BMC Public Health
http://www.biomedcentral.com/bmcpublichealth/content
(Accessed 5 December 2015)

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Research article
The burden of hypertension in sub-Saharan Africa: a four-country cross sectional study
David Guwatudde, Joan Nankya-Mutyoba, Robert Kalyesubula, Carien Laurence, Clement Adebamowo, IkeOluwapo Ajayi, Francis Bajunirwe, Marina Njelekela, Faraja Chiwanga, Todd Reid, Jimmy Volmink, Hans-Olov Adami, Michelle Holmes, Shona Dalal
BMC Public Health 2015, 15:1211 (5 December 2015)

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Research article
A cost-benefit analysis of a proposed overseas refugee latent tuberculosis infection screening and treatment program
La’Marcus Wingate, Margaret Coleman, Christopher de la Motte Hurst, Marie Semple, Weigong Zhou, Martin Cetron, John Painter
BMC Public Health 2015, 15:1201 (1 December 2015)

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Research article
Charting the evolution of approaches employed by the Global Alliance for Vaccines and Immunizations (GAVI) to address inequities in access to immunization: a systematic qualitative review of GAVI policies, strategies and resource allocation mechanisms through an equity lens (1999–2014)
Gian Gandhi
BMC Public Health 2015, 15:1198 (30 November 2015)
Abstract
Background
GAVI’s focus on reducing inequities in access to vaccines, immunization, and GAVI funds, − both between and within countries – has changed over time. This paper charts that evolution.
Methods
A systematic qualitative review was conducted by searching PubMed, Google Scholar and direct review of available GAVI Board papers, policies, and program guidelines. Documents were included if they described or evaluated GAVI policies, strategies, or programs and discussed equity of access to vaccines, utilization of immunization services, or GAVI funds in countries currently or previously eligible for GAVI support. Findings were grouped thematically, categorized into time periods covering GAVI’s phases of operations, and assessed depending on whether the approaches mediated equity of opportunity or equity of outcomes between or within countries.
Results
Serches yielded 2816 documents for assessment. After pre-screening and removal of duplicates, 552 documents underwent detailed evaluation and pertinent information was extracted from 188 unique documents. As a global funding mechanism, GAVI responded rationally to a semi-fixed funding constraint by focusing on between-country equity in allocation of resources. GAVI’s predominant focus and documented successes have been in addressing between-country inequities in access to vaccines comparing lower income (GAVI-eligible) countries with higher income (ineligible) countries. GAVI has had mixed results at addressing between-country inequities in utilization of immunization services, and has only more recently put greater emphasis and resources towards addressing within-country inequities in utilization to immunization services. Over time, GAVI has progressively added vaccines to its portfolio. This expansion should have addressed inter-country, inter-regional, inter-generational and gender inequities in disease burden, however, evidence is scant with respect to final outcomes.
Conclusion
In its next phase of operations, the Alliance can continue to demonstrate its strength as a highly effective multi-partner enterprise, capable of learning and innovating in a world that has changed much since its inception. By building on its successes, developing more coherent and consistent approaches to address inequities between and within countries and by monitoring progress and outcomes, GAVI is well-positioned to bring the benefits of vaccination to previously unreached and underserved communities towards provision of universal health coverage.

Bulletin of the World Health Organization
Volume 93, Number 12, December 2015, 817-892
http://www.who.int/bulletin/volumes/93/12/en/

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EDITORIALS
Learning from Ebola: readiness for outbreaks and emergencies
Margaret Chan
doi: 10.2471/BLT.15.165720
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Research
Improving outcomes for caregivers through treatment of young people affected by war: a randomized controlled trial in Sierra Leone
Ryan K McBain, Carmel Salhi, Katrina Hann, Jim Kellie, Alimamy Kamara, Joshua A Salomon, Jane J Kim & Theresa S Betancourt
Abstract
Objective
To measure the benefits to household caregivers of a psychotherapeutic intervention for adolescents and young adults living in a war-affected area.
Methods
Between July 2012 and July 2013, we carried out a randomized controlled trial of the Youth Readiness Intervention – a cognitive–behavioural intervention for war-affected young people who exhibit depressive and anxiety symptoms and conduct problems – in Freetown, Sierra Leone. Overall, 436 participants aged 15–24 years were randomized to receive the intervention (n = 222) or care as usual (n = 214). Household caregivers for the participants in the intervention arm (n = 101) or control arm (n = 103) were interviewed during a baseline survey and again, if available (n = 155), 12 weeks later in a follow-up survey. We used a burden assessment scale to evaluate the burden of care placed on caregivers in terms of emotional distress and functional impairment. The caregivers’ mental health – i.e. internalizing, externalizing and prosocial behaviour – was evaluated using the Oxford Measure of Psychosocial Adjustment. Difference-in-differences multiple regression analyses were used, within an intention-to-treat framework, to estimate the treatment effects.
Findings
Compared with the caregivers of participants of the control group, the caregivers of participants of the intervention group reported greater reductions in emotional distress (scale difference: 0.252; 95% confidence interval, CI: 0.026–0.4782) and greater improvements in prosocial behaviour (scale difference: 0.249; 95% CI: 0.012–0.486) between the two surveys.
Conclusion
A psychotherapeutic intervention for war-affected young people can improve the mental health of their caregivers.

