Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

interest of alternative methodes in drug evaluation on particular populations

La référence de l’évaluation clinique de l’efficacité et la sécurité du médicament est l’essai thérapeutique randomisé rigoureux sur le plan méthodologique. Le développement du médicament peut être compliqué dans les maladies rares, ou dans les populations éthiquement difficiles à inclure dans les essais cliniques (femme enceinte, enfants, pathologies avec atteinte cognitive), faute d’effectif suffisant. Le manque de puissance ou d’événements observables à l’échelle de l’échantillon entraine un défaut d’évaluation du médicament comparé à la population générale. L’objectif de cette thèse est d’aborder les autres méthodes possibles d’évaluation du médicament dans ces populations particulières, et particulièrement la pharmaco-épidémiologie sur la base populationnelle du Système National des Données de Santé (SNDS). Nous avons d’abord évalué la sécurité des anti-TNFα chez les femmes françaises enceintes atteintes de Maladies Inflammatoires Chroniques Intestinales (MICI), et chez leurs enfants durant la première année de vie à partir des données du SNDS. Les anti-TNFα étaient associés à un risque accru de complications maternelles durant la grossesse, indépendamment de la durée de traitement. Il n’y avait pas de risque infectieux accru chez l’enfant jusqu’à 1 an. Dans cette même cohorte, nous avons ensuite étudié la sécurité des vaccins recommandés durant la première année de vie chez les enfants exposés in utero aux anti-TNFα. Aucun événement indésirable lié au vaccin contre la tuberculose ou la rougeole n’a été détecté chez ces enfants. Ces résultats permettent de démontrer l’intérêt de ces méthodes alternatives comme outil de l’évaluation du médicament, et peuvent participer à l’amélioration des recommandations cliniques de meilleure qualité, dans les populations où l’essai clinique randomisé n’est pas envisageable.Well conducted randomized clinical trial is considered gold standard in drug safety and efficacy evaluation. Drug development can be challenging in rare diseases, or in ethically sensitive populations (pregnant women, children, patient with cognitive defect), because of low number of subjects. The low rate of observed events at a sample scale in this population can lead to a biased evaluation of drugs compared to the general population. The aim of this work was to address alternative methods for drug evaluation in particular populations, especially pharmaco-epidemiology on populational database of the SNDS (Système National des Données de Santé). We first evaluate the safety of anti-TNFα in French pregnant women with a diagnosis of Inflammatory Bowel Disease (IBD), and in their children during their first year of life, using the SNDS database. Anti-TNFα use was associated with an increased risk of overall maternal complications during pregnancy, whatever the duration of treatment. There was no increased risk in children up to 1 year of age. In this same cohort, we then studies the security of recommended vaccines during the first year of life in children exposed in utero to antiTNF, and born to mothers with IBD. No adverse event related to tuberculosis or measles was observed. Those results demonstrate the value of alternative methods as useful tools for drug evaluation, and can strengthen the quality of clinical recommendations, in populations where clinical trial cannot be considered

Intérêt des méthodes alternatives dans l’évaluation du médicament dans les populations particulières

Well conducted randomized clinical trial is considered gold standard in drug safety and efficacy evaluation. Drug development can be challenging in rare diseases, or in ethically sensitive populations (pregnant women, children, patient with cognitive defect), because of low number of subjects. The low rate of observed events at a sample scale in this population can lead to a biased evaluation of drugs compared to the general population. The aim of this work was to address alternative methods for drug evaluation in particular populations, especially pharmaco-epidemiology on populational database of the SNDS (Système National des Données de Santé). We first evaluate the safety of anti-TNFα in French pregnant women with a diagnosis of Inflammatory Bowel Disease (IBD), and in their children during their first year of life, using the SNDS database. Anti-TNFα use was associated with an increased risk of overall maternal complications during pregnancy, whatever the duration of treatment. There was no increased risk in children up to 1 year of age. In this same cohort, we then studies the security of recommended vaccines during the first year of life in children exposed in utero to antiTNF, and born to mothers with IBD. No adverse event related to tuberculosis or measles was observed. Those results demonstrate the value of alternative methods as useful tools for drug evaluation, and can strengthen the quality of clinical recommendations, in populations where clinical trial cannot be considered.La référence de l’évaluation clinique de l’efficacité et la sécurité du médicament est l’essai thérapeutique randomisé rigoureux sur le plan méthodologique. Le développement du médicament peut être compliqué dans les maladies rares, ou dans les populations éthiquement difficiles à inclure dans les essais cliniques (femme enceinte, enfants, pathologies avec atteinte cognitive), faute d’effectif suffisant. Le manque de puissance ou d’événements observables à l’échelle de l’échantillon entraine un défaut d’évaluation du médicament comparé à la population générale. L’objectif de cette thèse est d’aborder les autres méthodes possibles d’évaluation du médicament dans ces populations particulières, et particulièrement la pharmaco-épidémiologie sur la base populationnelle du Système National des Données de Santé (SNDS). Nous avons d’abord évalué la sécurité des anti-TNFα chez les femmes françaises enceintes atteintes de Maladies Inflammatoires Chroniques Intestinales (MICI), et chez leurs enfants durant la première année de vie à partir des données du SNDS. Les anti-TNFα étaient associés à un risque accru de complications maternelles durant la grossesse, indépendamment de la durée de traitement. Il n’y avait pas de risque infectieux accru chez l’enfant jusqu’à 1 an. Dans cette même cohorte, nous avons ensuite étudié la sécurité des vaccins recommandés durant la première année de vie chez les enfants exposés in utero aux anti-TNFα. Aucun événement indésirable lié au vaccin contre la tuberculose ou la rougeole n’a été détecté chez ces enfants. Ces résultats permettent de démontrer l’intérêt de ces méthodes alternatives comme outil de l’évaluation du médicament, et peuvent participer à l’amélioration des recommandations cliniques de meilleure qualité, dans les populations où l’essai clinique randomisé n’est pas envisageable

