Robert Wood Johnson Foundation [to 5 March 2016]
http://www.rwjf.org/en/about-rwjf/newsroom/news-releases.html

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Mon Feb 29 00:01:00 EST 2016
Poll Finds Majority of Americans View Their Health Care Experiences Positively
While the majority of Americans are satisfied with the health care they receive, but many still experience significant problems with health care costs, insurance coverage, and accessing care when they need it.

American Journal of Tropical Medicine and Hygiene
March 2016; 94 (3)
http://www.ajtmh.org/content/current

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Perspective Piece
Travel Vaccines Enter the Digital Age: Creating a Virtual Immunization Record
Kumanan Wilson, Katherine M. Atkinson, and Cameron P. Bell
Am J Trop Med Hyg 2016 94:485-488; Published online December 28, 2015, doi:10.4269/ajtmh.15-0510
Abstract
At present, proof of immunization against diseases such as yellow fever is required at some international borders in concordance with the International Health Regulations. The current standard, the International Certificate of Vaccination or Prophylaxis (ICVP), has limitations as a paper record including the possibility of being illegible, misplaced, or damaged. We believe that a complementary, digital record would offer advantages to public health and travelers alike. These include enhanced availability and reliability, potential to include lot specific information, and integration with immunization information systems. Challenges exist in implementation, particularly pertaining to verification at border crossings. We describe a potential course for the development and implementation of a digital ICVP record.

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Articles
Community Attitudes Toward Mass Drug Administration for Control and Elimination of Neglected Tropical Diseases After the 2014 Outbreak of Ebola Virus Disease in Lofa County, Liberia
Joshua Bogus, Lincoln Gankpala, Kerstin Fischer, Alison Krentel, Gary J. Weil, Peter U. Fischer,
Karsor Kollie, and Fatorma K. Bolay
Am J Trop Med Hyg 2016 94:497-503; Published online December 14, 2015, doi:10.4269/ajtmh.15-0591
Abstract
The recent outbreak of Ebola virus disease (EVD) interrupted mass drug administration (MDA) programs to control and eliminate neglected tropical diseases in Liberia. MDA programs treat entire communities with medication regardless of infection status to interrupt transmission and eliminate lymphatic filariasis and onchocerciasis. Following reports of hostilities toward health workers and fear that they might be spreading EVD, it was important to determine whether attitudes toward MDA might have changed after the outbreak. We surveyed 140 community leaders from 32 villages in Lofa County, Liberia, that had previously participated in MDA and are located in an area that was an early epicenter of the EVD outbreak. Survey respondents reported a high degree of community trust in the MDA program, and 97% thought their communities were ready to resume MDA. However, respondents predicted that fewer people would comply with MDA after the EVD epidemic than before. The survey also uncovered fears in the community that EVD and MDA might be linked. Respondents suggested that MDA programs emphasize to people that the medications are identical to those previously distributed and that MDA programs have nothing to do with EVD.

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Articles
Diarrhea Prevalence, Care, and Risk Factors Among Poor Children Under 5 Years of Age in Mesoamerica
Danny V. Colombara, Bernardo Hernández, Claire R. McNellan, Sima S. Desai, Marielle C. Gagnier, Annie Haakenstad, Casey Johanns, Erin B. Palmisano, Diego Ríos-Zertuche, Alexandra Schaefer, Paola Zúñiga-Brenes, Nicholas Zyznieuski, Emma Iriarte, and Ali H. Mokdad
Am J Trop Med Hyg 2016 94:544-552; Published online January 19, 2016, doi:10.4269/ajtmh.15-0750
Abstract
Care practices and risk factors for diarrhea among impoverished communities across Mesoamerica are unknown. Using Salud Mesoamérica Initiative baseline data, collected 2011–2013, we assessed the prevalence of diarrhea, adherence to evidence-based treatment guidelines, and potential diarrhea correlates in poor and indigenous communities across Mesoamerica. This study surveyed 14,500 children under 5 years of age in poor areas of El Salvador, Guatemala, Mexico (Chiapas State), Nicaragua, and Panama. We compared diarrhea prevalence and treatment modalities using χ2 tests and used multivariable Poisson regression models to calculate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) for potential correlates of diarrhea. The 2-week point prevalence of diarrhea was 13% overall, with significant differences between countries (P < 0.05). Approximately one-third of diarrheal children were given oral rehydration solution and less than 3% were given zinc. Approximately 18% were given much less to drink than usual or nothing to drink at all. Antimotility medication was given to 17% of diarrheal children, while antibiotics were inappropriately given to 36%. In a multivariable regression model, compared with children 0–5 months, those 6–23 months had a 49% increased risk for diarrhea (aRR = 1.49, 95% CI = 1.15, 1.95). Our results call for programs to examine and remedy low adherence to evidence-based treatment guidelines.

Annals of Internal Medicine
1 March 2016, Vol. 164. No. 5
http://annals.org/issue.aspx

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Ideas and Opinions
Interrupting Ebola Transmission in Liberia Through Community-Based Initiatives
Mosoka Fallah, PhD, MPH; Bernice Dahn, MD, MPH; Tolbert G. Nyenswah, Esq, MPH; Moses Massaquoi, MD, MPH; Laura A. Skrip, MPH; Dan Yamin, PhD; Martial Ndeffo Mbah, PhD; Netty Joe, MD; Siedoh Freeman, MD; Thomas Harris, BA; Zinnah Benson, BBA; and Alison P. Galvani, PhD
In Liberia, programs based on community engagement were effective in controlling the Ebola virus disease epidemic. This article details the community-based initiative that was instrumental to the shift in transmission dynamics.