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PERSPECTIVES
Including migrant populations in health impact assessments
Lara Miramontes, Kevin Pottie, Maria Benkhalti Jandu, Vivian Welch, Keith Miller, Megan James & Janet Hatcher Roberts
doi: 10.2471/BLT.14.142315
Bulletin of the World Health Organization 2015;93:888-889. doi: http://dx.doi.org/10.2471/BLT.14.142315

In 2010, there were 214 million international migrants worldwide, a number that is projected to double by 2050.1 Migrants’ motives for leaving their countries of origin include employment and education opportunities, escape from conflict and discrimination and the desire to raise families in economically and politically stable environments.
New migrants are often healthier than the general population on arrival, but their health may deteriorate after settlement,2 due to unfamiliar social conditions, infectious diseases, or restricted access to health services. Cultural and linguistic barriers may contribute to poor delivery of health services. The 61st World Health Assembly called on all Member States to “promote migrant-sensitive health policies”.3 Some subgroups – especially refugees – have a greater burden of infectious diseases and mental disorders than the indigenous population.4 Guidelines have been developed to assist health workers in the clinical management of migrating populations.4 However, there are no explicit decision-support tools for policy-makers to ensure health equity for migrants. Here we discuss how health impact assessment can account for the needs of migrant populations…

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 5 December 2015]

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Research
Incorporating research evidence into decision-making processes: researcher and decision-maker perceptions from five low- and middle-income countries
Zubin Shroff, Bhupinder Aulakh, Lucy Gilson, Irene Agyepong, Fadi El-Jardali, Abdul Ghaffar Health Research Policy and Systems 2015, 13:70 (30 November 2015)
Abstract
Background
The ‘Sponsoring National Processes for Evidence-Informed Policy Making in the Health Sector of Developing Countries’ program was launched by the Alliance for Health Policy and Systems Research, WHO, in July 2008. The program aimed to catalyse the use of evidence generated through health policy and systems research in policymaking processes through (1) promoting researchers and policy advocates to present their evidence in a manner that is easy for policymakers to understand and use, (2) creating mechanisms to spur the demand for and application of research evidence in policymaking, and (3) increased interaction between researchers, policy advocates, and policymakers. Grants ran for three years and five projects were supported in Argentina, Bangladesh, Cameroon, Nigeria and Zambia. This paper seeks to understand why projects in some settings were perceived by the key stakeholders involved to have made progress towards their goals, whereas others were perceived to have not done so well. Additionally, by comparing experiences across five countries, we seek to illustrate general learnings to inform future evidence-to-policy efforts in low- and middle-income countries.
Methods
We adopted the theory of knowledge translation developed by Jacobson et al. (J Health Serv Res Policy 8(2):94–9, 2003) as a framing device to reflect on project experiences across the five cases. Using data from the projects’ external evaluation reports, which included information from semi-structured interviews and quantitative evaluation surveys of those involved in projects, and supplemented by information from the projects’ individual technical reports, we applied the theoretical framework with a partially grounded approach to analyse each of the cases and make comparisons.
Results and conclusion
There was wide variation across projects in the type of activities carried out as well as their intensity. Based on our findings, we can conclude that projects perceived as having made progress towards their goals were characterized by the coming together of a number of domains identified by the theory. The domains of Jacobson’s theoretical framework, initially developed for high-income settings, are of relevance to the low- and middle-income country context, but may need modification to be fully applicable to these settings. Specifically, the relative fragility of institutions and the concomitantly more significant role of individual leaders point to the need to look at leadership as an additional domain influencing the evidence-to-policy process.

Journal of Global Infectious Diseases (JGID)
October-December 2015 Volume 7 | Issue 4 Page Nos. 125-174
http://www.jgid.org/currentissue.asp?sabs=n

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The Ebola outbreak of 2014-2015: From coordinated multilateral action to effective disease containment, vaccine development, and beyond
Thomas R Wojda1, Pamela L Valenza2, Kristine Cornejo2, Thomas McGinley2, Sagar C Galwankar3, Dhanashree Kelkar3, Richard P Sharpe1, Thomas J Papadimos4, Stanislaw P Stawicki1
1 Department of Surgery, St. Luke’s University Health Network, Bethlehem, Pennsylvania and Phillipsburg, New Jersey, USA
2 Department of Family Medicine, St. Luke’s University Health Network, Bethlehem, Pennsylvania and Phillipsburg, New Jersey, USA
3 Department of Emergency Medicine, University of Florida, Jacksonville, Florida, USA
4 Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, Ohio, USA
Abstract
The Ebola outbreak of 2014-2015 exacted a terrible toll on major countries of West Africa. Latest estimates from the World Health Organization indicate that over 11,000 lives were lost to the deadly virus since the first documented case was officially recorded. However, significant progress in the fight against Ebola was made thanks to a combination of globally-supported containment efforts, dissemination of key information to the public, the use of modern information technology resources to better track the spread of the outbreak, as well as more effective use of active surveillance, targeted travel restrictions, and quarantine procedures. This article will outline the progress made by the global public health community toward containing and eventually extinguishing this latest outbreak of Ebola. Economic consequences of the outbreak will be discussed. The authors will emphasize policies and procedures thought to be effective in containing the outbreak. In addition, we will outline selected episodes that threatened inter-continental spread of the disease. The emerging topic of post-Ebola syndrome will also be presented. Finally, we will touch on some of the diagnostic (e.g., point-of-care [POC] testing) and therapeutic (e.g., new vaccines and pharmaceuticals) developments in the fight against Ebola, and how these developments may help the global public health community fight future epidemics.

