Infectious Diseases of Poverty
http://www.idpjournal.com/content
[Accessed 14 May 2016]

.
Research Article
Prevalence of chronic infections and susceptibility to measles and varicella-zoster virus in Latin American immigrants
Yves Jackson, Lilian Santos, Isabelle Arm-Vernez, Anne Mauris, Hans Wolff, François Chappuis and Laurent Getaz
Published on: 11 May 2016
Abstract
Background
Large numbers of Latin American immigrants recently arrived in Western Europe. Curative and preventive programmes need to take account of their risk of suffering and transmitting imported chronic infections and of their susceptibility to cosmopolitan infections. We aimed to assess the prevalence and co-occurrence of imported chronic infections among Latin American immigrants, and their susceptibility to highly prevalent cosmopolitan infections.
Methods
Adult participants were recruited in the community and in a primary health centre in Geneva in 2008. Serological tests were performed on stored sera for HIV, HBV, syphilis, Strongyloides stercoralis, Trypanosoma cruzi, varicella and measles. We considered only chronic active infections in the analysis.
Results and discussion
The 1 012 participants, aged 37.2 (SD 11.3) years, were mostly female (82.5 %) and Bolivians (48 %). Overall, 209 (20.7 %) had at least one and 27 (2.7 %) two or more chronic infections. T. cruzi (12.8 %) and S. stercoralis (8.4 %) were the most prevalent chronic active infections compared to syphilis (0.4 %), HBV (0.4 %) and HIV (1.4 %). Concomitant infections affected 28.2 and 18.5 % of T. cruzi and S. stercoralis infected cases. Bolivian origin (aOR: 13.6; 95 % CI: 3.2–57.9) was associated with risk of multiple infections. Susceptibilities for VZV and measles were 0.7 and 1.4 %, respectively. Latin American immigrants are at risk of complications and possible reactivation of chronic parasitic infections but have overall low risks of chronic viral and syphilitic active infections.
Conclusions
Systematic screening for chronic active parasitic infections is therefore necessary especially among Bolivians. The high protection rate against measles and VZV doesn’t require specific preventive interventions.

International Health
Volume 8 Issue 3 May 2016
http://inthealth.oxfordjournals.org/content/current

.
EDITORIAL
Africa in transition: the case of malaria
Kevin Marsh
Extract
Int. Health (2016) 8 (3): 155-156 doi:10.1093/inthealth/ihw022
In 2000, the Economist carried an infamous cover describing Africa as ‘the hopeless continent’. In 2013 this was replaced with one designating Africa ‘the hopeful continent’. The idea of ‘Africa rising’ is in the air and although this is a hotly debated area, no one doubts that Africa is in a period of dramatic transition. Most African economies are growing at around 5% per annum; the current GDP of Africa of around $2.4 trillion is expected to rise more than tenfold by 2050, when its population is predicted to be above 2 billion, with 60% living in urban areas. These changes will be paralleled by equally dramatic changes in health, a process which is already well underway. Much has been written about the dual challenges of persisting infectious diseases at the same time as an increasing burden of non-communicable diseases. Tackling these challenges will call for a major investment in research and here there are exciting transitions too. The launch by the African Academy of Sciences (ASS), in-partnership with NEPAD and a group of international partners, of the Alliance for Accelerating Excellence in Science in Africa (AESA) (http://aasciences.ac.ke/programmes/easa/alliance-for-accelerating-excellence-in-science-in-africa-aesa/) marks a genuine shift in the centre of gravity for health research in Africa. One particularly welcome manifestation of this …

.
Commentaries
Collecting data on violence against children and young people: need for a universal standard
Karen M. Devriesa,*, Dipak Nakerb, Adrienne Monteath-van Dokc, Claire Milligand and Alice Shirleyd
Author Affiliations
aLondon School of Hygiene and Tropical Medicine, 15–17 Tavistock Place, WC1H 9SH, UK
bRaising Voices, 16 Tufnell Drive, Kamwokya P. O. Box 6770, Kampala, Uganda
cPlan International, Dukes Court, Block A, Duke Street, Woking, Surrey GU21 5BH, UK
dSave the Children, St John’s Lane, London, EC1 M 4AR, UK
*Corresponding author: E-mail: karen.devries@lshtm.ac.uk
Abstract
Preventing and responding to violence against children is an aim of the new Sustainable Development Goals. Numerous agencies are now collecting data from children about violence, including academics, non-governmental organisations, government agencies, consultants and others. Data are necessary to ensure appropriate prevention and response, but there is a real risk of harm to children if ethical standards are not adhered to. There are additional complexities in settings where child protection systems are not well developed. We propose specific suggestions for good practice, based on our past experience and policies, and call for all agencies to adhere to high ethical standards.
.

