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Noé A, Dang TD, Axelrad C, Burrell E, Germano S, Elia S, Burgner D, Perrett KP, Curtis N, Messina NL. BNT162b2 COVID-19 vaccination in children alters cytokine responses to heterologous pathogens and Toll-like receptor agonists. Front Immunol 2023; 14:1242380. [PMID: 37691937 PMCID: PMC10485613 DOI: 10.3389/fimmu.2023.1242380] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/24/2023] [Indexed: 09/12/2023] Open
Abstract
Background Vaccines can have beneficial off-target (heterologous) effects that alter immune responses to, and protect against, unrelated infections. The heterologous effects of COVID-19 vaccines have not been investigated in children. Aim To investigate heterologous and specific immunological effects of BNT162b2 COVID-19 vaccination in children. Methods A whole blood stimulation assay was used to investigate in vitro cytokine responses to heterologous stimulants (killed pathogens, Toll-like receptor ligands) and SARS-CoV-2 antigens. Samples from 29 children, aged 5-11 years, before and 28 days after a second BNT162b2 vaccination were analysed (V2 + 28). Samples from eight children were analysed six months after BNT162b2 vaccination. Results At V2 + 28, interferon-γ and monocyte chemoattractant protein-1 responses to S. aureus, E. coli, L. monocytogenes, BCG vaccine, H. influenzae, hepatitis B antigen, poly(I:C) and R848 stimulations were decreased compared to pre-vaccination. For most of these heterologous stimulants, IL-6, IL-15 and IL-17 responses were also decreased. There were sustained decreases in cytokine responses to viral, but not bacterial, stimulants six months after BNT162b2 vaccination. Cytokine responses to irradiated SARS-CoV-2, and spike glycoprotein subunits (S1 and S2) were increased at V2 + 28 for most cytokines and remained higher than pre-vaccination responses 6 months after BNT162b2 vaccination for irradiated SARS-CoV-2 and S1. There was no correlation between BNT162b2 vaccination-induced anti-SARS-CoV2-receptor binding domain IgG antibody titre at V2 + 28 and cytokine responses. Conclusions BNT162b2 vaccination in children alters cytokine responses to heterologous stimulants, particularly one month after vaccination. This study is the first to report the immunological heterologous effects of COVID-19 vaccination in children.
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Affiliation(s)
- Andrés Noé
- Infection, Immunity and Global Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Infectious Diseases Unit, The Royal Children’s Hospital, Melbourne, Parkville, VIC, Australia
| | - Thanh D. Dang
- Infection, Immunity and Global Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Christine Axelrad
- Infection, Immunity and Global Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Emma Burrell
- Infection, Immunity and Global Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Susie Germano
- Infection, Immunity and Global Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Sonja Elia
- Infectious Diseases Unit, The Royal Children’s Hospital, Melbourne, Parkville, VIC, Australia
| | - David Burgner
- Infection, Immunity and Global Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Infectious Diseases Unit, The Royal Children’s Hospital, Melbourne, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Kirsten P. Perrett
- Infectious Diseases Unit, The Royal Children’s Hospital, Melbourne, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Population Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Nigel Curtis
- Infection, Immunity and Global Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Infectious Diseases Unit, The Royal Children’s Hospital, Melbourne, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Nicole L. Messina
- Infection, Immunity and Global Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
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Noé A, Datoo MS, Flaxman A, Husainy MA, Jenkin D, Bellamy D, Makinson RA, Morter R, Ramos Lopez F, Sheridan J, Voukantsis D, Prasad N, Hill AVS, Ewer KJ, Spencer AJ. Deep Immune Phenotyping and Single-Cell Transcriptomics Allow Identification of Circulating TRM-Like Cells Which Correlate With Liver-Stage Immunity and Vaccine-Induced Protection From Malaria. Front Immunol 2022; 13:795463. [PMID: 35197971 PMCID: PMC8859435 DOI: 10.3389/fimmu.2022.795463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 10/15/2021] [Accepted: 01/10/2022] [Indexed: 12/14/2022] Open