First record for Brettus cingulatus in Vietnam (Araneae: Salticidae: Spartaeini)

Tam, Truong Van, Huy, Le Ngo Quoc, Phuc, Nguyen Trong, Nhan, Vo Hieu, Khang, Luu Vinh (2021): First record for Brettus cingulatus in Vietnam (Araneae: Salticidae: Spartaeini). Peckhamia 229 (1): 1-2, DOI: http://doi.org/10.5281/zenodo.716937

COUPLING OF MEMBRANE BIOREACTOR AND OZONATION FOR REMOVAL OF ANTIBIOTICS FROM HOSPITAL WASTEWATER

Antibiotic residues in the environment and their potential toxic effects have been considered as one of the emerging research area in the environmental field. Their continuous introduction in our environment may increase their negative impacts on human health.  In this study, the eliminations of antibiotic such as Norfloxacin (NOR), Ciprofloxacin (CIP), Ofloxacin (OFL) and Sulfamethoxazole (SMZ) in wastewater of hospital were processed by membrane bioreactor (MBR) coupled with ozonation process. In particular, the MBR was applied for the antibiotic removals followed by ozonation process as a post-treatment stage to create an adequate integration to enhance removal efficiency. Achieved results after MBR treatment showed that the removal efficiency of NOR, CIP, OFL and SMZ were 90 ± 4.0% , 83 ± 13% , 81 ± 13 % and  39 ± 6%, respectivley. In addition, those antibiotic matters were continously removed by ozonation process with the removal efficiency of 87±9.0% , 83±1.0% , 81±2.3% and 66±2.3% for NOR, CIP, OFL and SMZ, respectively. In summary, antibiotics could be basically limited by the combination of MBR and ozonation before discharging in aquatic environment

PreCEE (Pregnancy and Combined Environmental Exposure), a research program in two middle-sized cities - Part 2, Results and discussion

International audienceData from nearly 11000 deliveries that occurred between 2005 and 2009 at the Besan�on or Dijon (France) were collected during the PreCEE program, including medical, obstetrical, socio-economic and environmental conditions (noise, air pollution, proximity to green spaces). Several approaches were conducted to investigate the relationships between the occurrence of adverse pregnancy outcomes (APO) and the urban environment of two middle-sized cities, and to estimate the potential modulation of vulnerability on the impact of noise or air pollution during pregnancy. The mean NO<sub>2</sub> level ranged between 24 and 25 �g/m<sup>3</sup> and the mean L<sub>night</sub> ranged between 51 and 52 dB(A). The correlation between noise and NO<sub>2</sub> indices ranged from 0.41 to 0.59. The accumulation of 15 vulnerability markers regrouped in six dimensions (maternal age, smoking, body mass index, socio-economic, medico-obstetrical and environmental vulnerabilities) was analysed in comparison with four APO. Among the 3686 women included in this approach, 21% were not exposed to any marker and 19% accumulated three or more markers among the six dimensions. The risk of APO increased significantly with the cumulative number of vulnerabilities. Secondly, two case-control studies were conducted on preterm delivery on single pregnancies. First, only pregnancies without any associated comorbidities were considered (N=1511). No significant differences in pollutant exposure levels were found between cases and controls in this study. The second study was focused on pregnancies with associated comorbidities (N=2503). The OR associated with NO<sub>2</sub>>40μg.m<sup>-3</sup> was 0.83 (95%CI: 0.61-1.13) and the OR associated with L<sub>night</sub>&_geq;55dB(A) was 1.23 (95%CI: 0.97-1.56). A strong and monotonic association between the cumulative number of comorbidities during pregnancy and preterm delivery was also identified. Low levels of air pollution do not seem to affect preterm delivery. However, moderate noise exposure could potentially affect pregnancy when associated with vulnerability factors