Original Articles
Ethical challenges in research with orphans and vulnerable children: a qualitative study of researcher experiences
Int. Health (2016) 8 (3): 187-196 doi:10.1093/inthealth/ihw020
Maureen C. Kelley, Tracy Brazg, Benjamin S. Wilfond, Liliana J. Lengua, Beth E. Rivin, Susanne P. Martin-Herz, and Douglas S. Diekema
Corresponding author: Present address: The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus – Roosevelt Drive, Oxford OX3 7LF; Tel: +44 186 561 7805; E-mail: maureen.kelley@ethox.ox.ac.uk
Abstract
Background Orphans and vulnerable children (OVCs) represent a significant population worldwide, enduring poor health and living conditions. Evidence-based interventions are needed. However, without parents, ethical concerns about including OVCs in research persist. The aim of our study was to better understand the ethical challenges facing researchers who work with OVCs.
Methods We conducted semi-structured interviews with 12 international pediatric researchers working with OVCs in seven countries. We used descriptive content analysis to characterize the ethical rationale for inclusion and associated challenges.
Results Researchers believed research was justified as a necessary means for informing evidence-based interventions to benefit OVCs directly or as a population. Ethical challenges included difficulty identifying OVCs given variation among children living without parents; difficulty identifying guardians among a range of caregivers; concerns about meaningfulness of guardian consent; difficulty assessing risk; and responding to children’s many needs.
Conclusions A range of caregivers bear responsibility to protect OVC’s interests in place of parents in research but are often not prepared to do so. This places greater burden on researchers to assess risks and respond to children’s needs. Findings suggest that we should improve support and rethink the roles of guardians, researchers and older children in research participation and protection.

International Journal of Infectious Diseases
May 2016 Volume 46, p1-126
http://www.ijidonline.com/current

.
Original Reports
Taking forward the World TB Day 2016 theme ‘Unite to End Tuberculosis’ for the WHO Africa Region
Francine Ntoumi, Pontiano Kaleebu, Eusebio Macete, Sayoki Mfinanga, Jeremiah Chakaya, Dorothy Yeboah-Manu, Matthew Bates, Peter Mwaba, Markus Maeurer, Eskild Petersen, Alimuddin Zumla
p34–37
Published online: March 8 2016
Preview
Tuberculosis (TB) has remained a global emergency ever since it was declared as such by the World Health Organization (WHO) in 1993.1 The theme designated for this year’s World TB Day, March 24, 2016, is ‘Unite to End TB’.2 World TB Day is held to commemorate the day in 1882 when Professor Robert Koch announced his ground-breaking discovery of the cause of TB, the bacillus Mycobacterium tuberculosis.3 At the time of Koch’s announcement in Berlin, TB was widespread and rampaging through Europe and the Americas, causing the death of one out of every seven people.

JAMA
May 10, 2016, Vol 315, No. 18
http://jama.jamanetwork.com/issue.aspx

.
Viewpoint
The Emerging Zika Virus Epidemic in the Americas: Research Priorities FREE
Helen M. Lazear, PhD; Elizabeth M. Stringer, MD; Aravinda M. de Silva, PhD
Excerpt
…CONCLUSIONS
The size of the current ZIKV epidemic, its potential for further spread, and the potential teratogenic effects of this virus require development of ZIKV-specific diagnostic agents and a better understanding of pathogenic mechanisms. The association between ZIKV infection and microcephaly has been the cause of much alarm and has been the driving force behind a substantial public health response and a drive to develop vaccines and antivirals to combat ZIKV infection.
Zika virus represents just the most recent example of an epidemic of vector-borne disease brought about by the introduction of a virus to a new host population and ecological landscape. Although current research priorities must focus on the immediate need to develop specific diagnostic tools and understand the teratogenic potential of ZIKV, public health efforts to address the current epidemic must be informed by experience with previous outbreaks of viruses transmitted by Aedes mosquitoes.

JAMA Pediatrics
May 2016, Vol 170, No. 5
http://archpedi.jamanetwork.com/issue.aspx
.
Editorial
Adolescent and Young Adult Health
The Pertussis Problem and a Possible Solution: Will Parents Go Along?
Mark H. Sawyer, MD
.
Adolescent and Young Adult Health
Human Papillomavirus Vaccination and Cervical Cytology Outcomes Among Urban Low-Income Minority Females
Annika M. Hofstetter, MD, PhD, MPH; Danielle C. Ompad, PhD; Melissa S. Stockwell, MD, MPH; Susan L. Rosenthal, PhD; Karen Soren, MD
.
Adolescent and Young Adult Health
Impact of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccinations on Reported Pertussis Cases Among Those 11 to 18 Years of Age in an Era of Waning Pertussis Immunity: A Follow-up Analysis
Tami H. Skoff, MS; Stacey W. Martin, MSc
.
Epidemiological and Economic Effects of Priming With the Whole-Cell Bordetella pertussis Vaccine
Haedi DeAngelis, MA; Samuel V. Scarpino, PhD; Meagan C. Fitzpatrick, PhD; Alison P. Galvani, PhD; Benjamin M. Althouse, PhD, ScM
Includes: Supplemental Content

Journal of Epidemiology & Community Health
June 2016, Volume 70, Issue 6
http://jech.bmj.com/content/current

.
Essay
Birth control policies in Iran: a public health and ethics perspective
Mehdi Aloosh1, Yashar Saghai2
Author Affiliations
1McGill University Health Centre, Montreal, Quebec, Canada
2Berman Institute of Bioethics, Johns Hopkins University, Baltimore, USA
Correspondence to Dr Mehdi Aloosh, McGill University, McGill University Health Centre, Montreal, Quebec, H4A 3J1, Canada; mehdi.aloosh@mail.mcgill.ca
Abstract
In less than one generation, a unique demographic transition has taken place in Iran. A population growth rate of 4.06% in 1984 fell to 1.15% in 1993 and a total fertility rate of 6.4 births per woman in 1984 declined to 1.9 in 2010. In 2012, Iranian policymakers shifted away from a birth control policy towards a pro-natalist policy. At first glance, this may seem reasonable since its goal is to avoid the consequences of an aging population. However, we argue that the policy package raises serious public health, socioeconomic, environmental and ethical concerns and is likely to fail on its own terms.

