Accessing sub‑national cholera epidemiological data for Nigeria and the Democratic Republic of Congo during the seventh pandemic

BACKGROUND: Vibrio cholerae is a water-borne pathogen with a global burden estimate at 1.4 to 4.0 million annual cases. Over 94% of these cases are reported in Africa and more research is needed to understand cholera dynamics in the region. Cholera data are lacking, mainly due to reporting issues, creating barriers for widespread research on cholera epidemiology and management in Africa. MAIN BODY: Here, we present datasets that were created to help address this gap, collating freely available sub-national cholera data for Nigeria and the Democratic Republic of Congo. The data were collated from a variety of English and French publicly available sources, including the World Health Organization, PubMed, UNICEF, EM-DAT, the Nigerian CDC and peer-reviewed literature. These data include information on cases, deaths, age, gender, oral cholera vaccination, risk factors and interventions. CONCLUSION: These datasets can facilitate qualitative, quantitative and mixed methods research in these two high burden countries to assist in public health planning. The data can be used in collaboration with organisations in the two countries, which have also collected data or undertaking research. By making the data and methods available, we aim to encourage their use and further data collection and compilation to help improve the data gaps for cholera in Africa

Association between Conflict and Cholera in Nigeria and the Democratic Republic of the Congo

Cholera outbreaks significantly contribute to disease mortality and morbidity in low- and middle-income countries. Cholera outbreaks have several social and environmental risk factors and extreme conditions can act as catalysts. A social extreme with known links to infectious disease outbreaks is conflict, causing disruption to services, loss of income and displacement. Here, we used the self-controlled case series method in a novel application and found that conflict increased the risk of cholera in Nigeria by 3.6 times and 19.7% of cholera outbreaks were attributable to conflict. In the Democratic Republic of Congo (DRC), conflict increased the risk of cholera by 2.6 times and 12.3% of cholera outbreaks were attributable to conflict. Our results highlight the importance of rapid and sufficient assistance during conflict-related cholera outbreaks, while also working towards conflict resolution and addressing pre-existing vulnerabilities such as poverty and access to healthcare. Article Summary Line Conflict significantly increased the risk of cholera outbreaks in Nigeria and the Democratic Republic of Congo and pre-existing vulnerabilities and conflict resolution should be a top priority to protect health.Association between Conflict and Cholera in Nigeria and the Democratic Republic of the CongopublishedVersio

Tracking infectious diseases in a warming world.

Using infectious diseases sensitive to climate as indicators of climate change helps stimulate andinform public health response

Cholera past and future in Nigeria: Are the Global Task Force on Cholera Control’s 2030 targets achievable?

Background Understanding and continually assessing the achievability of global health targets is key to reducing disease burden and mortality. The Global Task Force on Cholera Control (GTFCC) Roadmap aims to reduce cholera deaths by 90% and eliminate the disease in twenty countries by 2030. The Roadmap has three axes focusing on reporting, response and coordination. Here, we assess the achievability of the GTFCC targets in Nigeria and identify where the three axes could be strengthened to reach and exceed these goals. Methodology/Principal findings Using cholera surveillance data from Nigeria, cholera incidence was calculated and used to model time-varying reproduction number (R). A best fit random forest model was identified using R as the outcome variable and several environmental and social covariates were considered in the model, using random forest variable importance and correlation clustering. Future scenarios were created (based on varying degrees of socioeconomic development and emission reductions) and used to project future cholera transmission, nationally and sub-nationally to 2070. The projections suggest that significant reductions in cholera cases could be achieved by 2030, particularly in the more developed southern states, but increases in cases remain a possibility. Meeting the 2030 target, nationally, currently looks unlikely and we propose a new 2050 target focusing on reducing regional inequities, while still advocating for cholera elimination being achieved as soon as possible. Conclusion/Significance The 2030 targets could potentially be reached by 2030 in some parts of Nigeria, but more effort is needed to reach these targets at a national level, particularly through access and incentives to cholera testing, sanitation expansion, poverty alleviation and urban planning. The results highlight the importance of and how modelling studies can be used to inform cholera policy and the potential for this to be applied in other contexts

Screening tools for Autism Spectrum Disorder, used with people with an Intellectual Disability: A systematic review

Background A diagnosis of autism spectrum disorder (ASD) can be beneficial in ensuring the person receives appropriate support. People with intellectual disability often have undiagnosed co-occurring ASD, due to the specific diagnostic challenges that having intellectual disability can present. Screening tools can be useful to indicate those who are likely to require full diagnostic assessment of ASD. Method We conducted a systematic review of the literature. The databases ProQuest, PsycArticles, PubMed, and Web of Science were searched for articles published before July 2019. When duplicates were removed 3068 articles were retained. Articles were removed in stages and were retained if there was a possibility that the content was relevant. In total, 14 articles were reviewed fully. Results The articles covered eight ASD screening instruments and were reviewed in respect of the quality of the available reliability and validity data when used with people with intellectual disability. Conclusion A few tools have psychometric properties that indicate they have potential to screen for ASD in people with intellectual disability, but overall research with this group is limited, particularly in terms of reliability. The implications for screening and diagnosis of ASD in people with intellectual disability are discussed

Understanding the risks for post-disaster infectious disease outbreaks: a systematic review protocol.