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 5 March 2016)

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Research article
Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: systematic review
Maya Semrau, Heidi Lempp, Roxanne Keynejad, Sara Evans-Lacko, James Mugisha, Shoba Raja, Jagannath Lamichhane, Atalay Alem, Graham Thornicroft and Charlotte Hanlon
Published on: 1 March 2016
Abstract
Background
The involvement of mental health service users and their caregivers in health system policy and planning, service monitoring and research can contribute to mental health system strengthening, but as yet there have been very few efforts to do so in low- and middle-income countries (LMICs).
Methods
This systematic review examined the evidence and experience of service user and caregiver involvement in mental health system strengthening, as well as models of best practice for evaluation of capacity-building activities that facilitate their greater participation. Both the peer-reviewed and the grey literature were included in the review, which were identified through database searches (MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, SciELO, Google Scholar and Cochrane), as well as hand-searching of reference lists and the internet, and a snowballing process of contacting experts active in the area. This review included any kind of study design that described or evaluated service user, family or caregiver (though not community) involvement in LMICs (including service users with intellectual disabilities, dementia, or child and adolescent mental health problems) and that were relevant to mental health system strengthening across five categories. Data were extracted and summarised as a narrative review.
Results
Twenty papers matched the inclusion criteria. Overall, the review found that although there were examples of service user and caregiver involvement in mental health system strengthening in numerous countries, there was a lack of high-quality research and a weak evidence base for the work that was being conducted across countries. However, there was some emerging research on the development of policies and strategies, including advocacy work, and to a lesser extent the development of services, service monitoring and evaluation, with most service user involvement having taken place within advocacy and service delivery. Research was scarce within the other health system strengthening areas.
Conclusions
Further research on service user and caregiver involvement in mental health system strengthening in LMICs is recommended, in particular research that includes more rigorous evaluation. A series of specific recommendations are provided based on the review.

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 5 March 2016)

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Debate
Implications of prioritizing HIV cure: new momentum to overcome old challenges in HIV

Curing HIV is a new strategic priority for several major AIDS organizations. In step with this new priority, HIV cure research and related programs are advancing in low, middle, and high-income country settings…
Joseph D. Tucker, Adam Gilbertson, Ying-Ru Lo and Marco Vitória
BMC Infectious Diseases 2016 16:109
Published on: 3 March 2016

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 5 March 2016)

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Research article
The impact of armed conflict on adolescent transitions: a systematic review of quantitative research on age of sexual debut, first marriage and first birth in young women under the age of 20 years
Sarah Neal, Nicole Stone and Roger Ingham
BMC Public Health 2016 16:225
Published on: 4 March 2016
Abstract
Background
Young women in conflict-affected regions are at risk of a number of adverse outcomes as a result of violence, economic deterioration and the breakdown of community structures and services. This paper presents the findings of a systematic review of quantitative literature reporting how key sexual and reproductive health (SRH) outcomes among young women under the age of 20 years are affected by exposure to armed conflict; namely, sexual debut, first marriage and first birth. Increases in these outcomes among young women are all associated with potential negative public health consequences. It also examines and documents possible causal pathways for any changes seen.
Methods
To fit with our inclusion criteria, all reviewed studies included outcomes for comparable populations not exposed to conflict either temporally or spatially. A total of 19 studies with results from 21 countries or territories met our inclusion criteria; seven presented findings on marriage, four on fertility and eight on both of these outcomes. Only one study reporting on sexual debut met our criteria.
Results
Findings show clear evidence of both declines and increases in marriage and childbirth among young women in a range of conflict-affected settings. Several studies that showed increases in marriage below the age of 20 years reported that such increases were concentrated in the younger teenagers. Trends in fertility were predominantly driven by marriage patterns. Suggested causal pathways for the changes observed could be grouped into three categories: involuntary, gender and psycho-social and economic and material factors.
Conclusion
The review reveals a paucity of literature on the impact of conflict on SRH outcomes of young women. Further quantitative and qualitative studies are needed to explore how conflict influences SRH events in young women over both the short- and longer-term.

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Research article
Maternal profiles and social determinants of malnutrition and the MDGs: What have we learnt?
Edem M. A. Tette, Eric K. Sifah, Edmund T. Nartey, Peter Nuro-Ameyaw, Pricilla Tete-Donkor and Richard B. Biritwum
BMC Public Health 2016 16:214
Published on: 2 March 2016
Abstract
Background
Maternal socio-demographic and health profiles are important determinants of malnutrition in children. In the 1990s, malnutrition was associated with low-birth-weight, young mothers and low maternal socio-economic status at Princess Marie Louise Children’s Hospital (PML). It is not known how this has changed by efforts to achieve the Millennium Development Goals. We examined socio-demographic and health profiles of mothers of children with acute malnutrition and those without the condition to identify risk factors for malnutrition and focus on preventive efforts.
Methods
An unmatched case–control study was conducted in 2013 at PML, the largest facility for treating malnourished children in Ghana in 2013. Mothers of children with moderate and severe acute malnutrition were compared with mothers of well-nourished children. Weight-for-height was used to classify malnutrition. Record forms and a semi-structured questionnaire were used for data collection. An analysis was done with Stata 11.0 software.
Results
Altogether, 371 mothers were studied consisting of 182 mothers of malnourished children and 189 mothers of well-nourished children. Mothers of malnourished children were more likely to be unmarried or cohabiting, have lower family incomes, HIV infection and chronic disease. They were less likely to stay with or provide alternative care for their child. Awareness and use of social services, health insurance and a cash transfer programme were low. A remarkable reduction in the number of malnourished children occurred when families earned more than $250 USD a month. Over-nutrition was present in both groups of mothers.
Conclusion
Low family income, unmarried status and type of child care were the main social determinants of malnutrition. There appears to be a reduction in the number of other poor socio-demographic characteristics in both the study and control groups compared to results from a previous study at the same centre, probably because of efforts toward attaining the MDGs. These findings suggest that prevention and optimum management need to involve multidisciplinary teams consisting of health professionals, social workers and/or key workers to enable families at risk to access social care and social protection interventions (MDG 1). This will make the management of malnutrition more effective, prevent relapse, protect the next child and address maternal over-nutrition.

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 5 March 2016)

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Research Article
Factors influencing willingness to participate in new drug trial studies: a study among parents whose children were recruited into these trials in northern Ghana
James Akazili, Samuel Chatio, Fabian Sebastian Achana, Abraham Oduro, Edmund W. Kanmiki and Frank Baiden
BMC Research Notes 2016 9:139
Published on: 3 March 2016
Abstract
Background
During the last decade, the number of clinical trials conducted in sub-Saharan Africa has increased significantly which has helped to address priority health problems in the region. Navrongo health research centre since it was established in 1989, has conducted several trial studies including rectal artesunate trial in the Kassena-Nankana districts. However, there is little evidence-based for assessing the impact of new drug trials. This study explored factors that motivate parents to allow their children to participate in new drug trials in northern Ghana.
Method
The study used both quantitative and qualitative methods. The participants were randomly selected from among parents whose children were enrolled in a new drug trial conducted in the Kassena-Nankana districts between 2000 and 2003. QSR Nvivo 9 software was used to code the qualitative data into themes before analysis while STATA software Version 11.2© was used to analyze the quantitative data.
Results
The results showed that majority (95.9 %) of the parents were willing to allow their children to be enrolled in future new drug trials. The main factors motivating their willingness to allow their children to be enrolled in these trials were quality of health care services offered to trial participants (92.9 %), detail medical examination (90.8 %), promptness of care provided (94.4 %) and quality of drugs (91.9 %). Other factors mentioned included disease prevention (99.5 %) and improved living standard (96.1 %). Parents reported that the conduct of these trials had reduced the frequency of disease occurrences in the communities because of the quality of health care services provided to the children recruited into these trial studies.
Conclusion
Though the implementation of clinical trials in the study area is believed to have positive impact on health status of people particularly trial participants, measures should however be taken to address safety and likely side effects of new drugs given to trial participants during these trial studies.

