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Exploring relationships between drought and epidemic cholera in Africa using generalised linear models

Charnley, Gina E. C. ; Kelman, Ilan ; Green, Nathan ; [et al.]

Springer Science and Business Media LLC ; 2021

In: BMC Infectious Diseases Vol. 21, No. 1 ( 2021-12)

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In: BMC Infectious Diseases, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)

Abstract: Temperature and precipitation are known to affect Vibrio cholerae outbreaks. Despite this, the impact of drought on outbreaks has been largely understudied. Africa is both drought and cholera prone and more research is needed in Africa to understand cholera dynamics in relation to drought. Methods Here, we analyse a range of environmental and socioeconomic covariates and fit generalised linear models to publicly available national data, to test for associations with several indices of drought and make cholera outbreak projections to 2070 under three scenarios of global change, reflecting varying trajectories of CO 2 emissions, socio-economic development, and population growth. Results The best-fit model implies that drought is a significant risk factor for African cholera outbreaks, alongside positive effects of population, temperature and poverty and a negative effect of freshwater withdrawal. The projections show that following stringent emissions pathways and expanding sustainable development may reduce cholera outbreak occurrence in Africa, although these changes were spatially heterogeneous. Conclusions Despite an effect of drought in explaining recent cholera outbreaks, future projections highlighted the potential for sustainable development gains to offset drought-related impacts on cholera risk. Future work should build on this research investigating the impacts of drought on cholera on a finer spatial scale and potential non-linear relationships, especially in high-burden countries which saw little cholera change in the scenario analysis.

Type of Medium: Online Resource

ISSN: 1471-2334

URL: Article

DOI: 10.1186/s12879-021-06856-4

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2021

detail.hit.zdb_id: 2041550-3

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Accessing sub-national cholera epidemiological data for Nigeria and the Democratic Republic of Congo during the seventh pandemic

Charnley, Gina E. C. ; Kelman, Ilan ; Gaythorpe, Katy A. M. ; [et al.]

Springer Science and Business Media LLC ; 2022

In: BMC Infectious Diseases Vol. 22, No. 1 ( 2022-12)

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In: BMC Infectious Diseases, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)

Abstract: Vibrio cholerae is a water-borne pathogen with a global burden estimate at 1.4 to 4.0 million annual cases. Over 94% of these cases are reported in Africa and more research is needed to understand cholera dynamics in the region. Cholera data are lacking, mainly due to reporting issues, creating barriers for widespread research on cholera epidemiology and management in Africa. Main body Here, we present datasets that were created to help address this gap, collating freely available sub-national cholera data for Nigeria and the Democratic Republic of Congo. The data were collated from a variety of English and French publicly available sources, including the World Health Organization, PubMed, UNICEF, EM-DAT, the Nigerian CDC and peer-reviewed literature. These data include information on cases, deaths, age, gender, oral cholera vaccination, risk factors and interventions. Conclusion These datasets can facilitate qualitative, quantitative and mixed methods research in these two high burden countries to assist in public health planning. The data can be used in collaboration with organisations in the two countries, which have also collected data or undertaking research. By making the data and methods available, we aim to encourage their use and further data collection and compilation to help improve the data gaps for cholera in Africa.

Type of Medium: Online Resource

ISSN: 1471-2334

URL: Article

DOI: 10.1186/s12879-022-07266-w

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2022

detail.hit.zdb_id: 2041550-3

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Understanding the risks for post-disaster infectious disease outbreaks: a systematic review protocol

Charnley, Gina E C ; Kelman, Ilan ; Gaythorpe, Katy ; [et al.]

BMJ ; 2020

In: BMJ Open Vol. 10, No. 9 ( 2020-09), p. e039608-

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In: BMJ Open, BMJ, Vol. 10, No. 9 ( 2020-09), p. e039608-