INTRODUCTION: Disasters have many forms, including those related to natural hazards and armed conflict. Human-induced global change, such as climate change, may alter hazard parameters of these disasters. These alterations can have serious consequences for vulnerable populations, which often experience post-disaster infectious disease outbreaks, leading to morbidity and mortality. The risks and drivers for these outbreaks and their ability to form cascades are somewhat contested. Despite evidence for post-disaster outbreaks, reviews quantifying them have been on short time scales, specific geographic areas or specific hazards. This review aims to fill this gap and gain a greater understanding of the risk factors involved in these contextual outbreaks on a global level. METHODS AND ANALYSIS: Using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 checklist and Khan's methodological framework, a systematic search strategy will be created and carried out in August 2020. The strategy will search MEDLINE, Embase and GlobalHealth electronic databases and reference lists of selected literature will also be screened. Eligible studies will include any retrospective cross-sectional, case-control or cohort studies investigating an infectious disease outbreak in a local disaster affected population. Studies will not be excluded based on geographic area or publication date. Excluded papers will include non-English studies, reviews, single case studies and research discussing general risk factors, international refugee camps, public health, mental health and other non-communicable diseases, pathogen genetics or economics. Following selection, data will be extracted into a data charting form, that will be reviewed by other members of the team. The data will then be analysed both numerically and narratively. ETHICS AND DISSEMINATION: Only secondary data will be used and there will be no public or patient involvement; therefore, no ethical approval is needed. Our findings will aim to be disseminated through a peer-reviewed journal. The authors intend to use the results to inform future mathematical modelling studies

Agricultural land-uses consistently exacerbate infectious disease risks in Southeast Asia.

Agriculture has been implicated as a potential driver of human infectious diseases. However, the generality of disease-agriculture relationships has not been systematically assessed, hindering efforts to incorporate human health considerations into land-use and development policies. Here we perform a meta-analysis with 34 eligible studies and show that people who live or work in agricultural land in Southeast Asia are on average 1.74 (CI 1.47-2.07) times as likely to be infected with a pathogen than those unexposed. Effect sizes are greatest for exposure to oil palm, rubber, and non-poultry based livestock farming and for hookworm (OR 2.42, CI 1.56-3.75), malaria (OR 2.00, CI 1.46-2.73), scrub typhus (OR 2.37, CI 1.41-3.96) and spotted fever group diseases (OR 3.91, CI 2.61-5.85). In contrast, no change in infection risk is detected for faecal-oral route diseases. Although responses vary by land-use and disease types, results suggest that agricultural land-uses exacerbate many infectious diseases in Southeast Asia

Corrigendum to "Global correlates of emerging zoonoses: Anthropogenic, environmental, and biodiversity risk factors" [Int. J. Infect. Dis. 53 (Supplement) (December 2016) 21]

The authors regret that Dr Moreno di Marco's name was published with errors in the original abstract. The authors would like to apologise for any inconvenience caused

Evaluating an evidence-based online screening tool to identify learning disability

Background Many people with a learning disability are unable to benefit from health improvement measures because their learning disability is unrecognised. Screening tools such as the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) can assist with the identification of learning disability. Aim To explore whether the use of a new online version of the CAIDS-Q to identify whether or not an individual was likely to have a learning disability was consistent with reported learning disability as identified previously by a healthcare or education professional. Methods Anonymous data from people who used the online CAIDS-Q in the first weeks of the launch were collated and analysed. Results Of the 159 people who used the online CAIDS-Q, 126 (79%) were family members and/or carers of the person being screened and 31 (19%) were professionals (predominantly healthcare and education professionals). Of the 52 people who had been identified previously as having a learning disability, 47 (90%) were correctly identified as such by the CAIDS-Q score. Conclusion The CAIDS-Q online screening tool for learning disability can be used by professionals and parents. It correctly identified 90% of people who had previously been identified as having a learning disability. The accuracy of the online version of the CAIDS-Q is similar to hard copy versions, which suggests that it may be an accurate tool that can assist with the identification of people with a learning disability