The Lancet
Dec 05, 2015 Volume 386 Number 10010 p2227-2364 e46-e55
http://www.thelancet.com/journals/lancet/issue/current

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Editorial
Adolescent health: boys matter too
The Lancet
Summary
It has been a good year for adolescents. Many global health reports and initiatives now mention adolescents. So also does the latest UN Population Fund’s State of the World Population 2015 report, released on Dec 3. Shelter from the Storm: a transformative agenda for women and girls in a crisis-prone world reminds us that there are 26 million women and adolescent girls in their childbearing years in need of humanitarian assistance worldwide. During the past 2 years or so, adolescents have been increasingly included in the women’s and child health agenda, culminating in UN Secretary-General Ban Ki-moon’s updated Global Strategy for Women’s and Children’s Health into the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030), presented on Sept 26 at the General Assembly.

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Articles
Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation
Dr Danzhen You, PhD, Lucia Hug, MA, Simon Ejdemyr, MA, Priscila Idele, PhD, Daniel Hogan, PhD, Colin Mathers, PhD, Patrick Gerland, PhD, Jin Rou New, MA, Leontine Alkema, PhD
for the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME)
Summary
Background
In 2000, world leaders agreed on the Millennium Development Goals (MDGs). MDG 4 called for a two-thirds reduction in the under-5 mortality rate between 1990 and 2015. We aimed to estimate levels and trends in under-5 mortality for 195 countries from 1990 to 2015 to assess MDG 4 achievement and then intended to project how various post-2015 targets and observed rates of change will affect the burden of under-5 deaths from 2016 to 2030.
Methods
We updated the UN Inter-agency Group for Child Mortality Estimation (UN IGME) database with 5700 country-year datapoints. As of July, 2015, the database contains about 17 000 country-year datapoints for mortality of children younger than 5 years for 195 countries, and includes all available nationally-representative data from vital registration systems, population censuses, household surveys, and sample registration systems. We used these data to generate estimates, with uncertainty intervals, of under-5 (age 0–4 years) mortality using a Bayesian B-spline bias-reduction model (B3 model). This model includes a data model to adjust for systematic biases associated with different types of data sources. To provide insights into the global and regional burden of under-5 deaths associated with post-2015 targets, we constructed five scenario-based projections for under-5 mortality from 2016 to 2030 and estimated national, regional, and global under-5 mortality rates up to 2030 for each scenario.
Results
The global under-5 mortality rate has fallen from 90·6 deaths per 1000 livebirths (90% uncertainty interval 89·3–92·2) in 1990 to 42·5 (40·9–45·6) in 2015. During the same period, the annual number of under-5 deaths worldwide dropped from 12·7 million (12·6 million–13·0 million) to 5·9 million (5·7 million–6·4 million). The global under-5 mortality rate reduced by 53% (50–55%) in the past 25 years and therefore missed the MDG 4 target. Based on point estimates, two regions—east Asia and the Pacific, and Latin America and the Caribbean—achieved the MDG 4 target. 62 countries achieved the MDG 4 target, of which 24 were low-income and lower-middle income countries. Between 2016 and 2030, 94·4 million children are projected to die before the age of 5 years if the 2015 mortality rate remains constant in each country, and 68·8 million would die if each country continues to reduce its mortality rate at the pace estimated from 2000 to 2015. If all countries achieve the Sustainable Development Goal of an under-5 mortality rate of 25 or fewer deaths per 1000 livebirths by 2030, we project 56·0 million deaths by 2030. About two-thirds of all sub-Saharan African countries need to accelerate progress to achieve this target.
Interpretation
Despite substantial progress in reducing child mortality, concerted efforts remain necessary to avoid preventable under-5 deaths in the coming years and to accelerate progress in improving child survival further. Urgent actions are needed most in the regions and countries with high under-5 mortality rates, particularly those in sub-Saharan Africa and south Asia.
Funding
None.

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Articles
Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
GBD 2013 Risk Factors Collaborators*
Summary
Background
The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.
Methods
Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk–outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990–2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol.
Findings
All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8–58·5) of deaths and 41·6% (40·1–43·0) of DALYs. Risks quantified account for 87·9% (86·5–89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa.
Interpretation
Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.
Funding
Bill & Melinda Gates Foundation.