Abstract: Disasters have many forms, including those related to natural hazards and armed conflict. Human-induced global change, such as climate change, may alter hazard parameters of these disasters. These alterations can have serious consequences for vulnerable populations, which often experience post-disaster infectious disease outbreaks, leading to morbidity and mortality. The risks and drivers for these outbreaks and their ability to form cascades are somewhat contested. Despite evidence for post-disaster outbreaks, reviews quantifying them have been on short time scales, specific geographic areas or specific hazards. This review aims to fill this gap and gain a greater understanding of the risk factors involved in these contextual outbreaks on a global level. Methods and analysis Using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 checklist and Khan’s methodological framework, a systematic search strategy will be created and carried out in August 2020. The strategy will search MEDLINE, Embase and GlobalHealth electronic databases and reference lists of selected literature will also be screened. Eligible studies will include any retrospective cross-sectional, case–control or cohort studies investigating an infectious disease outbreak in a local disaster affected population. Studies will not be excluded based on geographic area or publication date. Excluded papers will include non-English studies, reviews, single case studies and research discussing general risk factors, international refugee camps, public health, mental health and other non-communicable diseases, pathogen genetics or economics. Following selection, data will be extracted into a data charting form, that will be reviewed by other members of the team. The data will then be analysed both numerically and narratively. Ethics and dissemination Only secondary data will be used and there will be no public or patient involvement; therefore, no ethical approval is needed. Our findings will aim to be disseminated through a peer-reviewed journal. The authors intend to use the results to inform future mathematical modelling studies.

Type of Medium: Online Resource

ISSN: 2044-6055 , 2044-6055

URL: Article

DOI: 10.1136/bmjopen-2020-039608

Language: English

Publisher: BMJ

Publication Date: 2020

detail.hit.zdb_id: 2599832-8

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Traits and risk factors of post-disaster infectious disease outbreaks: a systematic review

Charnley, Gina E. C. ; Kelman, Ilan ; Gaythorpe, Katy A. M. ; [et al.]

Springer Science and Business Media LLC ; 2021

In: Scientific Reports Vol. 11, No. 1 ( 2021-03-10)

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In: Scientific Reports, Springer Science and Business Media LLC, Vol. 11, No. 1 ( 2021-03-10)

Abstract: Infectious disease outbreaks are increasingly recognised as events that exacerbate impacts or prolong recovery following disasters. Yet, our understanding of the frequency, geography, characteristics and risk factors of post-disaster disease outbreaks globally is lacking. This limits the extent to which disease outbreak risks can be prepared for, monitored and responded to following disasters. Here, we conducted a global systematic review of post-disaster outbreaks and found that outbreaks linked to conflicts and hydrological events were most frequently reported, and most often caused by bacterial and water-borne agents. Lack of adequate WASH facilities and poor housing were commonly reported risk factors. Displacement, through infrastructure damage, can lead to risk cascades for disease outbreaks; however, displacement can also be an opportunity to remove people from danger and ultimately protect health. The results shed new light on post-disaster disease outbreaks and their risks. Understanding these risk factors and cascades, could help improve future region-specific disaster risk reduction.

Type of Medium: Online Resource

ISSN: 2045-2322

URL: Article

DOI: 10.1038/s41598-021-85146-0

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2021

detail.hit.zdb_id: 2615211-3

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Cholera past and future in Nigeria: Are the Global Task Force on Cholera Control’s 2030 targets achievable?

Charnley, Gina E. C. ; Yennan, Sebastian ; Ochu, Chinwe ; [et al.]

Public Library of Science (PLoS) ; 2023

In: PLOS Neglected Tropical Diseases Vol. 17, No. 5 ( 2023-5-1), p. e0011312-

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In: PLOS Neglected Tropical Diseases, Public Library of Science (PLoS), Vol. 17, No. 5 ( 2023-5-1), p. e0011312-

Abstract: Understanding and continually assessing the achievability of global health targets is key to reducing disease burden and mortality. The Global Task Force on Cholera Control (GTFCC) Roadmap aims to reduce cholera deaths by 90% and eliminate the disease in twenty countries by 2030. The Roadmap has three axes focusing on reporting, response and coordination. Here, we assess the achievability of the GTFCC targets in Nigeria and identify where the three axes could be strengthened to reach and exceed these goals. Methodology/Principal findings Using cholera surveillance data from Nigeria, cholera incidence was calculated and used to model time-varying reproduction number (R). A best fit random forest model was identified using R as the outcome variable and several environmental and social covariates were considered in the model, using random forest variable importance and correlation clustering. Future scenarios were created (based on varying degrees of socioeconomic development and emissions reductions) and used to project future cholera transmission, nationally and sub-nationally to 2070. The projections suggest that significant reductions in cholera cases could be achieved by 2030, particularly in the more developed southern states, but increases in cases remain a possibility. Meeting the 2030 target, nationally, currently looks unlikely and we propose a new 2050 target focusing on reducing regional inequities, while still advocating for cholera elimination being achieved as soon as possible. Conclusion/Significance The 2030 targets could potentially be reached by 2030 in some parts of Nigeria, but more effort is needed to reach these targets at a national level, particularly through access and incentives to cholera testing, sanitation expansion, poverty alleviation and urban planning. The results highlight the importance of and how modelling studies can be used to inform cholera policy and the potential for this to be applied in other contexts.

