Publications

@article{Neyer2024,

title = {Increased erythroferrone levels in malarial anaemia},

author = {Peter J. Neyer and B\'{e}renger Kabor\'{e} and Christos T. Nakas and Salou Diallo and Halidou Tinto and Annelies Post and Andre J. Ven and Andreas R. Huber and Carlo R. Largiad\`{e}r and Angelika Hammerer-Lercher},

url = {https://pubmed.ncbi.nlm.nih.gov/38279554/},

doi = {10.1111/BJH.19309},

issn = {1365-2141},

year  = {2024},

date = {2024-01-01},

journal = {British journal of haematology},

volume = {204},

issue = {5},

pages = {2066-2070},

publisher = {Br J Haematol},

abstract = {We assessed the diagnostic potential of erythroferrone as a biomarker for iron homeostasis comparing iron deficiency cases with anaemia of inflammation and controls. The dysregulation of the hepcidin axis was observed by Latour et al. in a mouse model of malarial anaemia induced by prolonged Plasmodium infection leading to increased erythroferrone concentrations. In line with that, we found significantly higher erythroferrone levels in cases with malaria and anaemia in an African population, compared to asymptomatic controls. Therefore, our findings extend the previous ones of the mouse model, suggesting also a dysregulation of the hepcidin axis in humans, which should be further corroborated in prospective studies and may lay the basis for the development of improved treatment strategies according to ERFE concentrations in such patients.},

keywords = {Anemia, Anemia / blood, Anemia / etiology, Angelika Hammerer-Lercher, Animals, B\'{e}renger Kabor\'{e}, Biomarkers* / blood, doi:10.1111/bjh.19309, Female, Hepcidins / blood, Humans, Iron / blood, Iron / metabolism, Iron-Deficiency / blood, Malaria* / blood, Malaria* / complications, Male, MEDLINE, Mice, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Peptide Hormones* / blood, Peter J Neyer, pmid:38279554, PubMed Abstract},

pubstate = {published},

tppubtype = {article}

}

@article{Valia2024,

title = {Antibiotic use by clinical presentation across all healthcare providers in rural Burkina Faso: a healthcare visit exit survey},

author = {Daniel Valia and Brecht Ingelbeen and Gu\'{e}tawend\'{e} Job Wilfried Nassa and B\'{e}renger Kabor\'{e} and Fran\c{c}ois Kiemd\'{e} and Toussaint Rouamba and Ad\'{e}la\"{i}de Compaor\'{e} and Juste St\'{e}phane Kouanda and Annie Robert and Hector Rodriguez-Villalobos and Marianne A B Van Der Sande and Halidou Tinto},

url = {https://pubmed.ncbi.nlm.nih.gov/39051704/},

doi = {10.1093/JAC/DKAE252},

issn = {1460-2091},

year  = {2024},

date = {2024-01-01},

journal = {The Journal of antimicrobial chemotherapy},

volume = {79},

issue = {10},

publisher = {J Antimicrob Chemother},

abstract = {DOI: 10.1093/jac/dkae252; Journal of Antimicrobial Chemotherapy, 00, 0, 2024-07-25.; Abstract: Background: To guide antibiotic stewardship interventions, understanding for what indications antibiotics are used is essential. Methods: In rural Burkina Faso, we measured antibiotic dispensing across all healthcare providers. From October 2021 to February 2022, we surveyed patients in Nanoro district, Burkina Faso, following visits to health centres (3), pharmacies (2), informal medicine vendors (5) and inpatients in health centres. We estimated prevalence of antibiotic use and the proportion of Watch group antibiotics by provider type and by clinical presentation, assessing compliance with WHO’s AWaRe Antibiotic Book. We estimated per capita antibiotic use by multiplying prevalence of antibiotic use, mean DDD per adult treatment course, and the rate of healthcare visits per 1000 inhabitants per day, estimated from a prior household survey. Results: Outpatient antibiotic use was more fre},

keywords = {Adolescent, Adult, Anti-Bacterial Agents* / therapeutic use, Antimicrobial Stewardship* / statistics \& numerical data, Brecht Ingelbeen, Burkina Faso, Daniel Valia, doi:10.1093/jac/dkae252, Drug Utilization / statistics \& numerical data, Female, Halidou Tinto, Health Personnel* / statistics \& numerical data, Humans, Male, MEDLINE, Middle Aged, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11441991, pmid:39051704, PubMed Abstract, Rural Population* / statistics \& numerical data, Surveys and Questionnaires, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{Kiemde2024,

title = {Impact of a package of point-of-care diagnostic tests, a clinical diagnostic algorithm and adherence training on antibiotic prescriptions for the management of non-severe acute febrile illness in primary health facilities during the COVID-19 pandemic in Burkina Faso},

author = {Francois Kiemde and Juvenal Nkeramahame and Ana Belen Ibarz and Sabine Dittrich and Piero Olliaro and Daniel Valia and Toussaint Rouamba and Berenger Kabore and Alima Nadine Kone and Seydou Sawadogo and Antonia Windkouni Bere and Diane Yirgnur Some and Athanase Mwinessobaonfou Some and Adelaide Compaore and Philip Horgan and Stephan Weber and Thomas Keller and Halidou Tinto},

url = {https://pubmed.ncbi.nlm.nih.gov/39192209/},

doi = {10.1186/S12879-024-09787-Y},

issn = {1471-2334},

year  = {2024},

date = {2024-01-01},

journal = {BMC infectious diseases},

volume = {24},

issue = {1},

publisher = {BMC Infect Dis},

abstract = {Objective: To assess the impact of an intervention package on the prescription of antibiotic and subsequently the rate of clinical recovery for non-severe acute febrile illnesses at primary health centers. Methods: Patients over 6 months of age presenting to primary health care centres with fever or history of fever within the past 7 days were randomized to receive either the intervention package constituted of point-of-care tests including COVID-19 antigen tests, a diagnostic algorithm and training and communication packages, or the standard practice. The primary outcomes were antibiotic prescriptions at Day 0 (D0) and the clinical recovery at Day 7 (D7). Secondary outcomes were non-adherence of participants and parents/caregivers to prescriptions, health workers’ non-adherence to the algorithm, and the safety of the intervention. Results: A total of 1098 patients were enrolled. 551 (50.2%) were randomized to receive the intervention versus 547 (49.8%) received standard care. 1054 (96.0%) completed follow-up and all of them recovered at D7 in both arms. The proportion of patients with antibiotic prescriptions at D0 were 33.2% (183/551) in the intervention arm versus 58.1% (318/547) under standard care, risk difference (RD) -24.9 (95% CI -30.6 to -19.2, p \< 0.001), corresponding to one more antibiotic saved every four (95% CI: 3 to 5) consultations. This reduction was also statistically significant in children from 6 to 59 months (RD -34.5; 95% CI -41.7 to -27.3; p \< 0.001), patients over 18 years (RD -35.9; 95%CI -58.5 to -13.4; p = 0.002), patients with negative malaria test (RD -46.9; 95% CI -53.9 to -39.8; p \< 0.001), those with a respiratory diagnosis (RD -48.9; 95% CI -56.9 to -41.0, p \< 0.001) and those not vaccinated against COVID-19 (-24.8% 95%CI -30.7 to -18.9, p-value: \<0.001). A significant reduction in non-adherence to prescription by patients was reported (RD -7.1; 95% CI -10.9 to -3.3; p \< 0.001). Conclusion: The intervention was associated with significant reductions of antibiotic prescriptions and non-adherence, chiefly among patients with non-malaria fever, those with respiratory symptoms and children below 5 years of age. The addition of COVID-19 testing did not have a major impact on antibiotic use at primary health centers. Trial registration: Clinitrial.gov; NCT04081051 registered on 06/09/2019.},

keywords = {Adolescent, Adult, Algorithms*, Anti-Bacterial Agents* / therapeutic use, Burkina Faso, Child, COVID-19* / diagnosis, doi:10.1186/s12879-024-09787-y, Female, Fever* / drug therapy, Francois Kiemde, Halidou Tinto, Humans, Infant, Juvenal Nkeramahame, Male, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11351252, pmid:39192209, Point-of-Care Systems, Point-of-Care Testing, Preschool, Primary Health Care*, PubMed Abstract, Randomized controlled trial, SARS-Cov-2},

pubstate = {published},

tppubtype = {article}

}

@article{Schmit2024,

title = {The public health impact and cost-effectiveness of the R21/Matrix-M malaria vaccine: a mathematical modelling study},

author = {Nora Schmit and Hillary M. Topazian and H. Magloire Natama and Duncan Bellamy and Ousmane Traor\'{e} and M. Athanase Som\'{e} and Toussaint Rouamba and Marc Christian Tahita and Massa Achille Bonko and Aboubakary Sourabi\'{e} and Hermann Sorgho and Lisa Stockdale and Samuel Provstgaard-Morys and Jeremy Aboagye and Danielle Woods and Katerina Rapi and Mehreen S. Datoo and Fernando Ramos Lopez and Giovanni D. Charles and Kelly McCain and Jean Bosco Ouedraogo and Mainga Hamaluba and Ally Olotu and Alassane Dicko and Halidou Tinto and Adrian V. S. Hill and Katie J. Ewer and Azra C. Ghani and Peter Winskill},

url = {https://pubmed.ncbi.nlm.nih.gov/38342107/},

doi = {10.1016/S1473-3099(23)00816-2},

issn = {1474-4457},

year  = {2024},

date = {2024-01-01},

journal = {The Lancet. Infectious diseases},

volume = {24},

issue = {5},

pages = {465-475},

publisher = {Lancet Infect Dis},

abstract = {Background: The R21/Matrix-M vaccine has demonstrated high efficacy against Plasmodium falciparum clinical malaria in children in sub-Saharan Africa. Using trial data, we aimed to estimate the public health impact and cost-effectiveness of vaccine introduction across sub-Saharan Africa. Methods: We fitted a semi-mechanistic model of the relationship between anti-circumsporozoite protein antibody titres and vaccine efficacy to data from 3 years of follow-up in the phase 2b trial of R21/Matrix-M in Nanoro, Burkina Faso. We validated the model by comparing predicted vaccine efficacy to that observed over 12\textendash18 months in the phase 3 trial. Integrating this framework within a mathematical transmission model, we estimated the cases, malaria deaths, and disability-adjusted life-years (DALYs) averted and cost-effectiveness over a 15-year time horizon across a range of transmission settings in sub-Saharan Africa. Cost-effectiveness was estimated incorporating the cost of vaccine introduction (dose, consumables, and delivery) relative to existing interventions at baseline. We report estimates at a median of 20% parasite prevalence in children aged 2\textendash10 years (PfPR2\textendash10) and ranges from 3% to 65% PfPR2\textendash10. Findings: Anti-circumsporozoite protein antibody titres were found to satisfy the criteria for a surrogate of protection for vaccine efficacy against clinical malaria. Age-based implementation of a four-dose regimen of R21/Matrix-M vaccine was estimated to avert 181 825 (range 38 815\textendash333 491) clinical cases per 100 000 fully vaccinated children in perennial settings and 202 017 (29 868\textendash405 702) clinical cases per 100 000 fully vaccinated children in seasonal settings. Similar estimates were obtained for seasonal or hybrid implementation. Under an assumed vaccine dose price of US$3, the incremental cost per clinical case averted was $7 (range 4\textendash48) in perennial settings and $6 (3\textendash63) in seasonal settings and the incremental cost per DALY averted was $34 (29\textendash139) in perennial settings and $30 (22\textendash172) in seasonal settings, with lower cost-effectiveness ratios in settings with higher PfPR2\textendash10. Interpretation: Introduction of the R21/Matrix-M malaria vaccine could have a substantial public health benefit across sub-Saharan Africa. Funding: The Wellcome Trust, the Bill \& Melinda Gates Foundation, the UK Medical Research Council, the European and Developing Countries Clinical Trials Partnership 2 and 3, the NIHR Oxford Biomedical Research Centre, and the Serum Institute of India, Open Philanthropy.},

