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Wangdi K, Sheel M, Fuimaono S, Graves PM, Lau CL. Lymphatic filariasis in 2016 in American Samoa: Identifying clustering and hotspots using non-spatial and three spatial analytical methods. PLoS Negl Trop Dis 2022; 16:e0010262. [PMID: 35344542 PMCID: PMC8989349 DOI: 10.1371/journal.pntd.0010262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/24/2021] [Revised: 04/07/2022] [Accepted: 02/15/2022] [Indexed: 02/04/2023] Open
Abstract
Background
American Samoa completed seven rounds of mass drug administration from 2000–2006 as part of the Global Programme to Eliminate Lymphatic Filariasis (LF). However, resurgence was confirmed in 2016 through WHO-recommended school-based transmission assessment survey and a community-based survey. This paper uses data from the 2016 community survey to compare different spatial and non-spatial methods to characterise clustering and hotspots of LF.
Method
Non-spatial clustering of infection markers (antigen [Ag], microfilaraemia [Mf], and antibodies (Ab [Wb123, Bm14, Bm33]) was assessed using intra-cluster correlation coefficients (ICC) at household and village levels. Spatial dependence, clustering and hotspots were examined using semivariograms, Kulldorf’s scan statistic and Getis-Ord Gi* statistics based on locations of surveyed households.
Results
The survey included 2671 persons (750 households, 730 unique locations in 30 villages). ICCs were higher at household (0.20–0.69) than village levels (0.10–0.30) for all infection markers. Semivariograms identified significant spatial dependency for all markers (range 207–562 metres). Using Kulldorff’s scan statistic, significant spatial clustering was observed in two previously known locations of ongoing transmission: for all markers in Fagali’i and all Abs in Vaitogi. Getis-Ord Gi* statistic identified hotspots of all markers in Fagali’i, Vaitogi, and Pago Pago-Anua areas. A hotspot of Ag and Wb123 Ab was identified around the villages of Nua-Seetaga-Asili. Bm14 and Bm33 Ab hotspots were seen in Maleimi and Vaitogi-Ili’ili-Tafuna.
Conclusion
Our study demonstrated the utility of different non-spatial and spatial methods for investigating clustering and hotspots, the benefits of using multiple infection markers, and the value of triangulating results between methods.
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Affiliation(s)
- Kinley Wangdi
- Department of Global Health, Research School of Population Health, College of Health and Medicine, Australian National University, Acton, Canberra, Australia
- * E-mail:
| | - Meru Sheel
- National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Acton, Canberra, Australia
| | | | - Patricia M. Graves
- College of Public Health, Medical and Veterinary Sciences and Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Colleen L. Lau
- Department of Global Health, Research School of Population Health, College of Health and Medicine, Australian National University, Acton, Canberra, Australia
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia
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Spedding M, Kohrt B, Myers B, Stein DJ, Petersen I, Lund C, Sorsdahl K. ENhancing Assessment of Common Therapeutic factors (ENACT) tool: adaptation and psychometric properties in South Africa. Glob Ment Health (Camb) 2022; 9:375-383. [PMID: 36618718 PMCID: PMC9806986 DOI: 10.1017/gmh.2022.40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 06/22/2022] [Accepted: 07/11/2022] [Indexed: 01/11/2023] Open
Abstract
Background The ENhancing Assessment of Common Therapeutic factors (ENACT) tool measures a set of therapeutic competencies required for the effective psychological intervention, including delivery by non-specialists. This paper describes the systematic adaptation of the ENACT for the South African (SA) context and presents the tool's initial psychometric properties. Methods We employed a four-step process: (1) Item generation: 204 therapeutic factors were generated by SA psychologists and drawn from the original ENACT as potential items; (2) Item relevance: SA therapists identified 96 items that were thematically coded according to their relationship to one another and were assigned to six domains; (3) Item utility: The ENACT-SA scale was piloted by rating recordings of psychological therapy sessions and stakeholder input; and (4) Psychometric properties: Internal consistency and inter-rater reliability of the final 12-item ENACT-SA were explored using Cronbach's alpha and intraclass correlation co-efficient (ICC) for both clinical psychologists and registered counsellors. Results Although the original ENACT provided a framework for developing a tool for use in SA, several modifications were made to improve the applicability of the tool for the SA context, and optimise its adaptability other contexts. The adapted 12-item tool's internal consistency was good, while the inter-rater reliability was acceptable for both clinical psychologists and registered counsellors. Conclusion The ENACT-SA is a reliable tool to assess common factors in psychological treatments. It is recommended that the tool be used in conjunction with assessment protocols and treatment-specific competency measures to fully assess implementation fidelity and potential mechanisms of therapeutic change.