Bulletin of the World Health Organization
Volume 94, Number 3, March 2016, 157-232
http://www.who.int/bulletin/volumes/94/3/en/

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EDITORIALS
Data sharing in public health emergencies: a call to researchers
Christopher Dye, Kidist Bartolomeos, Vasee Moorthy & Marie Paule Kieny
http://dx.doi.org/10.2471/BLT.16.170860

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Measuring quality-of-care in the context of sustainable development goal 3: a call for papers
Yoko Akachi, Finn Tarp, Edward Kelley, Tony Addison & Margaret E Kruk
http://dx.doi.org/10.2471/BLT.16.170605

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Research
Size and distribution of the global volume of surgery in 2012
Thomas G Weiser, Alex B Haynes, George Molina, Stuart R Lipsitz, Micaela M Esquivel, Tarsicio Uribe-Leitz, Rui Fu, Tej Azad, Tiffany E Chao, William R Berry & Atul A Gawande
http://dx.doi.org/10.2471/BLT.15.159293
Abstract
Objective
To estimate global surgical volume in 2012 and compare it with estimates from 2004.
Methods
For the 194 Member States of the World Health Organization, we searched PubMed for studies and contacted key informants for reports on surgical volumes between 2005 and 2012. We obtained data on population and total health expenditure per capita for 2012 and categorized Member States as very-low, low, middle and high expenditure. Data on caesarean delivery were obtained from validated statistical reports. For Member States without recorded surgical data, we estimated volumes by multiple imputation using data on total health expenditure. We estimated caesarean deliveries as a proportion of all surgery.
Findings
We identified 66 Member States reporting surgical data. We estimated that 312.9 million operations (95% confidence interval, CI: 266.2–359.5) took place in 2012, an increase from the 2004 estimate of 226.4 million operations. Only 6.3% (95% CI: 1.7–22.9) and 23.1% (95% CI: 14.8–36.7) of operations took place in very-low- and low-expenditure Member States representing 36.8% (2573 million people) and 34.2% (2393 million people) of the global population of 7001 million people, respectively. Caesarean deliveries comprised 29.6% (5.8/19.6 million operations; 95% CI: 9.7–91.7) of the total surgical volume in very-low-expenditure Member States, but only 2.7% (5.1/187.0 million operations; 95% CI: 2.2–3.4) in high-expenditure Member States.
Conclusion
Surgical volume is large and growing, with caesarean delivery comprising nearly a third of operations in most resource-poor settings. Nonetheless, there remains disparity in the provision of surgical services globally.

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POLICY & PRACTICE
Psychosocial effects of an Ebola outbreak at individual, community and international levels
Tine Van Bortel, Anoma Basnayake, Fatou Wurie, Musu Jambai, Alimamy Sultan Koroma, Andrew T Muana, Katrina Hann, Julian Eaton, Steven Martin & Laura B Nellums
http://dx.doi.org/10.2471/BLT.15.158543

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PERSPECTIVES
A new global agenda for nutrition and health: the importance of agriculture and food systems
Andrew D Jones & Gebisa Ejeta
http://dx.doi.org/10.2471/BLT.15.164509

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Disability, noncommunicable disease and health information
Nicola C Richards, Hebe N Gouda, Jo Durham, Rasika Rampatige, Anna Rodney & Maxine Whittaker
http://dx.doi.org/10.2471/BLT.15.156869

Current Opinion in Infectious Diseases
April 2016 – Volume 29 – Issue 2 pp: v-v,99-228
http://journals.lww.com/co-infectiousdiseases/pages/currenttoc.aspx

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RESPIRATORY INFECTIONS
Pneumococcal vaccination
Cillóniz, Catia; Amaro, Rosanel; Torres, Antoni
Abstract
Purpose of review: Pneumococcal diseases (invasive diseases, pneumonia, otitis media, and sinusitis) are among the most frequent preventable infectious diseases carrying a very high morbidity and case fatality rate worldwide. Pneumococcal vaccination is a key element to reduce the global burden of the disease in children and adult population. Our aim is to discuss current knowledge of the epidemiology of pneumococcal disease and pneumococcal vaccines.
Recent findings:
After the introduction of conjugate vaccines (PCV7 and PCV13), rates of pneumococcal diseases because of vaccine serotypes have decreased considerably among children in the vaccine target and among nonvaccinated children and adults. Results of the Community-Acquired Pneumonia Immunization Trial in Adults demonstrated 45.6% efficacy of PCV13 against the first episode of pneumonia, 45% against first-episode nonbacteremic pneumococcal pneumonia, and 75% against the first episode of invasive pneumococcal diseases in adults older than 65 years. Recommendations for pneumococcal vaccination have changed recently in both the United States and Europe.
Summary:
The changing epidemiology of pneumococcal diseases should be closely investigated to assess the effectiveness and the usefulness of the current vaccination policies, and to identify future directions for preventing pneumococcal infections.

Developing World Bioethics
April 2016 Volume 16, Issue 1 Pages 1–60
http://onlinelibrary.wiley.com/doi/10.1111/dewb.2016.16.issue-1/issuetoc

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EDITORIAL
Future Infectious Disease Outbreaks: Ethics of Emergency Access to Unregistered Medical Interventions and Clinical Trial Designs (pages 2–3)
Udo Schuklenk
Article first published online: 19 JAN 2016 | DOI: 10.1111/dewb.12102
[No abstract]

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ORIGINAL ARTICLES
Managing Ethical Challenges to Mental Health Research in Post-Conflict Settings (pages 15–28)
Anna Chiumento, Muhammad Naseem Khan, Atif Rahman and Lucy Frith
Article first published online: 8 JAN 2015 | DOI: 10.1111/dewb.12076
Abstract
Recently the World Health Organization (WHO) has highlighted the need to strengthen mental health systems following emergencies, including natural and manmade disasters. Mental health services need to be informed by culturally attuned evidence that is developed through research. Therefore, there is an urgent need to establish rigorous ethical research practice to underpin the evidence-base for mental health services delivered during and following emergencies.

