The impact of surveillance and other factors on detection of emergent and circulating vaccine derived polioviruses

Background: Circulating vaccine derived poliovirus (cVDPV) outbreaks remain a threat to polio eradication. To reduce cases of polio from cVDPV of serotype 2, the serotype 2 component of the vaccine has been removed from the global vaccine supply, but outbreaks of cVDPV2 have continued. The objective of this work is to understand the factors associated with later detection in order to improve detection of these unwanted events. Methods: The number of nucleotide differences between each cVDPV outbreak and the oral polio vaccine (OPV) strain was used to approximate the time from emergence to detection. Only independent emergences were included in the analysis. Variables such as serotype, surveillance quality, and World Health Organization (WHO) region were tested in a negative binomial regression model to ascertain whether these variables were associated with higher nucleotide differences upon detection. Results: In total, 74 outbreaks were analysed from 24 countries between 2004 and 2019. For serotype 1 (n=10), the median time from seeding until outbreak detection was 284 (95% uncertainty interval (UI) 284-2008) days, for serotype 2 (n=59), 276 (95% UI 172-765) days, and for serotype 3 (n=5), 472 (95% UI 392-603) days. Significant improvement in the time to detection was found with increasing surveillance of non-polio acute flaccid paralysis (AFP) and adequate stool collection. Conclusions: cVDPVs remain a risk globally; all WHO regions have reported at least one VDPV outbreak since the first outbreak in 2001. Maintaining surveillance for poliomyelitis after local elimination is essential to quickly respond to both emergence of VDPVs and potential importations. Considerable variation in the time between emergence and detection of VDPVs were apparent, and other than surveillance quality and inclusion of environmental surveillance, the reasons for this remain unclear.

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Post-polio eradication: vaccination strategies and options for India

Healthcare in Low-resource Settings ◽

10.4081/hls.2014.1978 ◽

2014 ◽

Vol 2 (2) ◽

Author(s):

Jayakrishnan Thayyil ◽

Thejus Jayakrishnan

Keyword(s):

International Health ◽

Main Tool ◽

Oral Polio Vaccine ◽

Polio Eradication ◽

World Health ◽

Wild Poliovirus ◽

Polio Vaccine ◽

Vaccination Strategies ◽

Health Agencies ◽

Health Organization

In 1988, the World Health Organization (WHO) resolved to eradicate poliomyelitis globally. Since then, the initiative has reported dramatic progress in decreasing the incidence of poliomyelitis and limiting the geographical extent of transmission. 2013 is recorded as the second consecutive year not reporting wild poliovirus (WPV) from India. If the country can retain this position for one more year India will be declared as polio eradicated. What should be the future vaccination strategies? We searched and reviewed the full text of the available published literature on polio eradication via PubMed and examined Internet sources and websites of major international health agencies. The oral polio vaccine (OPV) has been the main tool in the polio eradication program. Once WPV transmission is interrupted, the poliomyelitis will be caused only by OPV. India could expect 1 vaccine-associated paralytic polio per 4.2-4.6 million doses of OPV. Considering the threat of vaccine-derived viruses to polio eradication, WHO urged to develop a strategy to safely discontinue OPV after certification. The ultimate aim is to stop OPV safely and effectively, and eventually substitute with inactivated polio vaccine (IPV). The argument against the use of IPV is its cost. From India, field based data were available on the efficacy of IPV, which was better than OPV. IPV given intradermally resulted in seroconversion rates similar to full-dose intramuscular vaccine. The incremental cost of adopting IPV to replace OPV is relatively low, about US $1 per child per year, and most countries should be able to afford this additional cost.