keywords = {Antibodies, Burkina Faso / epidemiology, Child, Cost-Benefit Analysis*, Falciparum* / economics, Falciparum* / epidemiology, Falciparum* / prevention \& control, Female, Hillary M Topazian, Humans, Infant, Malaria, Malaria Vaccines* / administration \& dosage, Malaria Vaccines* / economics, Malaria Vaccines* / immunology, Male, MEDLINE, Models, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Nora Schmit, Peter Winskill, Plasmodium falciparum / immunology, pmid:38342107, Preschool, Protozoan / blood, Protozoan Proteins / immunology, Public Health* / economics, PubMed Abstract, Research Support, Theoretical*, Vaccine Efficacy},

pubstate = {published},

tppubtype = {article}

}

@article{Barry2024,

title = {Helminth exposure and immune response to the two-dose heterologous Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen},

author = {Houreratou Barry and Edouard Lhomme and Mathieu Sur\'{e}naud and Moumini Nouctara and Cynthia Robinson and Viki Bockstal and Innocent Valea and Serge Somda and Halidou Tinto and Nicolas Meda and Brian Greenwood and Rodolphe Thi\'{e}baut and Christine Lacabaratz},

url = {https://pubmed.ncbi.nlm.nih.gov/38603720/},

doi = {10.1371/JOURNAL.PNTD.0011500},

issn = {1935-2735},

year  = {2024},

date = {2024-01-01},

journal = {PLoS neglected tropical diseases},

volume = {18},

issue = {4},

publisher = {PLoS Negl Trop Dis},

abstract = {Background The exposure to parasites may influence the immune response to vaccines in endemic African countries. In this study, we aimed to assess the association between helminth exposure to the most prevalent parasitic infections, schistosomiasis, soil transmitted helminths infection and filariasis, and the Ebola virus glycoprotein (EBOV GP) antibody concentration in response to vaccination with the Ad26.ZEBOV, MVA-BN-Filo vaccine regimen in African and European participants using samples obtained from three international clinical trials. Methods/Principal findings We conducted a study in a subset of participants in the EBL2001, EBL2002 and EBL3001 clinical trials that evaluated the Ad26.ZEBOV, MVA-BN-Filo vaccine regimen against EVD in children, adolescents and adults from the United Kingdom, France, Burkina Faso, Cote d’Ivoire, Kenya, Uganda and Sierra Leone. Immune markers of helminth exposure at baseline were evaluated by ELISA with three commercial kits which detect IgG antibodies against schistosome, filarial and Strongyloides antigens. Luminex technology was used to measure inflammatory and activation markers, and Th1/Th2/Th17 cytokines at baseline. The association between binding IgG antibodies specific to EBOV GP (measured on day 21 post-dose 2 and on Day 365 after the first dose respectively), and helminth exposure at baseline was evaluated using a multivariable linear regression model adjusted for age and study group. Seventy-eight (21.3%) of the 367 participants included in the study had at least one helminth positive ELISA test at baseline, with differences of prevalence between studies and an increased prevalence with age. The most frequently detected antibodies were those to Schistosoma mansoni (10.9%), followed by Acanthocheilonema viteae (9%) and then Strongyloides ratti (7.9%). Among the 41 immunological analytes tested, five were significantly (p \< .003) lower in participants with at least one positive helminth ELISA test result: CCL2/MCP1, FGFbasic, IL-7, IL-13 and CCL11/Eotaxin compared to participants with negative helminth ELISA tests. No significant association was found with EBOV-GP specific antibody concentration at 21 days post-dose 2, or at 365 days post-dose 1, adjusted for age group, study, and the presence of any helminth antibodies at baseline. Conclusions/Significance No clear association was found between immune markers of helminth exposure as measured by ELISA and post-vaccination response to the Ebola Ad26.ZEBOV/ MVA-BN-Filo vaccine regimen. Trial registration NCT02416453, NCT02564523, NCT02509494. ClinicalTrials.gov.},

keywords = {Adolescent, Adult, Africa, Aged, Animals, Antibodies, Child, Christine Lacabaratz, Cytokines / immunology, doi:10.1371/journal.pntd.0011500, Ebola Vaccines* / administration \& dosage, Ebola Vaccines* / immunology, Ebola* / immunology, Ebola* / prevention \& control, Ebolavirus / genetics, Ebolavirus / immunology, Edouard Lhomme, Enzyme-Linked Immunosorbent Assay, Female, Helminth / blood, Helminthiasis / immunology, Helminthiasis / prevention \& control, Helminths / genetics, Helminths / immunology, Hemorrhagic Fever, Houreratou Barry, Humans, Immunoglobulin G / blood, Male, MEDLINE, Middle Aged, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC11037528, pmid:38603720, Preschool, PubMed Abstract, Research Support, Viral* / blood, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{Datoo2024,

title = {Safety and efficacy of malaria vaccine candidate R21/Matrix-M in African children: a multicentre, double-blind, randomised, phase 3 trial},

author = {Mehreen S. Datoo and Alassane Dicko and Halidou Tinto and Jean Bosco Ou\'{e}draogo and Mainga Hamaluba and Ally Olotu and Emma Beaumont and Fernando Ramos Lopez and Hamtandi Magloire Natama and Sophie Weston and Mwajuma Chemba and Yves Daniel Compaore and Djibrilla Issiaka and Diallo Salou and Athanase M. Some and Sharon Omenda and Alison Lawrie and Philip Bejon and Harish Rao and Daniel Chandramohan and Rachel Roberts and Sandesh Bharati and Lisa Stockdale and Sunil Gairola and Brian M. Greenwood and Katie J. Ewer and John Bradley and Prasad S. Kulkarni and Umesh Shaligram and Adrian V. S. Hill and Almahamoudou Mahamar and Koualy Sanogo and Youssoufa Sidibe and Kalifa Diarra and Mamoudou Samassekou and Oumar Attaher and Amadou Tapily and Makonon Diallo and Oumar Mohamed Dicko and Mahamadou Kaya and Seydina Oumar Maguiraga and Yaya Sankare and Hama Yalcouye and Soumaila Diarra and Sidi Mohamed Niambele and Ismaila Thera and Issaka Sagara and Mala Sylla and Amagana Dolo and Nsajigwa Misidai and Sylvester Simando and Hania Msami and Omary Juma and Nicolaus Gutapaka and Rose Paul and Sarah Mswata and Ibrahim Sasamalo and Kasmir Johaness and Mwantumu Sultan and Annastazia Alexander and Isaac Kimaro and Kauye Lwanga and Mwajuma Mtungwe and Kassim Khamis and Lighton Rugarabam and Wilmina Kalinga and Mohammed Mohammed and Janeth Kamange and Jubilate Msangi and Batuli Mwaijande and Ivanny Mtaka and Matilda Mhapa and Tarsis Mlaganile and Thabit Mbaga and Rakiswende Serge Yerbanga and Wendkouni Samtouma and Abdoul Aziz Sienou and Zachari Kabre and Wendinpui Jedida Muriel Ouedraogo and G. Armel Bienvenu Yarbanga and Issaka Zongo and Hamade Savadogo and Joseph Sanon and Judicael Compaore and Idrissa Kere and Ferdinand Lionel Yoni and Tewende Martine Sanre and Seydou Bienvenu Ouattara and Samuel Provstgaard-Morys and Danielle Woods and Robert W. Snow and Nyaguara Amek and Caroline J. Ngetsa and Lynette Isabella Ochola-Oyier and Jennifer Musyoki and Marianne Munene and Noni Mumba and Uche Jane Adetifa and Charles Mwangi Muiruri and Jimmy Shangala Mwawaka and Mwatasa Hussein Mwaganyuma and Martha Njeri Ndichu and Joseph Ochieng Weya and Kelvin Njogu and Jane Grant and Jayne Webster and Anand Lakhkar and N. F\'{e}lix Andr\'{e} Ido and Ousmane Traore and Marc Christian Tahita and Massa Achille Bonko and Toussaint Rouamba and D. Florence Ouedraogo and Rachidatou Soma and Aida Millogo and Edouard Ouedraogo and Faizatou Sorgho and Fab\'{e} Konate and Innocent Valea},

url = {https://pubmed.ncbi.nlm.nih.gov/38310910/},

doi = {10.1016/S0140-6736(23)02511-4},

issn = {1474-547X},

year  = {2024},

date = {2024-01-01},

journal = {Lancet (London, England)},

volume = {403},

issue = {10426},

pages = {533-544},

publisher = {Lancet},

abstract = {Background: Recently, we found that a new malaria vaccine, R21/Matrix-M, had over 75% efficacy against clinical malaria with seasonal administration in a phase 2b trial in Burkina Faso. Here, we report on safety and efficacy of the vaccine in a phase 3 trial enrolling over 4800 children across four countries followed for up to 18 months at seasonal sites and 12 months at standard sites. Methods: We did a double-blind, randomised, phase 3 trial of the R21/Matrix-M malaria vaccine across five sites in four African countries with differing malaria transmission intensities and seasonality. Children (aged 5\textendash36 months) were enrolled and randomly assigned (2:1) to receive 5 μg R21 plus 50 μg Matrix-M or a control vaccine (licensed rabies vaccine [Abhayrab]). Participants, their families, investigators, laboratory teams, and the local study team were masked to treatment. Vaccines were administered as three doses, 4 weeks apart, with a booster administered 12 months after the third dose. Half of the children were recruited at two sites with seasonal malaria transmission and the remainder at standard sites with perennial malaria transmission using age-based immunisation. The primary objective was protective efficacy of R21/Matrix-M from 14 days after third vaccination to 12 months after completion of the primary series at seasonal and standard sites separately as co-primary endpoints. Vaccine efficacy against multiple malaria episodes and severe malaria, as well as safety and immunogenicity, were also assessed. This trial is registered on ClinicalTrials.gov, NCT04704830, and is ongoing. Findings: From April 26, 2021, to Jan 12, 2022, 5477 children consented to be screened, of whom 1705 were randomly assigned to control vaccine and 3434 to R21/Matrix-M; 4878 participants received the first dose of vaccine. 3103 participants in the R21/Matrix-M group and 1541 participants in the control group were included in the modified per-protocol analysis (2412 [51·9%] male and 2232 [48·1%] female). R21/Matrix-M vaccine was well tolerated, with injection site pain (301 [18·6%] of 1615 participants) and fever (754 [46·7%] of 1615 participants) as the most frequent adverse events. Number of adverse events of special interest and serious adverse events did not significantly differ between the vaccine groups. There were no treatment-related deaths. 12-month vaccine efficacy was 75% (95% CI 71\textendash79; p\<0·0001) at the seasonal sites and 68% (61\textendash74; p\<0·0001) at the standard sites for time to first clinical malaria episode. Similarly, vaccine efficacy against multiple clinical malaria episodes was 75% (71\textendash78; p\<0·0001) at the seasonal sites and 67% (59\textendash73; p\<0·0001) at standard sites. A modest reduction in vaccine efficacy was observed over the first 12 months of follow-up, of similar size at seasonal and standard sites. A rate reduction of 868 (95% CI 762\textendash974) cases per 1000 children-years at seasonal sites and 296 (231\textendash362) at standard sites occurred over 12 months. Vaccine-induced antibodies against the conserved central Asn-Ala-Asn-Pro (NANP) repeat sequence of circumsporozoite protein correlated with vaccine efficacy. Higher NANP-specific antibody titres were observed in the 5\textendash17 month age group compared with 18\textendash36 month age group, and the younger age group had the highest 12-month vaccine efficacy on time to first clinical malaria episode at seasonal (79% [95% CI 73\textendash84]; p\<0·001) and standard (75% [65\textendash83]; p\<0·001) sites. Interpretation: R21/Matrix-M was well tolerated and offered high efficacy against clinical malaria in African children. This low-cost, high-efficacy vaccine is already licensed by several African countries, and recently received a WHO policy recommendation and prequalification, offering large-scale supply to help reduce the great burden of malaria in sub-Saharan Africa. Funding: The Serum Institute of India, the Wellcome Trust, the UK National Institute for Health Research Oxford Biomedical Research Centre, and Open Philanthropy.},

keywords = {{Alassane Dicko, Antibodies, Burkina Faso, Child, Clinical Trial, Double-Blind Method, Female, Humans, Immunization, Infant, Malaria Vaccines* / adverse effects, Malaria* / drug therapy, Male, MEDLINE, Mehreen S Datoo, Multicenter Study, Nanoparticles*, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Phase III, Preschool, PubMed Abstract, Randomized controlled trial, Research Support, Saponins*},