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Affiliation(s)
- Maxine Spedding
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Brandon Kohrt
- Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
| | - Bronwyn Myers
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Western Australia, Australia
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Inge Petersen
- Center for Rural Health, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Crick Lund
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Katherine Sorsdahl
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Author for correspondence: Katherine Sorsdahl, E-mail:
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Darlow CA, Farrington N, Johnson A, McEntee L, Unsworth J, Jimenez-Valverde A, Kolamunnage-Dona R, Da Costa RMA, Ellis S, Franceschi F, Sharland M, Neely M, Piddock LJV, Das S, Hope W. OUP accepted manuscript. J Antimicrob Chemother 2022; 77:1334-1343. [PMID: 35170719 PMCID: PMC9047679 DOI: 10.1093/jac/dkac038] [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: 09/01/2021] [Accepted: 01/10/2022] [Indexed: 11/22/2022] Open
Abstract
Background Neonatal sepsis is a serious bacterial infection of neonates, globally killing up to 680 000 babies annually. It is frequently complicated by antimicrobial resistance, particularly in low- and middle-income country (LMIC) settings with widespread resistance to the WHO’s recommended empirical regimen of ampicillin and gentamicin. Objectives We assessed the utility of flomoxef and fosfomycin as a potential alternative empirical regimen for neonatal sepsis in these settings. Methods We studied the combination in a 16-arm dose-ranged hollow-fibre infection model (HFIM) experiment and chequerboard assays. We further assessed the combination using clinically relevant regimens in the HFIM with six Enterobacterales strains with a range of flomoxef/fosfomycin MICs. Results Pharmacokinetic/pharmacodynamic modelling of the HFIM experimental output, along with data from chequerboard assays, indicated synergy of this regimen in terms of bacterial killing and prevention of emergence of fosfomycin resistance. Flomoxef monotherapy was sufficient to kill 3/3 strains with flomoxef MICs ≤0.5 mg/L to sterility. Three of three strains with flomoxef MICs ≥8 mg/L were not killed by fosfomycin or flomoxef monotherapy; 2/3 of these were killed with the combination of the two agents. Conclusions These data suggest that flomoxef/fosfomycin could be an efficacious and synergistic regimen for the empirical treatment of neonatal sepsis in LMIC settings with prevalent antimicrobial resistance. Our HFIM results warrant further assessment of the flomoxef/fosfomycin combination in clinical trials.