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Suicide by pesticide poisoning in India: a review of pesticide regulations and their impact on suicide trends

10.21203/rs.2.15477/v2 ◽

2019 ◽

Author(s):

Toby Bonvoisin ◽

Leah Utyasheva ◽

Duleeka Knipe ◽

David Gunnell ◽

Michael Eddleston

Keyword(s):

Negative Binomial ◽

Public Health Problem ◽

State Level ◽

Negative Binomial Regression ◽

World Health ◽

State Governments ◽

Suicide Rates ◽

Level Data ◽

Agricultural Yield ◽

Health Organization

Abstract Background Pesticide self-poisoning is a common means of suicide in India. Banning highly hazardous pesticides (HHPs) from agricultural use has been successful in reducing suicides in several Asian countries without affecting agricultural output. Here, we describe national and state-level regulation of HHPs and explore how they might relate to suicide rates across India.Methods Information on pesticide regulation was collated from agriculture departments of the central and state governments. National and state-level data on suicides from 1995 to 2015 were obtained from the National Crime Records Bureau (NCRB). We used joinpoint analysis and negative binomial regression to investigate any effects on trends in suicide rates nationally and in Kerala.Results As of October 2019, 318 pesticides were registered for use in India, of which 18 were extremely (Class Ia) or highly (Class Ib) hazardous according to World Health Organization criteria. Despite many HHPs still being available, several bans have been implemented during the period studied. In our quantitative analyses we focused on the permanent bans in Kerala in 2005 (of endosulfan) and 2011 (of 14 other pesticides); and nationally in 2011 (of endosulfan). NCRB data indicate that pesticides were used in 441,918 reported suicides in India from 1995-2015, 90.3% of which occurred in 11 of the 29 states. There was statistical evidence of lower than expected rates of pesticide suicides (rate ratio [RR] 0.52, 95% CI 0.49-0.54) and total suicides nationally by 2014 (0.90, 0.87-0.93) after the 2011 endosulfan ban. In Kerala, there was a lower than expected pesticide suicide rate (0.45, 0.42-0.49), but no change to the already decreasing trend in total suicides after the 2011 ban of 14 pesticides. The 2005 ban on endosulfan showed a similar effect. Agricultural outputs continued growing following the bans.Discussion Highly hazardous pesticides continue to be used in India and pesticide suicide remains a serious public health problem. However, some pesticide bans do appear to have impacted previous trends in the rates of both pesticide suicides and all suicides. Comprehensive national bans of HHPs could lead to a reduction in suicides across India, in addition to reduced occupational poisoning, with minimal effects on agricultural yield.

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Epidemic poliomyelitis, post-poliomyelitis sequelae and the eradication program

Microbiology Australia ◽

10.1071/ma20053 ◽

2020 ◽

Vol 41 (4) ◽

pp. 196

Author(s):

Margaret M Peel

Keyword(s):

Late Onset ◽

Oral Polio Vaccine ◽

The United States ◽

Polio Eradication ◽

Oral Route ◽

World Health ◽

Paralytic Poliomyelitis ◽

Polio Vaccine ◽

The Central Nervous System ◽

Health Organization

Epidemics of paralytic poliomyelitis (polio) first emerged in the late 19th and early 20th centuries in the United States and the Scandinavian countries. They continued through the first half of the 20th century becoming global. A major epidemic occurred in Australia in 1951 but significant outbreaks were reported from the late 1930s to 1954. The poliovirus is an enterovirus that is usually transmitted by the faecal–oral route but only one in about 150 infections results in paralysis when the central nervous system is invaded. The Salk inactivated polio vaccine (IPV) became available in Australia in 1956 and the Sabin live attenuated oral polio vaccine (OPV) was introduced in 1966. After decades of stability, many survivors of the earlier epidemics experience late-onset sequelae including post-polio syndrome. The World Health Organization launched the global polio eradication initiative (GPEI) in 1988 based on the easily administered OPV. The GPEI has resulted in a dramatic decrease in cases of wild polio so that only Pakistan and Afghanistan report such cases in 2020. However, a major challenge to eradication is the reversion of OPV to neurovirulent mutants resulting in circulating vaccine-derived poliovirus (cVDPV). A novel, genetically stabilised OPV has been developed recently to stop the emergence and spread of cVDPV and OPV is being replaced by IPV in immunisation programs worldwide. Eradication of poliomyelitis is near to achievement and the expectation is that poliomyelitis will join smallpox as dreaded epidemic diseases of the past that will be consigned to history.

