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Nujum ZT, Asaria M, Kurup KK, Mini M, Mazumdar S, Daptardar M, Tiwari H. Cost-effectiveness of One Health interventions for rabies elimination: a systematic review. Trans R Soc Trop Med Hyg 2024; 118:223-233. [PMID: 37903657 DOI: 10.1093/trstmh/trad074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/31/2023] [Accepted: 10/05/2023] [Indexed: 11/01/2023] Open
Abstract
The 'One Health' (OH) approach is the most promising idea in realising the global goal of eliminating canine-mediated human rabies by 2030. However, taking an OH approach to rabies elimination can mean many different things to different people. We conducted a systematic review scrutinizing economic evaluations (EEs) retrieved from MEDLINE OVID, Embase OVID, Global Health OVID, CINAHL EBSCO and ECONLIT EBSCO that used the OH approach with the intent of identifying cost-effective sets of interventions that can be combined to implement an optimal OH-based rabies elimination program and highlight key gaps in the knowledge base. Our review suggests that an optimal OH program to tackle rabies should incorporate mass dog vaccination and integrated bite case management in combination with efficient use of post-exposure prophylaxis along with a shift to a 1-week abbreviated intradermal rabies vaccine regimen in humans. We recommend that future EEs of OH interventions for rabies elimination should be performed alongside implementation research to ensure proposed interventions are feasible and adopt a wider societal perspective taking into account costs and outcomes across both the human health and animal welfare sectors. The systematic review has been registered with PROSPERO.
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Affiliation(s)
- Zinia T Nujum
- Senior Visiting Fellow, Department of Health Policy, London School of Economics and Political Science, London WC2A2AE, UK
| | - Miqdad Asaria
- Assistant Professor, Department of Health Policy, London School of Economics and Political Science, London WC2A2AE, UK
| | - Karishma Krishna Kurup
- Research Fellow, Center for Universal Health, Chatham House (Royal Institute of International Affairs) London, UK
| | - Malathi Mini
- MSc Global Health Policy Candidate, London School of Economics and Political Science, London WC2A2AE, UK
| | - Sumit Mazumdar
- Research Fellow (Global Health), Centre for Health Economics, University of York Visiting Senior Fellow, Institute for Human Development, New Delhi, India
| | | | - Harish Tiwari
- DBT Wellcome India Alliance CPH Intermediate Fellow, Indian Institute of Technology Guwahati, Assam, India
- Research Affiliate, University of Sydney, Sydney, NSW, Australia
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Nunan D, Bashir K, Bilimoria K, Birdi J, Campbell F, Dean R, Downer MB, Costa GG, Golob MM, Heintzman A, Howe MS, Karunananthan S, Kurup KK, Leinberger-Jabari A, Luo Y, Mathe N, Miguel RTD, Morrow RL, Scobie C, South V, Stavisky J, Yadav UN. Ten resources for understanding bias in health research: EBM live workshop 2022. BMJ Evid Based Med 2023; 28:337-340. [PMID: 37479244 DOI: 10.1136/bmjebm-2023-112344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/07/2023] [Indexed: 07/23/2023]
Affiliation(s)
- David Nunan
- Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kainat Bashir
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Krish Bilimoria
- Department of Medicine, McGill University, Toronto, Ontario, UK
| | | | - Fiona Campbell
- Population Health Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Rachel Dean
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | - Matthew B Downer
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Gabriel Gonçalves Costa
- Instituto de Bioquímica Médica Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Melanie M Golob
- Department of Continuing Education, University of Oxford, Oxford, UK
| | - Angille Heintzman
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mark Steven Howe
- Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK
| | - Sathya Karunananthan
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Andrea Leinberger-Jabari
- Department of Continuing Education, University of Oxford, Oxford, UK
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, UAE
| | - Yan Luo
- Department of Health Promotion and Human Behavior, Faculty of Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Nonsikelelo Mathe
- Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | | | - Richard L Morrow
- Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | - Uday Narayan Yadav
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
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Mwatondo A, Rahman-Shepherd A, Hollmann L, Chiossi S, Maina J, Kurup KK, Hassan OA, Coates B, Khan M, Spencer J, Mutono N, Thumbi SM, Muturi M, Mutunga M, Arruda LB, Akhbari M, Ettehad D, Ntoumi F, Scott TP, Nel LH, Ellis-Iversen J, Sönksen UW, Onyango D, Ismail Z, Simachew K, Wolking D, Kazwala R, Sijali Z, Bett B, Heymann D, Kock R, Zumla A, Dar O. A global analysis of One Health Networks and the proliferation of One Health collaborations. Lancet 2023; 401:605-616. [PMID: 36682370 DOI: 10.1016/s0140-6736(22)01596-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/14/2022] [Accepted: 08/11/2022] [Indexed: 01/21/2023]
Abstract
There has been a renewed focus on threats to the human-animal-environment interface as a result of the COVID-19 pandemic, and investments in One Health collaborations are expected to increase. Efforts to monitor the development of One Health Networks (OHNs) are essential to avoid duplication or misalignment of investments. This Series paper shows the global distribution of existing OHNs and assesses their collective characteristics to identify potential deficits in the ways OHNs have formed and to help increase the effectiveness of investments. We searched PubMed, Google, Google Scholar, and relevant conference websites for potential OHNs and identified 184 worldwide for further analysis. We developed four case studies to show important findings from our research and exemplify best practices in One Health operationalisation. Our findings show that, although more OHNs were formed in the past 10 years than in the preceding decade, investment in OHNs has not been equitably distributed; more OHNs are formed and headquartered in Europe than in any other region, and emerging infections and novel pathogens were the priority focus area for most OHNs, with fewer OHNs focusing on other important hazards and pressing threats to health security. We found substantial deficits in the OHNs collaboration model regarding the diversity of stakeholder and sector representation, which we argue impedes effective and equitable OHN formation and contributes to other imbalances in OHN distribution and priorities. These findings are supported by previous evidence that shows the skewed investment in One Health thus far. The increased attention to One Health after the COVID-19 pandemic is an opportunity to focus efforts and resources to areas that need them most. Analyses, such as this Series paper, should be used to establish databases and repositories of OHNs worldwide. Increased attention should then be given to understanding existing resource allocation and distribution patterns, establish more egalitarian networks that encompass the breadth of One Health issues, and serve communities most affected by emerging, re-emerging, or endemic threats at the human-animal-environment interface.
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Affiliation(s)
- Athman Mwatondo
- Zoonotic Disease Unit, Ministry of Health, Nairobi, Kenya; International Livestock Research Institute, Nairobi, Kenya; Royal Institute of International Affairs, London, UK.
| | - Afifah Rahman-Shepherd
- London School of Hygiene & Tropical Medicine, London, UK; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Royal Institute of International Affairs, London, UK
| | - Lara Hollmann
- Royal Institute of International Affairs, London, UK
| | - Scott Chiossi
- Royal Institute of International Affairs, London, UK
| | - Josphat Maina
- Zoonotic Disease Unit, Ministry of Health, Nairobi, Kenya; International Livestock Research Institute, Nairobi, Kenya
| | | | | | | | - Mishal Khan
- London School of Hygiene & Tropical Medicine, London, UK; Department of Community Health Sciences and Department of Pathology, Aga Khan University, Karachi, Pakistan; Royal Institute of International Affairs, London, UK
| | - Julia Spencer
- London School of Hygiene & Tropical Medicine, London, UK
| | - Nyamai Mutono
- Paul G Allen School for Global Animal Health, Washington State University, Pullman, WA, USA; Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Samuel M Thumbi
- Paul G Allen School for Global Animal Health, Washington State University, Pullman, WA, USA; Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya; Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, UK