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Affiliation(s)
- Christopher A. Darlow
- Antimicrobial Pharmacodynamics and Therapeutics, University of Liverpool, Liverpool Health Partners, UK
- Corresponding author: E-mail:
| | - Nicola Farrington
- Antimicrobial Pharmacodynamics and Therapeutics, University of Liverpool, Liverpool Health Partners, UK
| | - Adam Johnson
- Antimicrobial Pharmacodynamics and Therapeutics, University of Liverpool, Liverpool Health Partners, UK
| | - Laura McEntee
- Antimicrobial Pharmacodynamics and Therapeutics, University of Liverpool, Liverpool Health Partners, UK
| | - Jennifer Unsworth
- Antimicrobial Pharmacodynamics and Therapeutics, University of Liverpool, Liverpool Health Partners, UK
| | - Ana Jimenez-Valverde
- Antimicrobial Pharmacodynamics and Therapeutics, University of Liverpool, Liverpool Health Partners, UK
| | | | - Renata M A Da Costa
- Global Antibiotic Research and Development Partnership, 15 Chemin Camille-Vidart, 1202 Geneva, Switzerland
| | - Sally Ellis
- Global Antibiotic Research and Development Partnership, 15 Chemin Camille-Vidart, 1202 Geneva, Switzerland
| | - François Franceschi
- Global Antibiotic Research and Development Partnership, 15 Chemin Camille-Vidart, 1202 Geneva, Switzerland
| | - Mike Sharland
- Paediatric Infectious Diseases Research Group, St George’s, University of London, UK
| | - Michael Neely
- Children’s Hospital Los Angeles and the Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Laura J. V. Piddock
- Global Antibiotic Research and Development Partnership, 15 Chemin Camille-Vidart, 1202 Geneva, Switzerland
| | - Shampa Das
- Antimicrobial Pharmacodynamics and Therapeutics, University of Liverpool, Liverpool Health Partners, UK
| | - William Hope
- Antimicrobial Pharmacodynamics and Therapeutics, University of Liverpool, Liverpool Health Partners, UK
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Cao N, Tan K, Zuo X, Annamalai T, Tse-Dinh YC. Mechanistic insights from structure of Mycobacterium smegmatis topoisomerase I with ssDNA bound to both N- and C-terminal domains. Nucleic Acids Res 2020; 48:4448-4462. [PMID: 32232337 PMCID: PMC7192597 DOI: 10.1093/nar/gkaa201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/26/2019] [Revised: 02/20/2020] [Accepted: 03/18/2020] [Indexed: 12/17/2022] Open
Abstract
Type IA topoisomerases interact with G-strand and T-strand ssDNA to regulate DNA topology. However, simultaneous binding of two ssDNA segments to a type IA topoisomerase has not been observed previously. We report here the crystal structure of a type IA topoisomerase with ssDNA segments bound in opposite polarity to the N- and C-terminal domains. Titration of small ssDNA oligonucleotides to Mycobacterium smegmatis topoisomerase I with progressive C-terminal deletions showed that the C-terminal region has higher affinity for ssDNA than the N-terminal active site. This allows the C-terminal domains to capture one strand of underwound negatively supercoiled DNA substrate first and position the N-terminal domains to bind and cleave the opposite strand in the relaxation reaction. Efficiency of negative supercoiling relaxation increases with the number of domains that bind ssDNA primarily with conserved aromatic residues and possibly with assistance from polar/basic residues. A comparison of bacterial topoisomerase I structures showed that a conserved transesterification unit (N-terminal toroid structure) for cutting and rejoining of a ssDNA strand can be combined with two different types of C-terminal ssDNA binding domains to form diverse bacterial topoisomerase I enzymes that are highly efficient in their physiological role of preventing excess negative supercoiling in the genome.