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Corrigendum to: Epidemic poliomyelitis, post-poliomyelitis sequelae and the eradication program

Microbiology Australia ◽

10.1071/ma20053_co ◽

2020 ◽

Vol 41 (4) ◽

pp. 223

Author(s):

Margaret M Peel

Keyword(s):

Late Onset ◽

Oral Polio Vaccine ◽

The United States ◽

Polio Eradication ◽

Oral Route ◽

World Health ◽

Paralytic Poliomyelitis ◽

Polio Vaccine ◽

The Central Nervous System ◽

Health Organization

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Pneumococcal Conjugate Vaccine Impact on Meningitis and Pneumonia Among Children Aged <5 Years—Zimbabwe, 2010–2016

Clinical Infectious Diseases ◽

10.1093/cid/ciz462 ◽

2019 ◽

Vol 69 (Supplement_2) ◽

pp. S72-S80 ◽

Cited By ~ 1

Author(s):

Vongai Dondo ◽

Hilda Mujuru ◽

Kusum Nathoo ◽

Vengai Jacha ◽

Ottias Tapfumanei ◽

...

Keyword(s):

Conjugate Vaccine ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Meningitis ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Negative Binomial Regression Model ◽

Pediatric Pneumonia ◽

Vaccine Impact ◽

Meningitis In Children ◽

The Impact

Abstract Background Streptococcus pneumoniae is a leading cause of pneumonia and meningitis in children aged <5 years. Zimbabwe introduced 13-valent pneumococcal conjugate vaccine (PCV13) in 2012 using a 3-dose infant schedule with no booster dose or catch-up campaign. We evaluated the impact of PCV13 on pediatric pneumonia and meningitis. Methods We examined annual changes in the proportion of hospitalizations due to pneumonia and meningitis among children aged <5 years at Harare Central Hospital (HCH) pre-PCV13 (January 2010–June 2012) and post-PCV13 (July 2013–December 2016) using a negative binomial regression model, adjusting for seasonality. We also evaluated post-PCV13 changes in serotype distribution among children with confirmed pneumococcal meningitis at HCH and acute respiratory infection (ARI) trends using Ministry of Health outpatient data. Results Pneumonia hospitalizations among children aged <5 years steadily declined pre-PCV13; no significant change in annual decline was observed post-PCV13. Post-PCV13 introduction, meningitis hospitalization decreased 30% annually (95% confidence interval [CI], –42, –14) among children aged 12–59 months, and no change was observed among children aged 0–11 months. Pneumococcal meningitis caused by PCV13 serotypes decreased from 100% in 2011 to 50% in 2016. Annual severe and moderate outpatient ARI decreased by 30% (95% CI, –33, –26) and 7% (95% CI, –11, –2), respectively, post-PCV13 introduction. Conclusions We observed declines in pediatric meningitis hospitalizations, PCV13-type pneumococcal meningitis, and severe and moderate ARI outpatient visits post-PCV13 introduction. Low specificity of discharge codes, changes in referral patterns, and improvements in human immunodeficiency virus care may have contributed to the lack of additional declines in pneumonia hospitalizations post-PCV13 introduction.

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Managing Threats on the High Seas: The Role of Naval Bases on Reducing Maritime Piracy

Armed Forces & Society ◽

10.1177/0095327x211049462 ◽

2021 ◽

pp. 0095327X2110494

Author(s):

Orlandrew E. Danzell ◽

Jacob A. Mauslein ◽

John D. Avelar

Keyword(s):

Global Economy ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Negative Binomial Regression Model ◽

Security Issue ◽

Maritime Piracy ◽

Time Series Dataset ◽

Binomial Regression ◽

The Impact

Weak coastal states often lack an adequate, sustained naval presence to monitor and police their territorial waters. Unpatrolled waters, both territorial and otherwise, may provide pirates with substantial financial opportunities that go far beyond any single country. Maritime piracy costs the global economy on average USD 24 billion per year. This research explores the impact of naval bases on acts of piracy to determine if naval presence can decrease the likelihood of piracy. To examine this important economic and national security issue, our research employs a zero-inflated negative binomial regression model. We also rely upon a newly constructed time-series dataset for the years 1992–2018. Our study shows that the presence of naval bases is essential in helping maritime forces combat piracy. Policymakers searching for options to combat piracy should find the results of this study especially useful in creating prescriptive approaches that aid in solving offshore problems.