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Against Permitted Exploitation in Developing World Research Agreements (pages 36–44)
Danielle M. Wenner
Article first published online: 17 FEB 2015 | DOI: 10.1111/dewb.12081
Abstract
This paper examines the moral force of exploitation in developing world research agreements. Taking for granted that some clinical research which is conducted in the developing world but funded by developed world sponsors is exploitative, it asks whether a third party would be morally justified in enforcing limits on research agreements in order to ensure more fair and less exploitative outcomes. This question is particularly relevant when such exploitative transactions are entered into voluntarily by all relevant parties, and both research sponsors and host communities benefit from the resulting agreements. I show that defenders of the claim that exploitation ought to be permitted rely on a mischaracterization of certain forms of interference as unjustly paternalistic and two dubious empirical assumptions about the results of regulation. The view I put forward is that by evaluating a system of constraints on international research agreements, rather than individual transaction-level interference, we can better assess the alternatives to permitting exploitative research agreements.

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Maintaining Research Integrity While Balancing Cultural Sensitivity: A Case Study and Lessons From the Field (pages 55–60)
Rebekah Sibbald, Bethina Loiseau, Benedict Darren, Salem A. Raman, Helen Dimaras and Lawrence C. Loh
Article first published online: 11 SEP 2015 | DOI: 10.1111/dewb.12089
Abstract
Contemporary emphasis on creating culturally relevant and context specific knowledge increasingly drives researchers to conduct their work in settings outside their home country. This often requires researchers to build relationships with various stakeholders who may have a vested interest in the research. This case study examines the tension between relationship development with stakeholders and maintaining study integrity, in the context of potential harms, data credibility and cultural sensitivity. We describe an ethical breach in the conduct of global health research by a arising from the ad-hoc participation of a community stakeholder external to the visiting research group. A framework for reflection is developed from a careful examination of underlying factors and presented with a discussion of consequences and mitigation measures. This framework aims to present lessons learned for researchers working abroad who might face similar situations in their work.

Food Policy
Volume 61, In Progress (May 2016)
http://www.sciencedirect.com/science/journal/03069192

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Original Research Article
Abolishing biofuel policies: Possible impacts on agricultural price levels, price variability and global food security
Pages 9-26
Sergio René Araujo Enciso, Thomas Fellmann, Ignacio Pérez Dominguez, Fabien Santini
Abstract
In this paper we assess the impact of abolishing biofuel policies (mandates, tax credits, import and export tariffs) on agricultural price levels and price variability as well as some aspects related to global food security. For the analysis we employ a recursive-dynamic agricultural multi-commodity model within a stochastic framework. Results of the 10-years forward looking scenario indicate that the removal of biofuel policies would have a significant effect on price variability of biofuels, but only a marginal impact on the variability of agricultural commodity prices. Without biofuel policies, global biofuel demand would decrease by 25% for ethanol and 32% for biodiesel. Moreover, prices would only moderately decrease for ethanol feedstock commodities like wheat and coarse grains, while prices for biodiesel feedstock commodities, specifically vegetable oils, would be more affected. Due to competing uses of crop production such as feed and industrial use, abolishing biofuel policies would not necessarily lead to an increase in global food security, as food use increases would remain low for most crops and regions.

International Health
Volume 8 Issue 2 February 2016
http://inthealth.oxfordjournals.org/content/current

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REVIEWS
Editor’s choice: Cardiac rehabilitation in low- and middle-income countries: a review on cost and cost-effectiveness
Neil B. Oldridge, Maureen T. Pakosh, and Randal J. Thomas
Int. Health (2016) 8 (2): 77-82 doi:10.1093/inthealth/ihv047

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Spillover effect of HIV-specific foreign aid on immunization services in Nigeria
Charles C. Chima and Luisa Franzini
Abstract
Background Health aid to Nigeria increased tremendously in the last decade and a significant portion of the funds were earmarked for HIV-associated programs. Studies on the impact of HIV-specific aid on the delivery of non-HIV health services in sub-Saharan Africa have yielded mixed results. This study assessed if there is a spillover effect of HIV-specific aid on childhood vaccinations in Nigeria.
Methods Multivariate logistic regression models were used to estimate the effect of aid disbursements in a previous year on the receipt of vaccines at the individual level in a given year. Estimations were done for approximately 11 700 children using data from demographic and health surveys conducted in Nigeria in 2003 and 2008.
Results US$1 increase in HIV aid per capita was associated with a decrease in the probability of receipt of vaccines by 8–31%: polio first dose decreased by 8%; polio final dose by 9%; diphtheria-pertussis-tetanus (DPT) first dose by 11%; DPT final dose by 19%; measles by 31%; final doses of polio and DPT plus measles vaccine by 8%.
Conclusions HIV-specific aid had a negative spillover effect on immunization services in Nigeria over the study period. Donors may need to rethink their funding strategies in favour of more horizontal approaches.

International Journal of Sustainable Development & World Ecology
Volume 23, Issue 3, 2016
http://www.tandfonline.com/toc/tsdw20/current

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Original Articles
Tourism effects on the environment and economic sustainability of sub-Saharan Africa
Jung Wan Lee & Tantatape Brahmasrene
pages 221-232
DOI:10.1080/13504509.2015.1114976
ABSTRACT
This paper integrates tourism, economic growth, and environmental issues in a multivariate format. Unlike recent research on this topic, a panel data of selected sample nations of sub-Saharan Africa is adopted by using cointegration and panel regression models. The current research discovers both long-run equilibrium and short-run dynamics between economic growth, tourism, energy use, and carbon emissions in sub-Saharan Africa. Furthermore, tourism and energy use show a highly significant direct impact on economic growth. In addition, tourism, energy use, and economic growth yield a highly significant positive effect on carbon emissions. Dissecting the region into oil producers and non-oil producers further suggests that the economic growth of sub-Saharan Africa has been accomplished by strong growth in tourism and energy use. However, there is highly significant evidence that in oil producing countries, CO2 emissions are directly affected by energy use and economic growth and not by tourism. For non-oil producing countries, tourism and energy use but not economic growth incur a highly significant positive impact on carbon emissions.

