The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 24 September 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 Global Foundation – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

pdf version: the-sentinel_-week-ending-24-september-2016

Contents
:: Week in Review
:: Key Agency/IGO/Governments Watch – Selected Updates from 30+ entities
:: INGO/Consortia/Joint Initiatives Watch – Media Releases, Major Initiatives, Research
:: Foundation/Major Donor Watch -Selected Updates
:: Journal Watch – Key articles and abstracts from 100+ peer-reviewed journals

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 17 September 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 Global Foundation – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

pdf version: the-sentinel_-week-ending-17-september-2016

Contents
:: Week in Review
:: Key Agency/IGO/Governments Watch – Selected Updates from 30+ entities
:: INGO/Consortia/Joint Initiatives Watch – Media Releases, Major Initiatives, Research
:: Foundation/Major Donor Watch -Selected Updates
:: Journal Watch – Key articles and abstracts from 100+ peer-reviewed journals

The Sentinel

Human Rights Action :: Humanitarian Response :: Health :: Education :: Heritage Stewardship ::
Sustainable Development
__________________________________________________
Week ending 10 September 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 Global Foundation – Center for Governance, Evidence, Ethics, Policy, Practice
david.r.curry@ge2p2center.net

pdf version: the-sentinel_-week-ending-10-september-2016

Contents
:: Week in Review
:: Key Agency/IGO/Governments Watch – Selected Updates from 30+ entities
:: INGO/Consortia/Joint Initiatives Watch – Media Releases, Major Initiatives, Research
:: Foundation/Major Donor Watch -Selected Updates
:: Journal Watch – Key articles and abstracts from 100+ peer-reviewed journals

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.

Annals of Internal Medicine
6 September 2016, Vol. 165. No. 5
http://annals.org/issue.aspx

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Original Research
The Anticipated Clinical and Economic Effects of 90–90–90 in South Africa
Rochelle P. Walensky, MD, MPH; Ethan D. Borre, BA; Linda-Gail Bekker, MD, PhD; Stephen C. Resch, PhD; Emily P. Hyle, MD, SM; Robin Wood, MMed, DSc (Med); Milton C. Weinstein, PhD; Andrea L. Ciaranello, MD, MPH; Kenneth A. Freedberg, MD, MSc; and A. David Paltiel, MBA, PhD
Abstract
Background: The Joint United Nations Programme on HIV/AIDS (UNAIDS) 90–90–90 global treatment target aims to achieve 73% virologic suppression among HIV-infected persons worldwide by 2020.
Objective: To estimate the clinical and economic value of reaching this ambitious goal in South Africa, by using a microsimulation model of HIV detection, disease, and treatment.
Design: Modeling of the “current pace” strategy, which simulates existing scale-up efforts and gradual increases in overall virologic suppression from 24% to 36% in 5 years, and the UNAIDS target strategy, which simulates 73% virologic suppression in 5 years.
Data Sources: Published estimates and South African survey data on HIV transmission rates (0.16 to 9.03 per 100 person-years), HIV-specific age-stratified fertility rates (1.0 to 9.1 per 100 person-years), and costs of care ($11 to $31 per month for antiretroviral therapy and $20 to $157 per month for routine care).
Target Population: South African HIV-infected population, including incident infections over the next 10 years.
Perspective: Modified societal perspective, excluding time and productivity costs.
Time Horizon: 5 and 10 years.
Intervention: Aggressive HIV case detection, efficient linkage to care, rapid treatment scale-up, and adherence and retention interventions toward the UNAIDS target strategy.
Outcome Measures: HIV transmissions, deaths, years of life saved, maternal orphans, costs (2014 U.S. dollars), and cost-effectiveness.
Results of Base-Case Analysis: Compared with the current pace strategy, over 5 years the UNAIDS target strategy would avert 873 000 HIV transmissions, 1 174 000 deaths, and 726 000 maternal orphans while saving 3 002 000 life-years; over 10 years, it would avert 2 051 000 HIV transmissions, 2 478 000 deaths, and 1 689 000 maternal orphans while saving 13 340 000 life-years. The additional budget required for the UNAIDS target strategy would be $7.965 billion over 5 years and $15.979 billion over 10 years, yielding an incremental cost-effectiveness ratio of $2720 and $1260 per year of life saved, respectively.
Results of Sensitivity Analysis: Outcomes generally varied less than 20% from base-case outcomes when key input parameters were varied within plausible ranges.
Limitation: Several pathways may lead to 73% overall virologic suppression; these were examined in sensitivity analyses.
Conclusion: Reaching the 90–90–90 HIV suppression target would be costly but very effective and cost-effective in South Africa. Global health policymakers should mobilize the political and economic support to realize this target.
Primary Funding Source: National Institutes of Health and the Steve and Deborah Gorlin MGH Research Scholars Award.