pubstate = {published},

tppubtype = {article}

}

@article{Mirzaev2024,

title = {Systematic review and meta-analysis of hepatitis E seroprevalence in Southeast Asia: a comprehensive assessment of epidemiological patterns},

author = {Ulugbek Khudayberdievich Mirzaev and Serge Ouoba and Ko Ko and Zayar Phyo and Chanroth Chhoung and Akuffo Golda Ataa and Aya Sugiyama and Tomoyuki Akita and Junko Tanaka},

url = {https://pubmed.ncbi.nlm.nih.gov/38789918/},

doi = {10.1186/S12879-024-09349-2},

issn = {1471-2334},

year  = {2024},

date = {2024-01-01},

journal = {BMC infectious diseases},

volume = {24},

issue = {1},

publisher = {BMC Infect Dis},

abstract = {The burden of hepatitis E in Southeast Asia is substantial, influenced by its distinct socio-economic and environmental factors, as well as variations in healthcare systems. The aim of this study was to assess the pooled seroprevalence of hepatitis E across countries within the Southeast Asian region by the UN division. The study analyzed 66 papers across PubMed, Web of Science, and Scopus databases, encompassing data from of 44,850 individuals focusing on anti-HEV seroprevalence. The investigation spanned nine countries, excluding Brunei and East Timor due to lack of data. The pooled prevalence of anti-HEV IgG was determined to be 21.03%, with the highest prevalence observed in Myanmar (33.46%) and the lowest in Malaysia (5.93%). IgM prevalence was highest in Indonesia (12.43%) and lowest in Malaysia (0.91%). The study stratified populations into high-risk (farm workers, chronic patients) and low-risk groups (general population, blood donors, pregnant women, hospital patients). It revealed a higher IgG\textemdash28.9%, IgM\textemdash4.42% prevalence in the former group, while the latter group exhibited figures of 17.86% and 3.15%, respectively, indicating occupational and health-related vulnerabilities to HEV. A temporal analysis (1987\textendash2023), indicated an upward trend in both IgG and IgM prevalence, suggesting an escalating HEV burden. These findings contribute to a better understanding of HEV seroprevalence in Southeast Asia, shedding light on important public health implications and suggesting directions for further research and intervention strategies. Key points Research Question Investigate the seroprevalence of hepatitis E virus (HEV) in Southeast Asian countries focusing on different patterns, timelines, and population cohorts. Findings Sporadic Transmission of IgG and IgM Prevalence: • Pooled anti-HEV IgG prevalence: 21.03% • Pooled anti-HEV IgM prevalence: 3.49% Seroprevalence among specific groups: High-risk group (farm workers and chronic patients): • anti-HEV IgG: 28.9% • anti-HEV IgM: 4.42% Low-risk group (general population, blood donors, pregnant women, hospital patients): • anti-HEV IgG: 17.86% • anti-HEV IgM: 3.15% Temporal Seroprevalence of HEV: Anti-HEV IgG prevalence increased over decades (1987\textendash1999; 2000\textendash2010; 2011\textendash2023): 12.47%, 18.43%, 29.17% as an anti-HEV IgM prevalence: 1.92%, 2.44%, 5.27% Importance Provides a comprehensive overview of HEV seroprevalence in Southeast Asia. Highlights variation in seroprevalence among different population groups. Reveals increasing trend in HEV seroprevalence over the years. Distinguishes between sporadic and epidemic cases for a better understanding of transmission dynamics.},

keywords = {Asia, doi:10.1186/s12879-024-09349-2, Female, Hepatitis Antibodies* / blood, Hepatitis E virus* / immunology, Hepatitis E* / blood, Hepatitis E* / epidemiology, Humans, Immunoglobulin G* / blood, Immunoglobulin M* / blood, Junko Tanaka, Male, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11127338, pmid:38789918, Pregnancy, Prevalence, PubMed Abstract, Risk Factors, Serge Ouoba, Seroepidemiologic Studies, Southeastern / epidemiology, Systematic review, Ulugbek Khudayberdievich Mirzaev},

pubstate = {published},

tppubtype = {article}

}

@article{Bassinga2024,

title = {Prevalence of asymptomatic malaria at the communal level in Burkina Faso: an application of the small area estimation approach},

author = {Herv\'{e} Bassinga and Mady Ouedraogo and Kadari Cisse and Parfait Yira and Sibiri Cl\'{e}ment Ouedraogo and Abdou Nombr\'{e} and Wofom Lydie Marie Bernard Bance and Mathias Kuepie and Toussaint Rouamba},

url = {https://pubmed.ncbi.nlm.nih.gov/39155384/},

doi = {10.1186/S12963-024-00341-1},

issn = {1478-7954},

year  = {2024},

date = {2024-01-01},

journal = {Population health metrics},

volume = {22},

issue = {1},

publisher = {Popul Health Metr},

abstract = {Background: In malaria-endemic countries, asymptomatic carriers of plasmodium represent an important reservoir for malaria transmission. Estimating the burden at a fine scale and identifying areas at high risk of asymptomatic carriage are important to guide malaria control strategies. This study aimed to estimate the prevalence of asymptomatic carriage at the communal level in Burkina Faso, the smallest geographical entity from which a local development policy can be driven. Methods: The data used in this study came from several open sources: the 2018 Multiple Indicator Cluster Survey on Malaria and the 2019 general census of the population data and environmental. The analysis involved a total of 5489 children under 5 from the malaria survey and 293,715 children under 5 from the census. The Elbers Langjouw and Langjouw (ELL) approach is used to estimate the prevalence. This approach consists of including data from several sources (mainly census and survey data) in a statistical model to obtain predictive indicators at a sub-geographical level, which are not measured in the population census. The method achieves this by finding correlations between common census variables and survey data. Findings: The findings suggest that the spatial distribution of the prevalence of asymptomatic carriage is very heterogeneous across the communes. It varies from a minimum of 5.1% (95% CI 3.6\textendash6.5) in the commune of Bobo-Dioulasso to a maximum of 41.4% (95% CI 33.5\textendash49.4) in the commune of Djigou\'{e}. Of the 341 communes, 208 (61%) had prevalences above the national average of 20.3% (95% CI 18.8\textendash21.2). Contributions: This analysis provided commune-level estimates of the prevalence of asymptomatic carriage of plasmodium in Burkina Faso. The results of this analysis should help to improve planning of malaria control at the communal level in Burkina Faso.},

keywords = {Asymptomatic Infections / epidemiology, Burkina Faso / epidemiology, Carrier State / epidemiology, Child, doi:10.1186/s12963-024-00341-1, Female, Herv\'{e} Bassinga, Humans, Infant, Mady Ouedraogo, Malaria* / epidemiology, Male, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11330607, pmid:39155384, Preschool, Prevalence, PubMed Abstract, Small-Area Analysis, Toussaint Rouamba},

pubstate = {published},

tppubtype = {article}

}

@article{Soumah2024,

title = {Prevalence of dermal trypanosomes in suspected and confirmed cases of gambiense human African trypanosomiasis in Guinea},

author = {Alseny M’Mah Soumah and Mariame Camara and Justin Windingoudi Kabor\'{e} and Ibrahim Sadissou and Hamidou Ilboudo and Christelle Travaill\'{e} and Oumou Camara and Magali Tichit and Jacques Kabor\'{e} and Salimatou Boiro and Aline Crouzols and Jean Marc Tsagmo Ngoune and David Hardy and A\"{i}ssata Camara and Vincent Jamonneau and Annette Macleod and Jean Mathieu Bart and Mamadou Camara and Bruno Bucheton and Brice Rotureau},

url = {https://pubmed.ncbi.nlm.nih.gov/39159265/},

doi = {10.1371/JOURNAL.PNTD.0012436},

issn = {1935-2735},

year  = {2024},

date = {2024-01-01},

journal = {PLoS neglected tropical diseases},

volume = {18},

issue = {8},

publisher = {PLoS Negl Trop Dis},

abstract = {The skin is an anatomical reservoir for African trypanosomes, yet the prevalence of extravascular parasite carriage in the population at risk of gambiense Human African Trypanosomiasis (gHAT) remains unclear. Here, we conducted a prospective observational cohort study in the HAT foci of Forecariah and Boffa, Republic of Guinea. Of the 18,916 subjects serologically screened for gHAT, 96 were enrolled into our study. At enrolment and follow-up visits, participants underwent a dermatological examination and had blood samples and superficial skin snip biopsies taken for examination by molecular and immuno-histological methods. In seropositive individuals, dermatological symptoms were significantly more frequent as compared to seronegative controls. Trypanosoma brucei DNA was detected in the blood of 67% of confirmed cases (22/33) and 9% of unconfirmed seropositive individuals (3/32). However, parasites were detected in the extravascular dermis of up to 71% of confirmed cases (25/35) and 41% of unconfirmed seropositive individuals (13/32) by PCR and/or immuno-histochemistry. Six to twelve months after treatment, trypanosome detection in the skin dropped to 17% of confirmed cases (5/30), whereas up to 25% of unconfirmed, hence untreated, seropositive individuals (4/16) were still found positive. Dermal trypanosomes were observed in subjects from both transmission foci, however, the occurrence of pruritus and the PCR positivity rates were significantly higher in unconfirmed seropositive individuals in Forecariah. The lower sensitivity of superficial skin snip biopsies appeared critical for detecting trypanosomes in the basal dermis. These results are discussed in the context of the planned elimination of gHAT.},

keywords = {Adolescent, Adult, African* / diagnosis, African* / epidemiology, African* / parasitology, Alseny M'mah Soumah, Brice Rotureau, Child, DNA, doi:10.1371/journal.pntd.0012436, Female, Guinea / epidemiology, Humans, Male, Mariame Camara, MEDLINE, Middle Aged, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Observational Study, PMC11361743, pmid:39159265, Prevalence, Prospective Studies, Protozoan / genetics, PubMed Abstract, Skin* / parasitology, Skin* / pathology, Trypanosoma brucei gambiense* / isolation \& purification, Trypanosomiasis, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{Micklesfield2023,

title = {Identifying the prevalence and correlates of multimorbidity in middle-aged men and women: a cross-sectional population-based study in four African countries},

author = {Lisa K. Micklesfield and Richard Munthali and Godfred Agongo and Gershim Asiki and Palwende Boua and Solomon S. R. Choma and Nigel J. Crowther and June Fabian and Francesc Xavier G\'{o}mez-Oliv\'{e} and Chodziwadziwa Kabudula and Eric Maimela and Shukri F. Mohamed and Engelbert A. Nonterah and Frederick J. Raal and Hermann Sorgho and Furahini D. Tluway and Alisha N. Wade and Shane A. Norris and Michele Ramsay},

url = {https://pubmed.ncbi.nlm.nih.gov/36918238/},

doi = {10.1136/BMJOPEN-2022-067788},

issn = {2044-6055},

year  = {2023},

date = {2023-01-01},

journal = {BMJ open},

volume = {13},

issue = {3},

publisher = {BMJ Open},

abstract = {Objectives To determine the prevalence of multimorbidity, to identify which chronic conditions cluster together and to identify factors associated with a greater risk for multimorbidity in sub-Saharan Africa (SSA). Design Cross-sectional, multicentre, population-based study. Setting Six urban and rural communities in four sub-Saharan African countries. Participants Men (n=4808) and women (n=5892) between the ages of 40 and 60 years from the AWI-Gen study. Measures Sociodemographic and anthropometric data, and multimorbidity as defined by the presence of two or more of the following conditions: HIV infection, cardiovascular disease, chronic kidney disease, asthma, diabetes, dyslipidaemia, hypertension. Results Multimorbidity prevalence was higher in women compared with men (47.2% vs 35%), and higher in South African men and women compared with their East and West African counterparts. The most common disease combination at all sites was dyslipidaemia and hypertension, with this combination being more prevalent in South African women than any single disease (25% vs 21.6%). Age and body mass index were associated with a higher risk of multimorbidity in men and women; however, lifestyle correlates such as smoking and physical activity were different between the sexes. Conclusions The high prevalence of multimorbidity in middle-aged adults in SSA is of concern, with women currently at higher risk. This prevalence is expected to increase in men, as well as in the East and West African region with the ongoing epidemiological transition. Identifying common disease clusters and correlates of multimorbidity is critical to providing effective interventions.},