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Community participation in the management of forest reserves in the Northern Region of Ghana
Rikiatu Husseini, Stephen B. Kendie & Patrick Agbesinyale
pages 245-256
DOI:10.1080/13504509.2015.1112858
ABSTRACT
The 1994 forest and wildlife policy of Ghana provides the basis for community participation in forest management through participatory forest management. Even though forest reserves in the Northern Region are said to be managed collaboratively, fringe communities are supposedly involved only in maintenance activities of the reserve boundaries and seedling planting in plantation programmes. The forest reserves are said to be threatened by illegal activities from the fringe communities. This study therefore examined the nature of community participation in the management of forest reserves.
It is a mixed method research in which structured interview schedule, in-depth interview and focus group discussion guides were used for data collection. Respondents comprised community members, forestry staff and NGOs. Communities’ participation was found to be passive and tokenistic and limited to boundary cleaning and providing labour on plantations. There is no formal collaboration between communities and Forest Services Division. Prospects to communities’ participation lie in the continuous flow of benefits and their active involvement in management decisions. Active involvement of communities in all decision-making processes, capacity building of communities and forestry staff, incentive schemes and awareness creation are recommended for promoting community participation in managing forest reserves in Northern Region.

Intervention – Journal of Mental Health and Psychological Support in Conflict Affected Areas
March 2016 – Volume 14 – Issue 1 pp: 2-96
http://journals.lww.com/interventionjnl/pages/currenttoc.aspx

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Articles
A post disaster capacity building model in Peru
Rivera-Holguín, Miryam; Velázquez, Tesania; Morote, Roxana
Abstract
This paper presents a model of a capacity building intervention, which encompasses twophases: reception and familiarity (a process of getting to know people to beyond their problems) and community mobilisation. This intervention was conducted with 65 participants from Chincha (Peru) urban and rural areas after the earthquake of 15 August 2007, highlighting a community intervention that was based on the content and methodology generated during the sessions. It is grounded in the recognition of local capacities and putting collective action into practice, through workshops and art to enhance culture and identity and empower participants. The 65 participants were able to mobilise their communities to design and create 17 murals and signboards. The main achievements of this model of intervention were the progressive withdrawal of external professionals involved, the development of personal skills of community leaders (e.g. self efficacy, organisation), and the systematic increase of leadership and community participation.

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Mental health and psychosocial support for the internally displaced persons in Bannu, Pakistan
Humayun, Asma; Azad, Nadia; Haq, Israr ul; More
Abstract
Following armed conflict in the North Waziristan Agency, a mental health and psychosocial support initiative was launched for internally displaced persons in Bannu, Pakistan. This was convened by volunteer mental health professionals, in collaboration with a variety of agencies (provincial government, military, humanitarian agencies) in a security compromised region. As part of the initiative, monthly camps were held for a period of six months. Mental health needs were assessed. A multidisciplinary team (psychiatrists, psychologists, psychiatric nurses and psychosocial workers) offered mental health care to 680 people who attended the camps, of which 28% were under the age of 18 years old. Twenty-one percent returned for follow-up, while others were followed-up in the community by psychosocial teams. Estimates of common mental disorders were found. Both pharmacological and psychological treatments were offered, according to existing guidelines. Active efforts were made to conduct holistic assessments and avoid a pure biomedical approach. This also provided an opportunity for training non specialist staff and led to formal (World Health Organization) mental health gap action plan training for primary care staff.

JAMA
March 1, 2016, Vol 315, No. 9
http://jama.jamanetwork.com/issue.aspx

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Viewpoint
The Emerging Zika Pandemic: Enhancing Preparedness
Daniel R. Lucey, MD, MPH; Lawrence O. Gostin, JD
Extract
This Viewpoint discusses Zika virus infection and health system preparedness and urges the World Health Organization to proactively respond to the growing global threat of infection.
The Zika virus (ZIKV), a flavivirus related to yellow fever, dengue, West Nile, and Japanese encephalitis, originated in the Zika forest in Uganda and was discovered in a rhesus monkey in 1947. The disease now has “explosive” pandemic potential, with outbreaks in Africa, Southeast Asia, the Pacific Islands, and the Americas.1 Since Brazil reported Zika virus in May 2015, infections have occurred in at least 20 countries in the Americas.2 Puerto Rico reported the first locally transmitted infection in December 2015, but Zika is likely to spread to the United States. The Aedes species mosquito (an aggressive daytime biter) that transmits Zika virus (as well as dengue, chikungunya, and yellow fever) occurs worldwide, posing a high risk for global transmission. Modeling anticipates significant international spread by travelers from Brazil to the rest of the Americas, Europe, and Asia.3 What steps are required now to shore up preparedness in the Americas and worldwide?…

Journal of Community Health
Volume 41, Issue 2, April 2016
http://link.springer.com/journal/10900/41/2/page/1

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Original Paper
Effects of Community Health Nurse-Led Intervention on Childhood Routine Immunization Completion in Primary Health Care Centers in Ibadan, Nigeria
V. B. Brown, O. A. Oluwatosin, J. O. Akinyemi, A. A. Adeyemo
Abstract
Immunization coverage of vulnerable children is often sub-optimal in many low- and middle-income countries. The use of a reminder/recall (R/R) system has been one of the strategies shown to be effective in improving immunization rates. In the resent study, we evaluated the effect of R/R and Primary Health Care Immunization Providers’ Training (PHCIPT) intervention on routine immunization completion among 595 infants in Ibadan, Nigeria. The design was a group randomized controlled trial with Local Government Area (LGA) being the unit of randomization. Four randomly selected LGAs were randomized to receive a cellphone R/R only (A), a PHCIPT only (B); combined R/R and PHCIPT (C) intervention or serve as a control group (D). Children aged 0–12 weeks were consecutively recruited into each group and followed up for 12 months. The primary outcome measure was routine immunization completion at 12 months of age. At the study endpoint, immunization completion rates were: group A, 98.6 %; group B, 70 %; group C, 97.3 %; and group D, 57.3 %. Compared to the control group, the cellphone R/R group was 72 % (RR 1.72, 95 % CI 1.50–1.98) and the combined RR/PHCIPT group 70 % (RR 1.70, 95 % CI 1.47–1.95) more likely to complete immunization. In contrast, immunization completion in the PHCIPT group was marginally different from the control group (RR 1.22, 95 % CI 1.03–1.45). These findings remained robust to adjustment for potential predictors of immunization completion as covariates. In conclusion, cellphone reminder/recall was effective in improving immunization completion in this Nigerian setting. Its use is recommended for large scale implementation.

