Using Decision Analysis to Improve Malaria Control Policy Making

Malaria and other vector-borne diseases represent a significant and growing burden in many tropical countries. Successfully addressing these threats will require policies that expand access to and use of existing control methods, such as insecticide-treated bed nets (ITNs) and artemesinin combination therapies (ACTs) for malaria, while weighing the costs and benefits of alternative approaches over time. This paper argues that decision analysis provides a valuable framework for formulating such policies and combating the emergence and re-emergence of malaria and other diseases. We outline five challenges that policy makers and practitioners face in the struggle against malaria, and demonstrate how decision analysis can help to address and overcome these challenges. A prototype decision analysis framework for malaria control in Tanzania is presented, highlighting the key components that a decision support tool should include. Developing and applying such a framework can promote stronger and more effective linkages between research and policy, ultimately helping to reduce the burden of malaria and other vector-borne diseases

Social Distancing Metrics and Estimates of SARS-CoV-2 Transmission Rates: Associations between mobile telephone data tracking and R

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19). In the absence of robust preventive or curative strategies, the implementation of social distancing has been a key component of limiting the spread of the virus. Methods: Daily estimates of R(t) were calculated, and compared with measures of social distancing made publicly available by Unacast. Daily-generated variables representing an overall grade for distancing, changes in distances traveled, encounters between individuals, and daily visitation, were modeled as predictors of average R value for the following week, using linear regression techniques for eight counties surrounding the city of Syracuse, NY. Supplementary analysis examined differences between counties. Results: A total of 225 observations were available across the 8 counties, with 166 meeting the Mean R(t)<3 outlier criterion for the regression models. Measurements for Distance (β=1.002, p=.001), Visitation (β=.887, p=.012), and Encounters (β=1.070, p=.001) were each predictors of R(t) for the following week. Mean R(t) drops when overall distancing grades move from D+ to C-. These trends were significant (p<.001 for each). Conclusions: Social distancing, when assessed by free and publicly available measures such as those shared by Unacast, has an impact on viral transmission rates. The Scorecard may also be useful for public messaging about social distance, in hospital planning, and in the interpretation of epidemiological models.https://deepblue.lib.umich.edu/bitstream/2027.42/155389/1/Uncast_by_R_manuscript_Final_watermarked.pdfDescription of Uncast_by_R_manuscript_Final_watermarked.pdf : Main Articl

Correction: Virtual Morality: Transitioning from Moral Judgment to Moral Action?

[This corrects the article DOI: 10.1371/journal.pone.0164374.]

Marine Copepods, The Wildebeest of the Ocean

Copepods are amongst the most abundant animals on our planet. Who knew?! These small (typically 1–10 mm) crustaceans are found in all of the world’s oceans and play an important role in regulating Earth’s climate. Like wildebeest in the Serengeti graze on grasslands and are food for lions, herbivorous copepods represent a vital link in oceanic food chains between microscopic algae and higher predators, such as fish, birds, and whales. A group of copepods called Calanus are particularly important in the Northern Hemisphere. These tiny-but-mighty animals also share the wildebeest’s need to make a large annual migration—but in their case, they sink thousands of meters downwards to spend the winter in the deep, dark ocean. Understanding the lives of marine copepods, and how their populations will respond to climate change, is crucial for predicting the future health of the marine environment and how it helps our planet

Detection of OH absorption against PSR B1849+00

We have searched for OH absorption against seven pulsars using the Arecibo telescope. In both OH mainlines (at 1665 and 1667 MHz), deep and narrow absorption features were detected toward PSR B1849+00. In addition, we have detected several absorption and emission features against B33.6+0.1, a nearby supernova remnant (SNR). The most interesting result of this study is that a pencil-sharp absorption sample against the PSR differs greatly from the large-angle absorption sample observed against the SNR. If both the PSR and the SNR probe the same molecular cloud then this finding has important implications for absorption studies of the molecular medium, as it shows that the statistics of absorbing OH depends on the size of the background source. We also show that the OH absorption against the PSR most likely originates from a small (<30 arcsec) and dense (>10^5 cm^-3) molecular clump.Comment: 12 pages, 8 figures. Accepted for publication in Ap

Longitudinal Analysis of Dengue Virus–Specific Memory T Cell Responses and Their Association With Clinical Outcome in Subsequent DENV Infection

