Characteristics of reviewed health research priority setting initiatives with a focus on LMICs.

<p>*Denotes category adds to more than 100% due to classification in a number of ways.</p><p><i>Region:</i> 3 initiatives were carried out in multiple regions; <i>Income classification:</i> 1 initiative was undertaken in three countries, with different income classifications.</p><p>Characteristics of reviewed health research priority setting initiatives with a focus on LMICs.</p

Identification of reports of health research priority setting initiatives from (a) peer reviewed and (b) non peer reviewed sources.

<p>Identification of reports of health research priority setting initiatives from (a) peer reviewed and (b) non peer reviewed sources.</p

The cumulative number of antibiotic treatments distributed in the predominantly hyperendemic region under a selection of the future intervention scenarios between 2012 and 2020.

<p>The reduced number of antibiotics required under the ‘increase facial cleanliness’, ‘increase facial cleanliness, screening and treatment’, and ‘current targets’ future scenarios reflects the lower incidence rates observed when the young population has a higher clean face prevalence. This lower incidence results in a lower disease prevalence and therefore fewer communities require large scale antibiotic programs to control the disease. The ‘proposed targets’ and ‘combination of all interventions’ scenarios illustrate the sharp initial increase in antibiotic distribution required to implement policies in which repeated MDA is administered to hyperendemic communities. However, the antibiotic distribution effort required under these scenarios is drastically reduced following an early peak, demonstrating the effectiveness of such programs in drastically reducing disease prevalence.</p

The shift in intervention strategy and intensity for the range of the alternative future intervention strategies considered.

<p>The shift in intervention strategy and intensity for the range of the alternative future intervention strategies considered.</p

The epidemiological effect of past intervention efforts on disease prevalence amongst 5–9 year old children in two de-identified remote Australian regions.

<p>The thin blue curves represent the 90% inter-percentile range of 1,000 model simulations with the past intervention effort applied as empirically recorded. The thick blue curve illustrates the mean simulation. The corresponding red curves describe the hypothetical scenario that a trivial intervention effort was observed. The black dots represent the weighted disease prevalence levels of 5–9 year old children found through annual screening events in each of the at-risk communities modelled within the specific region. Accompanying each of the observed prevalence points is a 95% confidence interval which reflects the regional screening coverage achieved in the given year. The extreme 2008 prevalence in the right hand figure is likely due to the temporary mass migration of individuals [<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003474#pntd.0003474.ref028" target="_blank">28</a>].</p

(a) Illustration of the model structure.

<p>The stars represent individuals, the rounded squares represent households, the circles represent communities and the rectangle represents a region. Each individual has a propensity to temporarily migrate from their usual abode in their home community to a household in a neighbouring community. Transmission can occur between individuals residing (either permanently or temporarily) within a household or between individuals currently within a community. Age-stratified mixing patterns differ dependent upon whether individuals are of the same household, a different household in the same community, or are temporary visitors to the household or community. <b>(b)</b> Natural history of trachoma utilised by the model. After contracting infection an individual enters a short latent period where infection load is such that the newly infected individual is not yet infectious, whilst active disease has yet to develop. The natural immune response then develops and the infected individual progresses to an infectious state where clinical disease is evident. Whilst in this stage of disease progression, the individual is not susceptible to re-infection. Following the clearance of infection, the individual enters a disease-only state in which they are immune to re-infection, but are subject to a prolonged disease episode when re-challenged. After partially resolving the clinical disease, an individual progresses into a second disease-only state where they are susceptible to re-infection. In the event that no re-infection occurs during this episode, the individual fully recovers to the susceptible state. The duration of each infection and disease state is dependent upon the age of the individual.</p

Scabies and Impetigo Prevalence and Risk Factors in Fiji: A National Survey

<div><p>Background</p><p>Scabies is recognised as a major public health problem in many countries, and is responsible for significant morbidity due to secondary bacterial infection of the skin causing impetigo, abscesses and cellulitis, that can in turn lead to serious systemic complications such as septicaemia, kidney disease and, potentially, rheumatic heart disease. Despite the apparent burden of disease in many countries, there have been few large-scale surveys of scabies prevalence or risk factors. We undertook a population-based survey in Fiji of scabies and impetigo to evaluate the magnitude of the problem and inform public health strategies.</p><p>Methodology/Principal Findings</p><p>A total of 75 communities, including villages and settlements in both urban and rural areas, were randomly selected from 305 communities across the four administrative divisions, and all residents in each location were invited to participate in skin examination by trained personnel. The study enrolled 10,887 participants. The prevalence of scabies was 23.6%, and when adjusted for age structure and geographic location based on census data, the estimated national prevalence was 18.5%. The prevalence was highest in children aged five to nine years (43.7%), followed by children aged less than five (36.5%), and there was also an indication of prevalence increasing again in older age. The prevalence of scabies was twice as high in iTaukei (indigenous) Fijians compared to Indo-Fijians. The prevalence of impetigo was 19.6%, with a peak in children aged five to nine years (34.2%). Scabies was very strongly associated with impetigo, with an estimated 93% population attributable risk.</p><p>Conclusions</p><p>As far as we are aware, this is the first national survey of scabies and impetigo ever conducted. We found that scabies occurs at high levels across all age groups, ethnicities, and geographical locations. Improved strategies are urgently needed to achieve control of scabies and its complications in endemic communities.</p></div

The aggregated likelihood of satisfying the trachoma control criteria by 2020 within a community under each of the considered future intervention scenarios, segregated by community endemicity.

<p>The values illustrated in the top left subplot indicate the significant increase in control likelihood that can be achieved by enhancing the intervention strategy and intensity in the worst affected communities.</p

Comparison of WHO and Australian 2006 guidelines for trachoma management.

<p>Comparison of WHO and Australian 2006 guidelines for trachoma management.</p

Distribution of treatment strategies used across all years of available data, in communities by whether communities ever had community-wide treatment.

<p>Distribution of treatment strategies used across all years of available data, in communities by whether communities ever had community-wide treatment.</p