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Original Paper
A Cluster-Randomized Trial to Evaluate a Mother–Daughter Dyadic Educational Intervention for Increasing HPV Vaccination Coverage in American Indian Girls
Rachel L. Winer, Angela A. Gonzales, Carolyn J. Noonan…
Abstract
We evaluated whether delivering educational presentations on human papillomavirus (HPV) to American Indian mothers affected HPV vaccination rates in their adolescent daughters. In March–April 2012, we recruited Hopi mothers or female guardians with daughters aged 9–12 years for a cluster-randomized intervention study on the Hopi Reservation. Participants attended mother-daughter dinners featuring educational presentations for mothers on either HPV (intervention) or juvenile diabetes (control) and completed baseline surveys. Eleven months later, we surveyed mothers on their daughters’ HPV vaccine uptake. We also reviewed aggregated immunization reports from the Indian Health Service to assess community-level HPV vaccination coverage from 2007 to 2013. Ninety-seven mother-daughter dyads participated; nine mothers reported that their daughters completed the three-dose HPV vaccination series before recruitment. Among the remaining mothers, 63 % completed the follow-up survey. Adjusting for household income, the proportion of daughters completing vaccination within 11 months post-intervention was similar in the intervention and control groups (32 vs. 28 %, adjusted RR = 1.2, 95 % confidence interval (CI) 0.6–2.3). Among unvaccinated daughters, those whose mothers received HPV education were more likely to initiate vaccination (50 vs. 27 %, adjusted RR = 2.6, 95 % CI 1.4–4.9) and complete three doses (adjusted RR = 4.0, 95 % CI 1.2–13.1) than girls whose mothers received diabetes education. Community-level data showed that 80 % of girls aged 13–17 years and 20 % of girls aged 11–12 completed the vaccination series by 2013. HPV vaccine uptake in Hopi girls aged 13–17 years is significantly higher than the U.S. national average. Brief educational presentations on HPV delivered to American Indian mothers might increase HPV vaccination rates in daughters aged 9–12 years.

Journal of Development Economics
Volume 119, Pages 1-138 (March 2016)
http://www.sciencedirect.com/science/journal/03043878/119

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Regular Articles
Labor market opportunities and women’s decision making power within households
Original Research Article
Pages 34-47
Kaveh Majlesi
Abstract
Despite the perceived importance of labor market opportunities in shaping married women’s outside option, and their bargaining power within households as a result, this link has received very little empirical attention. Using longitudinal data on who makes the decision on a wide range of issues within Mexican households and data from the administrative records of the Mexican Social Security Institute, this paper identifies the effects of relative changes in labor market opportunities for men and women on both working and non-working women’s decision making power. I find that increases in labor market opportunities improve women’s decision-making power as well as children’s health. Using differential labor demand shocks across Mexican industries caused by China’s admission to the WTO gives similar results.

Journal of Human Trafficking
Volume 2, Issue 1, 2016
http://www.tandfonline.com/toc/uhmt20/current
Introduction to the Special Issue
The Good, the Bad, the Ugly: Human Rights Violators in Comparative Perspective
DOI:10.1080/23322705.2016.1136166
Austin Choi-Fitzpatricka*
pages 1-14
Published online: 03 Mar 2016
ABSTRACT
A large and growing wave of scholarship has focused attention on a variety of contemporary forms of slavery. Early attention went to victims of sexual exploitation, though this is starting to slowly change with a growing body of work on labor exploitation. Previous studies focused exclusively on international trafficking and on the Global South whereas newer studies emphasize domestic trafficking and exploitation in the Global North. This article, and the special issue it introduces, suggests that it is high time scholars and advocates broaden their scope to more clearly focus on perpetrators and on the emancipation process. Perpetrators are too often thought of as “criminals of the worst sort,” a cultural shorthand that reduces understanding and thereby hampers both theory and practice of emancipation. For its part, emancipation is too often thought of as either “freedom” or the binary opposite of slavery. Here too, reality is more complex and fraught. In this article, I argue that a human rights approach to slaveholders and emancipation would improve greatly on the status quo.

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Articles
Eliminating Corporate Exploitation: Examining Accountability Regimes as Means to Eradicate Forced Labor from Supply Chains
Ashley Feasley
Columbus School of Law, Catholic University, Washington, DC, USA and Director of Advocacy, Catholic Legal Immigration Network, Inc., Silver Spring, Maryland, USApages 15-31
DOI:10.1080/23322705.2016.1137194
ABSTRACT
The existence of forced labor in a company’s supply chain represents the newest frontier of the global effort to eliminate forced labor. Corporations, beneficiaries of profits from products made with forced labor, represent the most nimble and most modern perpetrators of trafficking and exploitation. The negative publicity and consumer backlash that companies are facing for having forced labor in their supply chains reflects the new paradigm confronting corporate perpetrators with respect to international human rights. This article discusses four established regimes of accountability and reviews each regime’s efficacy in ensuring that corporations operate transparent, forced labor-free supply chains. The respective regimes: international regulation, market-based, civil liability, and domestic regulation, have achieved varying levels of success in recent years in an effort to make businesses accountable for ensuring forced labor-free supply chains. Analysis of accountability regimes and the successes and obstacles each regime has encountered in eliminating forced labor from corporate supply chains forcing companies to address forced labor maps progress that has occurred and also provides evaluation of what each accountability regime can provide to ensure businesses eliminate forced labor from their supply chains.

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Female Perpetrators in Internal Child Trafficking in China: An Empirical Study
Anqi Shen
School of Social Sciences, Business and Law, Teesside University, Middlesbrough, United Kingdom
pages 63-77
DOI:10.1080/23322705.2016.1136537
ABSTRACT
Through an empirical study, this article explores the overall profile of female traffickers of children in China and their role and performance in the trafficking processes. Its contribution to the human-trafficking literature lies in its focus on female perpetrators in particular. The article provides an overview of the international literature on female traffickers as well as contemporary knowledge about internal child trafficking in China. Empirical data from incarcerated traffickers suggest that portraying female traffickers as active players of criminal networks obscures the structural problems affecting female child traffickers. The short-term result is that the problems of female offenders are ignored, and the long-term impact is policy making that is disconnected from the lived experiences of an important population. From a gender perspective, this study suggests that female child traffickers are offenders as well as victims of social and gender inequalities in China’s reform era. This study also proposes that internal child trafficking in China should be brought in the international and Anglo-American debates surrounding human trafficking.