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 10 September 2016)

Research article
Charting health system reconstruction in post-war Liberia: a comparison of rural vs. remote healthcare utilization
Katherine Kentoffio, John D. Kraemer, Thomas Griffiths, Avi Kenny, Rajesh Panjabi, G. Andrew Sechler, Stephen Selinsky and Mark J. Siedner
BMC Health Services Research 2016 16:478
Published on: 7 September 2016
Abstract
Background
Despite a growing global emphasis on universal healthcare, access to basic primary care for remote populations in post-conflict countries remains a challenge. To better understand health sector recovery in post-conflict Liberia, this paper seeks to evaluate changes in utilization of health services among rural populations across a 5-year time span.
Methods
We assessed trends in healthcare utilization among the national rural population using the Liberian Demographic and Health Survey (DHS) from 2007 and 2013. We compared these results to results obtained from a two-staged cluster survey in 2012 in the district of Konobo, Liberia, to assess for differential health utilization in an isolated, remote region. Our primary outcomes of interest were maternal and child health service care seeking and utilization.
Results
Most child and maternal health indicators improved in the DHS rural sub-sample from 2007 to 2013. However, this progress was not reflected in the remote Konobo population. A lower proportion of women received 4+ antenatal care visits (AOR 0.28, P < 0.001) or any postnatal care (AOR 0.25, P <0.001) in Konobo as compared to the 2013 DHS. Similarly, a lower proportion of children received professional care for common childhood illnesses, including acute respiratory infection (9 % vs. 52 %, P < 0.001) or diarrhea (11 % vs. 46 %, P < 0.001).
Conclusions
Our data suggest that, despite the demonstrable success of post-war rehabilitation in rural regions, particularly remote populations in Liberia remain at disproportionate risk for limited access to basic health services. As a renewed effort is placed on health systems reconstruction in the wake of the Ebola-epidemic, a specific focus on solutions to reach isolated populations will be necessary in order to ensure extension of coverage to remote regions such as Konobo.

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Research article
Stigmatized by association: challenges for abortion service providers in Ghana
Unsafe abortion is an issue of public health concern and contributes significantly to maternal morbidity and mortality globally. Abortion evokes religious, moral, ethical, socio-cultural and medical concerns w…
Patience Aniteye, Beverley O’Brien and Susannah H. Mayhew
BMC Health Services Research 2016 16:486
Published on: 10 September 2016

Research article
Quality of care for remote orthopaedic consultations using telemedicine: a randomised controlled trial
Decentralised services using outreach clinics or modern technology are methods to reduce both patient transports and costs to the healthcare system. Telemedicine consultations via videoconference are one such …
Astrid Buvik, Einar Bugge, Gunnar Knutsen, Arvid Småbrekke and Tom Wilsgaard
BMC Health Services Research 2016 16:483
Published on: 8 September 2016

Research article
Developing, delivering and evaluating primary mental health care: the co-production of a new complex intervention
Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area…
Joanne Reeve, Lucy Cooper, Sean Harrington, Peter Rosbottom and Jane Watkins
BMC Health Services Research 2016 16:470
Published on: 6 September 2016

Research
Workplace health promotion for older workers: a systematic literature review
Aging of the workforce is a growing problem. As workers age, their physical, physiological and psychosocial capabilities change. Keeping older workers healthy and productive is a key goal of European labor pol…
Andrea Poscia, Umberto Moscato, Daniele Ignazio La Milia, Sonja Milovanovic, Jovana Stojanovic, Alice Borghini, Agnese Collamati, Walter Ricciardi and Nicola Magnavita
BMC Health Services Research 2016 16(Suppl 5):329
Published on: 5 September 2016