.

The influence of refugee status and secondary migration on preterm birth
Susitha Wanigaratne1,2, Donald C Cole3, Kate Bassil3, Ilene Hyman3, Rahim Moineddin4,
Marcelo L Urquia1,2,3
Author Affiliations
1Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
2Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
3Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
4Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
Correspondence to Dr Marcelo L Urquia, St. Michael’s Hospital, 30 Bond St., Toronto, ON M5B 1W8, Canada; marcelo.urquia@utoronto.ca
Abstract
Background It is unknown whether the risk of preterm birth (PTB) is elevated for forced (refugee) international migrants and whether prolonged displacement amplifies risk. While voluntary migrants who arrive from a country other than their country of birth (ie, secondary migrants) have favourable birth outcomes compared with those who migrated directly from their country of birth (ie, primary migrants), secondary migration may be detrimental for refugees who experience distinct challenges in transition countries. Our objectives were (1) to determine whether refugee status was associated with PTB and (2) whether the relation between refugee status and PTB differed between secondary and primary migrants.
Methods We conducted a retrospective population-based cohort study. Ontario immigration (2002–2010) and hospitalisation data (2002–2010) were linked to estimate adjusted cumulative odds ratios (ACOR) of PTB (22–31, 32–36, 37–41 weeks of gestation), with 95% CIs (95% CI) comparing refugees with non-refugees. We further included a product term between refugee status and secondary migration.
Results Overall, refugees (N=12 913) had 17% greater cumulative odds of short gestation (ACOR=1.17, 95% CI 1.07 to 1.28) compared with non-refugees (N=110 640). Secondary migration modified the association between refugee status and PTB (p=0.007). Secondary refugees had 58% greater cumulative odds of short gestation (ACOR=1.58, 95% CI 1.25 to 2.00) than secondary non-refugees, while primary refugees had 12% greater cumulative odds of short gestation (ACOR=1.12, 95% CI 1.02 to 1.23) than primary non-refugee immigrants.
Conclusions Refugee status, jointly with secondary migration, influences PTB among migrants.

Journal of Pediatrics
May 2016 Volume 172, p1-236
http://www.jpeds.com/current

.
Editor’s Persepctive
Lest we forget — the battle against malnutrition
Carlos A. Cuello-Garcia
p1–4
Published in issue: May 2016
Preview
We are now living in an era of postmillennium development goals and, although a significant number of them have been completed, a significant proportion of targets remain to be accomplished. Malnutrition is still a concern that affects millions worldwide. In this issue of The Journal, Chowdhury et al present a large scale population-based survey in Bangladesh, extracted from the Bangladesh Demographic Health Survey (2011). This could be considered a large and representative sample of a region where prevention of malnutrition is (and it should be kept as) a priority as a public health intervention.

.
Original Articles
Risk Factors for Child Malnutrition in Bangladesh: A Multilevel Analysis of a Nationwide Population-Based Survey
Mohammad Rocky Khan Chowdhury, Mohammad Shafiur Rahman, Mohammad Mubarak Hossain Khan, Mohammad Nazrul Islam Mondal, Mohammad Mosiur Rahman, Baki Billah
p194–201.e1

The Lancet
May 14, 2016 Volume 387 Number 10032 p1969-2062
http://www.thelancet.com/journals/lancet/issue/current

.
Viewpoint
Moving ahead: what will a renewed Countdown to 2030 for Women and Children look like?
Prof Zulfiqar A Bhutta, PhD, Mickey Chopra, MD
Published Online: 15 October 2015
Summary
The Countdown to 2015 initiative (Countdown) represents a remarkable consortium of academicians, UN agencies, and development partners, which over the past decade, has focused its attention on tracking and analysing coverage of key interventions for reproductive, maternal, newborn, and child health (RMNCH) across 75 high burden countries that account for more than 95% of global maternal and child deaths. Initially started to ensure follow-up on the landmark Lancet Child Survival series,1,2 with innovative consolidation and presentation of coverage data on key interventions by country and regions,3 Countdown rapidly evolved with an expansion of its mandate to include reproductive and maternal health indicators across the continuum of care4 and more recently, analysis of nutrition trends and health policies.