Type of Medium: Online Resource

ISSN: 1935-2735

URL: Article

DOI: 10.1371/journal.pntd.0011312

DOI: 10.1371/journal.pntd.0011312.g001

DOI: 10.1371/journal.pntd.0011312.g002

DOI: 10.1371/journal.pntd.0011312.g003

DOI: 10.1371/journal.pntd.0011312.g004

DOI: 10.1371/journal.pntd.0011312.g005

DOI: 10.1371/journal.pntd.0011312.t001

DOI: 10.1371/journal.pntd.0011312.t002

DOI: 10.1371/journal.pntd.0011312.s001

DOI: 10.1371/journal.pntd.0011312.s002

DOI: 10.1371/journal.pntd.0011312.s003

DOI: 10.1371/journal.pntd.0011312.s004

DOI: 10.1371/journal.pntd.0011312.r001

DOI: 10.1371/journal.pntd.0011312.r002

DOI: 10.1371/journal.pntd.0011312.r003

DOI: 10.1371/journal.pntd.0011312.r004

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2023

detail.hit.zdb_id: 2429704-5

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Charnley, Gina E. C. ; Kelman, Ilan ; Murray, Kris A.

Informa UK Limited ; 2022

In: Pathogens and Global Health Vol. 116, No. 1 ( 2022-01-02), p. 3-12

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In: Pathogens and Global Health, Informa UK Limited, Vol. 116, No. 1 ( 2022-01-02), p. 3-12

Type of Medium: Online Resource

ISSN: 2047-7724 , 2047-7732

URL: Article

DOI: 10.1080/20477724.2021.1981716

Language: English

Publisher: Informa UK Limited

Publication Date: 2022

detail.hit.zdb_id: 2658171-1

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Evaluating the risk of conflict on recent Ebola outbreaks in Guinea and the Democratic Republic of the Congo

Charnley, Gina E. C. ; Green, Nathan ; Kelman, Ilan ; [et al.]

Springer Science and Business Media LLC ; 2024

In: BMC Public Health Vol. 24, No. 1 ( 2024-03-20)

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In: BMC Public Health, Springer Science and Business Media LLC, Vol. 24, No. 1 ( 2024-03-20)

Abstract: Reducing Ebola virus transmission relies on the ability to identify cases and limit contact with infected bodily fluids through biosecurity, safe sex practices, safe burial and vaccination. Armed conflicts can complicate outbreak detection and interventions due to widespread disruption to governments and populations. Guinea and the Democratic Republic of the Congo (DRC) have historically reported the largest and the most recent Ebola virus outbreaks. Understanding if conflict played a role in these outbreaks may help in identifying key risks factors to improve disease control. Methods We used data from a range of publicly available data sources for both Ebola virus cases and conflict events from 2018 to 2021 in Guinea and the DRC. We fitted these data to conditional logistic regression models using the Self-Controlled Case Series methodology to evaluate the magnitude in which conflict increased the risk of reported Ebola virus cases in terms of incidence rate ratio. We re-ran the analysis sub-nationally, by conflict sub-event type and tested any lagged effects. Results Conflict was significantly associated with an increased risk of reported Ebola virus cases in both the DRC and Guinea in recent outbreaks. The effect was of a similar magnitude at 1.88- and 1.98-times increased risk for the DRC and Guinea, respectively. The greatest effects (often higher than the national values) were found in many conflict prone areas and during protest/riot-related conflict events. Conflict was influential in terms of Ebola virus risk from 1 week following the event and remained important by 10 weeks. Conclusion Extra vigilance is needed following protests and riot-related conflict events in terms of Ebola virus transmission. These events are highly disruptive, in terms of access to transportation and healthcare and are often in urban areas with high population densities. Additional public health messaging around these types of conflict events, relating to the risks and clinical symptoms may be helpful in reducing transmission. Future work should aim to further understand and quantify conflict severity and intensity, to evaluate dose–response relationships in terms of disease risk.

Type of Medium: Online Resource

ISSN: 1471-2458

URL: Article

DOI: 10.1186/s12889-024-18300-8

Language: English

Publisher: Springer Science and Business Media LLC

Publication Date: 2024

detail.hit.zdb_id: 2041338-5

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The impact of social and environmental extremes on cholera time varying reproduction number in Nigeria

Charnley, Gina E. C. ; Yennan, Sebastian ; Ochu, Chinwe ; [et al.]