keywords = {{Adult, Africa South of the Sahara / epidemiology, CollabAuthor(name='as members of AWI-Gen and the H3Africa Consortium', Cross-Sectional Studies, Dyslipidemias* / epidemiology, Extramural, Female, HIV Infections*, Humans, Hypertension* / epidemiology, Lisa K Micklesfield, Male, MEDLINE, Middle Aged, Multimorbidity, N.I.H., National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC10016250, Prevalence, PubMed Abstract, Research Support, Richard Munthali, Risk Factors, Sex Factors},

pubstate = {published},

tppubtype = {article}

}

@article{Chandramohan2021-qm,

title = {Seasonal malaria vaccination with or without seasonal malaria  chemoprevention},

author = {Daniel Chandramohan and Issaka Zongo and Issaka Sagara and Matthew Cairns and Rakiswend\'{e}-Serge Yerbanga and Modibo Diarra and Fr\'{e}d\'{e}ric Niki`ema and Amadou Tapily and Fr\'{e}d\'{e}ric Sompougdou and Djibrilla Issiaka and Charles Zoungrana and Koualy Sanogo and Alassane Haro and Mahamadou Kaya and Abdoul-Aziz Sienou and Seydou Traore and Almahamoudou Mahamar and Ismaila Thera and Kalifa Diarra and Amagana Dolo and Irene Kuepfer and Paul Snell and Paul Milligan and Christian Ockenhouse and Opokua Ofori-Anyinam and Halidou Tinto and Abdoulaye Djimde and Jean-Bosco Ou\'{e}draogo and Alassane Dicko and Brian Greenwood},

doi = {10.1056/NEJMoa2026330},

issn = {1533-4406 0028-4793},

year  = {2021},

date = {2021-09-09},

urldate = {2021-09-09},

journal = {N. Engl. J. Med.},

volume = {385},

number = {11},

pages = {1005--1017},

publisher = {Massachusetts Medical Society},

abstract = {BACKGROUND: Malaria control remains a challenge in many parts of 

 the Sahel and sub-Sahel regions of Africa. METHODS: We conducted 

 an individually randomized, controlled trial to assess whether 

 seasonal vaccination with RTS,S/AS01E was noninferior to 

 chemoprevention in preventing uncomplicated malaria and whether 

 the two interventions combined were superior to either one alone 

 in preventing uncomplicated malaria and severe malaria-related 

 outcomes. RESULTS: We randomly assigned 6861 children 5 to 17 

 months of age to receive sulfadoxine-pyrimethamine and 

 amodiaquine (2287 children [chemoprevention-alone group]), 

 RTS,S/AS01E (2288 children [vaccine-alone group]), or 

 chemoprevention and RTS,S/AS01E (2286 children [combination 

 group]). Of these, 1965, 1988, and 1967 children in the three 

 groups, respectively, received the first dose of the assigned 

 intervention and were followed for 3 years. Febrile seizure 

 developed in 5 children the day after receipt of the vaccine, 

 but the children recovered and had no sequelae. There were 305 

 events of uncomplicated clinical malaria per 1000 person-years 

 at risk in the chemoprevention-alone group, 278 events per 1000 

 person-years in the vaccine-alone group, and 113 events per 1000 

 person-years in the combination group. The hazard ratio for the 

 protective efficacy of RTS,S/AS01E as compared with 

 chemoprevention was 0.92 (95% confidence interval [CI], 0.84 to 

 1.01), which excluded the prespecified noninferiority margin of 

 1.20. The protective efficacy of the combination as compared 

 with chemoprevention alone was 62.8% (95% CI, 58.4 to 66.8) 

 against clinical malaria, 70.5% (95% CI, 41.9 to 85.0) against 

 hospital admission with severe malaria according to the World 

 Health Organization definition, and 72.9% (95% CI, 2.9 to 

 92.4) against death from malaria. The protective efficacy of the 

 combination as compared with the vaccine alone against these 

 outcomes was 59.6% (95% CI, 54.7 to 64.0), 70.6% (95% CI, 

 42.3 to 85.0), and 75.3% (95% CI, 12.5 to 93.0), respectively. 

 CONCLUSIONS: Administration of RTS,S/AS01E was noninferior to 

 chemoprevention in preventing uncomplicated malaria. The 

 combination of these interventions resulted in a substantially 

 lower incidence of uncomplicated malaria, severe malaria, and 

 death from malaria than either intervention alone. (Funded by 

 the Joint Global Health Trials and PATH; ClinicalTrials.gov 

 number, NCT03143218.).},

note = {Copyright © 2021 Massachusetts Medical Society.

Place: United States

PMID: 34432975},

keywords = {Amodiaquine/therapeutic use, Antimalarials/adverse effects/therapeutic use, Burkina Faso/epidemiology, Chemoprevention, Combination, Combined Modality Therapy, Double-Blind Method, Drug Combinations, Drug Therapy, Falciparum/epidemiology/mortality/prevention \& control, Febrile/etiology, Female, Hospitalization/statistics \& numerical data, Humans, Infant, Malaria, Malaria Vaccines/administration \& dosage/adverse effects, Male, Mali/epidemiology, Pyrimethamine/therapeutic use, Seasons, Seizures, Sulfadoxine/therapeutic use},

pubstate = {published},

tppubtype = {article}

}

@article{Compaore2021-hg,

title = {'Men are not playing their roles', maternal and child nutrition  in Nanoro, Burkina Faso},

author = {Ad\'{e}la"ide Compaor\'{e} and Kadija Ouedraogo and Palwende R Boua and Daniella Watson and Sarah H Kehoe and Marie-Louise Newell and Halidou Tinto and Mary Barker and Hermann Sorgho and INPreP group},

doi = {10.1017/S1368980020003365},

issn = {1475-2727 1368-9800},

year  = {2021},

date = {2021-08-01},

urldate = {2021-08-01},

journal = {Public Health Nutr.},

volume = {24},

number = {12},

pages = {3780--3790},

publisher = {Cambridge University Press (CUP)},

abstract = {OBJECTIVE: To collect context-specific insights into maternal 

 and child health and nutrition issues, and to explore potential 

 solutions in Nanoro, Burkina Faso. DESIGN: Eleven focus groups 

 with men and women from eleven communities, facilitated by local 

 researchers. SETTING: The study took place in the Nanoro Health 

 district, in the West-Central part of Burkina Faso. 

 PARTICIPANTS: Eighty-six men (18-55 years) and women by age 

 group: 18-25; 26-34 and 35-55 years, participated in the group 

 discussions. RESULTS: Participants described barriers to optimal 

 nutrition of mothers and children related to a range of 

 community factors, with gender inequality as central. Major 

 themes in the discussions are related to poverty and challenges 

 generated by socially and culturally determined gender roles. 

 Sub-themes are women lacking access to food whilst pregnant and 

 having limited access to health care and opportunities to 

 generate income. Although communities believe that food 

 donations should be implemented to overcome this, they also 

 pointed out the need for enhancing their own food production, 

 requiring improved agricultural technologies. Given the 

 important role that women could play in reducing malnutrition, 

 these communities felt they needed to be empowered to do so and 

 supported by men. They also felt that this had to be carried out 

 in the context of an enhanced health care system. CONCLUSIONS: 

 Findings reported here highlight the importance of 

 nutrition-sensitive interventions and women's empowerment in 

 improving maternal and child nutrition. There is a need to 

 integrate a sustainable multi-sectorial approach which goes 

 beyond food support.},

note = {Place: England

PMID: 33000717},

keywords = {Burkina Faso, Child, Child nutrition, Child Nutritional Physiological Phenomena, Community perceptions, Empowerment, Female, Humans, Male, Maternal nutrition, Mothers, Nutritional Status, Pregnancy, Qualitative research},

pubstate = {published},

tppubtype = {article}

}

@article{Jaspard2021-bl,

title = {Clinical presentation, outcomes and factors associated with  mortality: A prospective study from three COVID-19 referral  care centres in West Africa},

author = {Marie Jaspard and Mamadou Saliou Sow and Sylvain Juchet and Eric Diender\'{e} and Beatrice Serra and Richard Kojan and Billy Sivahera and Caroline Martin and Moumouni Kinda and Hans-Joerg Lang and Fod\'{e} Bangaly Sako and Fod\'{e} Amara Traor\'{e} and Eudoxie Koumbem and Halidou Tinto and Adama Sanou and Apoline Sondo and Flavien Kabor\'{e} and Joseph Donamou and Jean-Paul-Yassa Guilavogui and Fanny Velardo and Brice Bicaba and Olivier Marcy and Augustin Augier and Sani Sayadi and Armel Poda and Sakoba Keita and Xavier Anglaret and Denis Malvy and COVISTA group},

doi = {10.1016/j.ijid.2021.05.024},

issn = {1878-3511 1201-9712},

year  = {2021},

date = {2021-07-01},

urldate = {2021-07-01},

journal = {Int. J. Infect. Dis.},

volume = {108},

pages = {45--52},

publisher = {Elsevier BV},

abstract = {OBJECTIVES: The overall death toll from COVID-19 in Africa is 

 reported to be low but there is little individual-level evidence 

 on the severity of the disease. This study examined the clinical 

 spectrum and outcome of patients monitored in COVID-19 care 

 centres (CCCs) in two West-African countries. METHODS: Burkina 

 Faso and Guinea set up referral CCCs to hospitalise all 

 symptomatic SARS-CoV-2 carriers, regardless of the severity of 

 their symptoms. Data collected from hospitalised patients by 

 November 2020 are presented. RESULT: A total of 1,805 patients 

 (64% men, median age 41 years) were admitted with COVID-19. 

 Symptoms lasted for a median of 7 days (IQR 4-11). During 

 hospitalisation, 443 (25%) had a SpO2 \< 94% at least once, 237 

 (13%) received oxygen and 266 (15%) took corticosteroids. 

 Mortality was 5% overall, and 1%, 5% and 14% in patients 

 aged \<40, 40-59 and $geq$60 years, respectively. In 

 multivariable analysis, the risk of death was higher in men (aOR 

 2.0, 95% CI 1.1; 3.6), people aged $geq$60 years (aOR 2.9, 

 95% CI 1.7; 4.8) and those with chronic hypertension (aOR 2.1, 

 95% CI 1.2; 3.4). CONCLUSION: COVID-19 is as severe in Africa 

 as elsewhere, and there must be more vigilance for common risk 

 factors such as older age and hypertension.},

note = {Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

PMID: 34000419 

PMCID: PMC8120805},

keywords = {Adult, Aged, Burkina Faso/epidemiology, Comorbidities, COVID-19, Female, Hospitalization, Humans, Male, Mortality, Prospective Studies, Referral and Consultation, SARS-Cov-2, sub-Saharan Africa},

pubstate = {published},

tppubtype = {article}

}

@article{De_Wit2021-yi,

title = {Nutritional status in young children prior to the malaria  transmission season in Burkina Faso and Mali, and its impact on  the incidence of clinical malaria},

author = {Mariken Wit and Matthew Cairns and Yves Daniel Compaor\'{e} and Issaka Sagara and Irene Kuepfer and Issaka Zongo and Amadou Barry and Modibo Diarra and Amadou Tapily and Samba Coumare and Ismaila Thera and Frederic Nikiema and R Serge Yerbanga and Rosemonde M Guissou and Halidou Tinto and Alassane Dicko and Daniel Chandramohan and Brian Greenwood and Jean Bosco Ouedraogo},

doi = {10.1186/s12936-021-03802-2},

issn = {1475-2875},

year  = {2021},

date = {2021-06-22},

urldate = {2021-06-22},

journal = {Malar. J.},

volume = {20},

number = {1},

pages = {274},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: Malaria and malnutrition remain major problems in 

 Sahel countries, especially in young children. The direct effect 

 of malnutrition on malaria remains poorly understood, and may 

 have important implications for malaria control. In this study, 

 nutritional status and the association between malnutrition and 

 subsequent incidence of symptomatic malaria were examined in 

 children in Burkina Faso and Mali who received either 

 azithromycin or placebo, alongside seasonal malaria 

 chemoprevention. METHODS: Mid-upper arm circumference (MUAC) was 

 measured in all 20,185 children who attended a screening visit 

 prior to the malaria transmission season in 2015. Prior to the 

 2016 malaria season, weight, height and MUAC were measured among 

 4149 randomly selected children. Height-for-age, weight-for-age, 

 weight-for-height, and MUAC-for-age were calculated as 

 indicators of nutritional status. Malaria incidence was measured 

 during the following rainy seasons. Multivariable random effects 

 Poisson models were created for each nutritional indicator to 

 study the effect of malnutrition on clinical malaria incidence 

 for each country. RESULTS: In both 2015 and 2016, nutritional 

 status prior to the malaria season was poor. The most prevalent 

 form of malnutrition in Burkina Faso was being underweight 

 (30.5%; 95% CI 28.6-32.6), whereas in Mali stunting was most 

 prevalent (27.5%; 95% CI 25.6-29.5). In 2016, clinical malaria 

 incidence was 675 per 1000 person-years (95% CI 613-744) in 

 Burkina Faso, and 1245 per 1000 person-years (95% CI 1152-1347) 

 in Mali. There was some evidence that severe stunting was 

 associated with lower incidence of malaria in Mali (RR 0.81; 95% CI 0.64-1.02; p = 0.08), but this association was not seen 

 in Burkina Faso. Being moderately underweight tended to be 

 associated with higher incidence of clinical malaria in Burkina Faso (RR 1.27; 95% CI 0.98-1.64; p = 0.07), while this was the 

 case in Mali for moderate wasting (RR 1.27; 95% CI 0.98-1.64; p = 0.07). However, these associations were not observed in 

 severely affected children, nor consistent between countries. 