Memory T cells resulting from primary dengue virus (DENV) infection are hypothesized to influence the clinical outcome of subsequent DENV infection. However, the few studies involving prospectively collected blood samples have found weak and inconsistent associations with outcome and variable temporal trends in DENV-specific memory T cell responses between subjects. This study used both ex-vivo and cultured ELISPOT assays to further evaluate the associations between DENV serotype-cross-reactive memory T cells and severity of secondary infection. Using ex-vivo ELISPOT assays, frequencies of memory T cells secreting IFN-γ in response to DENV structural and non-structural peptide pools were low in PBMC from multiple time points prior to symptomatic secondary DENV infection and showed a variable response to infection. There were no differences in responses between subjects who were not hospitalized (NH, n=6) and those who were hospitalized with dengue hemorrhagic fever (hDHF, n=4). In contrast, responses in cultured ELISPOT assays were more reliably detectable prior to secondary infection and showed more consistent increases after infection. Responses in cultured ELISPOT assays were higher in individuals with hDHF (n=8) compared to NH (n=9) individuals before the secondary infection, with no difference between these groups after infection. These data demonstrate an association of pre-existing DENV-specific memory responses with the severity of illness in subsequent DENV infection, and suggest that frequencies of DENV-reactive T cells measured after short-term culture may be of particular importance for assessing the risk for more severe dengue disease

Longitudinal Analysis of Memory B and T Cell Responses to Dengue Virus in a 5-Year Prospective Cohort Study in Thailand

Prior exposure to dengue virus (DENV) has a profound impact on the outcome of infection, which varies according to the interval between infections. Antibodies secreted by B cells and cytokines secreted by T cells are thought to contribute both to protective immunity against DENV and the pathogenesis of dengue disease. We analyzed peripheral blood mononuclear cells (PBMC) collected from Thai children over a 5-year prospective cohort study to define the dynamics of DENV-specific memory B and T cell responses and the impact of symptomatic or subclinical DENV infections. To measure B cell responses, PBMC were stimulated with IL-2 plus R848 and culture supernatants were tested for DENV-binding antibodies by ELISA. To measure T cell responses, PBMC were stimulated in dual-color ELISPOT assays with overlapping peptide pools of structural and non-structural proteins from the four DENV types. B cell responses were low to one or more DENV types prior to symptomatic infection and increased with reactivity to all four types after infection. Subjects who had a subclinical infection or who did not experience a DENV infection during the study period showed strong memory B cell responses to all four DENV types. T cell responses to DENV peptides demonstrated a cytokine hierarchy of IFN-γ \u3e IL-2 \u3e IFN-γ/IL-2. T cell responses were low or absent prior to secondary infections. The trends in T cell responses to DENV peptides over 3 year post-infection were highly variable, but subjects who had experienced a secondary DENV1 infection showed higher cytokine responses compared to subjects who had experienced a secondary DENV2 or subclinical infection. The longitudinal nature of our study demonstrates persistent memory B cell responses over years and a lasting but variable impact of secondary DENV infection on DENV-specific T cell responses

Key findings and comparisons from analogous case-cluster studies for dengue virus infection conducted in Machala, Ecuador, and Kamphaeng Phet, Thailand

The Thai research study presented here was funded by an R01 award from the National Institutes of Health (PI: TE, GM83224-01A1). This Ecuadorian research study was supported, in part, by the Department of Defense Global Emerging Infection Surveillance (GEIS) grant (P0220_13_OT) and the Department of Medicine of SUNY Upstate Medical University. AS-I and SR were additionally supported by NSF DEB EEID 1518681 and NSF DEB RAPID 1641145.Dengue viruses (DENV) pose a significant and increasing threat to human health across broad regions of the globe. Currently, prevention, control, and treatment strategies are limited. Promising interventions are on the horizon, including multiple vaccine candidates under development and a renewed and innovative focus on controlling the vector, Aedes aegypti. However, significant gaps persist in our understanding of the similarities and differences in DENV epidemiology across regions of potential implementation and evaluation. In this manuscript, we highlight and compare findings from two analogous cluster-based studies for DENV transmission and pathogenesis conducted in Thailand and Ecuador to identify key features and questions for further pursuit. Despite a remarkably similar incidence of DENV infection among enrolled neighborhood contacts at the two sites, we note a higher occurrence of secondary infection and severe illness in Thailand compared to Ecuador. A higher force of infection in Thailand, defined as the incidence of infection among susceptible individuals, is suggested by the higher number of captured Aedes mosquitoes per household, the increasing proportion of asymptomatic infections with advancing age, and the high proportion of infections identified as secondary-type infections by serology. These observations should be confirmed in long-term, parallel prospective cohort studies conducted across regions, which would advantageously permit characterization of baseline immune status (susceptibility) and contemporaneous assessment of risks and risk factors for dengue illness.Publisher PDFPeer reviewe

Vaginal Colonization with Staphylococcus aureus in Healthy Women: A Review of Four Studies

Four studies assessed the frequency of vaginal Staphylococcus aureus colonization in healthy women and associated risk factors. An association was found between S. aureus vaginal colonization and colonization at the labia minora and the anterior nares. Significant risk factors associated with an increased risk of vaginal S. aureus in at least one study were a history of genital herpes simplex infection, insertion of tampons without an applicator, and the use of Rely (Procter & Gamble) tampons. The use of systemic antibiotics within 2 weeks of the vaginal culture decreased the risk of recovery of S. aureus. The overall frequency of vaginal S. aureus in the 808 women in the four studies was 9.2%