Abstract
Protection from liver-stage malaria requires high numbers of CD8+ T cells to find and kill Plasmodium-infected cells. A new malaria vaccine strategy, prime-target vaccination, involves sequential viral-vectored vaccination by intramuscular and intravenous routes to target cellular immunity to the liver. Liver tissue-resident memory (TRM) CD8+ T cells have been shown to be necessary and sufficient for protection against rodent malaria by this vaccine regimen. Ultimately, to most faithfully assess immunotherapeutic responses by these local, specialised, hepatic T cells, periodic liver sampling is necessary, however this is not feasible at large scales in human trials. Here, as part of a phase I/II P. falciparum challenge study of prime-target vaccination, we performed deep immune phenotyping, single-cell RNA-sequencing and kinetics of hepatic fine needle aspirates and peripheral blood samples to study liver CD8+ TRM cells and circulating counterparts. We found that while these peripheral ‘TRM-like’ cells differed to TRM cells in terms of previously described characteristics, they are similar phenotypically and indistinguishable in terms of key T cell residency transcriptional signatures. By exploring the heterogeneity among liver CD8+ TRM cells at single cell resolution we found two main subpopulations that each share expression profiles with blood T cells. Lastly, our work points towards the potential for using TRM−like cells as a correlate of protection by liver-stage malaria vaccines and, in particular, those adopting a prime-target approach. A simple and reproducible correlate of protection would be particularly valuable in trials of liver-stage malaria vaccines as they progress to phase III, large-scale testing in African infants. We provide a blueprint for understanding and monitoring liver TRM cells induced by a prime-target malaria vaccine approach.
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Affiliation(s)
- Andrés Noé
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
- *Correspondence: Andrés Noé, ; ; Alexandra J. Spencer,
| | - Mehreen S. Datoo
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Amy Flaxman
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | - Daniel Jenkin
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Duncan Bellamy
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | - Richard Morter
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | | | | | - Dimitrios Voukantsis
- Bioinformatics Hub, Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Naveen Prasad
- Bioinformatics Hub, Department of Oncology, University of Oxford, Oxford, United Kingdom
| | | | - Katie J. Ewer
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Alexandra J. Spencer
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
- *Correspondence: Andrés Noé, ; ; Alexandra J. Spencer,
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3
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Wedekind L, Noé A, Mokaya J, Tamandjou C, Kapulu M, Ruecker A, Kestelyn E, Zimba M, Khatamzas E, Eziefula AC, Mackintosh CL, Nascimento R, Ariana P, Best D, Gibbs E, Dunachie S, Hadley G, Ravenswood H, Young B, Kamau C, Marsh K, McShane H, Hale R, McPhilbin E, Ovseiko PV, Surender R, Worland C, White LJ, Matthews PC. Equity for excellence in academic institutions: a manifesto for change. Wellcome Open Res 2021; 6:142. [PMID: 34381874 PMCID: PMC8343400 DOI: 10.12688/wellcomeopenres.16861.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 11/20/2022] Open
Abstract
Higher academic institutions in the UK need to drive improvements in equity, diversity, and inclusion (EDI) through sustainable practical interventions. A broad view of inclusivity is based on an intersectional approach that considers race, geographical location, caring responsibilities, disability, neurodiversity, religion, and LGBTQIA+ identities. We describe the establishment of a diverse stakeholder group to develop practical grass-roots recommendations through which improvements can be advanced. We have developed a manifesto for change, comprising six domains through which academic institutions can drive progress through setting short, medium, and long-term priorities. Interventions will yield rewards in recruitment and retention of a diverse talent pool, leading to enhanced impact and output.