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Geographically Weighted Negative Binomial Regression Model Predicts Wildfire Occurrence in the Great Xing’an Mountains Better Than Negative Binomial Model

Forests ◽

10.3390/f10050377 ◽

2019 ◽

Vol 10 (5) ◽

pp. 377 ◽

Cited By ~ 4

Author(s):

Zhangwen Su ◽

Haiqing Hu ◽

Mulualem Tigabu ◽

Guangyu Wang ◽

Aicong Zeng ◽

...

Keyword(s):

Negative Binomial ◽

Negative Binomial Regression ◽

Negative Binomial Regression Model ◽

Stable Model ◽

Wildfire Occurrence ◽

Great Xing’An Mountains ◽

Binomial Regression ◽

The Impact ◽

The Relationship ◽

Better Than

Wildfire is a major disturbance that affects large area globally every year. Thus, a better prediction of the likelihood of wildfire occurrence is essential to develop appropriate fire prevention measures. We applied a global negative Binomial (NB) and a geographically weighted negative Binomial regression (GWNBR) models to determine the relationship between wildfire occurrence and its drivers factors in the boreal forests of the Great Xing’an Mountains, northeast China. Using geo-weighted techniques to consider the geospatial information of meteorological, topographic, vegetation type and human factors, we aimed to verify whether the performance of the NB model can be improved. Our results confirmed that the model fitting and predictions of GWNBR model were better than the global NB model, produced more precise and stable model parameter estimation, yielded a more realistic spatial distribution of model predictions, and provided the detection of the impact hotpots of these predictor variables. We found slope, vegetation cover, average precipitation, average temperature, and average relative humidity as important predictors of wildfire occurrence in the Great Xing’an Mountains. Thus, spatially differing relations improves the explanatory power of the global NB model, which does not explain sufficiently the relationship between wildfire occurrence and its drivers. Thus, the GWNBR model can complement the global NB model in overcoming the issue of nonstationary variables, thereby enabling a better prediction of the occurrence of wildfires in large geographical areas and improving management practices of wildfire.

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Who cares about local feed in local food products? Results from a consumer survey in Germany

British Food Journal ◽

10.1108/bfj-07-2018-0446 ◽

2019 ◽

Vol 121 (3) ◽

pp. 711-724 ◽

Cited By ~ 3

Author(s):

Adriano Profeta ◽

Ulrich Hamm

Keyword(s):

Negative Binomial ◽

Local Food ◽

Consumer Preferences ◽

Negative Binomial Regression ◽

Price Premium ◽

Negative Binomial Regression Model ◽

Animal Products ◽

Content Type ◽

Beef Steaks ◽

The Impact

Purpose The purpose of this paper is to analyse if German consumers are willing-to-pay a price premium for local food produced with local feed. The study provides insights into reasons explaining consumer preferences for animal products produced with local feed. Design/methodology/approach Computer self-assisted personal interviews (CASI) with 1,602 German consumers were conducted. To calculate the price premium for local feed, consumers were asked about their willingness-to-pay (WTP) for local feed. The respondents had to indicate their WTP for the local feed share levels 75, 90 and 100 per cent for pork cutlets, beef steaks, eggs and milk. To measure the impact of consumers’ attitudes and sociodemographic background on the WTP, a zero-inflated negative binomial regression model (ZINB) was calculated. Findings The study reveals that there is a high WTP for animal products produced with local feed. Furthermore, it delivers interesting insights into the WTP for different shares of local feed. Increasing WTPs for a 75, 90 and 100 per cent local feed origin could be found. The logit model in the zero-inflated regression showed that the buying frequency of organic foods exerted a particularly significant impact on one’s belonging to the group which has, in general, no additional WTP for locally produced feed. Originality/value Consumers’ perception of the supply chain of local products is virtually unexplored. This is one of the first papers that take this topic into account.

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1960. Lost in Translation: Comparing Rates of Outpatient Antibiotic Use in Three Metrics

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz359.137 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S62-S63

Author(s):

Christopher Prestel ◽

Laura M King ◽

Monina Bartoces ◽

Melinda M Neuhauser ◽

Lauri Hicks ◽

...