Does low to moderate environmental exposure to noise and air pollution influence preterm delivery in medium-sized cities?

International audienceBackground: Preterm birth (PB) is an important predictor of childhood morbidity and educational performance. Beyond the known risk factors, environmental factors, such as air pollution and noise, have been implicated in PB. In urban areas, these pollutants coexist. Very few studies have examined the effects of multi-exposure on the pregnancy duration. The objective of this study was to analyse the relationship between PB and environmental chronic multi-exposure to noise and air pollution in medium-sized cities.Methods: A case-control study was conducted among women living in the city of Besançon (121 671 inhabitants) or in the urban unit of Dijon (243 936 inhabitants) and who delivered in a university hospital between 2005 and 2009. Only singleton pregnancies without associated pathologies were considered. Four controls were matched to each case in terms of the mother’s age and delivery location. Residential noise and nitrogen dioxide (NO2) exposures were calculated at the mother’s address. Conditional logistic regression models were applied, and sensitivity analyses were performed.Results: This study included 302 cases and 1204 controls. The correlation between noise and NO2 indices ranged from 0.41 to 0.59. No significant differences were found in pollutant exposure levels between cases and controls. The adjusted odds ratios ranged between 0.96 and 1.08. Sensitivity analysis conducted using different temporal and spatial exposure windows demonstrated the same results.Conclusions: The results are in favour of a lack of connection between preterm delivery and multi-exposure to noise and air pollution in medium-sized cities for pregnant women without underlying disease

Sero-Prevalence of SARS-CoV-2 in High-Risk Populations in Vietnam

Background: As a response to the coronavirus disease 2019 (COVID-19) pandemic, Vietnam enforced strict quarantine, contact tracing and physical distancing policies. By December 2020, this strategy resulted in one of the lowest numbers of individuals infected with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) cases globally. This study aimed to determine the prevalence of SARS-CoV-2 antibody positivity among high-risk populations in Vietnam.Methods: A prevalence survey was undertaken within four communities in northern and central Vietnam, where at least two COVID-19 cases had been confirmed. Participants were classified according to the location of exposure: household contacts, close contacts, community members, and healthcare workers (HCWs) responsible for treating COVID-19 cases. Participants completed a baseline questionnaire that evaluated exposure history. SARS-CoV-2 IgG antibodies were quantified using a commercially available assay.Results: 3056 community members and 149 health care workers provided consent to participate. Among enrolled community members, 27 (0·9%) were household contacts and 53 (1·7%) were close contacts. Serology was performed in 3034 individuals. Among 13 individuals who were seropositive (0·4%), five household contacts (5/27, 18·5%), one close contact (1/53, 1·9%), and seven community members (7/2954, 0·2%) had detectable SARS-CoV-2 antibodies. All HCWs were negative for SARS-CoV-2 antibodies. Participants were tested a median of 15·1 (interquartile range 14·9 to 15·2) weeks after exposure.Conclusion: The presence of SARS-CoV-2 antibodies in high-risk communities and healthcare workers was low in communities in Vietnam with known COVID-19 cases. The public health response to the COVID-19 pandemic in Vietnam has been effective in limiting community transmission of SARS-CoV-2.Funding Statement: This project was supported by a grant funded by the Australian Department of Foreign Affairs and Trade, awarded in conjunction with the Australian National Health and Medical Research Council (APP1153346).Declaration of Interests: None declared.Ethics Approval Statement: Ethical approval was obtained from the Human Research Ethics Committees of the University of Sydney (HREC 2020/415) and Biomedical Research Ethics Committee of the National Hospital for Tropical Diseases (No. 10/HDDD-NDTU and No. 18/HDDD-NDTU). Consent was documented electronically using a tablet computer. In accordance with local expectations, all COVID-19 patients and other participants were provided with monetary compensation for their participation, equivalent to approximately US$4·30 and US$2·20, respectively