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Series
How to eliminate tuberculosis
Data for action: collection and use of local data to end tuberculosis
Grant Theron, Helen E Jenkins, Frank Cobelens, Ibrahim Abubakar, Aamir J Khan, Ted Cohen, David W Dowdy
2324

How to eliminate tuberculosis
Turning off the tap: stopping tuberculosis transmission through active case-finding and prompt effective treatment
Courtney M Yuen, Farhana Amanullah, Ashwin Dharmadhikari, Edward A Nardell, James A Seddon, Irina Vasilyeva, Yanlin Zhao, Salmaan Keshavjee, Mercedes C Becerra
2334

How to eliminate tuberculosis
Controlling the seedbeds of tuberculosis: diagnosis and treatment of tuberculosis infection
Molebogeng X Rangaka, Solange C Cavalcante, Ben J Marais, Sok Thim, Neil A Martinson, Soumya Swaminathan, Richard E Chaisson
2344

How to eliminate tuberculosis
Stopping tuberculosis: a biosocial model for sustainable development
Katrina F Ortblad, Joshua A Salomon, Till Bärnighausen, Rifat Atun
2354

The Lancet Infectious Diseases
Dec 2015 Volume 15 Number 12 p1361-1498
http://www.thelancet.com/journals/laninf/issue/current

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Editorial
Tuberculosis reaches new milestones, good and bad
The Lancet Infectious Diseases
DOI: http://dx.doi.org/10.1016/S1473-3099(15)00431-4
Summary
The 20th instalment of WHO’s Global tuberculosis report was published on Oct 28, 2015, heralded by the headline that tuberculosis mortality had nearly halved over the past 25 years. This positive news was closely followed by the sobering announcement that tuberculosis now ranks alongside HIV among the leading infectious causes of death, with the deaths of 1·5 million people being attributable to the disease. Most of these deaths could have been prevented; in fact, tuberculosis has been a curable disease since the 1950s.

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Immunogenicity of the RTS,S/AS01 malaria vaccine and implications for duration of vaccine efficacy: secondary analysis of data from a phase 3 randomised controlled trial
Michael T White, Robert Verity, Jamie T Griffin, Kwaku Poku Asante, Seth Owusu-Agyei, Brian Greenwood, Chris Drakeley, Samwel Gesase, John Lusingu, Daniel Ansong, Samuel Adjei, Tsiri Agbenyega, Bernhards Ogutu, Lucas Otieno, Walter Otieno, Selidji T Agnandji, Bertrand Lell, Peter Kremsner, Irving Hoffman, Francis Martinson, Portia Kamthunzu, Halidou Tinto, Innocent Valea, Hermann Sorgho, Martina Oneko, Kephas Otieno, Mary J Hamel, Nahya Salim, Ali Mtoro, Salim Abdulla, Pedro Aide, Jahit Sacarlal, John J Aponte, Patricia Njuguna, Kevin Marsh, Philip Bejon, Eleanor M Riley, Azra C Ghani
1450
Open Access
Summary
Background
The RTS,S/AS01 malaria vaccine targets the circumsporozoite protein, inducing antibodies associated with the prevention of Plasmodium falciparum infection. We assessed the association between anti-circumsporozoite antibody titres and the magnitude and duration of vaccine efficacy using data from a phase 3 trial done between 2009 and 2014.
Methods
Using data from 8922 African children aged 5–17 months and 6537 African infants aged 6–12 weeks at first vaccination, we analysed the determinants of immunogenicity after RTS,S/AS01 vaccination with or without a booster dose. We assessed the association between the incidence of clinical malaria and anti-circumsporozoite antibody titres using a model of anti-circumsporozoite antibody dynamics and the natural acquisition of protective immunity over time.
Findings
RTS,S/AS01-induced anti-circumsporozoite antibody titres were greater in children aged 5–17 months than in those aged 6–12 weeks. Pre-vaccination anti-circumsporozoite titres were associated with lower immunogenicity in children aged 6–12 weeks and higher immunogenicity in those aged 5–17 months. The immunogenicity of the booster dose was strongly associated with immunogenicity after primary vaccination. Anti-circumsporozoite titres wane according to a biphasic exponential distribution. In participants aged 5–17 months, the half-life of the short-lived component of the antibody response was 45 days (95% credible interval 42–48) and that of the long-lived component was 591 days (557–632). After primary vaccination 12% (11–13) of the response was estimated to be long-lived, rising to 30% (28–32%) after a booster dose. An anti-circumsporozoite antibody titre of 121 EU/mL (98–153) was estimated to prevent 50% of infections. Waning anti-circumsporozoite antibody titres predict the duration of efficacy against clinical malaria across different age categories and transmission intensities, and efficacy wanes more rapidly at higher transmission intensity.
Interpretation
Anti-circumsporozoite antibody titres are a surrogate of protection for the magnitude and duration of RTS,S/AS01 efficacy, with or without a booster dose, providing a valuable surrogate of effectiveness for new RTS,S formulations in the age groups considered.
Funding
UK Medical Research Council.