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Affiliation(s)
- Lauren Wedekind
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Andrés Noé
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jolynne Mokaya
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Cynthia Tamandjou
- Division of Health Economics, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Andrea Ruecker
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Evelyn Kestelyn
- Oxford University Clinical Research Unit (OUCRU), Hanoi, Vietnam
| | - Machilu Zimba
- Equality and Diversity Unit, University of Oxford, Oxford, UK
| | - Elham Khatamzas
- Department of Medicine III, University Hospital, LMU, Munich, Germany
- Regional Infectious Diseases Unit, Western General Hospital, Edinburgh, UK
| | | | | | - Roger Nascimento
- International Health and Tropical Medicine, Centre for Tropical Medicine and Global Health, Medawar Building, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Proochista Ariana
- International Health and Tropical Medicine, Centre for Tropical Medicine and Global Health, Medawar Building, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Denise Best
- Oxford University Clinical Academic Graduate School (OUCAGS), John Radcliffe Hospital, Oxford, UK
| | - Edward Gibbs
- Department of Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Susanna Dunachie
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
| | - Gina Hadley
- Department of Medicine, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
- Harris Manchester College, Oxford, UK
| | | | - Bernadette Young
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
| | | | - Kevin Marsh
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Africa Oxford Initiative, Medawar Building, University of Oxford, Oxford, UK
| | - Helen McShane
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
- NIHR BRC, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
| | - Rob Hale
- MaynardLeigh Associates, London, UK
| | - Elena McPhilbin
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Pavel V. Ovseiko
- Radcliffe Department of Medicine, John Radcliffe Hospital, Oxford, UK
| | - Oxford Equity in Academia consortium
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
- Division of Health Economics, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- KEMRI Wellcome Trust, Kilifi, Kenya
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Oxford University Clinical Research Unit (OUCRU), Hanoi, Vietnam
- Equality and Diversity Unit, University of Oxford, Oxford, UK
- Department of Medicine III, University Hospital, LMU, Munich, Germany
- Regional Infectious Diseases Unit, Western General Hospital, Edinburgh, UK
- University of Sussex, Falmer, Brighton, UK
- International Health and Tropical Medicine, Centre for Tropical Medicine and Global Health, Medawar Building, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Oxford University Clinical Academic Graduate School (OUCAGS), John Radcliffe Hospital, Oxford, UK
- Department of Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
- Department of Medicine, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
- Harris Manchester College, Oxford, UK
- Africa Oxford Initiative, Medawar Building, University of Oxford, Oxford, UK
- NIHR BRC, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
- MaynardLeigh Associates, London, UK
- Radcliffe Department of Medicine, John Radcliffe Hospital, Oxford, UK
- Department of Social Policy, Social Sciences Division, University of Oxford, Oxford, UK
- Big Data Institute, University of Oxford, Oxford, UK
| | - Rebecca Surender
- Department of Social Policy, Social Sciences Division, University of Oxford, Oxford, UK
| | - Claire Worland
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Lisa J. White
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Big Data Institute, University of Oxford, Oxford, UK
| | - Philippa C. Matthews
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Oxford, UK
- Harris Manchester College, Oxford, UK
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Noé A, Cargill TN, Nielsen CM, Russell AJC, Barnes E. The Application of Single-Cell RNA Sequencing in Vaccinology. J Immunol Res 2020; 2020:8624963. [PMID: 32802896 PMCID: PMC7411487 DOI: 10.1155/2020/8624963] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 03/20/2020] [Accepted: 07/09/2020] [Indexed: 02/06/2023] Open
Abstract
Single-cell RNA sequencing allows highly detailed profiling of cellular immune responses from limited-volume samples, advancing prospects of a new era of systems immunology. The power of single-cell RNA sequencing offers various opportunities to decipher the immune response to infectious diseases and vaccines. Here, we describe the potential uses of single-cell RNA sequencing methods in prophylactic vaccine development, concentrating on infectious diseases including COVID-19. Using examples from several diseases, we review how single-cell RNA sequencing has been used to evaluate the immunological response to different vaccine platforms and regimens. By highlighting published and unpublished single-cell RNA sequencing studies relevant to vaccinology, we discuss some general considerations how the field could be enriched with the widespread adoption of this technology.