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Preliminary Data on a Sample of Perpetrators of Domestic Trafficking for Sexual Exploitation: Suggestions for Research and Practice
Katherine Gotch
Integrated Clinical & Correctional Services, Portland, Oregon, USA
pages 99-109
DOI:10.1080/23322705.2016.1136539
ABSTRACT
Trafficking for sexual exploitation is one aspect of human trafficking and, in recent years, there has been an increased awareness of and focus on domestic trafficking for sexual exploitation within the United States; however, very little is known about the psychological characteristics or criminogenic (i.e., causing or likely to cause criminal behavior) risk/need factors of the perpetrators who profit from domestic trafficking for sexual exploitation. In an attempt to expand the scope of known data on perpetrators of domestic trafficking for sexual exploitation, descriptive statistical analyses looking at factors hypothesized to be related to the psychological characteristics, criminogenic risk/need factors, and potential treatment interventions were conducted on a sample of 28 adult male offenders with an arrest, charge, and/or conviction of street-level domestic trafficking for sexual exploitation behavior in their history. The results provide preliminary data regarding the developmental/environmental factors, psychological characteristics, and criminogenic risk/need factors of this offender population, as well as support the hypothesis that perpetrators of domestic trafficking for sexual exploitation behavior appear to be a unique offender population requiring specialized management and therapeutic interventions. Suggestions and implications for practice and research are also provided.

Journal of International Development
March 2016 Volume 28, Issue 2 Pages 159–308
http://onlinelibrary.wiley.com/doi/10.1002/jid.v28.2/issuetoc

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Research Articles
Understanding the Effects of Faith: A Comparison of Religious and Secular HIV Prevention NGOS in Kenya (pages 161–176)
Megan Hershey
Article first published online: 17 FEB 2015 | DOI: 10.1002/jid.3075
Abstract
Religious non-governmental organizations (NGOs) are active in development efforts, yet the role faith plays in these organizations—and its effects on programs—remains unclear. Drawing on evidence from a study of Kenyan NGOs, I find that faith rarely emerges in the programs of Christian religious NGOs. I argue that both secular and religious NGOs are constrained by donor restrictions and a need for legitimacy that simultaneously remove religious elements from religious NGOs and promote minimal religious practices within secular organizations. The second half of the article discusses the nuanced ways in which faith does manifest within the organizational characteristics and practices of NGOs

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The Effect of Remittances on Domestic Capital Formation in Select African Countries: A Comparative Empirical Analysis (pages 243–265)
Zelealem Yiheyis and Kasahun Woldemariam
Article first published online: 5 NOV 2015 | DOI: 10.1002/jid.3194
Abstract
Remittances are expected to affect domestic investment, among others, through induced rise in savings and easing of financial constraints. However, the empirical evidence on the relationship between the two variables is rather thin, especially in the context of Africa. This study investigates the short-run and long-run effects of remittances on domestic investment in four African countries using the bounds testing approach to cointegration analysis. The findings of the study indicate that whether remittances spur domestic capital formation varies by country and the time horizon considered, highlighting, among others, the importance of identifying the factors that tend to condition their relationship.

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Review Articles
The Impact of Remittances on Children’s Human Capital Accumulation: Evidence from Morocco (pages 266–280)
Jamal Bouoiyour and Amal Miftah
Article first published online: 11 SEP 2015 | DOI: 10.1002/jid.3147
Abstract
Using a nationally representative household data set from Morocco, the present study seeks to estimate the effects of migrants’ remittances on household investments in children’s human capital. Three findings emerge. First, children in remittance-receiving households are more likely to attend school and less likely to drop out compared with those in non-remittance-receiving households. Second, children’s participation in labour market decreases in the presence of international remittances. Third, remittances are associated with significantly lower level of no schooling for girls. These findings support the growing view that remittances can help increase the educational opportunities, especially for female children.

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Rethinking Microfinance for Developed Countries (pages 281–302)
Matteo Pedrini, Valentina Bramanti, Marco Minciullo and Laura Maria Ferri
Article first published online: 15 FEB 2016 | DOI: 10.1002/jid.3205
Abstract
Despite the growth of the sector, microfinance’s academic research in developed countries is still very limited. The paper builds on earlier works, which discuss four technical problems related to the diffusion of microfinance in developing countries. In re-framing their approach to apply it to developed countries, we propose a set of recommendations in order to foster the growth of the microfinance sector: (1) the use of financial institutions to supply microfinance products; (2) the development of an alternative credit scoring in banks; (3) the adoption of a regulatory framework for microfinance; and (4) the use of networks as social collaterals.

The Lancet Infectious Diseases
Mar 2016 Volume 16 Number 3 p265-384 e11-e33
http://www.thelancet.com/journals/laninf/issue/current

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Editorial
Zika virus in the dock
The Lancet Infectious Diseases
DOI: http://dx.doi.org/10.1016/S1473-3099(16)00085-2
Summary
In October, 2015, the Ministry of Health in Brazil reported an unexplained increase in cases of microcephaly, a congenital malformation normally associated with incomplete brain development, in newborn babies (4783 cases vs 150 in the previous year). The reported cases have caused widespread fear among pregnant women all over South and Central America, to the point that some nations such as Ecuador have recommended that their citizens postpone pregnancy to 2018, to give time to investigate the causes of the increase of microcephaly cases.

