Reference Physiological Ranges for Serum Biochemical Parameters among Healthy Cameroonians to Support HIV Vaccine and Related Clinical Trials

Background: A valid scientific evaluation of the efficacy of HIV vaccines or antiretroviral drugs includes measurement of changes in physiological parameters of subjects from known established baseline reference ranges. This study was designed to establish reference ranges for biochemical parameters among healthy adult Cameroonians to support planned HIV Vaccine clinical trials and scaling up of ARV drugs among AIDS patients.Methods: After informed consent, blood and urine samples were collected from a total of 576 adult Cameroonians and analyzed for the presence of underlying pathologies that may affect biochemical parameters. Samples from 501 of them were found eligible for the determination of reference biochemical parameters. After complete assay, the data were subjected to both parametric and non parametric statistics for analyses with 2.5 and 97.5 percentiles considered as the lower and upper limits of reference ranges.Results: There were 331(66.1%) males and 170(33.9) females, with 359(71.7%) and 142(28.3) of them residing in the urban and rural areas respectively. Statistically significant differences (P<0.05) were observed in the following biochemical parameters between urban and rural participants: AST, ALT, alkaline phosphatase, creatinine, total protein, albumin, triglyceride, total cholesterol, and the bilirubins. When the data were regrouped into sex, there were statistically significant differences (P<0.05) in the following parameters between males and females: AST, ALT, creatinine, albumin, triglyceride, total cholesterol, and direct bilirubin.Conclusion: The present study shows that sex and geographic location have significant impact on reference physiological biochemical parameters of healthy, adult Cameroonians; hence this should be taken into consideration when monitoring participants either during HIV Vaccine clinical trials or on antiretroviral (ARV) drugs treatment.Key Words: Normal Biochemical Ranges, Health Adult Cameroonians

Rubella vaccine introduction in the South African public vaccination schedule : mathematical modelling for decision making

CITATION: Motaze, Nkengafac Villyen et al. 2020. Rubella vaccine introduction in the South African public vaccination schedule : mathematical modelling for decision making. Vaccines, 8(3):383, doi:10.3390/vaccines8030383.The original publication is available at: https://www.mdpi.comBackground: age structured mathematical models have been used to evaluate the impact of rubella-containing vaccine (RCV) introduction into existing measles vaccination programs in several countries. South Africa has a well-established measles vaccination program and is considering RCV introduction. This study aimed to provide a comparison of different scenarios and their relative costs within the context of congenital rubella syndrome (CRS) reduction or elimination. Methods: we used a previously published age-structured deterministic discrete time rubella transmission model. We obtained estimates of vaccine costs from the South African medicines price registry and the World Health Organization. We simulated RCV introduction and extracted estimates of rubella incidence, CRS incidence and effective reproductive number over 30 years. Results: compared to scenarios without mass campaigns, scenarios including mass campaigns resulted in more rapid elimination of rubella and congenital rubella syndrome (CRS). Routine vaccination at 12 months of age coupled with vaccination of nine-year-old children was associated with the lowest RCV cost per CRS case averted for a similar percentage CRS reduction. Conclusion: At 80% RCV coverage, all vaccine introduction scenarios would achieve rubella and CRS elimination in South Africa. Any RCV introduction strategy should consider a combination of routine vaccination in the primary immunization series and additional vaccination of older childrenPublisher's versio