Maternal and Child Health Journal
Volume 19, Issue 12, December 2015
http://link.springer.com/journal/10995/19/12/page/1

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Original Paper
An Intervention to Enhance Obstetric and Newborn Care in India: A Cluster Randomized-Trial
Shivaprasad S. Goudar, Richard J. Derman
Abstract
Objectives
This study assessed whether community mobilization and interventions to improve emergency obstetric and newborn care reduced perinatal mortality (PMR) and neonatal mortality rates (NMR) in Belgaum, India.
Methods
The cluster-randomised controlled trial was conducted in Belgaum District, Karnataka State, India. Twenty geographic clusters were randomized to control or the intervention. The intervention engaged and mobilized community and health authorities to leverage support; strengthened community-based stabilization, referral, and transportation; and aimed to improve quality of care at facilities.
Results
17,754 Intervention births and 15,954 control births weighing ≥1000 g, respectively, were enrolled and analysed. Comparing the baseline period to the last 6 months period, the NMR was lower in the intervention versus control clusters (OR 0.60, 95 % CI 0.34–1.06, p = 0.076) as was the PMR (OR 0.74, 95 % CI 0.46–1.19, p = 0.20) although neither reached statistical significance. Rates of facility birth and caesarean section increased among both groups. There was limited influence on quality of care measures.
Conclusions for Practice
The intervention had large but not statistically significant effects on neonatal and perinatal mortality. Community mobilization and increased facility care may ultimately improve neonatal and perinatal survival, and are important in the context of the global transition towards institutional delivery.

Nature
Volume 528 Number 7580 pp7-158 3 December 2015
http://www.nature.com/nature/current_issue.html

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World View
The world must accept that the HPV vaccine is safe
But the science alone will not be enough to build public and political confidence, says Heidi Larson.
01 December 2015

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Supplement: Infectious disease control and elimination: Modelling the impact of improved diagnostics
Diagnostic technologies play a pivotal part in understanding and addressing the burden of infectious diseases. The Diagnostics Modelling Consortium was established in 2013 to facilitate the integration of diagnostic data into models of disease transmission dynamics. In this supplement, the Consortium and its partners report on the latest research outcomes across several major diseases. The outputs demonstrate that improved, well-considered diagnostics could support the elimination of multiple diseases in the field.
Free full access

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Introduction
Expanding the role of diagnostic and prognostic tools for infectious diseases in resource-poor settings
Open Access
Azra C. Ghani, Deborah Hay Burgess, Alison Reynolds & Christine Rousseau
Nature 528, S50-S52 (03 December 2015)

Pediatrics
December 2015, VOLUME 136 / ISSUE 6
http://pediatrics.aappublications.org/content/136/6?current-issue=y

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Special Article
Model for Service Delivery for Developmental Disorders in Low-Income Countries
Syed Usman Hamdani, Fareed Aslam Minhas, Zafar Iqbal, Atif Rahman
Abstract
As in many low-income countries, the treatment gap for developmental disorders in rural Pakistan is near 100%. We integrated social, technological, and business innovations to develop and pilot a potentially sustainable service for children with developmental disorders in 1 rural area. Families with developmental disorders were identified through a mobile phone–based interactive voice response system, and organized into “Family Networks.” “Champion” family volunteers were trained in evidence-based interventions. An Avatar-assisted Cascade Training and information system was developed to assist with training, implementation, monitoring, and supervision. In a population of ∼30 000, we successfully established 1 self-sustaining Family Network consisting of 10 trained champion family volunteers working under supervision of specialists, providing intervention to 70 families of children with developmental disorders. Each champion was responsible for training and providing ongoing support to 5 to 7 families from his or her village, and the families supported each other in management of their children. A pre-post evaluation of the program indicated that there was significant improvement in disability and socioemotional difficulties in the child, reduction in stigmatizing experiences, and greater family empowerment to seek services and community resources for the child. There was no change in caregivers’ well-being. To replicate this service more widely, a social franchise model has been developed whereby the integrated intervention will be “boxed” up and passed on to others to replicate with appropriate support. Such integrated social, technological, and business innovations have the potential to be applied to other areas of health in low-income countries.