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Safety and immunogenicity of a chimpanzee adenovirus-vectored Ebola vaccine in healthy adults: a randomised, double-blind, placebo-controlled, dose-finding, phase 1/2a study
Olga De Santis, Régine Audran, Emilie Pothin, Loane Warpelin-Decrausaz, Laure Vallotton, Grégoire Wuerzner, Camille Cochet, Daniel Estoppey, Viviane Steiner-Monard, Sophie Lonchampt, Anne-Christine Thierry, Carole Mayor, Robert T Bailer, Olivier Tshiani Mbaya, Yan Zhou, Aurélie Ploquin, Nancy J Sullivan, Barney S Graham, François Roman, Iris De Ryck, W Ripley Ballou, Marie Paule Kieny, Vasee Moorthy, François Spertini, Blaise Genton
Summary
Background
The ongoing Ebola outbreak led to accelerated efforts to test vaccine candidates. On the basis of a request by WHO, we aimed to assess the safety and immunogenicity of the monovalent, recombinant, chimpanzee adenovirus type-3 vector-based Ebola Zaire vaccine (ChAd3-EBO-Z).
Methods
We did this randomised, double-blind, placebo-controlled, dose-finding, phase 1/2a trial at the Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Participants (aged 18–65 years) were randomly assigned (2:2:1), via two computer-generated randomisation lists for individuals potentially deployed in endemic areas and those not deployed, to receive a single intramuscular dose of high-dose vaccine (5 × 1010 viral particles), low-dose vaccine (2·5 × 1010 viral particles), or placebo. Deployed participants were allocated to only the vaccine groups. Group allocation was concealed from non-deployed participants, investigators, and outcome assessors. The safety evaluation was not masked for potentially deployed participants, who were therefore not included in the safety analysis for comparison between the vaccine doses and placebo, but were pooled with the non-deployed group to compare immunogenicity. The main objectives were safety and immunogenicity of ChAd3-EBO-Z. We did analysis by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02289027.
Findings
Between Oct 24, 2014, and June 22, 2015, we randomly assigned 120 participants, of whom 18 (15%) were potentially deployed and 102 (85%) were non-deployed, to receive high-dose vaccine (n=49), low-dose vaccine (n=51), or placebo (n=20). Participants were followed up for 6 months. No vaccine-related serious adverse events were reported. We recorded local adverse events in 30 (75%) of 40 participants in the high-dose group, 33 (79%) of 42 participants in the low-dose group, and five (25%) of 20 participants in the placebo group. Fatigue or malaise was the most common systemic adverse event, reported in 25 (62%) participants in the high-dose group, 25 (60%) participants in the low-dose group, and five (25%) participants in the placebo group, followed by headache, reported in 23 (57%), 25 (60%), and three (15%) participants, respectively. Fever occurred 24 h after injection in 12 (30%) participants in the high-dose group and 11 (26%) participants in the low-dose group versus one (5%) participant in the placebo group. Geometric mean concentrations of IgG antibodies against Ebola glycoprotein peaked on day 28 at 51 μg/mL (95% CI 41·1–63·3) in the high-dose group, 44·9 μg/mL (25·8–56·3) in the low-dose group, and 5·2 μg/mL (3·5–7·6) in the placebo group, with respective response rates of 96% (95% CI 85·7–99·5), 96% (86·5–99·5), and 5% (0·1–24·9). Geometric mean concentrations decreased by day 180 to 25·5 μg/mL (95% CI 20·6–31·5) in the high-dose group, 22·1 μg/mL (19·3–28·6) in the low-dose group, and 3·2 μg/mL (2·4–4·9) in the placebo group. 28 (57%) participants given high-dose vaccine and 31 (61%) participants given low-dose vaccine developed glycoprotein-specific CD4 cell responses, and 33 (67%) and 35 (69%), respectively, developed CD8 responses.
Interpretation
ChAd3-EBO-Z was safe and well tolerated, although mild to moderate systemic adverse events were common. A single dose was immunogenic in almost all vaccine recipients. Antibody responses were still significantly present at 6 months. There was no significant difference between doses for safety and immunogenicity outcomes. This acceptable safety profile provides a reliable basis to proceed with phase 2 and phase 3 efficacy trials in Africa.
Funding
Swiss State Secretariat for Education, Research and Innovation (SERI), through the EU Horizon 2020 Research and Innovation Programme.

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Immunogenicity and safety of a novel monovalent high-dose inactivated poliovirus type 2 vaccine in infants: a comparative, observer-blind, randomised, controlled trial
Xavier Sáez-Llorens, Ralf Clemens, Geert Leroux-Roels, José Jimeno, Sue Ann Costa Clemens, William C Weldon, M Steven Oberste, Natanael Molina, Ananda S Bandyopadhyay
Summary
Background
Following the proposed worldwide switch from trivalent oral poliovirus vaccine (tOPV) to bivalent types 1 and 3 OPV (bOPV) in 2016, inactivated poliovirus vaccine (IPV) will be the only source of protection against poliovirus type 2. With most countries opting for one dose of IPV in routine immunisation schedules during this transition because of cost and manufacturing constraints, optimisation of protection against all poliovirus types will be a priority of the global eradication programme. We assessed the immunogenicity and safety of a novel monovalent high-dose inactivated poliovirus type 2 vaccine (mIPV2HD) in infants.
Methods
This observer-blind, comparative, randomised controlled trial was done in a single centre in Panama. We enrolled healthy infants who had not received any previous vaccination against poliovirus. Infants were randomly assigned (1:1) by computer-generated randomisation sequence to receive a single dose of either mIPV2HD or standard trivalent IPV given concurrently with a third dose of bOPV at 14 weeks of age. At 18 weeks, all infants were challenged with one dose of monovalent type 2 OPV (mOPV2). Primary endpoints were seroconversion and median antibody titres to type 2 poliovirus 4 weeks after vaccination with mIPV2HD or IPV; and safety (as determined by the proportion and nature of serious adverse events and important medical events for 8 weeks after vaccination). The primary immunogenicity analyses included all participants for whom a post-vaccination blood sample was available. All randomised participants were included in the safety analyses. This trial is registered with ClinicalTrials.gov, number NCT02111135.
Findings
Between April 14 and May 9, 2014, 233 children were enrolled and randomly assigned to receive mIPV2HD (117 infants) or IPV (116 infants). 4 weeks after vaccination with mIPV2HD or IPV, seroconversion to poliovirus type 2 was recorded in 107 (93·0%, 95% CI 86·8–96·9) of 115 infants in the mIPV2HD group compared with 86 (74·8%, 65·8–82·4) of 115 infants in the IPV group (difference between groups 18·3%, 95% CI 5·0–31·1; p<0·0001), and median antibody titres against poliovirus type 2 were 181 (95% CI 72·0–362·0) in the mIPV2HD group and 36 (18·0–113·8) in the IPV group (difference between groups 98·8, 95% CI 60·7–136·9; p<0·0001). Serious adverse events were reported for six (5%) of 117 infants in the mIPV2HD group and seven (6%) of 116 infants in the IPV group during the 8-week period after vaccination; none were related to vaccination. No important medical events were reported.
Interpretation
Our findings lend support to the use of mIPV2HD as an option for stockpiling for outbreak response or primary protection in selected areas at risk for emergence of poliovirus type 2 during the next phase of the polio eradication plan.
Funding
Bill & Melinda Gates Foundation.