| | - Mathew Muturi
- Zoonotic Disease Unit, Ministry of Agriculture, Livestock, and Fisheries, Nairobi, Kenya; International Livestock Research Institute, Nairobi, Kenya
| | - Mumbua Mutunga
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Liã Bárbara Arruda
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK
| | - Melika Akhbari
- Clinical Academic Training Office, University of Cambridge, Cambridge, UK
| | - Dena Ettehad
- Academic Foundation Programme, Faculty of Medicine, Imperial College London, Imperial College Healthcare NHS Trust, London, UK
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Democratic Republic of the Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | | | - Louis H Nel
- Department of Biochemistry, Genetics, and Microbiology, University of Pretoria, Pretoria, South Africa
| | | | - Ute Wolff Sönksen
- National Centre for Antimicrobials and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Diana Onyango
- The One Health for Humans, Environment, Animals and Livelihoods Project, Addis Ababa, Ethiopia
| | - Zuleka Ismail
- The One Health for Humans, Environment, Animals and Livelihoods Project, Addis Ababa, Ethiopia
| | - Kebadu Simachew
- The One Health for Humans, Environment, Animals and Livelihoods Project, Addis Ababa, Ethiopia
| | - David Wolking
- One Health Institute, University of California, Davis, CA, USA
| | - Rudovick Kazwala
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Zikankuba Sijali
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Bernard Bett
- International Livestock Research Institute, Nairobi, Kenya
| | - David Heymann
- Department of Infectious Disease Epidemiology, London, UK
| | - Richard Kock
- Royal Veterinary College, University of London, London, UK
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, University College London, London, UK; National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - Osman Dar
- Global Health Programme, Royal Institute of International Affairs, London, UK; Global Operations, UK Health Security Agency, London, UK
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Vogt F, Kurup KK, Mussleman P, Habrun C, Crowe M, Woodward A, Jaramillo-Gutierrez G, Kaldor J, Vong S, del Rio Vilas V. Contact tracing indicators for COVID-19: Rapid scoping review and conceptual framework. PLoS One 2022; 17:e0264433. [PMID: 35226699 PMCID: PMC8884491 DOI: 10.1371/journal.pone.0264433] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 02/10/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Contact tracing is one of the key interventions in response to the COVID-19 pandemic but its implementation varies widely across countries. There is little guidance on how to monitor contact tracing performance, and no systematic overview of indicators to assess contact tracing systems or conceptual framework for such indicators exists to date. METHODS We conducted a rapid scoping review using a systematic literature search strategy in the peer-reviewed and grey literature as well as open source online documents. We developed a conceptual framework to map indicators by type (input, process, output, outcome, impact) and thematic area (human resources, financial resources, case investigation, contact identification, contact testing, contact follow up, case isolation, contact quarantine, transmission chain interruption, incidence reduction). RESULTS We identified a total of 153 contact tracing indicators from 1,555 peer-reviewed studies, 894 studies from grey literature sources, and 15 sources from internet searches. Two-thirds of indicators were process indicators (102; 67%), while 48 (31%) indicators were output indicators. Only three (2%) indicators were input indicators. Indicators covered seven out of ten conceptualized thematic areas, with more than half being related to either case investigation (37; 24%) or contact identification (44; 29%). There were no indicators for the input area "financial resources", the outcome area "transmission chain interruption", and the impact area "incidence reduction". CONCLUSIONS Almost all identified indicators were either process or output indicators focusing on case investigation, contact identification, case isolation or contact quarantine. We identified important gaps in input, outcome and impact indicators, which constrains evidence-based assessment of contact tracing systems. A universally agreed set of indicators is needed to allow for cross-system comparisons and to improve the performance of contact tracing systems.