The Lancet Infectious Diseases
May 2016 Volume 16 Number 5 p507-618 e64-e81
http://www.thelancet.com/journals/laninf/issue/current
.
Editorial
Ebola PHEIC is over but emergency continues
The Lancet Infectious Diseases
Summary
On March 29, WHO Director-General Margaret Chan announced that the outbreak of Ebola virus disease in countries of west Africa was no longer a Public Health Emergency of International Concern (PHEIC). This decision was taken because, in the opinion of the International Health Regulations Emergency Committee on Ebola, the outbreak is no longer an extraordinary event, there is little risk of international spread, and affected countries have the capacity to rapidly respond to new cases. The Emergency Committee acknowledged that new clusters will continue to occur, but that they are happening at a decreasing frequency.
.
Articles
Group B streptococcus vaccination in pregnant women with or without HIV in Africa: a non-randomised phase 2, open-label, multicentre trial
Robert S Heyderman, Shabir A Madhi, Neil French, Clare Cutland, Bagrey Ngwira, Doris Kayambo, Robert Mboizi, Anthonet Koen, Lisa Jose, Morounfolu Olugbosi, Frederik Wittke, Karen Slobod, Peter M Dull
Open Access
Summary
Background
Neonates born to women infected with HIV are at increased risk for invasive group B streptococcus (GBS) disease. We aimed to compare safety and immunogenicity of trivalent glycoconjugate GBS vaccine in pregnant women with and without HIV in Malawi and South Africa.
Methods
In our non-randomised phase 2, open-label, multicentre study, we recruited pregnant women attending two antenatal clinics, one in Blantyre, Malawi, and one in Soweto, Johannesburg, South Africa. Participants were divided into three groups on the basis of their HIV infection status (no infection, infection and high CD4 cell count [>350 cells per μL], and infection and low CD4 cell count [>50 to ≤350 cells per μL]) and received a 5 μg dose of glycoconjugate GBS vaccine (serotypes Ia, Ib, and III, with CRM197 [Novartis Vaccines, Siena, Italy]) intramuscularly at 24–35 weeks’ gestation. GBS serotype-specific antibody concentrations were measured before vaccination (day 1), day 15, day 31, and at delivery, and in infants at birth and day 42 of life. The primary outcomes were safety in mothers and infants and the amount of placental transfer of GBS serotype-specific antibodies from mothers to their infants. All immunogenicity and safety analyses were done on the full analysis set, including participants who, or whose mother, correctly received the vaccine and who provided at least one valid assessable serum sample. This study is registered with ClinicalTrials.gov, number NCT01412801.
Findings
270 women and 266 infants were enrolled between Sept 26, 2011, and Dec 4, 2012 (90 women and 87 infants without HIV, 89 and 88 with HIV and high CD4 cell counts, and 91 and 91 with HIV and low CD4 cell counts, respectively). Seven women were lost to follow-up, six withdrew consent, one died, and two relocated. Eight infants died or were stillborn and two were lost to follow-up. Across serotypes, fold change in antibody concentrations were higher for the HIV-uninfected group than the HIV-infected groups. Transfer ratios were similar across all three groups (0·49–0·72; transfer ratio is infant geometric mean antibody concentration in blood collected within 72 h of birth divided by maternal geometric mean antibody concentration in blood collected at delivery); however, at birth, maternally derived serotype-specific antibody concentrations were lower for infants born to women infected with HIV (0·52–1·62 μg/mL) than for those born to women not infected with HIV (2·67–3·91 μg/mL). 151 (57%) of 265 women reported at least one solicited adverse reaction: 39 (45%) of 87 women with HIV and low CD4 cell counts, 52 (59%) of 88 women with HIV and high CD4 cell counts, and 60 (67%) of 90 women in the HIV-uninfected group. 49 (18%) of 269 women had at least one adverse event deemed possibly related to the vaccine (six [7%] in the HIV and low CD4 cell count group, 12 [13%] in the HIV and high CD4 cell count group, and 21 [23%] in the HIV-uninfected group), as did three (1%) of 266 neonates (zero, two [1%], and one [1%]); none of these events was regarded as serious.
Interpretation
The vaccine was less immunogenic in women infected with HIV than it was in those not infected, irrespective of CD4 cell count, resulting in lower levels of serotype-specific maternal antibody transferred to infants, which could reduce vaccine protection against invasive GBS disease. A validated assay and correlate of protection is needed to understand the potential protective value of this vaccine.
Funding
Novartis Vaccines and Diagnostics division (now part of the GlaxoSmithKline group of companies), Wellcome Trust UK, Medical Research Council: Respiratory and Meningeal Pathogens Research U

Lancet Global Health
May 2016 Volume 4 Number 5 e287-e343
http://www.thelancet.com/journals/langlo/issue/current

.
Editorial
Research capacity in Africa—will the sun rise again?
Justine Davies, Zoë Mullan
Published Online: 31 March 2016
Open Access
DOI: http://dx.doi.org/10.1016/S2214-109X(16)30046-8
Summary
Africa has a problem. It has the greatest burden of disease and lowest density of health-care professionals in the world. This we know. We also know that although infectious diseases and maternal, child, and neonatal health are improving, the burden of non-communicable diseases (NCDs) has been steadily increasing in the past few decades. We know that the health-care successes in Africa have largely been driven by donor aid, providing vertical solutions to specific problems; however, NCDs require complex care and strong health systems.

.
Comment
How the MDGs gave up on measuring access to medicines
Dzintars Gotham, Kristine H Onarheim, Melissa J Barber
Open Access
DOI: http://dx.doi.org/10.1016/S2214-109X(16)00066-8
Summary
In March, 2016, the United Nations Statistics Commission agreed upon the metrics used to measure progress towards, or away from, the new Sustainable Development Goals (SDGs).1 These so-called indicators define the real-world, measurable counterparts to the targets within the visionary goals of the sustainable development agenda. In the context of health in the SDGs, we wish to highlight the little-known story of the Millennium Development Goals’ (MDG) target on access to medicines. Of the 21 targets in the eight MDGs that permeated the development debate over the past 15 years, it was the only target that was dropped from the MDG report.

