scholarly journals Uncovering epidemiological dynamics in heterogeneous host populations using phylogenetic methods

2013 ◽  
Vol 368 (1614) ◽  
pp. 20120198 ◽  
Author(s):  
Tanja Stadler ◽  
Sebastian Bonhoeffer

Host population structure has a major influence on epidemiological dynamics. However, in particular for sexually transmitted diseases, quantitative data on population contact structure are hard to obtain. Here, we introduce a new method that quantifies host population structure based on phylogenetic trees, which are obtained from pathogen genetic sequence data. Our method is based on a maximum-likelihood framework and uses a multi-type branching process, under which each host is assigned to a type (subpopulation). In a simulation study, we show that our method produces accurate parameter estimates for phylogenetic trees in which each tip is assigned to a type, as well for phylogenetic trees in which the type of the tip is unknown. We apply the method to a Latvian HIV-1 dataset, quantifying the impact of the intravenous drug user epidemic on the heterosexual epidemic (known tip states), and identifying superspreader dynamics within the men-having-sex-with-men epidemic (unknown tip states).

2018 ◽  
Author(s):  
Brice A. J. Sarver ◽  
Matthew W. Pennell ◽  
Joseph W. Brown ◽  
Sara Keeble ◽  
Kayla M. Hardwick ◽  
...  

AbstractComparative methods allow researchers to make inferences about evolutionary processes and patterns from phylogenetic trees. In Bayesian phylogenetics, estimating a phylogeny requires specifying priors on parameters characterizing the branching process and rates of substitution among lineages, in addition to others. However, the effect that the selection of these priors has on the inference of comparative parameters has not been thoroughly investigated. Such uncertainty may systematically bias phylogenetic reconstruction and, subsequently, parameter estimation. Here, we focus on the impact of priors in Bayesian phylogenetic inference and evaluate how they affect the estimation of parameters in macroevolutionary models of lineage diversification. Specifically, we use BEAST to simulate trees under combinations of tree priors and molecular clocks, simulate sequence data, estimate trees, and estimate diversification parameters (e.g., speciation rates and extinction rates) from these trees. When substitution rate heterogeneity is large, parameter estimates deviate substantially from those estimated under the simulation conditions when not captured by an appropriate choice of relaxed molecular clock. However, in general, we find that the choice of tree prior and molecular clock has relatively little impact on the estimation of diversification rates insofar as the sequence data are sufficiently informative and substitution rate heterogeneity among lineages is low-to-moderate.


2018 ◽  
Author(s):  
Reinier Bom ◽  
Kalja van der Linden ◽  
Amy Matser ◽  
Nicolas Poulin ◽  
Maarten Schim van der Loeff ◽  
...  

HIV and other sexually transmitted infections remain a burden on men who have sex with men in the era of effective combination antiretroviral therapy. New prevention efforts are therefore needed. One of these approaches is the current country-wide free condom distribution at gay bars with darkrooms and gay saunas in the Netherlands. This study assessed the effects of free condom distribution on incidence and burden of disease of HIV and other sexually transmitted infections.A model was constructed to calculate the impact of free condom distribution on HIV, hepatitis C, chlamydia, gonorrhoea, and syphilis among men who have sex with men visiting these venues. Outcomes included new infections averted and disability-adjusted life years averted. Scenario studies were performed to predict the effects of a further increase of condom use, condom effectiveness and coverage. Lastly, cost-effectiveness and sensitivity analyses were performed.Condom use at public sex venues increased after the intervention. Our model showed decreases in annual incidence risk, ranging from 5.73% for gonorrhoea to 7.62% for HIV. The annual number of new infections averted was largest for chlamydia and gonorrhoea (261 and 394 infections, respectively), but 42 new HIV infections were averted as well. Over 98% of the decrease in burden of disease was due to HIV. In scenarios where condom use and condom effectiveness were further increased, this reduction became more extensive. The intervention was cost-effective and cost-saving (for every €1 spent on condom distribution, €5.51 was saved) and remained this in all sensitivity analyses.Free condoms at public sex venues can reduce the transmission of HIV and other sexually transmitted infections. Condom distribution is an affordable and easily implemented intervention that can reduce the burden of disease in men who have sex with men substantially.


2017 ◽  
Author(s):  
Sarah Cobey ◽  
Edward B. Baskerville ◽  
Caroline Colijn ◽  
William Hanage ◽  
Christophe Fraser ◽  
...  