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MESH Headings
- Animals
- Betacoronavirus/immunology
- COVID-19
- Cell Line
- Clinical Trials as Topic
- Coronavirus Infections/epidemiology
- Coronavirus Infections/immunology
- Coronavirus Infections/prevention & control
- Coronavirus Infections/virology
- Disease Models, Animal
- Drug Evaluation, Preclinical
- Host-Pathogen Interactions/genetics
- Host-Pathogen Interactions/immunology
- Humans
- Immunity, Cellular/genetics
- Immunity, Innate/genetics
- Immunogenicity, Vaccine
- Pandemics/prevention & control
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/immunology
- Pneumonia, Viral/prevention & control
- Pneumonia, Viral/virology
- RNA, Viral/isolation & purification
- RNA-Seq/methods
- SARS-CoV-2
- Single-Cell Analysis
- Vaccinology/methods
- Viral Vaccines/administration & dosage
- Viral Vaccines/immunology
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Affiliation(s)
- Andrés Noé
- The Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7DQ, UK
| | - Tamsin N. Cargill
- Peter Medawar Building for Pathogen Research and Oxford NIHR Biomedical Research Centre, Nuffield Department of Medicine, University of Oxford, South Parks Road, Oxford OX1 3SY, UK
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Carolyn M. Nielsen
- The Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7DQ, UK
| | | | - Eleanor Barnes
- Peter Medawar Building for Pathogen Research and Oxford NIHR Biomedical Research Centre, Nuffield Department of Medicine, University of Oxford, South Parks Road, Oxford OX1 3SY, UK
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford OX3 9DU, UK
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5
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Noé A, Zaman SI, Rahman M, Saha AK, Aktaruzzaman MM, Maude RJ. Mapping the stability of malaria hotspots in Bangladesh from 2013 to 2016. Malar J 2018; 17:259. [PMID: 29996835 PMCID: PMC6042289 DOI: 10.1186/s12936-018-2405-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria claims hundreds of thousands of lives each year, most of them children. A "malaria-free world" is the World Health Organization's vision, but elimination from the southeast Asian Region is hampered by factors including anti-malarial resistance and systematic underreporting. Malaria is a significant public health problem in Bangladesh and while there have been recent gains in control, there is large spatial and temporal heterogeneity in the disease burden. This study aims to determine the pattern and stability of malaria hotspots in Bangladesh with the end goal of informing intervention planning for elimination. RESULTS Malaria in Bangladesh exhibited highly seasonal, hypoendemic transmission in geographic hotspots, which remained conserved over time. The southeast areas of the Chittagong Hill Tracts were identified as malaria hotspots for all 4 years examined. Similarly, areas in Sunamganj and Netrakona districts in the Northeast were hotspots for 2013-2016. Highly stable hotspots from 1 year predicted the following year's hotspot locations in the southeast of Bangladesh. Hotspots did not appear to act as sources of spread with no evidence of consistent patterns of contiguous spread or recession of hotspots as high or low transmission seasons progressed. CONCLUSIONS Areas were identified with temporal and spatial clustering of high malaria incidence in Bangladesh. Further studies are required to understand the vector, sociodemographic and disease dynamics within these hotspots. Given the low caseloads occurring in the low transmission seasons, and the conserved nature of malaria hotspots, directing resources towards these areas may be an efficient way to achieve malaria elimination in Bangladesh.
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Affiliation(s)
- Andrés Noé
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok, 10400, Thailand
| | - Sazid Ibna Zaman
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok, 10400, Thailand
| | - Mosiqure Rahman
- National Malaria Elimination Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Anjan Kumar Saha
- National Malaria Elimination Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - M M Aktaruzzaman
- National Malaria Elimination Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Richard James Maude
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ, UK.
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok, 10400, Thailand.
- Harvard TH Chan School of Public Health, Harvard University, Boston, USA.