.
Comment
Consigned to the margins: a call for global action to challenge intellectual disability stigma
Katrina Scior, Aseel Hamid, Richard Hastings, Shirli Werner, Catherine Belton, Adebisi Laniyan, Maya Patel, Nora Groce, Maria Kett
Summary
Stigma as an important public health concern has been recognised in relation to conditions as diverse as HIV, leprosy, and mental illness. Little attention has been paid to date, however, to the pernicious effects of stigma on the wellbeing and life chances of one heavily stigmatised population: people with intellectual disabilities. Of the 15 billion people globally affected by disability,1 an estimated 2%, or 300 million, have an intellectual disability. They experience the same disadvantages and inequities as do people with other types of disabilities, but often face the additional disadvantage of having their needs inadequately understood and met, having limited recourse to assert their rights, and being poorly represented, including within the Disability Rights movement.

New England Journal of Medicine
May 12, 2016 Vol. 374 No. 19
http://www.nejm.org/toc/nejm/medical-journal

.
Perspective
The Zika Challenge
C.J. Haug, M.P. Kieny, and B. Murgue
[Concluding text]
…Many lessons learned from the response to the recent Ebola outbreak have helped in the response to the ZIKV outbreak. Most important, there is general agreement on the need for international collaboration on regulatory issues, research, and data sharing. For example, major regulatory agencies (such as Brazil’s Agência Nacional de Vigilância Sanitária, the U.S. Food and Drug Administration, and the European Medicines Agency) have committed to prioritizing the expedited evaluation of Zika products and will proactively reach out to product developers to provide advice on regulatory issues. Regulators have also initiated collaborations and are sharing their experiences with each other.

Another major advance over the Ebola response has been the speed with which data are being shared — for example, through the real-time posting of data from pathogenesis experiments in nonhuman primates. The December 2015 statement from the International Committee of Medical Journal Editors clarifying that prepublication dissemination of critical information will not prejudice later journal publication related to ZIKV or future public health emergencies has been helpful. Similarly, a February 2016 statement on open data sharing in ZIKV has been transformative in signaling that funders expect proactive data sharing. ZIKV provides a case study of the need for expedited research to answer basic questions, which will allow for development of control measures.

We are working in a new area with many unknowns. But as the WHO meeting showed, there is ample experience and expertise from work with other viruses and vectors — ranging from basic science to field work and surveillance — to guide clinical practice, research, and product development. It is critical that we collaborate rather than compete to find answers to the questions that worry millions of women of child-bearing age in areas where ZIKV is spreading rapidly and may become endemic.

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 14 May 2016)

.
Review
Socioeconomic Inequalities in Neglected Tropical Diseases: A Systematic Review
Tanja A. J. Houweling, Henrike E. Karim-Kos, Margarete C. Kulik, Wilma A. Stolk, Juanita A. Haagsma, Edeltraud J. Lenk, Jan Hendrik Richardus, Sake J. de Vlas
| published 12 May 2016 | PLOS Neglected Tropical Diseases
http://dx.doi.org/10.1371/journal.pntd.0004546
Abstract
Background
Neglected tropical diseases (NTDs) are generally assumed to be concentrated in poor populations, but evidence on this remains scattered. We describe within-country socioeconomic inequalities in nine NTDs listed in the London Declaration for intensified control and/or elimination: lymphatic filariasis (LF), onchocerciasis, schistosomiasis, soil-transmitted helminthiasis (STH), trachoma, Chagas’ disease, human African trypanosomiasis (HAT), leprosy, and visceral leishmaniasis (VL).
Methodology
We conducted a systematic literature review, including publications between 2004–2013 found in Embase, Medline (OvidSP), Cochrane Central, Web of Science, Popline, Lilacs, and Scielo. We included publications in international peer-reviewed journals on studies concerning the top 20 countries in terms of the burden of the NTD under study.
Principal findings
We identified 5,516 publications, of which 93 met the inclusion criteria. Of these, 59 papers reported substantial and statistically significant socioeconomic inequalities in NTD distribution, with higher odds of infection or disease among poor and less-educated people compared with better-off groups. The findings were mixed in 23 studies, and 11 studies showed no substantial or statistically significant inequality. Most information was available for STH, VL, schistosomiasis, and, to a lesser extent, for trachoma. For the other NTDs, evidence on their socioeconomic distribution was scarce.
The magnitude of inequality varied, but often, the odds of infection or disease were twice as high among socioeconomically disadvantaged groups compared with better-off strata. Inequalities often took the form of a gradient, with higher odds of infection or disease each step down the socioeconomic hierarchy. Notwithstanding these inequalities, the prevalence of some NTDs was sometimes also high among better-off groups in some highly endemic areas.
Conclusions
While recent evidence on socioeconomic inequalities is scarce for most individual NTDs, for some, there is considerable evidence of substantially higher odds of infection or disease among socioeconomically disadvantaged groups. NTD control activities as proposed in the London Declaration, when set up in a way that they reach the most in need, will benefit the poorest populations in poor countries.