 MUAC-for-age was not associated with malaria risk. CONCLUSIONS: 

 Both malnutrition and malaria were common in the study areas, 

 high despite high coverage of seasonal malaria chemoprevention 

 and long-lasting insecticidal nets. However, no strong or 

 consistent evidence was found for an association between any of 

 the nutritional indicators and the subsequent incidence of 

 clinical malaria.},

note = {PMID: 34158054 

PMCID: PMC8220741},

keywords = {Acute malnutrition, Antimalarials/administration \& dosage, Azithromycin/administration \& dosage, Burkina Faso, Burkina Faso/epidemiology, Child, Chronic malnutrition, Female, Humans, Incidence, Infant, Malaria, Malaria/epidemiology/transmission, Male, Nutritional Status, Preschool, seasonal malaria chemoprevention, Seasons},

pubstate = {published},

tppubtype = {article}

}

@article{Post2021-oo,

title = {Altered ex-vivo cytokine responses in children with asymptomatic  Plasmodium falciparum infection in Burkina Faso: An additional  argument to treat asymptomatic malaria?},

author = {Annelies Post and Berenger Kabor\'{e} and Mike Berendsen and Salou Diallo and Ousmane Traore and Rob J W Arts and Mihai G Netea and Leo A B Joosten and Halidou Tinto and Jan Jacobs and Quirijn Mast and Andr\'{e} Ven},

doi = {10.3389/fimmu.2021.614817},

issn = {1664-3224},

year  = {2021},

date = {2021-06-09},

urldate = {2021-06-09},

journal = {Front. Immunol.},

volume = {12},

pages = {614817},

publisher = {Frontiers Media SA},

abstract = {Introduction: Patients with clinical malaria have an increased 

 risk for bacterial bloodstream infections. We hypothesized that 

 asymptomatic malaria parasitemia increases susceptibility for 

 bacterial infections through an effect on the innate immune 

 system. We measured circulating cytokine levels and ex-vivo 

 cytokine production capacity in asymptomatic malaria and 

 compared with controls. Methods: Data were collected from 

 asymptomatic participants \<5 years old with and without positive 

 malaria microscopy, as well as from hospitalized patients \<5 

 years old with clinical malaria, bacteremia, or 

 malaria/bacteremia co-infections in a malaria endemic region of 

 Burkina Faso. Circulating cytokines (TNF-$alpha$, IFN-$gamma$, 

 IL-6, IL-10) were measured using multiplex assays. Whole blood 

 from asymptomatic participants with and without positive malaria 

 microscopy were ex-vivo stimulated with S. aureus, E. coli LPS 

 and Salmonella Typhimurium; cytokine concentrations 

 (TNF-$alpha$, IFN-$gamma$, IL-1$beta$, IL-6, IL-10) were 

 measured on supernatants using ELISA. Results: Included were children with clinical malaria (n=118), bacteremia (n=22), malaria and bacteremia co-infection (n=9), asymptomatic malaria (n=125), and asymptomatic controls (n=237). Children with either 

 clinical or asymptomatic malaria had higher plasma cytokine 

 concentrations than controls. Cytokine concentrations correlated 

 positively with malaria parasite density with the strongest correlation for IL-10 in both asymptomatic (r=0.63) and clinical malaria (r=0.53). Patients with bacteremia had lower circulating 

 IL-10, TNF-$alpha$ and IFN-$gamma$ and higher IL-6 

 concentrations, compared to clinical malaria. Ex-vivo whole 

 blood cytokine production to LPS and S. aureus was significantly 

 lower in asymptomatic malaria compared to controls. Whole blood 

 IFN-$gamma$ and IL-10 production in response to Salmonella was 

 also lower in asymptomatic malaria. Interpretation: In children 

 with asymptomatic malaria, cytokine responses upon ex-vivo 

 bacterial stimulation are downregulated. Further studies are 

 needed to explore if the suggested impaired innate immune 

 response to bacterial pathogens also translates into impaired 

 control of pathogens such as Salmonella spp.},

note = {Copyright © 2021 Post, Kabor\'{e}, Berendsen, Diallo, Traore, Arts, Netea, Joosten, Tinto, Jacobs, de Mast and van der Ven.

PMID: 34177883 

PMCID: PMC8220162},

keywords = {Asymptomatic Diseases, asymptomatic malaria, bacteraemia, Bacteremia, bloodstream infection, Burkina Faso/epidemiology, Cells, Child, Cultured, Cytokines/metabolism, Endemic Diseases, Female, Humans, Infant, iNTS, Lipopolysaccharides/immunology, Malaria/epidemiology/immunology, Male, Parasite Load, Plasmodium falciparum/physiology, Preschool, Salmonella},

pubstate = {published},

tppubtype = {article}

}

@article{Bognini2021-mk,

title = {Socioeconomic inequalities in curative healthcare-seeking for  children under five before and after the free healthcare  initiative in Sierra Leone: analysis of population-based survey  data},

author = {Joel D Bognini and Sekou Samadoulougou and Mady Ouedraogo and Tiga David Kangoye and Carine Van Malderen and Halidou Tinto and Fati Kirakoya-Samadoulougou},

doi = {10.1186/s12939-021-01474-7},

issn = {1475-9276},

year  = {2021},

date = {2021-05-21},

urldate = {2021-05-21},

journal = {Int. J. Equity Health},

volume = {20},

number = {1},

pages = {124},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: Socioeconomic inequalities between and within countries lead to disparities in the use of health services. These disparities could lead to child  mortality in children under 5 years by depriving them of healthcare. Therefore,  initiatives to remove healthcare fees such as the Free Healthcare Initiative (FHCI)  adopted in Sierra Leone can contribute to reducing these inequities in  healthcare-seeking for children. This study aimed to assess the socioeconomic  inequalities in healthcare-seeking for children under 5 years of age before and  after the implementation of the FHCI. METHODS: Data were included on 1207, 2815,  1633, and 1476 children under 5 years of age with fever from the 2008, 2013, 2016,  and 2019 nationwide surveys, respectively. Concentration curves were drawn for the  period before (2008) and after (2013-2019) the implementation of the FHCI to assess  socioeconomic inequalities in healthcare-seeking. Finally, Erreyger's corrected  concentration indices were calculated to understand the magnitude of these  inequalities. RESULTS: Before the implementation of the FHCI, there were  inequalities in healthcare-seeking for children under five (Erreyger's corrected  concentration index (CI) = 0.168, standard error (SE) = 0.049; p \< 0.001) in favor  of the wealthy households. These inequalities decreased after the implementation of  the FHCI (CI = 0.061, SE = 0.033; p = 0.06 in 2013, CI = 0.039, SE = 0.04; p = 0.32  in 2016, and CI = - 0.0005, SE = 0.362; p = 0.98 in 2019). Furthermore, before the  implementation of the FHCI, a significant pro-rich inequality in the districts of  Kenema (CI = 0.117, SE = 0.168, p = 0.021), Kono (CI = 0.175, SE = 0.078, p = 0.028)  and Western Area Urban (CI = 0.070, SE = 0.032, p = 0.031) has been observed. After  the implementation of the FHCI in 2019, these disparities were reduced, 11 of the 14  districts had a CI around the value of equality, and only in 2 districts the  pro-rich inequality were significant (Western Area Urban (CI = 0.035, SE = 0.016,  p = 0.039) and Western Area Rural (CI = 0.066, SE = 0.030, p = 0.027)). CONCLUSION:  The results of this study demonstrated that socio-economic inequalities in  healthcare-seeking for children have been considerably reduced after the FHCI in  Sierra Leone. To further reduce these inequalities, policy actions can focus on the  increase of availability of health services in the districts where the  healthcare-seeking remained pro-rich.},

note = {PMID: 34020665 

PMCID: PMC8140517},

keywords = {Adolescent, Adult, Child, Children under five, Delivery of Health Care/economics, Female, Health Care Surveys, Healthcare Disparities/economics/statistics \& numerical data, Healthcare utilization, Humans, Infant, Male, Parents/psychology, Patient Acceptance of Health Care/statistics \& numerical data, Preschool, Sierra Leone, Socioeconomic Factors, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{Adoke2021-el,

title = {A randomized, double-blind, phase 2b study to investigate the  efficacy, safety, tolerability and pharmacokinetics of a  single-dose regimen of ferroquine with artefenomel in adults and  children with uncomplicated Plasmodium falciparum malaria},

author = {Yeka Adoke and Rella Zoleko-Manego and Serge Ouoba and Alfred B Tiono and Grace Kaguthi and Juv^encio Eduardo Bonzela and Tran Thanh Duong and Alain Nahum and Marielle Bouyou-Akotet and Bernhards Ogutu and Alphonse Ouedraogo and Fiona Macintyre and Andreas Jessel and Bart Laurijssens and Mohammed H Cherkaoui-Rbati and Cathy Cantalloube and Anne Claire Marrast and Rapha"el Bejuit and David White and Timothy N C Wells and Florian Wartha and Didier Leroy and Afizi Kibuuka and Ghyslain Mombo-Ngoma and Daouda Ouattara and Ir`ene Mugenya and Bui Quang Phuc and Francis Bohissou and Denise P Mawili-Mboumba and Fredrick Olewe and Issiaka Soulama and Halidou Tinto and FALCI Study Group},

doi = {10.1186/s12936-021-03749-4},

issn = {1475-2875},

year  = {2021},

date = {2021-05-19},

urldate = {2021-05-19},

journal = {Malar. J.},

volume = {20},

number = {1},

pages = {222},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: For uncomplicated Plasmodium falciparum malaria, 

 highly efficacious single-dose treatments are expected to 

 increase compliance and improve treatment outcomes, and thereby 

 may slow the development of resistance. The efficacy and safety 

 of a single-dose combination of artefenomel (800 mg) plus 

 ferroquine (400/600/900/1200 mg doses) for the treatment of 

 uncomplicated P. falciparum malaria were evaluated in Africa 

 (focusing on children $\leq$ 5 years) and Asia. METHODS: The 

 study was a randomized, double-blind, single-dose, multi-arm 

 clinical trial in patients aged \> 6 months to 5 years and 20 

 Asian patients. None of the treatment arms met the target 

 efficacy criterion for PCR-adjusted ACPR at Day 28 (lower limit 

 of 95% confidence interval [CI] \> 90%). PCR-adjusted ACPR at 

 Day 28 [95% CI] in the PP Set ranged from 78.4% [64.7; 88.7%] 

 to 91.7% [81.6; 97.2%] for the 400 mg to 1200 mg ferroquine 

 dose. Efficacy rates were low in Vietnamese patients, ranging 

 from 20 to 40%. A clear relationship was found between drug 

 exposure (artefenomel and ferroquine concentrations at Day 7) 