Keyword(s):

Negative Binomial ◽

National Level ◽

Negative Binomial Regression ◽

Antibiotic Use ◽

World Health ◽

Oral Antibiotic ◽

Defined Daily Doses ◽

Days Of Therapy ◽

Health Organization ◽

Over Time

Abstract Background The Centers for Disease Control and Prevention (CDC) tracks US outpatient antibiotic use in prescriptions per 1000 persons (Rx/1000), while the World Health Organization uses defined daily doses per 1000 persons (DDD/1000), which are based on average adult dose, for global surveillance. A third metric, days of therapy (DOT)/1,000 persons, has not been previously evaluated at the national level. We aim to compare time trends in outpatient oral antibiotic use as Rx/1000, DDD/1000, and DOT/1,000 in the same data to inform ongoing CDC surveillance and facilitate international comparison. Methods We identified dispensed outpatient oral antibiotics using pharmacy claims in 2011–2016 IBM® MarketScan® Commercial Databases for individuals <65 years old. Using enrollment data, we calculated mean annual membership with drug coverage. Annual rates of outpatient oral antibiotic use were calculated for Rx/1000, DDD/1000, and DOT/1000 persons. Prescriptions written with a ratio of DDD to days supplied >10 were considered biologically implausible and excluded from DDD calculations. We examined trends for each metric from 2011 to 2016 using negative binomial regression. Results Annual numbers of outpatient oral antibiotic prescriptions ranged from 18.6 million to 30.0 million (mean 24.3 million). Overall, Rx/1000 decreased by 7% from 892 in 2011 to 829 in 2016 (Figure 1). From 2011 to 2016, DDD/1000 increased 2% from 23.8 to 24.2 while DOT/1000 decreased 9% from 25.4 to 23.1. Significant per-year decreases were found from 2011 to 2016 for Rx/1000 (−1.1%) and for DOT/1000 (−1.6%), while no significant per-year change was seen with DDD/1000 (table). DDD/1000 underestimate use in pediatrics under the age of 10 (Figure 2). Prolonged duration is seen in adolescents and reflected by DOT/1000. Conclusion Trends in DDD/1000 for population aged <65 years do not mirror trends in Rx/1000 and DOT/1000. These differences may reflect that Rx/1000 and DOT/1000 more accurately capture antibiotic prescriptions in children than DDD/1000. As DDD/1000 underestimate antibiotic use in children, DDD/1000 underestimates reduction in antibiotic use over time and may not accurately reflect changes in use over time. Disclosures All Authors: No reported Disclosures.

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Getting the Word Out, Rain or Shine: The Impact of Message Features and Hazard Context on Message Passing Online

Weather Climate and Society ◽

10.1175/wcas-d-19-0021.1 ◽

2019 ◽

Vol 11 (4) ◽

pp. 763-776 ◽

Cited By ~ 1

Author(s):

Jeannette Sutton ◽

Scott L. Renshaw ◽

Sarah C. Vos ◽

Michele K. Olson ◽

Robert Prestley ◽

...

Keyword(s):

Message Passing ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Weather Forecast ◽

Weather Conditions ◽

Negative Binomial Regression Model ◽

Message Content ◽

Governmental Organizations ◽

Passing Rate ◽

The Impact

Abstract Networked social media provide governmental organizations, such as the National Weather Service (NWS), the opportunity to communicate directly with stakeholders over long periods of time as a form of online engagement. Typologies of engagement include aspects of message content that provide information, contribute to community building, and inspire action and aspects of message microstructural features that facilitate interaction and dialogue, such as directed messages, hashtags, and URLs. Currently, little is known regarding the effect of message strategies on behavioral outcomes, and whether those effects vary under different weather conditions. In this paper we examine how message practices used on Twitter by the NWS are related to message engagement under routine and nonroutine weather conditions. Our analysis employs a census of tweets sent by 12 NWS Weather Forecast Offices in spring 2016 and uses a combination of manual and automated coding to identify engagement content and microstructure features present in each message. We identify factors that increase and decrease message retransmission (retweets) within this corpus under varying threat conditions, using a mixed-effects negative binomial regression model. We find that inclusion of actionable message content, information about historical weather facts, attached visual imagery (such as a map or infograph), and named event hashtags increases message passing during both threat and nonthreat periods. In contrast, messages that include forecast and nowcast content and messages that are sent in reply to other users have a lower passing rate. Findings suggest that common message features do alter message passing, potentially informing message design practices aimed at increasing the reach of messages sent under threat conditions.

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