PLoS One
http://www.plosone.org/
[Accessed 14 May 2016]

.
Research Article
Population-Level Impact of Ontario’s Infant Rotavirus Immunization Program: Evidence of Direct and Indirect Effects
Sarah E. Wilson, Laura C. Rosella, Jun Wang, Nicole Le Saux, Natasha S. Crowcroft, Tara Harris, Shelly Bolotin, Shelley L. Deeks
| published 11 May 2016 | PLOS ONE
http://dx.doi.org/10.1371/journal.pone.0154340
Abstract
Objective
To evaluate the direct and indirect population impact of rotavirus (RV) immunization on hospitalizations and emergency department (ED) visits for acute gastroenteritis (AGE) in Ontario before and after the publicly-funded RV immunization program.
Methods
Administrative data was used to identify ED visits and hospitalizations for all Ontarians using ICD-10 codes. We used two outcome definitions: RV-specific AGE (RV-AGE) and codes representing RV-, other viral and cause unspecified AGE (“overall AGE”). The pre-program and public program periods were August 1, 2005 to July 31, 2011; and August 1, 2011 to March 31, 2013, respectively. A negative binominal regression model that included the effect of time was used to calculate rates and rate ratios (RRs) and 95% confidence intervals (CIs) for RV-AGE and overall AGE between periods, after adjusting for age, seasonality and secular trends. Analyses were conducted for all ages combined and age stratified.
Results
Relative to the pre-program period, the adjusted RRs for RV-AGE and overall AGE hospitalizations in the public program period were 0.29 (95%CI: 0.22–0.39) and 0.68 (95%CI: 0.62–0.75), respectively. Significant reductions in RV-AGE hospitalizations were noted overall and for the following age bands: < 12 months, 12–23 months, 24–35 months, 3–4 years, and 5–19 years. Significant declines in overall AGE hospitalizations were observed across all age bands, including older adults > = 65 years (RR 0.80, 95%CI: 0.72–0.90). The program was associated with adjusted RRs of 0.32 (95% CI: 0.20–0.52) for RV-AGE ED visits and 0.90 (95% CI: 0.85–0.96) for overall AGE ED visits.
Conclusions
This large, population-based study provides evidence of the impact of RV vaccine in preventing hospitalizations and ED visits for RV-AGE and overall AGE, including herd effects.

Science
13 May 2016 Vol 352, Issue 6287
http://www.sciencemag.org/current.dtl

.
Editorial
Pursuit of integral ecology
Marcelo Sánchez Sorondo1,*, Veerabhadran Ramanathan2,†
Summary
Later this month (23 and 24 May), the United Nations will convene the first World Humanitarian Summit in Istanbul, where global and local leaders will commit to putting each and every person’s safety, dignity, freedom, and right to thrive at the heart of decision-making. More than 125 million people are in need of humanitarian assistance, a level of suffering not seen since World War II. The social problems are wide and deep, from war and human trafficking to the gross inequality between the wealthy 1% and the poorest 3 billion of the population. Included in the summit’s Agenda for Humanity are climate and natural disasters. Indeed, 1 year ago, Pope Francis emphasized, in the encyclical Laudato Si, that complex crises have both social and environmental dimensions. The bond between humans and the natural world means that we live in an “integral ecology,” and as such, an integrated approach to environmental and social justice is required.

.
Perspectives
Reconciliation in Sierra Leone
By Katherine Casey, Rachel Glennerster
Science13 May 2016 : 766-767
Short, low-cost interventions can help communities to recover from civil war
Summary
Since the end of World War II, there have been 259 armed conflicts in 159 locations (1). Sierra Leone’s civil war began 25 years ago, at a time when roughly 25% of all countries worldwide were experiencing civil war (2). How can individuals and groups recover from such violent conflicts? On page 787 of this issue, Cilliers et al. (3) provide rigorous evidence on the efficacy of one postwar reconciliation strategy that was implemented in 100 communities in Sierra Leone (4).

.
Refugee protection and resettlement problems
By Elizabeth Cullen Dunn
Science13 May 2016 : 772-773
Refugees face painful uncertainties that could be ameliorated by aid agency coordination
Summary
In 2015, more than a million refugees and other migrants entered the European Union. They are just a small part of the world’s rapidly burgeoning population of displaced people, which climbed by more than 37% between 2009 and 2015 to reach 59.5 million people. Humanitarian aid to these people has been dramatically insufficient, and many displaced people now lack adequate food, medical care, housing, or transportation. As a geographer, I spent 16 months between 2009 and 2013 conducting participant observation research in camps for displaced people in Georgia (see the photo), where I discovered serious shortfalls in the humanitarian aid system. Increasingly, humanitarian aid is a temporary solution to a permanent problem, a stopgap that not only does not help displaced people resettle but, instead, makes it more difficult for them to move on with their lives.