AbstractIt is a truism that antimicrobial drugs select for resistance, but explaining pathogen- and population-specific variation in patterns of resistance remains an open problem. Like other common commensals, Streptococcus pneumoniae has demonstrated persistent coexistence of drug-sensitive and drug-resistant strains. Theoretically, this outcome is unlikely. We modeled the dynamics of competing strains of S. pneumoniae to investigate the impact of transmission dynamics and treatment-induced selective pressures on the probability of stable coexistence. We find that the outcome of competition is extremely sensitive to structure in the host population, although coexistence can arise from age-assortative transmission models with age-varying rates of antibiotic use. Moreover, we find that the selective pressure from antibiotics arises not so much from the rate of antibiotic use per se but from the frequency of treatment: frequent antibiotic therapy disproportionately impacts the fitness of sensitive strains. This same phenomenon explains why serotypes with longer durations of carriage tend to be more resistant. These dynamics may apply to other potentially pathogenic, microbial commensals and highlight how population structure, which is often omitted from models, can have a large impact.


2020 ◽  
Vol 69 (5) ◽  
pp. 884-896 ◽  
Author(s):  
Erik M Volz ◽  
Wiuf Carsten ◽  
Yonatan H Grad ◽  
Simon D W Frost ◽  
Ann M Dennis ◽  
...  

Abstract Population structure influences genealogical patterns, however, data pertaining to how populations are structured are often unavailable or not directly observable. Inference of population structure is highly important in molecular epidemiology where pathogen phylogenetics is increasingly used to infer transmission patterns and detect outbreaks. Discrepancies between observed and idealized genealogies, such as those generated by the coalescent process, can be quantified, and where significant differences occur, may reveal the action of natural selection, host population structure, or other demographic and epidemiological heterogeneities. We have developed a fast non-parametric statistical test for detection of cryptic population structure in time-scaled phylogenetic trees. The test is based on contrasting estimated phylogenies with the theoretically expected phylodynamic ordering of common ancestors in two clades within a coalescent framework. These statistical tests have also motivated the development of algorithms which can be used to quickly screen a phylogenetic tree for clades which are likely to share a distinct demographic or epidemiological history. Epidemiological applications include identification of outbreaks in vulnerable host populations or rapid expansion of genotypes with a fitness advantage. To demonstrate the utility of these methods for outbreak detection, we applied the new methods to large phylogenies reconstructed from thousands of HIV-1 partial pol sequences. This revealed the presence of clades which had grown rapidly in the recent past and was significantly concentrated in young men, suggesting recent and rapid transmission in that group. Furthermore, to demonstrate the utility of these methods for the study of antimicrobial resistance, we applied the new methods to a large phylogeny reconstructed from whole genome Neisseria gonorrhoeae sequences. We find that population structure detected using these methods closely overlaps with the appearance and expansion of mutations conferring antimicrobial resistance. [Antimicrobial resistance; coalescent; HIV; population structure.]


2014 ◽  
Vol 143 (8) ◽  
pp. 1575-1584 ◽  
Author(s):  
M. XIRIDOU ◽  
L. C. SOETENS ◽  
F. D. H. KOEDIJK ◽  
M. A. B. VAN DER SANDE ◽  
J. WALLINGA

SUMMARYGonorrhoea is one of the most common sexually transmitted infections. The control of gonorrhoea is extremely challenging because of the repeated development of resistance to the antibiotics used for its treatment. We explored different strategies to control the spread of antimicrobial resistance and prevent increases in gonorrhoea prevalence. We used a mathematical model that describes gonorrhoea transmission among men who have sex with men and distinguishes gonorrhoea strains sensitive or resistant to three antibiotics. We investigated the impact of combination therapy, switching first-line antibiotics according to resistance thresholds, and other control efforts (reduced sexual risk behaviour, increased treatment rate). Combination therapy can delay the spread of resistance better than using the 5% resistance threshold. Increased treatment rates, expected to enhance gonorrhoea control, may reduce gonorrhoea prevalence only in the short term, but could lead to more resistance and higher prevalence in the long term. Re-treatment of resistant cases with alternative antibiotics can substantially delay the spread of resistance. In conclusion, combination therapy and re-treatment of resistant cases with alternative antibiotics could be the most effective strategies to prevent increases in gonorrhoea prevalence due to antimicrobial resistance.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12639
Author(s):  
Hsiu-Chin Lin ◽  
Chia-Jung Tsai ◽  
Hui-Yu Wang