Public Library of Science (PLoS) ; 2022

In: PLOS Global Public Health Vol. 2, No. 12 ( 2022-12-14), p. e0000869-

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In: PLOS Global Public Health, Public Library of Science (PLoS), Vol. 2, No. 12 ( 2022-12-14), p. e0000869-

Abstract: Nigeria currently reports the second highest number of cholera cases in Africa, with numerous socioeconomic and environmental risk factors. Less investigated are the role of extreme events, despite recent work showing their potential importance. To address this gap, we used a machine learning approach to understand the risks and thresholds for cholera outbreaks and extreme events, taking into consideration pre-existing vulnerabilities. We estimated time varying reproductive number (R) from cholera incidence in Nigeria and used a machine learning approach to evaluate its association with extreme events (conflict, flood, drought) and pre-existing vulnerabilities (poverty, sanitation, healthcare). We then created a traffic-light system for cholera outbreak risk, using three hypothetical traffic-light scenarios (Red, Amber and Green) and used this to predict R. The system highlighted potential extreme events and socioeconomic thresholds for outbreaks to occur. We found that reducing poverty and increasing access to sanitation lessened vulnerability to increased cholera risk caused by extreme events (monthly conflicts and the Palmers Drought Severity Index). The main limitation is the underreporting of cholera globally and the potential number of cholera cases missed in the data used here. Increasing access to sanitation and decreasing poverty reduced the impact of extreme events in terms of cholera outbreak risk. The results here therefore add further evidence of the need for sustainable development for disaster prevention and mitigation and to improve health and quality of life.

Type of Medium: Online Resource

ISSN: 2767-3375

URL: Article

DOI: 10.1371/journal.pgph.0000869

DOI: 10.1371/journal.pgph.0000869.g001

DOI: 10.1371/journal.pgph.0000869.g002

DOI: 10.1371/journal.pgph.0000869.g003

DOI: 10.1371/journal.pgph.0000869.g004

DOI: 10.1371/journal.pgph.0000869.g005

DOI: 10.1371/journal.pgph.0000869.g006

DOI: 10.1371/journal.pgph.0000869.g007

DOI: 10.1371/journal.pgph.0000869.s001

DOI: 10.1371/journal.pgph.0000869.s002

DOI: 10.1371/journal.pgph.0000869.s003

DOI: 10.1371/journal.pgph.0000869.s004

DOI: 10.1371/journal.pgph.0000869.s005

DOI: 10.1371/journal.pgph.0000869.s006

DOI: 10.1371/journal.pgph.0000869.s007

DOI: 10.1371/journal.pgph.0000869.s008

DOI: 10.1371/journal.pgph.0000869.s009

DOI: 10.1371/journal.pgph.0000869.s010

DOI: 10.1371/journal.pgph.0000869.s011

DOI: 10.1371/journal.pgph.0000869.s012

DOI: 10.1371/journal.pgph.0000869.r001

DOI: 10.1371/journal.pgph.0000869.r002

DOI: 10.1371/journal.pgph.0000869.r003

DOI: 10.1371/journal.pgph.0000869.r004

DOI: 10.1371/journal.pgph.0000869.r005

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2022

detail.hit.zdb_id: 3101394-6

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Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Parker, Chris C ; Clarke, Noel W ; Cook, Adrian D ; [et al.]

Elsevier BV ; 2024

In: The Lancet Vol. 403, No. 10442 ( 2024-06), p. 2405-2415

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In: The Lancet, Elsevier BV, Vol. 403, No. 10442 ( 2024-06), p. 2405-2415

Type of Medium: Online Resource

ISSN: 0140-6736

URL: Article

DOI: 10.1016/S0140-6736(24)00548-8

RVK:

XA 10000

Language: English

Publisher: Elsevier BV

Publication Date: 2024

detail.hit.zdb_id: 2067452-1

detail.hit.zdb_id: 3306-6

detail.hit.zdb_id: 1476593-7

SSG: 5,21

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Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Parker, Chris C ; Kynaston, Howard ; Cook, Adrian D ; [et al.]

Elsevier BV ; 2024

In: The Lancet Vol. 403, No. 10442 ( 2024-06), p. 2416-2425

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In: The Lancet, Elsevier BV, Vol. 403, No. 10442 ( 2024-06), p. 2416-2425

Type of Medium: Online Resource

ISSN: 0140-6736

URL: Article

DOI: 10.1016/S0140-6736(24)00549-X

RVK:

XA 10000

Language: English

Publisher: Elsevier BV

Publication Date: 2024

detail.hit.zdb_id: 2067452-1

detail.hit.zdb_id: 3306-6

detail.hit.zdb_id: 1476593-7

SSG: 5,21

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