Research
Predictors of healthy ageing: public health policy targets
The public health policy agenda oriented towards healthy ageing becomes the highest priority for the European countries. The article discusses the healthy ageing concept and its possible determinants with an a…
Agnieszka Sowa, Beata Tobiasz-Adamczyk, Roman Topór-Mądry, Andrea Poscia and Daniele Ignazio la Milia
BMC Health Services Research 2016 16(Suppl 5):289
Published on: 5 September 2016

BMC Medical Ethics
http://www.biomedcentral.com/bmcmedethics/content
(Accessed 10 September 2016)

Debate
Research involving adults lacking capacity to consent: the impact of research regulation on ‘evidence biased’ medicine
Victoria Shepherd
Published on: 8 September 2016
Abstract
Background
Society is failing in its moral obligation to improve the standard of healthcare provided to vulnerable populations, such as people who lack decision making capacity, by a misguided paternalism that seeks to protect them by excluding them from medical research. Uncertainties surround the basis on which decisions about research participation is made under dual regulatory regimes, which adds further complexity. Vulnerable individuals’ exclusion from research as a result of such regulation risks condemning such populations to poor quality care as a result of ‘evidence biased’ medicine.
Main Text
This paper explores the research regulation provisions for proxy decision making for those unable to provide informed consent for themselves, and the subsequent legal and practical difficulties for decision-makers. There are two separate regulatory regimes governing research involving adults who lack capacity to consent in England and Wales. The Mental Capacity Act 2005 governs how incapacitated adults can be involved in research, however clinical trials of medicinal products are separately regulated by the Medicines for Human Use (Clinical Trials) Regulations 2004. There are significant differences under these dual regimes in the provisions for those lacking capacity to participate in medical research. The level of risk permitted differs, with a greater requirement for justification for participation in a clinical trial than other types of research. Who acts as proxy decision maker, how much information is provided to the person lacking capacity, and whether they retain the power of veto also significantly differs.
Conclusion
The development of two separate regulatory regimes has resulted in significant differences between the provisions for clinical trials and other forms of research, and from usual medical practice. The resulting uncertainty has reinforced the tendency of those approving and conducting research to exclude adults lacking capacity to avoid difficult decisions about seeking consent for their participation. Future developments, such as the incoming EU Regulations, may address some of these differences, however the justification and level of risk permitted requires review to ensure that requirements are appropriate and proportionate to the burdens and risks for the individual, and also to the benefits for the wider population represented.

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 10 September 2016)
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Research article
Spatiotemporal dynamics of the Ebola epidemic in Guinea and implications for vaccination and disease elimination: a computational modeling analysis
Marco Ajelli, Stefano Merler, Laura Fumanelli, Ana Pastore y Piontti, Natalie E. Dean, Ira M. Longini, M. Elizabeth Halloran and Alessandro Vespignani
Abstract
Background
Among the three countries most affected by the Ebola virus disease outbreak in 2014–2015, Guinea presents an unusual spatiotemporal epidemic pattern, with several waves and a long tail in the decay of the epidemic incidence.
Methods
Here, we develop a stochastic agent-based model at the level of a single household that integrates detailed data on Guinean demography, hospitals, Ebola treatment units, contact tracing, and safe burial interventions. The microsimulation-based model is used to assess the effect of each control strategy and the probability of elimination of the epidemic according to different intervention scenarios, including ring vaccination with the recombinant vesicular stomatitis virus-vectored vaccine.
Results
The numerical results indicate that the dynamics of the Ebola epidemic in Guinea can be quantitatively explained by the timeline of the implemented interventions. In particular, the early availability of Ebola treatment units and the associated isolation of cases and safe burials helped to limit the number of Ebola cases experienced by Guinea. We provide quantitative evidence of a strong negative correlation between the time series of cases and the number of traced contacts. This result is confirmed by the computational model that suggests that contact tracing effort is a key determinant in the control and elimination of the disease. In data-driven microsimulations, we find that tracing at least 5–10 contacts per case is crucial in preventing epidemic resurgence during the epidemic elimination phase. The computational model is used to provide an analysis of the ring vaccination trial highlighting its potential effect on disease elimination.
Conclusions
We identify contact tracing as one of the key determinants of the epidemic’s behavior in Guinea, and we show that the early availability of Ebola treatment unit beds helped to limit the number of Ebola cases in Guinea.