.
Reconciling after civil conflict increases social capital but decreases individual well-being
By Jacobus Cilliers, Oeindrila Dube, Bilal Siddiqi
Science13 May 2016 : 787-794
Exposure to the truth promotes social reconciliation, but at the cost of mental health.
Editor’s Summary
The psychological cost of reconciliation
During civil wars, individuals and communities who were previously good neighbors can end up fighting each other. One approach to reknit these sundered social ties is to bring perpetrators and victims together in truth and reconciliation forums. Cilliers et al. found that these forums have helped to reestablish social bonds in Sierra Leone, but that they have also imposed a cost on the victims’ mental health (see the Perspective by Casey and Glennerster).
Abstract
Civil wars divide nations along social, economic, and political cleavages, often pitting one neighbor against another. To restore social cohesion, many countries undertake truth and reconciliation efforts. We examined the consequences of one such effort in Sierra Leone, designed and implemented by a Sierra Leonean nongovernmental organization called Fambul Tok. As a part of this effort, community-level forums are set up in which victims detail war atrocities, and perpetrators confess to war crimes. We used random assignment to study its impact across 200 villages, drawing on data from 2383 individuals. We found that reconciliation had both positive and negative consequences. It led to greater forgiveness of perpetrators and strengthened social capital: Social networks were larger, and people contributed more to public goods in treated villages. However, these benefits came at a substantial cost: The reconciliation treatment also worsened psychological health, increasing depression, anxiety, and posttraumatic stress disorder in these same villages. For a subset of villages, we measured outcomes both 9 months and 31 months after the intervention. These results show that the effects, both positive and negative, persisted into the longer time horizon. Our findings suggest that policy-makers need to restructure reconciliation processes in ways that reduce their negative psychological costs while retaining their positive societal benefits.

.
Zika virus impairs growth in human neurospheres and brain organoids
By Patricia P. Garcez, Erick Correia Loiola, Rodrigo Madeiro da Costa, Luiza M. Higa, Pablo Trindade, Rodrigo Delvecchio, Juliana Minardi Nascimento, Rodrigo Brindeiro, Amilcar Tanuri, Stevens K. Rehen
Science13 May 2016 : 816-818
Zika virus infection in cell culture models damages human neural stem cells to limit growth and cause cell death.

Social Science & Medicine
Volume 155, Pages 1-102 (April 2016)
http://www.sciencedirect.com/science/journal/02779536/155

.
Review article
Global health diplomacy: A critical review of the literature
Review Article
Pages 61-72
Arne Ruckert, Ronald Labonté, Raphael Lencucha, Vivien Runnels, Michelle Gagnon
Abstract
Global health diplomacy (GHD) describes the practices by which governments and non-state actors attempt to coordinate and orchestrate global policy solutions to improve global health. As an emerging field of practice, there is little academic work that has comprehensively examined and synthesized the theorization of Global Health Diplomacy (GHD), nor looked at why specific health concerns enter into foreign policy discussion and agendas. With the objective of uncovering the driving forces behind and theoretical explanations of GHD, we conducted a critical literature review. We searched three English-language scholarly databases using standardized search terms which yielded 606 articles. After screening of abstracts based on our inclusion/exclusion criteria, we retained 135 articles for importing into NVivo10 and coding. We found a lack of rigorous theorizing about GHD and fragmentation of the GHD literature which is not clearly structured around key issues and their theoretical explanations. To address this lack of theoretical grounding, we link the findings from the GHD literature to how theoretical concepts used in International Relations (IR) have been, and could be invoked in explaining GHD more effectively. To do this, we develop a theoretical taxonomy to explain GHD outcomes based on a popular categorization in IR, identifying three levels of analysis (individual, domestic/national, and global/international) and the driving forces for the integration of health into foreign policy at each level.

Stability: International Journal of Security & Development
http://www.stabilityjournal.org/articles
[accessed 14 May 2016]

.
Commentary
Migratory Crisis in the Mediterranean: Managing Irregular Flows
Susana Ferreira
12 May 2016
Abstract
The current migratory crisis in the Mediterranean questions the European Union’s (EU) capacity to manage migratory flows. So far, the EU has placed a particular emphasis on border management, given a lack of political will that continues to prevent more in depth institutional responses. The current situation in the Mediterranean, and the EU’s response is a cause of concern due to the risk it represents to the human security of migrants, and the questions it raises regarding the management of migratory flows within the EU. The major question to emerge during this crisis is: How does the EU manage irregular migration flows while safeguarding migrants’ human rights?

The Sentinel

Human Rights Action :: Humanitarian Response :: Health ::
Holistic Development :: Sustainable Resilience
__________________________________________________
Week ending 7 May 2016

This weekly digest is intended to aggregate and distill key content from a broad spectrum of practice domains and organization types including key agencies/IGOs, NGOs, governments, academic and research institutions, consortia and collaborations, foundations, and commercial organizations. We also monitor a spectrum of peer-reviewed journals and general media channels. The Sentinel’s geographic scope is global/regional but selected country-level content is included. We recognize that this spectrum/scope yields an indicative and not an exhaustive product. Comments and suggestions should be directed to:

David R. Curry
Editor &
Founding Managing Director
GE2P2 – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

pdf version: The Sentinel_ week ending 7 May 2016

:: Journal Watch

The Sentinel will track key peer-reviewed journals which address a broad range of interests in human rights, humanitarian response, health and development. It is not intended to be exhaustive. We will add to those monitored below as we encounter relevant content and upon recommendation from readers. We selectively provide full text of abstracts and other content but note that successful access to some of the articles and other content may require subscription or other access arrangement unique to the publisher. Please suggest additional journals you feel warrant coverage.

American Journal of Tropical Medicine and Hygiene
May 2016; 94 (5)
http://www.ajtmh.org/content/current

.
Perspective Piece
Modeling Key Malaria Drugs’ Impact on Global Health: A Reason to Invest in the Global Health Impact Index
Nicole Hassoun
Am J Trop Med Hyg 2016 94:942-946; Published online February 8, 2016, doi:10.4269/ajtmh.15-0409
Abstract
Millions of people cannot access good quality essential medicines they need for some of the world’s worst diseases like malaria. The World Health Organization estimates that, in 2013, 198 million people became sick with malaria and 584,000 people died of the disease, while the Institute for Health Metrics Evaluation estimates that there were 164,929,872 cases of malaria in 2013 and 854,568 deaths in 2013. There are many attempts to model different aspects of the global burden of tropical diseases like malaria, but it is also important to measure success in averting malaria-related death and disability. This perspective proposes investing in a systematic effort to measure the benefits of health interventions for malaria along the lines of a model embodied in the Global Health Impact Index (global-health-impact.org).

