Estimating the effect of vaccination on antimicrobial-resistant typhoid fever in 73 countries supported by Gavi: a mathematical modelling study

BACKGROUND: Multidrug resistance and fluoroquinolone non-susceptibility (FQNS) are major concerns for the epidemiology and treatment of typhoid fever. The 2018 prequalification of the first typhoid conjugate vaccine (TCV) by WHO provides an opportunity to limit the transmission and burden of antimicrobial-resistant typhoid fever. METHODS: We combined output from mathematical models of typhoid transmission with estimates of antimicrobial resistance from meta-analyses to predict the burden of antimicrobial-resistant typhoid fever across 73 lower-income countries eligible for support from Gavi, the Vaccine Alliance. We considered FQNS and multidrug resistance separately. The effect of vaccination was predicted on the basis of forecasts of vaccine coverage. We explored how the potential effect of vaccination on the prevalence of antimicrobial resistance varied depending on key model parameters. FINDINGS: The introduction of routine immunisation with TCV at age 9 months with a catch-up campaign up to age 15 years was predicted to avert 46-74% of all typhoid fever cases in 73 countries eligible for Gavi support. Vaccination was predicted to reduce the relative prevalence of antimicrobial-resistant typhoid fever by 16% (95% prediction interval [PI] 0-49). TCV introduction with a catch-up campaign was predicted to avert 42.5 million (95% PI 24.8-62.8 million) cases and 506 000 (95% PI 187 000-1.9 million) deaths caused by FQNS typhoid fever, and 21.2 million (95% PI 16.4-26.5 million) cases and 342 000 (95% PI 135 000-1.5 million) deaths from multidrug-resistant typhoid fever over 10 years following introduction. INTERPRETATION: Our results indicate the benefits of prioritising TCV introduction for countries with a high avertable burden of antimicrobial-resistant typhoid fever. FUNDING: The Bill & Melinda Gates Foundation

Two-Loop Quantum Corrections of Scalar QED with Non-Minimal Chern-Simons Coupling

We investigate two-loop quantum corrections to non-minimally coupled Maxwell-Chern-Simons theory. The non-minimal gauge interaction represents the magnetic moment interaction between the charged scalar and the electromagnetic field. We show that the one-loop renormalizability of the theory found in previous work does not survive to the two-loop level. However, with an appropriate choice of the non-minimal coupling constant, it is possible to renormalize the two-loop effective potential and hence render it potentially useful for a detailed analysis of spontaneous symmetry breaking induced by radiative corrections.Comment: 29 pages, including 21 figures. One author added, some formulae corrected and references adde

Vortices and domain walls in a Chern-Simons theory with magnetic moment interaction

We study the structure and properties of vortices in a recently proposed Abelian Maxwell-Chern-Simons model in $2 +1$ dimensions. The model which is described by gauge field interacting with a complex scalar field, includes two parity and time violating terms: the Chern-Simons and the anomalous magnetic terms. Self-dual relativistic vortices are discussed in detail. We also find one dimensional soliton solutions of the domain wall type. The vortices are correctly described by the domain wall solutions in the large flux limit.Comment: To be published in Phys RevD 23 pages, RevTex, 5 figure

Psicoterapia y problemas actuales. Debates y alternativas

Ante la proliferación de fenómenos psicosociales, como el suicidio, la violencia sexual, los trastornos del comportamiento alimenticio y las crisis de identidad, emerge esta obra, como una respuesta reflexiva que aborda desde una pluralidad de perspectivas el quehacer psicoterapéutico, para favorecer una comprensión amplia de estas situaciones problema y ofrecer, desde la experiencia de sus autores, alternativas de entendimiento y de desarrollo de tratamientos para la atención de quienes las viven. El objetivo es compartir una comprensión innovadora de la práctica del psicoterapeuta, desde una mirada caracterizada por el diálogo interdisciplinario. Ello a partir de la recuperación de las estrategias implementadas frente a distintas coyunturas, así como a través de la reflexión personal en torno a la formación y el ejercicio profesional del psicoterapeuta, que pueden favorecer la retroalimentación y la generación de formas de intervención más adecuadas a la realidad de algunos dilemas contemporáneos y de los entornos en que estos se desenvuelven. Un libro recomendable para estudiantes, docentes y profesionales en el campo de la psicoterapia y la salud psicosocial.ITESO. A.C