 and efficacy (primary endpoint), with higher concentrations of 

 both drugs resulting in higher efficacy. Six distinct kelch-13 

 mutations were detected in parasite isolates from 10/272 African 

 patients (with 2 mutations known to be associated with 

 artemisinin resistance) and 18/20 Asian patients (all C580Y 

 mutation). Vomiting within 6 h of initial artefenomel 

 administration was common (24.6%) and associated with lower 

 drug exposures. CONCLUSION: The efficacy of 

 artefenomel/ferroquine combination was suboptimal in African 

 children aged $\leq$ 5 years, the population of interest, and 

 vomiting most likely had a negative impact on efficacy. Trial 

 registration ClinicalTrials.gov, NCT02497612. Registered 14 Jul 

 2015, https://clinicaltrials.gov/ct2/show/NCT02497612?term=NCT02497612\&draw=2\&rank=1.},

note = {PMID: 34011358 

PMCID: PMC8135182},

keywords = {Adamantane/administration \& dosage/analogs \& derivatives, Adolescent, Adult, Aged, Aminoquinolines/administration \& dosage, Benin, Burkina Faso, C580Y, Child, Combination treatment, Double-Blind Method, Drug Combinations, Exposure\textendashresponse, Falciparum/prevention \& control, Female, Ferroquine, Ferrous Compounds/administration \& dosage, Gabon, Humans, Infant, Kelch-13 mutation, Kenya, Malaria, Male, Metallocenes/administration \& dosage, Middle Aged, Mozambique, Parasite clearance, Peroxides/administration \& dosage, Pharmacokinetics/pharmacodynamics, Plasmodium falciparum/drug effects, Preschool, resistance, Uganda, Vietnam, Vomiting, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{Datoo2021-dk,

title = {Efficacy of a low-dose candidate malaria vaccine, R21 in  adjuvant Matrix-M, with seasonal administration to children in  Burkina Faso: a randomised controlled trial},

author = {Mehreen S Datoo and Magloire H Natama and Athanase Som\'{e} and Ousmane Traor\'{e} and Toussaint Rouamba and Duncan Bellamy and Prisca Yameogo and Daniel Valia and Moubarak Tegneri and Florence Ouedraogo and Rachidatou Soma and Seydou Sawadogo and Faizatou Sorgho and Karim Derra and Eli Rouamba and Benedict Orindi and Fernando Ramos Lopez and Amy Flaxman and Federica Cappuccini and Reshma Kailath and Sean Elias and Ekta Mukhopadhyay and Andres Noe and Matthew Cairns and Alison Lawrie and Rachel Roberts and Innocent Val\'{e}a and Hermann Sorgho and Nicola Williams and Gregory Glenn and Louis Fries and Jenny Reimer and Katie J Ewer and Umesh Shaligram and Adrian V S Hill and Halidou Tinto},

doi = {10.1016/S0140-6736(21)00943-0},

issn = {1474-547X 0140-6736},

year  = {2021},

date = {2021-05-15},

urldate = {2021-05-15},

journal = {Lancet},

volume = {397},

number = {10287},

pages = {1809--1818},

publisher = {Elsevier BV},

abstract = {BACKGROUND: Stalled progress in controlling Plasmodium 

 falciparum malaria highlights the need for an effective and 

 deployable vaccine. RTS,S/AS01, the most effective malaria 

 vaccine candidate to date, demonstrated 56% efficacy over 12 

 months in African children. We therefore assessed a new 

 candidate vaccine for safety and efficacy. METHODS: In this 

 double-blind, randomised, controlled, phase 2b trial, the 

 low-dose circumsporozoite protein-based vaccine R21, with two 

 different doses of adjuvant Matrix-M (MM), was given to children 

 aged 5-17 months in Nanoro, Burkina Faso-a highly seasonal 

 malaria transmission setting. Three vaccinations were 

 administered at 4-week intervals before the malaria season, with 

 a fourth dose 1 year later. All vaccines were administered 

 intramuscularly into the thigh. Group 1 received 5 $mu$g R21 

 plus 25 $mu$g MM, group 2 received 5 $mu$g R21 plus 50 $mu$g 

 MM, and group 3, the control group, received rabies 

 vaccinations. Children were randomly assigned (1:1:1) to groups 

 1-3. An independent statistician generated a random allocation 

 list, using block randomisation with variable block sizes, which 

 was used to assign participants. Participants, their families, 

 and the local study team were all masked to group allocation. 

 Only the pharmacists preparing the vaccine were unmasked to 

 group allocation. Vaccine safety, immunogenicity, and efficacy 

 were evaluated over 1 year. The primary objective assessed 

 protective efficacy of R21 plus MM (R21/MM) from 14 days after 

 the third vaccination to 6 months. Primary analyses of vaccine 

 efficacy were based on a modified intention-to-treat population, 

 which included all participants who received three vaccinations, 

 allowing for inclusion of participants who received the wrong 

 vaccine at any timepoint. This trial is registered with 

 ClinicalTrials.gov, NCT03896724. FINDINGS: From May 7 to June 

 13, 2019, 498 children aged 5-17 months were screened, and 48 

 were excluded. 450 children were enrolled and received at least 

 one vaccination. 150 children were allocated to group 1, 150 

 children were allocated to group 2, and 150 children were 

 allocated to group 3. The final vaccination of the primary 

 series was administered on Aug 7, 2019. R21/MM had a favourable 

 safety profile and was well tolerated. The majority of adverse 

 events were mild, with the most common event being fever. None 

 of the seven serious adverse events were attributed to the 

 vaccine. At the 6-month primary efficacy analysis, 43 (29%) of 

 146 participants in group 1, 38 (26%) of 146 participants in 

 group 2, and 105 (71%) of 147 participants in group 3 developed 

 clinical malaria. Vaccine efficacy was 74% (95% CI 63-82) in 

 group 1 and 77% (67-84) in group 2 at 6 months. At 1 year, 

 vaccine efficacy remained high, at 77% (67-84) in group 1. 

 Participants vaccinated with R21/MM showed high titres of 

 malaria-specific anti-Asn-Ala-Asn-Pro (NANP) antibodies 28 days 

 after the third vaccination, which were almost doubled with the 

 higher adjuvant dose. Titres waned but were boosted to levels 

 similar to peak titres after the primary series of vaccinations 

 after a fourth dose administered 1 year later. INTERPRETATION: 

 R21/MM appears safe and very immunogenic in African children, 

 and shows promising high-level efficacy. FUNDING: The European 

 \& Developing Countries Clinical Trials Partnership, Wellcome 

 Trust, and National Institute for Health Research Oxford 

 Biomedical Research Centre.},

note = {Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights  reserved.

PMID: 33964223 

PMCID: PMC8121760},

keywords = {Adjuvants, Burkina Faso, Double-Blind Method, Falciparum/prevention \& control, Female, Hepatitis B Surface Antigens, Humans, Immunogenicity, Immunologic/administration \& dosage, Infant, Malaria, Malaria Vaccines/therapeutic use, Malaria/prevention \& control, Male, Nanoparticles/administration \& dosage, Proportional Hazards Models, Protozoan Proteins/immunology, Saponins/administration \& dosage, Treatment Outcome, Vaccine, Vaccines, Virus-Like Particle/therapeutic use},

pubstate = {published},

tppubtype = {article}

}

@article{Nonterah2021-pc,

title = {Adiposity phenotypes and subclinical atherosclerosis in adults  from sub-Saharan Africa: An H3Africa AWI-gen study},

author = {Engelbert A Nonterah and Michiel L Bots and Abraham Oduro and Godfred Agongo and Cassandra C Soo and Lisa K Micklesfield and Felistas Mashinya and Palwend\'{e} R Boua and Shukri F Mohamed and Alisha N Wade and Catherine Kyobutungi and Halidou Tinto and Shane A Norris and Stephen M Tollman and Mich`ele Ramsay and Diederick E Grobbee and Kerstin Klipstein-Grobusch and Nigel J Crowther and AWI-Gen and H3Africa Consortium},

doi = {10.5334/gh.863},

issn = {2211-8179 2211-8160},

year  = {2021},

date = {2021-03-19},

urldate = {2021-03-19},

journal = {Glob. Heart},

volume = {16},

number = {1},

pages = {19},

publisher = {Ubiquity Press, Ltd.},

abstract = {Background: Obesity and adipose tissue distribution contribute 

 to an increased risk of cardiovascular disease (CVD) by 

 promoting atherosclerosis. This association has been poorly 

 studied in sub-Saharan Africa (SSA) despite the rising 

 prevalence of cardiovascular disease. Objectives: We determined 

 the association between various adiposity phenotypes and carotid 

 intima-media thickness (CIMT), a proxy of subclinical 

 atherosclerosis, in a large SSA population. Methods: A 

 population-based cross-sectional study was performed from 

 2013-2016 in Burkina Faso, Ghana, Kenya and South Africa. Body 

 mass index (BMI), waist (WC), hip circumferences (HC), visceral 

 (VAT) and subcutaneous adipose tissue (SCAT) using B-mode 

 ultrasound were measured. Ultrasonography of left and right far 

 wall CIMT of the common carotid artery was used as an indicator 

 of subclinical atherosclerosis. Individual participant data 

 meta-analyses were used to determine the associations between 

 adiposity phenotypes and CIMT in the pooled sample while 

 adjusted multivariable linear regression analyses were used for 

 site specific analyses. Results: Data were obtained from 9,010 

 adults (50.3% women and a mean age of 50$pm$ 6years). Men had 

 higher levels of visceral fat than women while women had higher 

 BMI, waist and hip circumference and subcutaneous fat than men 

 at all sites except Burkina Faso. In the pooled analyses, BMI 

 ($beta$-value [95% CIs]: 19.5 [16.8, 22.3] $mu$m) showed the 

 strongest relationship with CIMT followed by VAT (5.86 [4.65, 

 7.07] $mu$m), SCAT (5.00 [2.85, 7.15] $mu$m), WC (1.27 [1.09, 

 1.44] $mu$m) and HC (1.23 [1.04, 1.42] $mu$m). Stronger 

 associations were observed in men than in women. Conclusion: 

 Obesity within SSA will likely result in higher levels of 

 atherosclerosis and promote the occurrence of cardio- and 

 cerebrovascular events, especially in males, unless addressed 

 through primary prevention of obesity in both rural and urban 

 communities across Africa. The inverse association of VAT with 

 CIMT in Burkina Faso and Ghana requires further investigation. 

 Highlights: All adiposity phenotypes were positively associated 

 with common carotid intima-media thickness (CIMT) in the entire 

 cohort (pooled analyses).BMI had the strongest association with 

 CIMT compared to other phenotypes.The magnitude of association 

 between adiposity phenotypes and CIMT was higher in men than in 

 women.Subcutaneous adipose tissue was inversely associated with 

 CIMT only in women.An unexpected finding was the inverse 

 association of visceral adipose tissue with CIMT in Burkina Faso 

 and Ghana.},

note = {Copyright: © 2021 The Author(s).