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 10 September 2016)

Commentary
Infectious diseases epidemic threats and mass gatherings: refocusing global attention on the continuing spread of the Middle East Respiratory syndrome coronavirus (MERS-CoV)
Alimuddin Zumla, Abdulaziz N. Alagaili, Matthew Cotten and Esam I. Azhar
BMC Medicine 2016 14:132
Published on: 7 September 2016
Abstract
Media and World Health Organization (WHO) attention on Zika virus transmission at the 2016 Rio Olympic Games and the 2015 Ebola virus outbreak in West Africa diverted the attention of global public health authorities from other lethal infectious diseases with epidemic potential. Mass gatherings such as the annual Hajj pilgrimage hosted by Kingdom of Saudi Arabia attract huge crowds from all continents, creating high-risk conditions for the rapid global spread of infectious diseases. The highly lethal Middle Eastern respiratory syndrome coronavirus (MERS-CoV) remains in the WHO list of top emerging diseases likely to cause major epidemics. The 2015 MERS-CoV outbreak in South Korea, in which 184 MERS cases including 33 deaths occurred in 2 months, that was imported from the Middle East by a South Korean businessman was a wake-up call for the global community to refocus attention on MERS-CoV and other emerging and re-emerging infectious diseases with epidemic potential. The international donor community and Middle Eastern countries should make available resources for, and make a serious commitment to, taking forward a “One Health” global network for proactive surveillance, rapid detection, and prevention of MERS-CoV and other epidemic infectious diseases threats.

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 10 September 2016)

Research article
The social patterning of risk factors for noncommunicable diseases in five countries: evidence from the modeling the epidemiologic transition study (METS)
Associations between socioeconomic status (SES) and risk factors for noncommunicable diseases (NCD-RFs) may differ in populations at different stages of the epidemiological transition. We assessed the social p…
Silvia Stringhini, Terrence E. Forrester, Jacob Plange-Rhule, Estelle V. Lambert, Bharathi Viswanathan, Walter Riesen, Wolfgang Korte, Naomi Levitt, Liping Tong, Lara R. Dugas, David Shoham, Ramon A. Durazo-Arvizu, Amy Luke and Pascal Bovet

Debate
Schools of public health in low and middle-income countries: an imperative investment for improving the health of populations?
Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges….
Fauziah Rabbani, Leah Shipton, Franklin White, Iman Nuwayhid, Leslie London, Abdul Ghaffar, Bui Thi Thu Ha, Göran Tomson, Rajiv Rimal, Anwar Islam, Amirhossein Takian, Samuel Wong, Shehla Zaidi, Kausar Khan, Rozina Karmaliani, Imran Naeem Abbasi…

Conflict and Health
http://www.conflictandhealth.com/
[Accessed 10 September 2016]

Research
Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment
Alex Adaku, James Okello, Blakeley Lowry, Jeremy C. Kane, Stephen Alderman, Seggane Musisi and Wietse A. Tol
Published on: 7 September 2016
Abstract
Background
Since December 2013, an armed conflict in South Sudan has resulted in the displacement of over 2.2 million people, more than 270,000 of whom are presently in refugee settlements located throughout Uganda. Existing literature suggests that refugees are at increased risk for a range of mental health and psychosocial problems. There is international consensus on the importance of needs and resource assessments to inform potential mental health and psychosocial support (MHPSS) interventions.
Methods
We conducted a MHPSS needs and resource assessment in Rhino Camp refugee settlement in northern Uganda, between June and August 2014. We followed World Health Organization (WHO) and United Nations High Commissioner for Refugees (UNHCR) guidelines for MHPSS needs assessments in humanitarian settings. The assessment used a range of methodologies including: 1) a desk (literature) review to understand the context for mental health service provision; 2) an analysis of data from existing health information systems (HIS); 3) an assessment of the current infrastructure for service provision using a shortened version of a Who does What Where until When (4Ws); and 4) semi-structured individual and group interviews (total n = 86) with key informants (n = 13) and general community members (individual interviews n = 28, four focus groups with n = 45).
Results
Data from the HIS indicated that visits to health centers in refugee settlements attributable to psychotic disorders, severe emotional disorders, and other psychological complaints increased following the refugee influx between 2013 and 2014, but overall help-seeking from health centers was low compared to estimates from epidemiological studies. In semi-structured interviews the three highest ranked mental health and psychosocial problems included “overthinking”, ethnic conflict, and child abuse. Other concerns included family separation, drug abuse, poverty, and unaccompanied minors. The 4Ws assessment revealed that there were very limited MHPSS services available in Rhino Camp.
Conclusions
The types of MHPSS problems among South Sudanese refugees in northern Uganda are diverse and the burden appears to be considerable, yet there are currently few available services. The assessment indicates the need for a range of services addressing social concerns as well as varied types of mental conditions. The idiom of “overthinking” may form a useful starting point for intervention development and mental health communication.