Genome-scale metabolic reconstructions of multiple <i>Salmonella</i> strains reveal serovar-specific metabolic traits

Salmonella serovars colonize a wide range of hosts but the underlying genetic determinants remain poorly understood. Here, Seif et al. use a network-based computational analysis to link specific metabolic capabilities with host range and nutritional niche

Strategies to Prevent Cholera Introduction during International Personnel Deployments: A Computational Modeling Analysis Based on the 2010 Haiti Outbreak.

BackgroundIntroduction of Vibrio cholerae to Haiti during the deployment of United Nations (UN) peacekeepers in 2010 resulted in one of the largest cholera epidemics of the modern era. Following the outbreak, a UN-commissioned independent panel recommended three pre-deployment intervention strategies to minimize the risk of cholera introduction in future peacekeeping operations: screening for V. cholerae carriage, administering prophylactic antimicrobial chemotherapies, or immunizing with oral cholera vaccines. However, uncertainty regarding the effectiveness of these approaches has forestalled their implementation by the UN. We assessed how the interventions would have impacted the likelihood of the Haiti cholera epidemic.Methods and findingsWe developed a stochastic model for cholera importation and transmission, fitted to reported cases during the first weeks of the 2010 outbreak in Haiti. Using this model, we estimated that diagnostic screening reduces the probability of cases occurring by 82% (95% credible interval: 75%, 85%); however, false-positive test outcomes may hamper this approach. Antimicrobial chemoprophylaxis at time of departure and oral cholera vaccination reduce the probability of cases by 50% (41%, 57%) and by up to 61% (58%, 63%), respectively. Chemoprophylaxis beginning 1 wk before departure confers a 91% (78%, 96%) reduction independently, and up to a 98% reduction (94%, 99%) if coupled with vaccination. These results are not sensitive to assumptions about the background cholera incidence rate in the endemic troop-sending country. Further research is needed to (1) validate the sensitivity and specificity of rapid test approaches for detecting asymptomatic carriage, (2) compare prophylactic efficacy across antimicrobial regimens, and (3) quantify the impact of oral cholera vaccine on transmission from asymptomatic carriers.ConclusionsScreening, chemoprophylaxis, and vaccination are all effective strategies to prevent cholera introduction during large-scale personnel deployments such as that precipitating the 2010 Haiti outbreak. Antimicrobial chemoprophylaxis was estimated to provide the greatest protection at the lowest cost among the approaches recently evaluated by the UN

Intervention timeline.

<p>Events in 2010 are listed on the left alongside the timeframe for the simulated interventions: (I) RDT screening, (IIa) time-of-departure prophylaxis with antimicrobial drugs, (IIb) early-initiated prophylaxis with antimicrobial drugs beginning 7 d prior to deployment, (III) two-dose OCV immunization at 36 and 22 d prior to deployment, (IVa) two-dose OCV immunization combined with time-of-departure chemoprophylaxis, and (IVb) two-dose OCV immunization combined with early-initiated chemoprophylaxis.</p

Epidemiological dynamics.

<p>We illustrate model-data concordance by plotting case observations (points) along with sample paths from stochastic realizations of the model (<i>n =</i> 100) under the status-quo scenario used for fitting. We plot instances (<i>n</i> = 79) in which transmission ensued and omit those where no epidemic occurred (<i>n</i> = 21). (<b>A</b>): Cases in the Artibonite-adjacent communes; (<b>B</b>): cases in all other communes.</p