PMID: 33833943 

PMCID: PMC7977036},

keywords = {adiposity, Adult, Body Mass Index, cardiovascular   disease, Carotid intima-media thickness, Cross-Sectional Studies, Female, Ghana, Humans, Male, Middle Aged, obesity, Obesity/complications/epidemiology, Phenotype, Risk Factors, sub-Saharan Africa, subclinical   atherosclerosis},

pubstate = {published},

tppubtype = {article}

}

@article{Post2021-zl,

title = {Infection Manager System (IMS) as a new hemocytometry-based  bacteremia detection tool: A diagnostic accuracy study in a  malaria-endemic area of Burkina Faso},

author = {Annelies Post and Berenger Kabor\'{e} and Joel Bognini and Salou Diallo and Palpouguini Lompo and Basile Kam and Natacha Herssens and Fred Opzeeland and Christa E Gaast-de Jongh and Jeroen D Langereis and Marien I Jonge and Janette Rahamat-Langendoen and Teun Bousema and Heiman Wertheim and Robert W Sauerwein and Halidou Tinto and Jan Jacobs and Quirijn Mast and Andre J Ven},

doi = {10.1371/journal.pntd.0009187},

issn = {1935-2735 1935-2727},

year  = {2021},

date = {2021-03-01},

urldate = {2021-03-01},

journal = {PLoS Negl. Trop. Dis.},

volume = {15},

number = {3},

pages = {e0009187},

publisher = {Public Library of Science (PLoS)},

abstract = {BACKGROUND: New hemocytometric parameters can be used to 

 differentiate causes of acute febrile illness (AFI). We 

 evaluated a software algorithm-Infection Manager System 

 (IMS)-which uses hemocytometric data generated by Sysmex 

 hematology analyzers, for its accuracy to detect bacteremia in 

 AFI patients with and without malaria in Burkina Faso. Secondary 

 aims included comparing the accuracy of IMS with C-reactive 

 protein (CRP) and procalcitonin (PCT). METHODS: In a prospective 

 observational study, patients of $geq$ three-month-old (range 3 

 months- 90 years) presenting with AFI were enrolled. IMS, blood 

 culture and malaria diagnostics were done upon inclusion and 

 additional diagnostics on clinical indication. CRP, PCT, viral 

 multiplex PCR on nasopharyngeal swabs and bacterial- and malaria 

 PCR were batch-tested retrospectively. Diagnostic classification 

 was done retrospectively using all available data except IMS, 

 CRP and PCT results. FINDINGS: A diagnosis was affirmed in 549/914 (60.1%) patients and included malaria (n = 191) bacteremia (n = 69), viral infections (n = 145), and malaria-bacteremia co-infections (n = 47). The overall 

 sensitivity, specificity, and negative predictive value (NPV) of 

 IMS for detection of bacteremia in patients of $geq$ 5 years 

 were 97.0% (95% CI: 89.8-99.6), 68.2% (95% CI: 55.6-79.1) 

 and 95.7% (95% CI: 85.5-99.5) respectively, compared to 93.9% 

 (95% CI: 85.2-98.3), 39.4% (95% CI: 27.6-52.2), and 86.7% 

 (95% CI: 69.3-96.2) for CRP at $geq$20mg/L. The sensitivity, 

 specificity and NPV of PCT at 0.5 ng/ml were lower at 

 respectively 72.7% (95% CI: 60.4-83.0), 50.0% (95% CI: 

 37.4-62.6) and 64.7% (95% CI: 50.1-77.6) The diagnostic 

 accuracy of IMS was lower among malaria cases and patients \<5 

 years but remained equal to- or higher than the accuracy of CRP. 

 INTERPRETATION: IMS is a new diagnostic tool to differentiate 

 causes of AFI. Its high NPV for bacteremia has the potential to 

 improve antibiotic dispensing practices in healthcare facilities 

 with hematology analyzers. Future studies are needed to evaluate 

 whether IMS, combined with malaria diagnostics, may be used to 

 rationalize antimicrobial prescription in malaria endemic areas. 

 TRIAL REGISTRATION: ClinicalTrials.gov (NCT02669823) 

 https://clinicaltrials.gov/ct2/show/NCT02669823.},

note = {PMID: 33647009 

PMCID: PMC7951874},

keywords = {Adolescent, Automation, Bacteremia/diagnosis, Burkina Faso, C-Reactive Protein/analysis, Child, Coinfection/diagnosis/microbiology/parasitology, Female, Fever of Unknown Origin/diagnosis, Humans, Infant, Laboratory/methods, Malaria/diagnosis, Male, Preschool, Procalcitonin/analysis, Prospective Studies, Sensitivity and Specificity, Software, Virus Diseases/diagnosis},

pubstate = {published},

tppubtype = {article}

}

@article{Lompo2021-sk,

title = {Pathogens associated with acute diarrhea, and comorbidity with  malaria among children under five years old in rural Burkina  Faso},

author = {Palpouguini Lompo and Marc Christian Tahita and Hermann Sorgho and William Kabor\'{e} and Adama Kazienga and Ashmed Cheick Bachirou Nana and Hamtandi Magloire Natama and Isidore Juste Ouindgueta Bonkoungou and Nicolas Barro and Halidou Tinto},

doi = {10.11604/pamj.2021.38.259.15864},

issn = {1937-8688},

year  = {2021},

date = {2021-03-01},

urldate = {2021-03-01},

journal = {Pan Afr. Med. J.},

volume = {38},

pages = {259},

publisher = {Pan African Medical Journal},

abstract = {INTRODUCTION: acute diarrhea in children under five years is a public health problem in developing countries and particularly in malaria-endemic areas where both  diseases co-exist. The present study examined the etiology of childhood diarrhea and  its comorbidity with malaria in a rural area of Burkina Faso. 

METHODS: conventional  culture techniques, direct stools examination, and viruses´ detection by rapid tests  were performed on the fresh stools and microscopy was used to diagnose malaria. Some  risk factors were also assessed. RESULTS: on a total of 191 samples collected, at  least one pathogen was identified in 89 cases (46.6%). The proportions of pathogens  found on the 89 positive stool samples were parasites 51.69% (46 cases), viruses  39.33% (35 cases), and bacteria 14.61% (13 cases), respectively. The relationship  between malaria and infectious diarrhea was significant in viral and parasites  causes (p=0.005 and 0.043 respectively). Fever, vomiting and abdominal pain were the  major symptoms associated with diarrhea, with 71.51%, 31.72% and 23.66%  respectively. The highest viral diarrhea prevalence was reported during the dry  season (OR=5.29, 95% CI: 1.74 - 16.07, p=0.001) while parasite diarrhea was more  encountered during the rainy season (OR=0.41, 95% CI: 0.33 - 0.87, p=0.011).  CONCLUSION: Giardia spp and rotavirus were the leading cause of acute diarrhea in  Nanoro, Burkina Faso with a predominance of rotavirus in children less than 2 years.  Parasite and viral diarrhea were the most pathogens associated with malaria.  However, the high rate of negative stool samples suggests the need to determine  other enteric microorganisms.},

note = {Copyright: Palpouguini Lompo et al.

PMID: 34104307 

PMCID: PMC8164431},

keywords = {Abdominal Pain/epidemiology, Acute Disease, bacteria, Burkina Faso, Burkina Faso/epidemiology, Child, Comorbidity, Diarrhea, Diarrhea/epidemiology/microbiology, Female, Fever/epidemiology, Giardiasis/epidemiology, Humans, Infant, infectious, Malaria, Malaria/epidemiology, Male, parasite, pathogens, Preschool, Prevalence, Risk Factors, rotavirus, Rotavirus Infections/epidemiology, Rural Population, Seasons, Vomiting/epidemiology},

pubstate = {published},

tppubtype = {article}

}

@article{Natama2021-ft,

title = {Genetic variation in the immune system and malaria  susceptibility in infants: a nested case-control study in  Nanoro, Burkina Faso},

author = {Hamatandi Magloire Natama and Eduard Rovira-Vallbona and Meryam Krit and Pieter Guetens and Hermann Sorgho and M Athanase Som\'{e} and Maminata Traor\'{e}-Coulibaly and Innocent Val\'{e}a and Petra F Mens and Henk D F H Schallig and Dirk Berkvens and Luc Kestens and Halidou Tinto and Anna Rosanas-Urgell},

doi = {10.1186/s12936-021-03628-y},

issn = {1475-2875},

year  = {2021},

date = {2021-02-16},

urldate = {2021-02-01},

journal = {Malar. J.},

volume = {20},

number = {1},

pages = {94},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: Genetic polymorphisms in the human immune system 

 modulate susceptibility to malaria. However, there is a paucity 

 of data on the contribution of immunogenetic variants to malaria 

 susceptibility in infants, who present differential biological 

 features related to the immaturity of their adaptive immune 

 system, the protective effect of maternal antibodies and fetal 

 haemoglobin. This study investigated the association between 

 genetic variation in innate immune response genes and malaria 

 susceptibility during the first year of life in 656 infants from 

 a birth cohort survey performed in Nanoro, Burkina Faso. 

 METHODS: Seventeen single nucleotide polymorphisms (SNPs) in 11 

 genes of the immune system previously associated with different 

 malaria phenotypes were genotyped using TaqMan allelic 

 hybridization assays in a Fluidigm platform. Plasmodium 

 falciparum infection and clinical disease were documented by 

 active and passive case detection. Case-control association 

 analyses for both alleles and genotypes were carried out using 

 univariate and multivariate logistic regression. For cytokines 

 showing significant SNP associations in multivariate analyses, 

 cord blood supernatant concentrations were measured by 

 quantitative suspension array technology (Luminex). RESULTS: 

 Genetic variants in IL-1$beta$ (rs1143634) and 

 Fc$gamma$RIIA/CD32 (rs1801274)-both in allelic, dominant and 

 co-dominant models-were significantly associated with protection 

 from both P. falciparum infection and clinical malaria. 

 Furthermore, heterozygote individuals with rs1801274 SNP in 

 Fc$gamma$RIIA/CD32 showed higher IL-1RA levels compared to wild-type homozygotes (P = 0.024), a cytokine whose production 

 is promoted by the binding of IgG immune complexes to Fc$gamma$ 

 receptors on effector immune cells. CONCLUSIONS: These findings 

 indicate that genetic polymorphisms in genes driving innate 

 immune responses are associated to malaria susceptibility during 

 the first year of life, possibly by modulating production of 

 inflammatory mediators.},

note = {PMID: 33593344 

PMCID: PMC7885350},

keywords = {Burkina Faso, Case-Control Studies, Cytokines, Falciparum/parasitology, Female, Genetic Predisposition to Disease/genetics, Humans, Immunity, Immunogenetic variants, Infant, Innate immunity, Innate/genetics, Malaria, Male, Plasmodium falciparum, Plasmodium falciparum/physiology},

pubstate = {published},

tppubtype = {article}

}

@article{Gansane2021-yh,

title = {Anti-malarial efficacy and resistance monitoring of  artemether-lumefantrine and dihydroartemisinin-piperaquine shows  inadequate efficacy in children in Burkina Faso, 2017-2018},

author = {Adama Gansan\'{e} and Leah F Moriarty and Didier M\'{e}nard and Isidore Yerbanga and Esperance Ouedraogo and Paul Sondo and Rene Kinda and Casimir Tarama and Edwige Soulama and Madou Tapsoba and David Kangoye and Cheick Said Compaore and Ousmane Badolo and Blami Dao and Samuel Tchwenko and Halidou Tinto and Innocent Valea},

doi = {10.1186/s12936-021-03585-6},

issn = {1475-2875},

year  = {2021},

date = {2021-01-19},

urldate = {2021-01-01},

journal = {Malar. J.},

volume = {20},

number = {1},

pages = {48},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: The World Health Organization recommends regularly 

 assessing the efficacy of artemisinin-based combination therapy 

 (ACT), which is a critical tool in the fight against malaria. 

 This study evaluated the efficacy of two artemisinin-based 

 combinations recommended to treat uncomplicated Plasmodium 

 falciparum malaria in Burkina Faso in three sites: Niangoloko, 

 Nanoro, and Gourcy. METHODS: This was a two-arm randomized 

 control trial of the efficacy of artemether-lumefantrine (AL) 

 and dihydroartemisinin-piperaquine (DP). Children aged 6-59 

 months old were monitored for 42 days. The primary outcomes of 

 the study were uncorrected and PCR-corrected efficacies to day 

 28 for AL and 42 for DP. Molecular markers of resistance to 

 artemisinin derivatives and partner drugs were also analysed. 

 RESULTS: Of 720 children enrolled, 672 reached study endpoints 

 at day 28, 333 in the AL arm and 339 in the DP arm. 

 PCR-corrected 28-day per protocol efficacy in the AL arm was 

 74% (64-83%) in Nanoro, 76% (66-83%) in Gourcy, and 92% 

 (84-96%) in Niangoloko. The PCR-corrected 42-day per protocol 

 efficacy in the DP arm was 84% (75-89%) in Gourcy, 89% 

 (81-94%) in Nanoro, and 97% (92-99%) in Niangoloko. No Pfk13 

 mutation previously associated with artemisinin-resistance was 

 observed. No statistically significant association was found 

 between treatment outcome and presence of the 86Y mutation in 

 the Pfmdr1 gene. There was also no association observed between 

 treatment outcome and Pfpm2 or Pfmdr1 copy number variation. 