Background Species-specific information on distribution and demographic patterns provides important implications for conservation and fisheries management. However, such information is often lacking for morphologically-similar species, which may lead to biases in the assessments of these species and even decrease effort towards sustainable management. Here, we aimed to uncover the distribution range, population structure and demographic history for four exploited Trichiurus cutlassfishes using genetics. These cutlassfishes contribute substantial global fisheries catch, with a high proportion of catch harvested from the NW Pacific. Methods We chose the widely available mitochondrial 16S ribosomal RNA (16S) as the genetic marker for cutlassfishes. We compiled the 16S sequence data from both the GenBank and a survey of trawler catch samples along the NW Pacific coasts 22–39°N. Genealogical relationships within each species was visualized with haplotype networks and potential population differentiations were further evaluated with AMOVA. Demographic histories were estimated using neutrality test, mismatch analysis, and the Bayesian skyline plot. The reconstructed phylogenetic trees were used to delimit and estimate the divergence time of species and included populations. Results In each of two cosmopolitan species, T. lepturus and T. nanhaiensis, we observed distinct populations along the coasts of warm oceans; such population differentiation might result from historical geographic barriers in the Pleistocene. In the NW Pacific, four Trichiurus species vary in their distribution habitats, which reflect differential ecological niches among these species. The small-sized T. brevis are primarily found in nearshore habitats; the warm-affiliated T. nanhaiensis are present along the path of the Kuroshio Current; the cold-affiliated T. japonicus spatially diverged from the widely-distributed T. lepturus, with the latter mainly occupy in warmer regions. Despite these differences, a single well-mixing fish stock, thus one management unit, was identified in each of the four species, presumably due to expansion of their population sizes predated the Last Glacial Maximum and a lack of distribution barrier. The most dominant T. japonicus, which have at least one magnitude higher effective population size than the others, show a unique abrupt size expansion event at 75 to 50-kilo years ago when the low sea level occurred during the ice age. Main conclusions The demographic history revealed by our genetic analyses advances understanding of the current distribution and population structure for these congeneric species. Moreover, the uncovered population structure provides insight into the assessment and management of these species. Such information complements contemporary knowledge about these species and enables us to forecast their ability to resist future environmental and anthropogenic disturbances.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S215-S215
Author(s):  
Yewande Dayo ◽  
Chester Ashong ◽  
Andrew Hunter ◽  
Maria C Rodriguez-Barradas

Abstract Background The CDC recommends annual STD screenings in all sexually active women ³25 years old and men who have sex with men. Given the increased incidence of STDs and the need to improve their management, in September 2018 infectious diseases clinical pharmacists implemented a pharmacist-managed STD quality improvement project (QI) that reviewed positive STD test results with feedback to providers. We present the results of this QI project below. Methods The QI project consisted of prospective, daily reviews of all positive chlamydia, gonorrhea or syphilis tests (post-implementation period: 9/2018 to 2/2019). Patient electronic medical records were reviewed and assessed for the need for additional laboratory tests and to determine whether appropriate treatment was received, with feedback provided to the primary provider. In addition, risk factors were assessed to determine the appropriateness of human immunodeficiency virus (HIV) Pre-Exposure Prophylaxis (PrEP). A retrospective review of positive STD results from 9/2017 to 2/2018 was also conducted (pre-implementation period) for comparison. The purpose of this project was to evaluate the impact of pharmacist test result review on the appropriate testing, review appropriateness of prescribed treatments of patients diagnosed with any STD according to accepted clinical guidelines, and to inform the need for and the areas of focus for educating providers in the emergency room and primary care clinics on the management of these patients. Descriptive statistics, Chi square, and Fisher’s exacts tests were used to analyze the outcomes of the project. Results A total of 144 patients were included in the project (pre-implementation, n = 47; post-implementation n = 74). Please refer to the table for other results. Conclusion The implementation of a pharmacist-managed STD test review service decreased time to treatment and time to STD test result review. More patients in the post-implementation period received appropriate therapy compared with patients in the pre-intervention period. These findings indicate that there is a role for a pharmacist-managed STD test review service in assisting providers with quickly and appropriately connecting patients to care. Disclosures All authors: No reported disclosures.


2019 ◽  
Vol 147 ◽  
Author(s):  
J. Leenen ◽  
G.A.F.S. van Liere ◽  
C.J.P.A. Hoebe ◽  
A.A. Hogewoning ◽  
H.J.C. de Vries ◽  
...  

AbstractAlthough anorectalChlamydia trachomatis(CT) infections are frequently diagnosed in men who have sex with men (MSM) and women, the reason for this infection often remains unexplained, as anal sex is not always reported. Oropharyngeal infections inoculating the gastrointestinal (GI) tract may contribute to anorectal-CT infections, as evidence in animals suggests that chlamydia bacteria undergo GI passage; however, no evidence exists in humans. Longitudinal patient clinic-registry data from MSM (n= 17 125) and women (n= 4120) from two Dutch sexually transmitted infection clinics were analysed. When adjusting for confounding socio-demographics, co-infections and risk behaviour, previous (from 3 weeks up to 24 months) oropharyngeal CT was not a risk factor for subsequent anorectal CT in women (odds ratio (OR) 0.46; 95% confidence interval (CI) 0.18–1.18;P= 0.11) and MSM (OR 1.33; 95% CI 0.86–2.07;P= 0.204). Despite the large dataset, the numbers did not allow for the estimation of risk in specific subgroups of interest. The role of the GI tract cannot be excluded with this epidemiological study, but the impact of preceding oropharyngeal CT on anorectal-CT infection is likely limited.


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