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Affiliation(s)
- Florian Vogt
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, The Australian Capital Territory, Australia
| | | | - Paul Mussleman
- University Libraries, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Caroline Habrun
- New Mexico Emerging Infections Program, University of New Mexico, Albuquerque, New Mexico, United States of America
| | - Madeleine Crowe
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Alexandra Woodward
- Armed Forces Health Surveillance Division, U.S. Department of Defense, Global Emerging Infections Surveillance, Silver Spring, Maryland, United States of America
| | | | - John Kaldor
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Sirenda Vong
- South East Asia Regional Office, World Health Organization, New Delhi, India
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Sharma S, Goel K, Kurup KK, Grover GS, Bhaskar R. COVID-19 in Punjab, India: Epidemiological patterns, laboratory surveillance and contact tracing of COVID-19 cases, March-May 2020. Clin Epidemiol Glob Health 2021; 11:100769. [PMID: 33997478 PMCID: PMC8105128 DOI: 10.1016/j.cegh.2021.100769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 04/22/2021] [Accepted: 04/30/2021] [Indexed: 11/24/2022] Open
Abstract
Background In Punjab, first COVID-19 case was detected on March 5, 2020 followed by multiple clusters. Understanding the epidemiology of reported COVID-19 cases helps decision makers in planning future responses. We described the epidemiological patterns, laboratory surveillance and contact tracing of COVID-19 cases in Punjab. Methods We analysed state's COVID-19 data from March-May 2020 to describe time, place and person distribution. We analysed the laboratory surveillance and contact tracing reports to calculate frequency of testing, sample positivity rate (PR) and contacts traced per case. Findings A total of 2256 cases were reported from March-May 2020 (attack rate 75 cases/million and case fatality rate 2%). Attack rate was higher among males (81 cases/million males) and maximum affected age group was 60-69 years (164∙5 cases/million). Five of 22 districts reported almost half cases in May's first week. Mortality rate was highest among individuals >60 years (six deaths/million) and males (two deaths/million males). Of 45 deaths, 41 reported comorbidities [(hypertension (42%), diabetes (40%)]. COVID-19 testing increased from 46 samples/day (PR: 2%) in March's first week to 4000 samples/day (PR: 2∙5%) by May's end (2752 tests/million). Amritsar conducted 2035 tests/million (highest PR: 6∙5%) while Barnala conducted 4158 tests/million (lowest PR: 1%). For 2256 cases, 19,432 contacts were traced (nine contacts/case) with 11% positivity rate. Interpretation COVID-19 in Punjab mostly affected males, >60 years of age and individuals with comorbid conditions. Many districts with less testing and contact tracing had higher positivity rate. We recommended to implement and ensure adequate testing and contact tracing in all the districts of Punjab.
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Affiliation(s)
- Sahil Sharma
- National Centre for Disease Control (NCDC), Delhi, India
| | - Kapil Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Nair M, Kumar P, Mahajan R, Harshana A, Kurup KK, Moreto-Planas L, Burza S. Knowledge, Attitudes, and Practices Regarding Palliative Care: A Mixed-Methods Study from Bihar, India. J Palliat Care 2020; 36:9-11. [PMID: 32727299 DOI: 10.1177/0825859720946514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mohit Nair
- 16309Medecins Sans Frontieres, New Delhi, India
| | - Pragya Kumar
- All India Institute of Medical Sciences, Patna, India
| | | | | | | | | | - Sakib Burza
- 16309Medecins Sans Frontieres, New Delhi, India
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Kurup KK, Manickam P, Gurav Y. Infected food handlers led to an outbreak of hepatitis A in Ernakulam district, Kerala, Southern India, 2016. Clinical Epidemiology and Global Health 2020. [DOI: 10.1016/j.cegh.2019.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Kumar CPG, Sugunan AP, Yadav P, Kurup KK, Aarathee R, Manickam P, Bhatnagar T, Radhakrishnan C, Thomas B, Kumar A, Jayasree J, Philomina B, Kumar KGS, Thulaseedharan NK, Gupta N, Rajendran R, Saritha RL, Mourya DT, Gangakhedkar RR, Murhekar MV. Infections among Contacts of Patients with Nipah Virus, India. Emerg Infect Dis 2019; 25:1007-1010. [PMID: 31002050 PMCID: PMC6478200 DOI: 10.3201/eid2505.181352] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We conducted a serosurvey of 155 healthcare workers and 124 household and community members who had close contact with 18 patients who had laboratory-confirmed Nipah virus infections in Kerala, India. We detected 3 subclinical infections; 2 persons had IgM and IgG and 1 only IgM against Nipah virus.
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