Kenyan counties and identifying the facilitators and barriers to integrating portable sequencing into outbreak investigations. The meeting brought together stakeholders involved in outbreak response from the Ministry of Health and county health departments
Workshops notes and transcripts for "Developing an intervention to improve early infant HIV diagnosis service uptake among postpartum women in Malawi’s primary healthcare using a co-designing approach with stakeholders"
No full textLow health service use by women and infants after birth limits early infant HIV diagnosis (EID). From August 2021 to December 2022, we collaborated with 44 healthcare workers (HCW), service users, and non-governmental organisation stakeholders from seven public facilities and five non-governmental organisations in Blantyre, building on a previous study. We analysed context-specific problems in EID services and co-designed a context-appropriate enhanced health system intervention to improve the uptake of six weeks’ EID services in primary health facilities in Blantyre, Malawi, using qualitative methods and co-designing workshops. The Behaviour Change Wheel, Theoretical Domain Framework and Consolidated Framework for sustainability constructs in healthcare guided the workshops. Reflexive thematic analysis of the data showed that stakeholders found that EID services were sub-optimal and identified challenges to service provision in 5 key areas: (1) client identification, (2) context-appropriate client-centred service integration, (3) HCW coordination and accountability, (4) HCW capacity building for optimal service delivery, and (5) intervention sustainability. Specifically, client and HCW stigma perceptions, referral gaps, resource challenges, HCW lack of time and poor documentation affected client identification; HCW clustered work shifts to extend off-duty periods, failure to synchronise client appointments, and lack of resources were barriers to client-centred integrated services; dysfunctional teams, minimal supervision and misconduct among HCW impacted coordination and accountability; and lack of information sharing and limited training reduced HCW capacity for service delivery. Context-appropriate stakeholder informed co-design initiatives to address identified challenges included: clients’ unique identifiers, booking systems, strengthening leadership, data validation, care pathways, and facility-based training. We recommend evaluating these initiatives in low resource settings as they have potential to address the identified EID service implementation gaps and significantly improve the EID of HIV in contexts of greatest need
Convergent evolution of artemisinin and chloroquine resistance in Ethiopian Plasmodium falciparum parasites
No full textThe emergence of antimalarial drug resistance has threatened the control and elimination of malaria in Africa. Ethiopia, once a success story in case reduction, is now facing resurgence. This study examined the key drug resistance genes (Pfmdr1, Pfcrt, Pfk13, Pfdhfr, and Pfdhps) and mitochondrial genomes of 605 Plasmodium falciparum isolates from 15 districts across Ethiopia, varying in transmission intensity and P. vivax co-endemicity. A dominant PfMDR1 NFSND haplotype, associated with reduced lumefantrine susceptibility, was identified alongside near-fixation of the PfCRT CVIET chloroquine-resistant haplotype in specific areas. Concerningly, PfK13 variants associated with partial artemisinin resistance – R622I (10%), A675V (1.7%), and P441L (1.1%) – were expanding. Drug resistance markers were primarily found in settings with low transmission of P. falciparum and high levels of P. vivax coendemicity. Along with a distinct parasite lineage and limited gene flow, these findings suggest that local evolutionary and therapeutic pressures shape resistance. This underscores the urgent need for targeted genomic surveillance to guide tailored interventions and contain the spread of multidrug-resistant P. falciparum
Factors associated with self-reported ability to comply with home isolation after COVID-19 diagnosis in vulnerable communities in Brazil
No full textThis study investigates the factors associated with the self-reported ability to comply with home isolation after a COVID-19 diagnosis in vulnerable communities in Salvador (Bahia) and Rio de Janeiro (Brazil). It is a cross-sectional study including 324 participants from the project “Expansion of testing, quarantine, e-health, and telemonitoring strategies to address the COVID-19 pandemic in Brazil” (TQT COVID-19). Results indicate that high household density (≥0.5 persons per room) was significantly associated with a lower ability to isolate (adjusted OR=0.41; 95% CI: 0.20–0.82; p=0.01). Housing conditions, more than individual characteristics, were decisive for adherence to home isolation. Findings highlight the need for public policies that address structural inequalities and expand access to adequate housing in vulnerable settings
epireview: Tools to update and summarise the latest pathogen data from the Pathogen Epidemiology Review Group (PERG)
No full textepireview is a tool to obtain the latest data, figures and tables from the Pathogen Epidemiology Review Group (PERG). This package also contains functions to update pathogen-specific databases with new data from peer-reviewed papers as they become available
Bazlshtm/Shingrix_uptake
No full textA repository for code and codelists for the paper "Disparities in uptake of Shingrix® vaccine in immunosuppressed individuals in England: a population-based cohort study
Dataset for: "Interventions to improve access to opioid agonist therapy in acute hospitals: A scoping review"
No full textMany people who use illicit opioids have negative experiences when admitted to hospital, which is partly due to poor availability of opioid agonist therapy (OAT). We conducted a scoping review of interventions to increase access OAT to for hospital patients, with searches of MEDLINE, EMBASE, PsychINFO, and CINAHL for evaluations published before 29 July 2024. We followed a registered protocol (identifier: CRD42022313237). We included interventions in acute inpatient or emergency department settings, and extracted intervention characteristics, location, evaluation design and quality, and evidence for effectiveness. We included 57 studies; 50 from the United States, six from Canada, and one from the UK. Fifty-one were published in 2015 or later. We identified three intervention classes: (a) pathways to initiate OAT in emergency departments, entailing screening patients or training staff to identify withdrawal, initiating buprenorphine, and supported referrals (26 studies); (b) multidisciplinary ‘addiction consult teams’, which provide substance-related care across hospital departments, advise primary medical teams on issues such as pain relief and withdrawal management, and support patients with discharge and onward care (18 studies); and (c) Interventions that build capacity of general clinical teams to provide OAT to inpatients, including protocols to identify patients who need OAT, multidisciplinary patient review, and training/clinical education (13 studies). Most interventions included multiple components, and the most common were clinical education and measures to improve continuity of OAT after discharge, such as bridge prescriptions and supported referrals to community prescribers. Almost all studies concluded that interventions were effective, however evaluation methods were generally weak and most used before/after or case series designs. Efforts to improve OAT in acute hospitals emerged recently in North America and focus on addiction consult teams and initiation of buprenorphine in emergency departments. Although formal evaluation is weak, these models may represent starting points for national policy and larger research programmes
Optimization and Characterization of N-Acetamide Indoles as Antimalarials That Target PfATP4
No full textSupporting files for "Optimization and Characterization of N-Acetamide Indoles as Antimalarials That Target PfATP4". This include metabolomics data (XLSX); Molecular Formula Strings (CSV); Crystal structure (PDB); and a file containing Caco-2 data, P. falciparum and P. knowlesi asexual (parental and drug-resistant lines) and gamete dose response data, MIR, AReBar, metabolomic, standard membrane feeding assay, mouse model and plasma exposure data, and compound spectra (PDF)
kingaa/pomp
No full textAn R package for statistical inference on partially observed Markov processes
gigs: Assess Fetal, Newborn, and Child Growth with International Standards
No full textProduced as part of the Guidance for International Growth Standards project at the London School of Hygiene & Tropical Medicine, gigs provides a single, simple interface for working with the WHO Child Growth standards and outputs from the INTERGROWTH-21st project. You will find functions for converting from anthropometric measures (e.g. weight or length) to z-scores and centiles, and the inverse. Also included are functions for classifying newborn and infant growth according to literature-based cut-offs