 CONCLUSION: The results of this study indicate evidence of 

 inadequate efficacy of AL at day 28 and DP at day 42 in the same 

 two sites. A change of first-line ACT may be warranted in 

 Burkina Faso. Trial Registry Pan African Clinical Trial Registry 

 Identifier: PACTR201708002499311. Date of registration: 8/3/2017 

 https://pactr.samrc.ac.za/Search.aspx.},

keywords = {Antimalarial, Antimalarials/pharmacology, Artemether, Artemether-lumefantrine, Artemisinins/pharmacology, Burkina Faso, Child, Dihydroartemisinin-piperaquine, Drug Resistance, Efficacy, Falciparum/drug therapy, Female, Lumefantrine Drug Combination/pharmacology, Malaria, Male, Plasmodium falciparum, Preschool, Quinolines/pharmacology},

pubstate = {published},

tppubtype = {article}

}

@article{Skrip2020-fq,

title = {Clinical management and mortality among COVID-19 cases in  sub-Saharan Africa: A retrospective study from Burkina Faso and  simulated case analysis},

author = {Laura Skrip and Karim Derra and Mikaila Kabor\'{e} and Navideh Noori and Adama Gansan\'{e} and Innocent Val\'{e}a and Halidou Tinto and Bicaba W Brice and Mollie Van Gordon and Brittany Hagedorn and Herv\'{e} Hien and Benjamin M Althouse and Edward A Wenger and Andr\'{e} Lin Ou\'{e}draogo},

doi = {10.1016/j.ijid.2020.09.1432},

issn = {1878-3511 1201-9712},

year  = {2020},

date = {2020-12-01},

urldate = {2020-12-01},

journal = {Int. J. Infect. Dis.},

volume = {101},

pages = {194--200},

publisher = {Elsevier BV},

abstract = {BACKGROUND: Absolute numbers of COVID-19 cases and deaths 

 reported to date in the sub-Saharan Africa (SSA) region have 

 been significantly lower than those across the Americas, Asia 

 and Europe. As a result, there has been limited information 

 about the demographic and clinical characteristics of deceased 

 cases in the region, as well as the impacts of different case 

 management strategies. METHODS: Data from deceased cases 

 reported across SSA through 10 May 2020 and from hospitalized 

 cases in Burkina Faso through 15 April 2020 were analyzed. 

 Demographic, epidemiological and clinical information on 

 deceased cases in SSA was derived through a line-list of 

 publicly available information and, for cases in Burkina Faso, 

 from aggregate records at the Centre Hospitalier Universitaire 

 de Tengandogo in Ouagadougou. A synthetic case population was 

 probabilistically derived using distributions of age, sex and 

 underlying conditions from populations of West African countries 

 to assess individual risk factors and treatment effect sizes. 

 Logistic regression analysis was conducted to evaluate the 

 adjusted odds of survival for patients receiving oxygen therapy 

 or convalescent plasma, based on therapeutic effectiveness 

 observed for other respiratory illnesses. RESULTS: Across SSA, 

 deceased cases for which demographic data were available were 

 predominantly male (63/103, 61.2%) and aged \>50 years (59/75, 

 78.7%). In Burkina Faso, specifically, the majority of deceased 

 cases either did not seek care at all or were hospitalized for a 

 single day (59.4%, 19/32). Hypertension and diabetes were often 

 reported as underlying conditions. After adjustment for sex, age 

 and underlying conditions in the synthetic case population, the 

 odds of mortality for cases not receiving oxygen therapy were 

 significantly higher than for those receiving oxygen, such as 

 due to disruptions to standard care (OR 2.07; 95% CI 

 1.56-2.75). Cases receiving convalescent plasma had 50% reduced 

 odds of mortality than those who did not (95% CI 0.24-0.93). 

 CONCLUSIONS: Investment in sustainable production and 

 maintenance of supplies for oxygen therapy, along with messaging 

 around early and appropriate use for healthcare providers, 

 caregivers and patients could reduce COVID-19 deaths in SSA. 

 Further investigation into convalescent plasma is warranted 

 until data on its effectiveness specifically in treating 

 COVID-19 becomes available. The success of supportive or 

 curative clinical interventions will depend on earlier treatment 

 seeking, such that community engagement and risk communication 

 will be critical components of the response.},

note = {Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

PMID: 32987177 

PMCID: PMC7518969},

keywords = {Adolescent, Adult, Africa South of the Sahara, Aged, Antiviral Agents/administration \& dosage, Asia/epidemiology, Burkina Faso, Burkina Faso/epidemiology, Child, Clinical management of SARS-CoV-2 infection: convalescent plasma, COVID-19/drug therapy/epidemiology/mortality/therapy, Europe/epidemiology, Female, Health systems strengthening, Humans, Immunization, Infant, Male, Mortality, Oxygen therapy, Pandemics, Passive, Preschool, Retrospective Studies, SARS-CoV-2 infection, SARS-CoV-2/drug effects/physiology, sub-Saharan Africa, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {High Levels of Genetic Diversity within Nilo-Saharan Populations: Implications for Human Adaptation.},

author = {Julius Mulindwa and Harry Noyes and Hamidou Ilboudo and Luca Pagani and Oscar Nyangiri and Magambo Phillip Kimuda and Bernardin Ahouty and Olivier Fataki Asina and Elvis Ofon and Kelita Kamoto and Justin Windingoudi Kabore and Mathurin Koffi and Dieudonne Mumba Ngoyi and Gustave Simo and John Chisi and Issa Sidibe and John Enyaru and Martin Simuunza and Pius Alibu and Vincent Jamonneau and Mamadou Camara and Andy Tait and Neil Hall and Bruno Bucheton and Annette MacLeod and Christiane Hertz-Fowler and Enock Matovu},

doi = {10.1016/j.ajhg.2020.07.007},

issn = {1537-6605 0002-9297},

year  = {2020},

date = {2020-09-01},

urldate = {2020-09-01},

journal = {American journal of human genetics},

volume = {107},

issue = {3},

pages = {473-486},

abstract = {Africa contains more human genetic variation than any other continent, but the majority of the population-scale analyses of the African peoples have focused on just two of the four major linguistic groups, the Niger-Congo and Afro-Asiatic, leaving the Nilo-Saharan and Khoisan populations under-represented. In order to assess genetic variation and signatures of selection within a Nilo-Saharan population and between the Nilo-Saharan and Niger-Congo and Afro-Asiatic, we sequenced 50 genomes from the Nilo-Saharan Lugbara population of North-West Uganda and 250 genomes from 6 previously unsequenced Niger-Congo populations. We compared these data to data from a further 16 Eurasian and African populations including the Gumuz, another putative Nilo-Saharan population from Ethiopia. Of the 21 million variants identified in the Nilo-Saharan population, 3.57 million (17%) were not represented in dbSNP and included predicted non-synonymous mutations with possible phenotypic effects. We found greater genetic differentiation between the Nilo-Saharan Lugbara and Gumuz populations than between any two Afro-Asiatic or Niger-Congo populations. F3 tests showed that Gumuz contributed a genetic component to most Niger-Congo B populations whereas Lugabara did not. We scanned the genomes of the Lugbara for evidence of selective sweeps. We found selective sweeps at four loci (SLC24A5, SNX13, TYRP1, and UVRAG) associated with skin pigmentation, three of which already have been reported to be under selection. These selective sweeps point toward adaptations to the intense UV radiation of the Sahel.},

keywords = {*Nilo-Saharan, *population genetic variation, *signatures of selection, Adaptation, Antiporters/genetics, Blacks/genetics, Data Management, Ethiopia/epidemiology, Female, Genetic Variation/*genetics, Genetic/*genetics, Genetics, Genome, Haplotypes/genetics, Human/genetics, Humans, Male, Membrane Glycoproteins/genetics, Oxidoreductases/genetics, Physiological/*genetics, Polymorphism, Population, Selection, Single Nucleotide/genetics, Skin Pigmentation/*genetics, Sorting Nexins/genetics, Tumor Suppressor Proteins/genetics, Uganda/epidemiology},

pubstate = {published},

tppubtype = {article}

}

@article{RTS2015,

title = {Efficacy and safety of RTS,S/AS01 malaria vaccine with or without a booster dose in infants and children in Africa: final results of a phase 3, individually randomised, controlled trial},

author = {S Clinical Trials Partnership RTS},

url = {https://pubmed.ncbi.nlm.nih.gov/25913272/},

doi = {10.1016/S0140-6736(15)60721-8},

issn = {1474-547X},

year  = {2015},

date = {2015-01-01},

journal = {Lancet (London, England)},

volume = {386},

issue = {9988},

pages = {31-45},

publisher = {Lancet},

abstract = {Background The efficacy and safety of the RTS,S/AS01 candidate malaria vaccine during 18 months of follow-up have been published previously. Herein, we report the final results from the same trial, including the efficacy of a booster dose. Methods From March 27, 2009, until Jan 31, 2011, children (age 5-17 months) and young infants (age 6-12 weeks) were enrolled at 11 centres in seven countries in sub-Saharan Africa. Participants were randomly assigned (1:1:1) at first vaccination by block randomisation with minimisation by centre to receive three doses of RTS,S/AS01 at months 0, 1, and 2 and a booster dose at month 20 (R3R group); three doses of RTS,S/AS01 and a dose of comparator vaccine at month 20 (R3C group); or a comparator vaccine at months 0, 1, 2, and 20 (C3C [control group]). Participants were followed up until Jan 31, 2014. Cases of clinical and severe malaria were captured through passive case detection. Serious adverse events (SAEs) were recorded. Analyses were by modified intention to treat and per protocol. The coprimary endpoints were the occurrence of malaria over 12 months after dose 3 in each age category. In this final analysis, we present data for the efficacy of the booster on the occurrence of malaria. Vaccine efficacy (VE) against clinical malaria was analysed by negative binomial regression and against severe malaria by relative risk reduction. This trial is registered with ClinicalTrials.gov, number NCT00866619. Findings 8922 children and 6537 young infants were included in the modified intention-to-treat analyses. Children were followed up for a median of 48 months (IQR 39-50) and young infants for 38 months (34-41) after dose 1. From month 0 until study end, compared with 9585 episodes of clinical malaria that met the primary case definition in children in the C3C group, 6616 episodes occurred in the R3R group (VE 36·3%, 95% CI 31·8-40·5) and 7396 occurred in the R3C group (28·3%, 23·3-32·9); compared with 171 children who experienced at least one episode of severe malaria in the C3C group, 116 children experienced at least one episode of severe malaria in the R3R group (32·2%, 13·7 to 46·9) and 169 in the R3C group (1·1%, -23·0 to 20·5). In young infants, compared with 6170 episodes of clinical malaria that met the primary case definition in the C3C group, 4993 episodes occurred in the R3R group (VE 25·9%, 95% CI 19·9-31·5) and 5444 occurred in the R3C group (18·3%, 11·7-24·4); and compared with 116 infants who experienced at least one episode of severe malaria in the C3C group, 96 infants experienced at least one episode of severe malaria in the R3R group (17·3%, 95% CI -9·4 to 37·5) and 104 in the R3C group (10·3%, -17·9 to 31·8). In children, 1774 cases of clinical malaria were averted per 1000 children (95% CI 1387-2186) in the R3R group and 1363 per 1000 children (995-1797) in the R3C group. The numbers of cases averted per 1000 young infants were 983 (95% CI 592-1337) in the R3R group and 558 (158-926) in the R3C group. The frequency of SAEs overall was balanced between groups. However, meningitis was reported as a SAE in 22 children: 11 in the R3R group, ten in the R3C group, and one in the C3C group. The incidence of generalised convulsive seizures within 7 days of RTS,S/AS01 booster was 2·2 per 1000 doses in young infants and 2·5 per 1000 doses in children. Interpretation RTS,S/AS01 prevented a substantial number of cases of clinical malaria over a 3-4 year period in young infants and children when administered with or without a booster dose. Efficacy was enhanced by the administration of a booster dose in both age categories. Thus, the vaccine has the potential to make a substantial contribution to malaria control when used in combination with other effective control measures, especially in areas of high transmission. Funding GlaxoSmithKline Biologicals SA and the PATH Malaria Vaccine Initiative.},

keywords = {{Africa South of the Sahara / epidemiology, Age Factors, Clinical Trial, Double-Blind Method, Falciparum / epidemiology, Falciparum / prevention \& control*, Female, Follow-Up Studies, Hospitalization / statistics \& numerical data, Humans, Immunization, Immunization Schedule, Incidence, Infant, Malaria, Malaria Vaccines*, Male, MEDLINE, Multicenter Study, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Phase III, PMC5626001, PubMed Abstract, Randomized controlled trial, Research Support, S Clinical Trials Partnership'},

pubstate = {published},

tppubtype = {article}

}