PharmacoEconomics
Volume 33, Issue 12, December 2015
http://link.springer.com/journal/40273/33/12/page/1

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Dealing with Time in Health Economic Evaluation: Methodological Issues and Recommendations for Practice
James F. O’Mahony, Anthony T. Newall, Joost van Rosmalen
Abstract
Time is an important aspect of health economic evaluation, as the timing and duration of clinical events, healthcare interventions and their consequences all affect estimated costs and effects. These issues should be reflected in the design of health economic models. This article considers three important aspects of time in modelling: (1) which cohorts to simulate and how far into the future to extend the analysis; (2) the simulation of time, including the difference between discrete-time and continuous-time models, cycle lengths, and converting rates and probabilities; and (3) discounting future costs and effects to their present values. We provide a methodological overview of these issues and make recommendations to help inform both the conduct of cost-effectiveness analyses and the interpretation of their results. For choosing which cohorts to simulate and how many, we suggest analysts carefully assess potential reasons for variation in cost effectiveness between cohorts and the feasibility of subgroup-specific recommendations. For the simulation of time, we recommend using short cycles or continuous-time models to avoid biases and the need for half-cycle corrections, and provide advice on the correct conversion of transition probabilities in state transition models. Finally, for discounting, analysts should not only follow current guidance and report how discounting was conducted, especially in the case of differential discounting, but also seek to develop an understanding of its rationale. Our overall recommendations are that analysts explicitly state and justify their modelling choices regarding time and consider how alternative choices may impact on results.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 5 December 2015)

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The Ebola Vaccine, Iatrogenic Injuries, and Legal Liability
Amir Attaran, Kumanan Wilson
Policy Forum | published 01 Dec 2015 | PLOS Medicine
10.1371/journal.pmed.1001911
Summary Points
:: The development and eventual deployment of an Ebola vaccine was delayed for various technical and financial reasons, but with the apparent success of a vaccine candidate in a recently reported clinical trial, an urgent problem is the lack of any system to protect vaccine firms from the risks of legal liability caused by vaccine-related injuries.
:: Without indemnity or security against the legal risks, vaccine firms are less likely to engage in research and development of vaccines, particularly for rare diseases of poor countries such as Ebola.
:: WHO’s traditional method of mitigating the legal risks through indemnification agreements with countries appears too slow to implement in urgent pandemic situations. Also, the enforceability of any WHO-backed legal agreement is placed in doubt because the United Nations has the option to claim immunity from lawsuits.
:: Creating a compensation system for vaccine injuries, based on no-fault principles and, most likely, overseen by the World Bank, could address the liability concerns and facilitate getting novel vaccines into clinical trials and to the market. This system would also ensure that recipients of these vaccines are fairly compensated in the rare instances that they are harmed.

PLoS One
http://www.plosone.org/
[Accessed 5 December 2015]

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Cost-Effectiveness of Peer Counselling for the Promotion of Exclusive Breastfeeding in Uganda
Lumbwe Chola, Lars T. Fadnes, Ingunn M. S. Engebretsen, Lungiswa Nkonki, Victoria Nankabirwa, Halvor Sommerfelt, James K. Tumwine, Thorkild Tylleskar, Bjarne Robberstad, PROMISE-EBF Study Group
Research Article | published 30 Nov 2015 | PLOS ONE
10.1371/journal.pone.0142718

Prehospital & Disaster Medicine
Volume 30 – Issue 06 – December 2015
https://journals.cambridge.org/action/displayIssue?jid=PDM&tab=currentissue
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Frameworks for Disaster Research and Evaluation
Samuel J. Stratton
DOI: http://dx.doi.org/10.1017/S1049023X15005397 (About DOI), Published online: 11 November 2015

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Special Reports
Research and Evaluations of the Health Aspects of Disasters, Part III: Framework for the Temporal Phases of Disasters
Marvin L. Birnbaum, Elaine K. Daily and Ann P. O’Rourke

Research and Evaluations of the Health Aspects of Disasters, Part IV: Framework for Societal Structures: the Societal Systems
Marvin L. Birnbaum, Elaine K. Daily and Ann P. O’Rourke

Research and Evaluations of the Health Aspects of Disasters, Part V: Epidemiological Disaster Research
Marvin L. Birnbaum, Elaine K. Daily and Ann P. O’Rourke

Reproductive Health
http://www.reproductive-health-journal.com/content
[Accessed 5 December 2015]

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Research
Perceptions and experiences of adolescents, parents and school administrators regarding adolescent-parent communication on sexual and reproductive health issues in urban and rural Uganda
Wilson Muhwezi, Anne Katahoire, Cecily Banura, Herbert Mugooda, Doris Kwesiga, Sheri Bastien, Knut-Inge Klepp Reproductive Health 2015, 12:110 (30 November 2015)

Science
4 December 2015 vol 350, issue 6265, pages 1125-1288
http://www.sciencemag.org/current.dtl

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Introduction to Special Issue – Toward Healthy Aging
Putting Off the Inevitable
Stella Hurtley, Leslie Roberts, L. Bryan Ray, Beverly A. Purnell, Caroline Ash
The dream of cheating death has evolved into a scientific quest to extend healthy life span. Scientists and doctors are looking for ways to maximize the number of years that we live free of chronic diseases, cancer, and cognitive decline. But before we can intervene, we have to understand the cellular and molecular mechanisms that drive aging and senescence. Some clues reside in our telomeres, the tips of our chromosomes that shrink with age. Others lie in our stem cells, which can only go on for so long repairing our tissues. Our mitochondria, too, the so-called powerhouses of the cell, may hold some answers to prolonging youthfulness. Other research points to changes in the gut microbiota associated with frailty in the aged. At a mechanistic level, the modulation of coenzyme NAD+ usage or production can prolong both health span and life span. Current geroscience initiatives aim to harness basic insights in aging research to promote general advances in healthy aging.