.
Surveying the Knowledge and Practices of Health Professionals in China, India, Iran, and Mexico on Treating Tuberculosis
Steven J. Hoffman, G. Emmanuel Guindon, John N. Lavis, Harkanwal Randhawa, Francisco Becerra-Posada, Masoumeh Dejman, Katayoun Falahat, Hossein Malek-Afzali, Parasurama Ramachandran, Guang Shi, and C. A. K. Yesudian
Abstract
Research evidence continues to reveal findings important for health professionals’ clinical practices, yet it is not consistently disseminated to those who can use it. The resulting deficits in knowledge and service provision may be especially pronounced in low- and middle-income countries that have greater resource constraints. Tuberculosis treatment is an important area for assessing professionals’ knowledge and practices because of the effectiveness of existing treatments and recognized gaps in professionals’ knowledge about treatment. This study surveyed 384 health professionals in China, India, Iran, and Mexico on their knowledge and practices related to tuberculosis treatment. Few respondents correctly answered all five knowledge questions (12%) or self-reported performing all five recommended clinical practices “often or very often” (3%). Factors associated with higher knowledge scores included clinical specialization and working with researchers. Factors associated with better practices included training in the care of tuberculosis patients, being based in a hospital, trusting systematic reviews of randomized controlled double-blind trials, and reading summaries of articles, reports, and reviews. This study highlights several strategies that may prove effective in improving health professionals’ knowledge and practices related to tuberculosis treatment. Facilitating interactions with researchers and training in acquiring systematic reviews may be especially helpful.

.
Effectiveness of Oral Cholera Vaccine in Haiti: 37-Month Follow-Up
Karine Sévère, Vanessa Rouzier, Stravinsky Benedict Anglade, Claudin Bertil, Patrice Joseph,
Alexandra Deroncelay, Marie Marcelle Mabou, Peter F. Wright, Florence Duperval Guillaume,
and Jean William Pape
Am J Trop Med Hyg 2016 94:1136-1142; Published online February 29, 2016, doi:10.4269/ajtmh.15-0700
Abstract
The first oral cholera vaccine (OCV) campaign, since its prequalification by the World Health Organization, in response to an ongoing cholera epidemic (reactive vaccination) was successfully conducted in a poor urban slum of approximately 70,000 inhabitants in Port-au-Prince, Haiti, in 2012. Vaccine coverage was 75% of the target population. This report documents the impact of OCV in reducing the number of culture-confirmed cases of cholera admitted to the Groupe Haïtien d’Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) cholera treatment center from that community in the 37 months postvaccination (April 2012–April 30, 2015). Of 1,788 patients with culture-confirmed cholera, 1,770 (99%) were either from outside the vaccine area (1,400 cases) or from the vaccinated community who had not received OCV (370 cases). Of the 388 people from the catchment area who developed culture-confirmed cholera, 370 occurred among the 17,643 people who had not been vaccinated (2.1%) and the remaining 18 occurred among the 52,357 people (0.034%) who had been vaccinated (P < 0.001), for an efficacy that approximates 97.5%. Despite not being designed as a randomized control trial, the very high efficacy is a strong evidence for the effectiveness of OCV as part of an integrated package for the control of cholera in outbreak settings.

.
Use of Balanced Scorecard Methodology for Performance Measurement of the Health Extension Program in Ethiopia
Hailay D. Teklehaimanot, Awash Teklehaimanot, Aregawi A. Tedella, and Mustofa Abdella
Am J Trop Med Hyg 2016 94:1157-1169; Published online February 29, 2016, doi:10.4269/ajtmh.15-0192
Abstract
In 2004, Ethiopia introduced a community-based Health Extension Program to deliver basic and essential health services. We developed a comprehensive performance scoring methodology to assess the performance of the program. A balanced scorecard with six domains and 32 indicators was developed. Data collected from 1,014 service providers, 433 health facilities, and 10,068 community members sampled from 298 villages were used to generate weighted national, regional, and agroecological zone scores for each indicator. The national median indicator scores ranged from 37% to 98% with poor performance in commodity availability, workforce motivation, referral linkage, infection prevention, and quality of care. Indicator scores showed significant difference by region (P < 0.001). Regional performance varied across indicators suggesting that each region had specific areas of strength and deficiency, with Tigray and the Southern Nations, Nationalities and Peoples Region being the best performers while the mainly pastoral regions of Gambela, Afar, and Benishangul-Gumuz were the worst. The findings of this study suggest the need for strategies aimed at improving specific elements of the program and its performance in specific regions to achieve quality and equitable health services.

Annals of Internal Medicine
3 May 2016, Vol. 164. No. 9
http://annals.org/issue.aspx

.

Ideas and Opinions
Zika Virus: Rapid Spread in the Western Hemisphere FREE
Lin H. Chen, MD; and Davidson H. Hamer, MD