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 10 September 2016]

Research
Mapping of research on maternal health interventions in low- and middle-income countries: a review of 2292 publications between 2000 and 2012
Matthew Chersich, Duane Blaauw, Mari Dumbaugh, Loveday Penn-Kekana, Siphiwe Thwala, Leon Bijlmakers, Emily Vargas, Elinor Kern, Josephine Kavanagh, Ashar Dhana, Francisco Becerra-Posada, Langelihle Mlotshwa, Victor Becerril-Montekio, Priya Mannava, Stanley Luchters, Minh Duc Pham…
Published on: 6 September 2016
Abstract
Background
Progress in achieving maternal health goals and the rates of reductions in deaths from individual conditions have varied over time and across countries. Assessing whether research priorities in maternal health align with the main causes of mortality, and those factors responsible for inequitable health outcomes, such as health system performance, may help direct future research. The study thus investigated whether the research done in low- and middle-income countries (LMICs) matched the principal causes of maternal deaths in these settings.
Methods
Systematic mapping was done of maternal health interventional research in LMICs from 2000 to 2012. Articles were included on health systems strengthening, health promotion; and on five tracer conditions (haemorrhage, hypertension, malaria, HIV and other sexually transmitted infections (STIs)). Following review of 35,078 titles and abstracts in duplicate, data were extracted from 2292 full-text publications.
Results
Over time, the number of publications rose several-fold, especially in 2004–2007, and the range of methods used broadened considerably. More than half the studies were done in sub-Saharan Africa (55.4 %), mostly addressing HIV and malaria. This region had low numbers of publications per hypertension and haemorrhage deaths, though South Asia had even fewer. The proportion of studies set in East Asia Pacific dropped steadily over the period, and in Latin America from 2008 to 2012. By 2008–2012, 39.1 % of articles included health systems components and 30.2 % health promotion. Only 5.4 % of studies assessed maternal STI interventions, diminishing with time. More than a third of haemorrhage research included health systems or health promotion components, double that of HIV research.
Conclusion
Several mismatches were noted between research publications, and the burden and causes of maternal deaths. This is especially true for South Asia; haemorrhage and hypertension in sub-Saharan Africa; and for STIs worldwide. The large rise in research outputs and range of methods employed indicates a major expansion in the number of researchers and their skills. This bodes well for maternal health if variations in research priorities across settings and topics are corrected.

Health Affairs
September 2016; Volume 35, Issue 9
http://content.healthaffairs.org/content/current
Issue Focus: Payment Reforms, Prescription Drugs & More

Global
Training And Supervision Did Not Meaningfully Improve Quality Of Care For Pregnant Women Or Sick Children In Sub-Saharan Africa
Hannah H. Leslie, Anna Gage, Humphreys Nsona, Lisa R. Hirschhorn, and Margaret E. Kruk
Health Aff September 2016 35:1716-1724; doi:10.1377/hlthaff.2016.0261
Abstract
In-service training courses and supportive supervision of health workers are among the most common interventions to improve the quality of health care in low- and middle-income countries. Despite extensive investment from donors, evaluations of the long-term effect of these two interventions are scarce. We used nationally representative surveys of health systems in seven countries in sub-Saharan Africa to examine the association of in-service training and supervision with provider quality in antenatal and sick child care. The results of our analysis showed that observed quality of care was poor, with fewer than half of evidence-based actions completed by health workers, on average. In-service training and supervision were associated with quality of sick child care; they were associated with quality of antenatal care only when provided jointly. All associations were modest—at most, improvements related to interventions were equivalent to 2 additional provider actions out of the 18–40 actions expected per visit. In-service training and supportive supervision as delivered were not sufficient to meaningfully improve the quality of care in these countries. Greater attention to the quality of health professional education and national health system performance will be required to provide the standard of health care that patients deserve.