Questions remain throughout the aging field. By tweaking everything from genes to diets to environmental temperature and mating, scientists have created Methuselah flies and other remarkably long-lived animals while garnering fundamental insights into the biology of aging. Still, researchers puzzle over the most basic questions, such as what determines the life spans of animals. Meanwhile, a handful of molecular biologists are searching for ways to measure a person’s biological, as opposed to chronological, age, but that quest, too, has proved elusive.

An ever-growing literature addresses both theoretical and pragmatic approaches to the challenge of aging. In this special issue, we have focused mainly on the cellular aspects of mammalian aging, with the goal of spurring future developments in promoting health span, if not life span.

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Policy Forum
Climate Policy
Can Paris pledges avert severe climate change?
Allen A. Fawcett, Gokul C. Iyer, Leon E. Clarke, James A. Edmonds, Nathan E. Hultman, Haewon C. McJeon, Joeri Rogelj, Reed Schuler, Jameel Alsalam, Ghassem R. Asrar, Jared Creason, Minji Jeong, James McFarland, Anupriya Mundra, and Wenjing Shi
Science 4 December 2015: 1168-1169.
Published online 26 November 2015 [DOI:10.1126/science.aad5761]
Reducing risks of severe outcomes and improving chances of limiting warming to 2°C
Current international climate negotiations seek to catalyze global emissions reductions through a system of nationally determined country-level emissions reduction targets that would be regularly updated. These “Intended Nationally Determined Contributions” (INDCs) would constitute the core of mitigation commitments under any agreement struck at the upcoming Paris Conference of the Parties to the United Nations Framework Convention on Climate Change (UNFCCC) (1). With INDCs now reported from more than 150 countries and covering around 90% of global emissions, we can begin to assess the role of this round of INDCs in facilitating or frustrating achievement of longer-term climate goals. In this context, it is important to understand what these INDCs collectively deliver in terms of two objectives. First, how much do they reduce the probability of the highest levels of global mean surface temperature change? Second, how much do they improve the odds of achieving the international goal of limiting temperature change to under 2°C relative to preindustrial levels (2)? Although much discussion has focused on the latter objective (3–5), the former is equally important when viewing climate mitigation from a risk-management perspective.

Social Science & Medicine
Volume 145, Pages 1-248 (November 2015)
http://www.sciencedirect.com/science/journal/02779536/145

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Special issue section Health Systems in Asia 2013; Edited by Kai Hong Phua, Shenglan Tang and Kabir Sheikh
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Editorial – Health Systems of Asia: Equity, Governance and Social Impact
Pages 141-144
Kai Hong Phua, Kabir Sheikh, Sheng-Lan Tang, Vivian Lin
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District-level variations in childhood immunizations in India: The role of socio-economic factors and health infrastructure
Original Research Article
Pages 163-172
Anu Rammohan, Niyi Awofeso
Abstract
Routine childhood immunizations against measles and DPT are part of the World Health Organization’s (WHO) Expanded Program on Immunization (EPI) set up in 1974, with the aim of reducing childhood morbidity and mortality. Despite this, immunization rates are sub-optimal in developing countries such as India, with wide heterogeneity observed across districts and socio-economic characteristics. The aim of this paper is to examine district-level variations in the propensity to vaccinate a child in India for measles and DPT3, and analyse the extent to which these immunizations are given age-inappropriately, either prematurely or delayed. The present study uses data from the Indian District Level Household Survey (DLHS-3) collected in 2008, and the final sample contains detailed information on 42157 children aged between 12 and 60 months, across 549 Indian districts for whom we have complete information on immunization history. Our empirical study analyses: (i) the district-level average immunization rates for measles and DPT3, and (ii) the extent to which these immunizations have been given age-appropriately. A key contribution of this paper is that we link the household-level data at the district level to data on availability and proximity to health infrastructure and district-level socio-economic factors. Our results show that after controlling for an array of socio-economic characteristics, across all our models, the district’s income per capita is a strong predictor of better immunization outcomes for children. Mother’s education level at the district-level has a statistically significant and positive influence on immunization outcomes across all our models.
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Emerging challenges in implementing universal health coverage in Asia
Original Research Article
Pages 243-248
Caryn Bredenkamp, Timothy Evans, Leizel Lagrada, John Langenbrunner, Stefan Nachuk, Toomas Palu
Abstract
As countries in Asia converge on the goal of universal health coverage (UHC), some common challenges are emerging. One is how to ensure coverage of the informal sector so as to make UHC truly universal; a second is how to design a benefit package that is responsive and appropriate to current health challenges, yet fiscally sustainable; and a third is how to ensure “supply-side readiness”, i.e. the availability and quality of services, which is a necessary condition for translating coverage into improvements in health outcomes. Using examples from the Asia region, this paper discusses these three challenges and how they are being addressed.
On the first challenge, two promising approaches emerge: using general revenues to fully cover the informal sector, or employing a combination of tax subsidies, non-financial incentives and contributory requirements. The former can produce fast results, but places pressure on government budgets and may induce informality, while the latter will require a strong administrative mandate and systems to track the ability-to-pay. With respect to benefit packages, we find considerable variation in the nature and rigor of processes underlying the selection and updating of the services included. Also, in general, packages do not yet focus sufficiently on non-communicable diseases (NCDs) and related preventive outpatient care. Finally, there are large variations and inequities in the supply-side readiness, in terms of availability of infrastructure, equipment, essential drugs and staffing, to deliver on the promises of UHC. Health worker competencies are also a constraint.
While the UHC challenges are common, experience in overcoming these challenges is varied and many of the successes appear to be highly context-specific. This implies that researchers and policymakers need to rigorously, and regularly, assess different approaches, and share these findings across countries in Asia – and across the world.