A comparative evaluation of PDQ-Evidence

BACKGROUND: A strategy for minimising the time and obstacles to accessing systematic reviews of health system evidence is to collect them in a freely available database and make them easy to find through a simple ‘Google-style’ search interface. PDQ-Evidence was developed in this way. The objective of this study was to compare PDQ-Evidence to six other databases, namely Cochrane Library, EVIPNet VHL, Google Scholar, Health Systems Evidence, PubMed and Trip. METHODS: We recruited healthcare policy-makers, managers and health researchers in low-, middle- and highincome countries. Participants selected one of six pre-determined questions. They searched for a systematic review that addressed the chosen question and one question of their own in PDQ-Evidence and in two of the other six databases which they would normally have searched. We randomly allocated participants to search PDQ-Evidence first or to search the two other databases first. The primary outcomes were whether a systematic review was found and the time taken to find it. Secondary outcomes were perceived ease of use and perceived time spent searching. We asked open-ended questions about PDQ-Evidence, including likes, dislikes, challenges and suggestions for improvements. RESULTS: A total of 89 people from 21 countries completed the study; 83 were included in the primary analyses and 6 were excluded because of data errors that could not be corrected. Most participants chose PubMed and Cochrane Library as the other two databases. Participants were more likely to find a systematic review using PDQ-Evidence than using Cochrane Library or PubMed for the pre-defined questions. For their own questions, this difference was not found. Overall, it took slightly less time to find a systematic review using PDQ-Evidence. Participants perceived that it took less time, and most participants perceived PDQ-Evidence to be slightly easier to use than the two other databases. However, there were conflicting views about the design of PDQ-Evidence. CONCLUSIONS: PDQ-Evidence is at least as efficient as other databases for finding health system evidence. However, using PDQ-Evidence is not intuitive for some people

Reference Physiological Ranges for Serum Biochemical Parameters among Healthy Cameroonians to Support HIV Vaccine and Related Clinical Trials

Background: A valid scienti\ufb01c evaluation of the e\ufb03cacy of HIV vaccines or antiretroviral drugs includes measurement of changes in physiological parameters of subjects from known established baseline reference ranges. This study was designed to establish reference ranges for biochemical parameters among healthy adult Cameroonians to support planned HIV Vaccine clinical trials and scaling up of ARV drugs among AIDS patients. Methods: After informed consent, blood and urine samples were collected from a total of 576 adult Cameroonians and analyzed for the presence of underlying pathologies that may a\ufb00ect biochemical parameters. Samples from 501 of them were found eligible for the determination of reference biochemical parameters. After complete assay, the data were subjected to both parametric and non parametric statistics for analyses with 2.5 and 97.5 percentiles considered as the lower and upper limits of reference ranges. Results: There were 331 (66.1%) males and 170 (33.9) females, with 359 (71.7%) and 142 (28.3%) of them residing in the urban and rural areas respectively. Statistically signi\ufb01cant di\ufb00erences (P<0.05) were observed in the following biochemical parameters between urban and rural participants: AST, ALT, alkaline phosphatase, creatinine, total protein, albumin, triglyceride, total cholesterol, and the bilirubins. When the data were regrouped into sex, there were statistically signi\ufb01cant di\ufb00erences (P<0.05) in the following parameters between males and females: AST, ALT, creatinine, albumin, triglyceride, total cholesterol, and direct bilirubin. Conclusion: The present study shows that sex and geographic location have signi\ufb01cant impact on reference physiological biochemical parameters of healthy, adult Cameroonians; hence this should be taken into consideration when monitoring participants either during HIV Vaccine clinical trials or on antiretroviral (ARV) drugs treatment

Productive disruption: opportunities and challenges for innovation in infectious disease surveillance

Infectious diseases place an unacceptable and disproportionate social and economic burden on low-income countries. National disease control programmes have the difficult task of allocating limited budgets for interventions across regions of their countries, based on often disparate datasets of varying quality from a range of sources including clinics, hospitals, village health workers, the private sector and non-governmental organisations (NGOs). Every stage of the data collection and analysis pipeline for surveillance systems may be affected by a lack of capacity as well as by biases and misaligned incentives for reporting and managing data. Addressing these issues will be essential for effective reduction in the burden of endemic infectious diseases globally as well as to preparing for emerging epidemic threats

Productive disruption: opportunities and challenges for innovation in infectious disease surveillance

* New innovations that could transform infectious disease surveillance and control, including the use of Big Data, mobile health approaches and cutting edge quantitative methods, offer hope for disrupting traditional health systems and improving health worldwide.* Much has been made of their potential, but very few have been translated successfully into policy or scaled up to a population level.* We argue that there is currently a lack of integration of new approaches, making them unsustainable or unrealistic for most national control programmes and that the gulf between academia and policy makers remains a major barrier to their implementation.* We propose that these innovations must be designed with direct input from national control programmes and embedded within already existing health systems