Infectious Diseases of Poverty
http://www.idpjournal.com/content
[Accessed 10 September 2016]

Research Article
Bibliometric study of research and development for neglected diseases in the BRICS
Large numbers of people are suffering from a group of diseases that mainly affect developing countries, as there are no available or affordable products for prevention or treatment. Research and development (R…
Jing Bai, Wei Li, Yang-Mu Huang and Yan Guo

JAMA
September 6, 2016, Vol 316, No. 9
http://jama.jamanetwork.com/issue.aspx

Editorial
The Challenge of Latent TB Infection FREE
Henry M. Blumberg, MD; Joel D. Ernst, MD

US Preventive Services Task Force
Recommendation Statement
Screening for Latent Tuberculosis Infection in Adults: US Preventive Services Task Force Recommendation Statement FREE

Evidence Report
Primary Care Screening and Treatment for Latent Tuberculosis Infection in Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force FREE
Leila C. Kahwati, MD, MPH; Cynthia Feltner, MD, MPH; Michael Halpern, MD, PhD, MPH; Carol L. Woodell, BSPH; Erin Boland, BA; Halle R. Amick, MSPH; Rachel Palmieri Weber, PhD; Daniel E. Jonas, MD, MPH

JAMA Pediatrics
September 2016, Vol 170, No. 9
http://archpedi.jamanetwork.com/issue.aspx

Editorial
Infant Protection Against Influenza Through Maternal Immunization: A Call for More Immunogenic Vaccines
Flor M. Munoz, MD

Original Investigation
Duration of Infant Protection Against Influenza Illness Conferred by Maternal Immunization: Secondary Analysis of a Randomized Clinical Trial
Marta C. Nunes, PhD; Clare L. Cutland, MD; Stephanie Jones, MD; Andrea Hugo, MD; Richard Madimabe, BTech; Eric A. F. Simões, MD; Adriana Weinberg, MD; Shabir A. Madhi, MD, PhD; for the Maternal Flu Trial Team
Abstract
Importance
Influenza immunization of women during pregnancy protects the young infants against influenza illness. The duration of this protection remains unclear.
Objective
To evaluate the duration of infant protection conferred by maternal immunization and its association with transplacental antibody transfer.
Design, Setting, and Participants
Infants born to women who participated in a randomized, double-blind, placebo-controlled clinical trial in 2011 and 2012 on the safety, immunogenicity, and efficacy of trivalent inactivated influenza vaccine (IIV3) during pregnancy were followed up during the first 6 months of life for polymerase chain reaction (PCR)–confirmed influenza illness. In a secondary analysis of a subset of infants, hemagglutination inhibition (HAI) antibodies were measured. The study was performed at a single center in South Africa. The secondary analysis was performed in October 2014.
Exposure
Maternal immunization for influenza.
Main Outcomes and Measures
The vaccine’s efficacy against PCR-confirmed influenza illness and the percentage of infants with HAI titers of 1:40 or more by age group.
Results
There were 1026 infants (47.2% female) born to IIV3 recipients and 1023 infants (47.3% female) born to placebo recipients who were included in the analysis of the vaccine’s efficacy. The vaccine’s efficacy against PCR-confirmed influenza illness was highest among infants 8 weeks of age or younger at 85.6% (95% CI, 38.3%-98.4%) and decreased with increasing age to 25.5% (95% CI, −67.9% to 67.8%) among infants 8 to 16 weeks of age and to 30.3% (95% CI, −154.9% to 82.6%) among infants 16 to 24 weeks of age. Similarly, in the IIV3 group, the percentage of infants with HAI titers of 1:40 or more to the influenza vaccine strains decreased from more than 56% in the first week of life to less than 40% at 16 weeks of age and less than 10.0% at 24 weeks of age.
Conclusions and Relevance
Maternal immunization conferred protection against infection in the infants for a limited period during early life. The lack of protection beyond 8 weeks of age correlated with a decrease in maternally derived antibodies.
Trial Registration
clinicaltrials.gov Identifier: NCT01306669