Stanford Social Innovation Review
http://ssir.org/

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Measurement & Evaluation
Imagine a World of Good Data
By Peter L. Levin & Hallie Schneir 1
Unless we prioritize government collection, analysis, and distribution of data, public officials will continue to make decisions with limited facts, and citizens will get poorer services from the government than from the private sector.

Sustainability
Volume 7, Issue 11 (November 2015), Pages 14427-15784
http://www.mdpi.com/2071-1050/7/9

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Editorial: Planning, Development and Management of Sustainable Cities: A Commentary from the Guest Editors
by Tan Yigitcanlar and Md. Kamruzzaman
Sustainability 2015, 7(11), 14677-14688; doi:10.3390/su71114677
Received: 27 October 2015 / Revised: 27 October 2015 / Accepted: 27 October 2015 / Published: 3 November 2015
Abstract:
Cities are the most dramatic manifestations of human activities on the surface of the earth. These human-dominated organisms—i.e., cities—degrade natural habitats, simplify species composition, disrupt hydrological systems, and modify energy flow and nutrient cycling. Today, these consequential impacts of human activities, originated from population increase, rapid urbanization, high private motor vehicle dependency, deregulated industrialization and mass livestock production, are increasing exponentially and causing great deal of environmental, social, and economic challenges both at global and local scales. In such a situation, establishment of sustainable cities, through sustainable urban development practices, is seen as a potential panacea to combat these challenges responsibly, effectively, and efficiently. This paper offers a critical review of the key literature on the issues relating to planning, development and management of sustainable cities, introduces the contributions from the Special Issue, and speculates on the prospective research directions to place necessary mechanisms to secure a sustainable urban future for all.

TORTURE Journal
Volume 25, Nr. 2, 2015
http://www.irct.org/torture-journal

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Effect of counseling by paraprofessionals on depression, anxiety, somatization, and functioning in Indonesian torture survivors
Deborah Larson-Stoa, Gerard A. Jacobs, Abraham Jonathan, Bhava Poudyal

Geographical distribution of torture: An epidemiological study of torture reported by asylum applicants examined at the Department of Forensic Medicine, University of Copenhagen
J. Busch, S.H. Hansen, H.P. Hougen

Testimonial Therapy: Impact on social participation and emotional wellbeing among Indian survivors of torture and organized violence
Mia Myhre Jørgensen, Jens Modvig, Inger Agger, Lenin Raghuvanshi, Shirin Shabana Khan, Peter Polatin

Descriptive, inferential, functional outcome data on 9,025 torture survivors in the United States
Member Centers of the National Consortium of Torture Treatment Programs (NCTTP)

Elusive retributive justice in post-Khmer Rouge Cambodia: Challenges of using ECCC Victim Information Forms as a victim participatory rights mechanism
Leakhena Nou

Tropical Medicine & International Health
December 2015 Volume 20, Issue 12 Pages 1591–1854
http://onlinelibrary.wiley.com/doi/10.1111/tmi.2015.20.issue-12/issuetoc

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Systematic Reviews
Acute respiratory infection case definitions for young children: a systematic review of community-based epidemiologic studies in South Asia (pages 1607–1620)
Daniel E. Roth, Michelle F. Gaffey, Evelyn Smith-Romero, Tiffany Fitzpatrick and Shaun K. Morris
Article first published online: 20 SEP 2015 | DOI: 10.1111/tmi.12592

Systematic Reviews
Who, What, Where: an analysis of private sector family planning provision in 57 low- and middle-income countries (pages 1639–1656)
Oona M. R. Campbell, Lenka Benova, David Macleod, Catherine Goodman, Katharine Footman, Audrey L. Pereira and Caroline A. Lynch
Article first published online: 28 SEP 2015 | DOI: 10.1111/tmi.12597

Role of the private sector in childbirth care: cross-sectional survey evidence from 57 low- and middle-income countries using Demographic and Health Surveys (pages 1657–1673)
Lenka Benova, David Macleod, Katharine Footman, Francesca Cavallaro, Caroline A. Lynch and Oona M. R. Campbell
Article first published online: 28 SEP 2015 | DOI: 10.1111/tmi.12598