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Noé A, Ribeiro RM, Anselmo R, Maixenchs M, Sitole L, Munguambe K, Blanco S, le Souef P, García-Basteiro AL. Knowledge, attitudes and practices regarding tuberculosis care among health workers in Southern Mozambique. BMC Pulm Med 2017; 17:2. [PMID: 28056943 PMCID: PMC5217625 DOI: 10.1186/s12890-016-0344-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 03/04/2016] [Accepted: 12/09/2016] [Indexed: 11/25/2022] Open
Abstract
Background Tuberculosis (TB) control is more likely to be achieved if the level of knowledge regarding TB is increased among health workers managing high-risk groups. No formal assessments regarding knowledge, attitudes and practises of health workers about TB have been published for Mozambique, a country facing challenges in the fight against TB, with a fragile health system and considerable work overload of health personnel. The main objective of the study was to determine the level of knowledge, identify attitudes and assess practices regarding TB care and control among health care workers of the district of Manhiça. Methods A descriptive cross-sectional study was performed through the use of a specifically designed Knowledge, Attitudes and Practices (KAP) questionnaire in the district of Manhiça, a high tuberculosis and HIV burden rural area in Southern Mozambique. In this district, 14 health care facilities service a population of approximately 160,000 people. The questionnaire took 30–45 min to administer with external assistance not permitted. The survey contained 79 questions pertaining to four different areas: demographics, TB knowledge, attitudes and practices. Results The study sample included 170 health care workers. The average knowledge score was 14.89 points (SD = 3.61) out of a total possible 26 points. Less than 30% of respondents had heard of Xpert MTB/RIF®. Seventy per cent agreed there was stigma associated with TB and 48.2% believed this stigma was greater than that associated with HIV. The average practice score was 3.2 out of 9 points (35.6%, SD = 2.4). Conclusion Health care worker’s knowledge gaps identified in this study may result in substandard patient care. Specific deficiencies in understanding existed in terms of paediatric TB and Xpert MTB/RIF® testing. The present study provides impetus for tailored TB education among health care workers from a high TB burden rural area in Southern Mozambique. Electronic supplementary material The online version of this article (doi:10.1186/s12890-016-0344-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrés Noé
- School of Paediatrics and Child Health, University of Western Australia, Crawley, Australia
| | - Rafaela M Ribeiro
- Centro de Investigação em Saúde de Manhiça (CISM), CP 1929, Maputo, Mozambique
| | - Rui Anselmo
- Centro de Investigação em Saúde de Manhiça (CISM), CP 1929, Maputo, Mozambique
| | - Maria Maixenchs
- Centro de Investigação em Saúde de Manhiça (CISM), CP 1929, Maputo, Mozambique
| | - Layce Sitole
- Maternal and Infant Health Service, Manhiça District, Maputo, Mozambique
| | - Khatia Munguambe
- Centro de Investigação em Saúde de Manhiça (CISM), CP 1929, Maputo, Mozambique.,Faculdade de Medicina, Eduardo Mondlane University (UEM), Maputo, Mozambique
| | - Silvia Blanco
- Centro de Investigação em Saúde de Manhiça (CISM), CP 1929, Maputo, Mozambique.,ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Peter le Souef
- School of Paediatrics and Child Health, University of Western Australia, Crawley, Australia
| | - Alberto L García-Basteiro
- Centro de Investigação em Saúde de Manhiça (CISM), CP 1929, Maputo, Mozambique. .,ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain. .,Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, The Netherlands.
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Pardo J, Mena A, Prieto I, Noé A, Luna J, Vara J, Granados Plaza M, Diaz Herrera M, Pérez A. Breast cancer hypofractionated radiotherapy: Observational study of toxicity and outcome. Rep Pract Oncol Radiother 2013. [DOI: 10.1016/j.rpor.2013.03.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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8
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Alastuey I, Pardo J, Ariño A, Font J, Mena A, Prieto I, Hernández J, Noé A, Romero J. Radiation-induced-cancer risk in breast cancer patients. Photon or electron boost? Rep Pract Oncol Radiother 2013. [DOI: 10.1016/j.rpor.2013.03.109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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9
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Alastuey I, Noé A, Chiaramello C, Montemuiño S, Pardo J. Low-dose radiation-induced acute pericarditis (AP) in breast cancer patient. Rep Pract Oncol Radiother 2013. [DOI: 10.1016/j.rpor.2013.03.105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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10
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Mena A, Pardo J, Noé A, Alvarado A, Feltes N, Vara J, Prieto I, Olivera J, Luna J, Perez A. Acute Toxicity and Cosmetic Outcome Evaluation in 294 Breast Cancer Patients (pts) Treated With Hypofractionated Radiation Therapy (HPRT) After Conservative Surgery. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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