Journal of Human Trafficking
Volume 2, Issue 3, 2016
http://www.tandfonline.com/toc/uhmt20/current

research article
Child Sex-Trafficking Recognition, Intervention, and Referral: An Educational Framework for the Development of Health-Care-Provider Education Programs
23 Aug 2016
Cathy L. Miller, Gloria Duke & Sally Northam

research article
International Sporting Events and Human Trafficking: Effects of Mega-Events on a State’s Capacity to Address Human Trafficking
23 Aug 2016
Zack Bowersox

book review
Review of International Sex Trafficking of Women & Children – Understanding the Global Epidemic
02 Aug 2016
Yvon Dandurand

book review
Review of Global Human Trafficking: Critical Issues and Contexts
02 Aug 2016
Benjamin Thomas Greer

Journal of Immigrant and Minority Health
Volume 18, Issue 5, October 2016
http://link.springer.com/journal/10903/18/5/page/1

Original Paper
Latent Tuberculosis Infection Among Immigrant and Refugee Children Arriving in the United States: 2010
Eboni M. Taylor, John Painter, Drew L. Posey…

Original Paper
Behavioral and Environmental Explanations of Elevated Blood Lead Levels in Immigrant Children and Children of Immigrants
Stan A. Kaplowitz, Harry Perlstadt…

Original Paper
Immunization Coverage in Migrant School Children Along the Thailand-Myanmar Border
Aiko Kaji, Daniel M. Parker, Cindy S. Chu…

Original Paper
HPV Vaccine and Latino Immigrant Parents: If They Offer It, We Will Get It
Abraham Aragones, Margaux Genoff…

Journal of Infectious Diseases
Volume 214 Issue 6 September 15, 2016
http://jid.oxfordjournals.org/content/current

EDITORIAL COMMENTARIES
Editor’s choice: Dengue Vaccine: The Need, the Challenges, and Progress
Alan L. Rothman and Francis A. Ennis
J Infect Dis. (2016) 214 (6): 825-827 doi:10.1093/infdis/jiw068

Public Health Benefits of Routine Human Papillomavirus Vaccination for Adults in the Netherlands: A Mathematical Modeling Study
Suzette M. Matthijsse, Jan A. C. Hontelez, Steffie K. Naber, Kirsten Rozemeijer, Inge M. C. M. de Kok, Roel Bakker, Marjolein van Ballegooijen, Joost van Rosmalen, and Sake J. de Vlas
J Infect Dis. (2016) 214 (6): 854-861 doi:10.1093/infdis/jiw256

Journal of International Development
August 2016 Volume 28, Issue 6 Pages 825–1010
http://onlinelibrary.wiley.com/doi/10.1002/jid.v28.6/issuetoc

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Research Articles
Training Professionals and Eroding Relationships: Donors, Aids Care and Development in Urban Zambia (pages 827–844)
Amy S. Patterson
Version of Record online: 26 APR 2016 | DOI: 10.1002/jid.3222

Research Articles
Determinants and Trends of Socioeconomic Inequality in Child Malnutrition: The Case of Mozambique, 1996–2011 (pages 857–875)
Vincenzo Salvucci
Version of Record online: 6 AUG 2015 | DOI: 10.1002/jid.3135

Field Report
Deregulation and Access to Medicines: the Peruvian Experience (pages 997–1005)
Joan Costa Font
Version of Record online: 10 APR 2015 | DOI: 10.1002/jid.3096
Abstract
How does the deregulation of medicine influence access to drugs? This paper provides an economic policy assessment of the effects of medicine deregulation drawing on the Peruvian experience between 1991 and 2006. As in other low-income countries, health insurance development is inadequate, drug expenditure is mostly paid out-of-pocket and approximately one third of the Peruvian population has limited access to ‘essential medicines’. Market deregulation in this context could have exerted an impact on prices and hence reduce access to medicines. Based on this evidence, we find that product and price deregulation of the medicines market appears to have reduced consumer trust of locally produced medicines and incentivised a switch to branded and more expensive drugs. The latter resulted in a drug price spike, which in turn further decreased access to medicines.