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Affiliation(s)
- Nan Cao
- Department of Chemistry and Biochemistry, Florida International University, Miami, FL 33199, USA
- Biomolecular Sciences Institute, Florida International University, 11200 SW 8 St, Miami, FL 33199, USA
| | - Kemin Tan
- Structural Biology Center, X-ray Science Division, Advanced Photon Source, Argonne National Laboratory, 9700 S. Cass Avenue, Lemont, IL 60439, USA
| | - Xiaobing Zuo
- X-ray Science Division, Advanced Photon Source, Argonne National Laboratory, 9700 S. Cass Avenue, Lemont, IL 60439, USA
| | - Thirunavukkarasu Annamalai
- Department of Chemistry and Biochemistry, Florida International University, Miami, FL 33199, USA
- Biomolecular Sciences Institute, Florida International University, 11200 SW 8 St, Miami, FL 33199, USA
| | - Yuk-Ching Tse-Dinh
- Department of Chemistry and Biochemistry, Florida International University, Miami, FL 33199, USA
- Biomolecular Sciences Institute, Florida International University, 11200 SW 8 St, Miami, FL 33199, USA
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Shafique M, Lopes S, Doum D, Keo V, Sokha L, Sam B, Vibol C, Alexander N, Bradley J, Liverani M, Hii J, Rithea L, Aryal S, Hustedt J. Implementation of guppy fish (Poecilia reticulata), and a novel larvicide (Pyriproxyfen) product (Sumilarv 2MR) for dengue control in Cambodia: A qualitative study of acceptability, sustainability and community engagement. PLoS Negl Trop Dis 2019; 13:e0007907. [PMID: 31738759 PMCID: PMC6886868 DOI: 10.1371/journal.pntd.0007907] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 05/27/2019] [Revised: 12/02/2019] [Accepted: 11/05/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In Cambodia dengue vector control activities are focused on larviciding with temephos and pyrethroid based adulticide sprays to which Aedes have been shown to be increasingly resistant. A cluster randomized trial assessed the impact of using biological control tools (guppy fish, pyriproxyfen (PPF), and Communication for Behavioral Impact (COMBI) activities in combination), which would be used in a value comparison to traditional chemical control tools. Given these new intervention methods, a qualitative assessment was designed in order to represent the quality of understanding, acceptance, and implementation by participants. METHODOLOGY/PRINCIPAL FINDINGS A total of 103 participants in 12 Focus Group Discussions (FGDs) and nine In-Depth Interviews (IDIs) were included in the study. The majority of participants in intervention villages (50 out of 80) preferred guppy fish over other vector control methods due to ease of use and rearing, quick reproduction and propensity to eat larvae. A substantial number of participants (11 out of 40) in intervention villages with PPF favored it due to long-lasting effectiveness, lack of smell and easy maintenance. Participants showed high demand for both interventions and were willing to pay between 100-500 riel (0.03-0.13 USD). Nearly all participants perceived that the interventions resulted in a reduction in Aedes mosquitos (both adults and immatures) and dengue cases. The presence of larvae in the water despite the use of PPF was a source of concern for some participants, although this was overcome in some cases with proper health education through health volunteers. Interpersonal communication through health volunteers was the most favorite method of transmitting prevention messages. CONCLUSIONS/SIGNIFICANCE The community led COMBI strategy resulted in high acceptance and perceived effectiveness of the interventions in target villages. Health volunteers are an effective and accepted channel of communication to engage communities, disseminate information and promote behavioral change at the household and community level. If shown effective through corresponding entomological surveys, the interventions should be continued and further strengthened to ensure they are accessible, available and affordable.
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Affiliation(s)
| | - Sergio Lopes
- Technical Department, Malaria Consortium, Phnom Penh, Cambodia
| | - Dyna Doum
- Technical Department, Malaria Consortium, Phnom Penh, Cambodia
| | - Vanney Keo
- Technical Department, Malaria Consortium, Phnom Penh, Cambodia
| | - Ly Sokha
- National Dengue Control Program, National Center of Parasitology, Entomology, and Malaria Control, Phnom Penh, Cambodia
| | - BunLeng Sam
- National Dengue Control Program, National Center of Parasitology, Entomology, and Malaria Control, Phnom Penh, Cambodia
| | - Chan Vibol
- Malaria and other Vector-borne and Parasitic diseases, World Health Organization, Phnom Penh, Cambodia
| | - Neal Alexander
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - John Bradley
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Marco Liverani
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jeffrey Hii
- Technical Department, Malaria Consortium, Phnom Penh, Cambodia
| | - Leang Rithea
- National Dengue Control Program, National Center of Parasitology, Entomology, and Malaria Control, Phnom Penh, Cambodia
| | - Siddhi Aryal
- Technical Department, Malaria Consortium, Phnom Penh, Cambodia
| | - John Hustedt
- Technical Department, Malaria Consortium, Phnom Penh, Cambodia
- Malaria and other Vector-borne and Parasitic diseases, World Health Organization, Phnom Penh, Cambodia
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