Browsing by Author "Kang G"

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Associations Between Eight Earth Observation-Derived Climate Variables and Enteropathogen Infection: An Independent Participant Data Meta-Analysis of Surveillance Studies With Broad Spectrum Nucleic Acid Diagnostics.
(2022-Jan) Colston JM; Zaitchik BF; Badr HS; Burnett E; Ali SA; Rayamajhi A; Satter SM; Eibach D; Krumkamp R; May J; Chilengi R; Howard LM; Sow SO; Jahangir Hossain M; Saha D; Imran Nisar M; Zaidi AKM; Kanungo S; Mandomando I; Faruque ASG; Kotloff KL; Levine MM; Breiman RF; Omore R; Page N; Platts-Mills JA; Ashorn U; Fan YM; Shrestha PS; Ahmed T; Mduma E; Yori PP; Bhutta Z; Bessong P; Olortegui MP; Lima AAM; Kang G; Humphrey J; Prendergast AJ; Ntozini R; Okada K; Wongboot W; Gaensbauer J; Melgar MT; Pelkonen T; Freitas CM; Kosek MN; Global Health Rollins School of Public Health Emory University Atlanta GA USA.; Department of Child Health Institute of Medicine of Tribhuvan University Kirtipur Nepal.; Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MA USA.; Department of Pediatrics and Child Health The Aga Khan University Karachi Pakistan.; Department of Pediatrics National Academy of Medical Sciences Kanti Children's Hospital Kathmandu Nepal.; Centre for Enteric Diseases National Institute for Communicable Diseases Pretoria South Africa.; Centre for Nutrition & Food Security International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) Dhaka Bangladesh.; Hospital Pediátrico David Bernardino Luanda Angola.; Department of Pediatrics and Child Health Aga Khan University Karachi Pakistan.; Centre for Infectious Disease Research in Zambia Lusaka Zambia.; HIV/AIDS & Global Health Research Programme University of Venda Thohoyandou South Africa.; Division of Infectious Diseases and International Health and Public Health Sciences University of Virginia School of Medicine Charlottesville VA USA.; Children's Hospital Helsinki University Central Hospital Helsinki Finland.; Departments of Medicine and Pediatrics Center for Vaccine Development and Global Health University of Maryland School of Medicine Baltimore MD USA.; Centre pour le Développement des Vaccins, Mali Bamako Mali.; Department of Infectious Disease Epidemiology Bernhard Nocht Institute for Tropical Medicine (BNITM) Hamburg Germany.; Department of Pediatrics Vanderbilt University Medical Center Nashville TN USA.; Division of Infectious Diseases Programme for Emerging Infections International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) Dhaka Bangladesh.; Division of Infectious Diseases and International Health University of Virginia School of Medicine Charlottesville VA USA.; Pediatric Infectious Diseases Hospital Roosevelt Guatemala City Guatemala.; Zvitambo Institute for Maternal and Child Health Research Harare Zimbabwe.; Centre for Genomics and Child Health Blizard Institute Queen Mary University of London London UK.; Division of Nutrition and Clinical Services International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) Dhaka Bangladesh.; Research Institute for Microbial Diseases Osaka University Osaka Japan.; National Institute of Cholera and Enteric Diseases Kolkata India.; Asociacion Benefica PRISMA Iquitos Peru.; Department of Earth and Planetary Sciences Johns Hopkins Krieger School of Arts and Sciences Baltimore MA USA.; Centro de Investigação em Saúde de Manhiça Manhiça Mozambique.; Department of Medical Sciences National Institute of Health Nonthaburi Thailand.; Division of Viral Diseases US Centers for Disease Control and Prevention Atlanta GA USA.; Department of Physiology and Pharmacology Faculty of Medicine Federal University of Ceará Fortaleza Brazil.; Department of Epidemiology Colorado School of Public Health Center for Global Health Aurora CO USA.; Epidemiology and Health Economics GSK Vaccine Wavre Belgium.; Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine Banjul The Gambia.; Department of Gastrointestinal Sciences Christian Medical College Vellore India.; Haydom Global Health Institute Haydom Tanzania.; Department of Pediatrics University of Maryland School of Medicine Baltimore MD USA.; Kenya Medical Research Institute Center for Global Health Research Kisumu Kenya.; Center for Child, Adolescent and Maternal Health Research Tampere University Tampere Finland.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
Diarrheal disease, still a major cause of childhood illness, is caused by numerous, diverse infectious microorganisms, which are differentially sensitive to environmental conditions. Enteropathogen-specific impacts of climate remain underexplored. Results from 15 studies that diagnosed enteropathogens in 64,788 stool samples from 20,760 children in 19 countries were combined. Infection status for 10 common enteropathogens-adenovirus, astrovirus, norovirus, rotavirus, sapovirus,
Enterotoxigenic Escherichia coli (ETEC) vaccines: Priority activities to enable product development, licensure, and global access.
(2021-Jul-13) Khalil I; Walker R; Porter CK; Muhib F; Chilengi R; Cravioto A; Guerrant R; Svennerholm AM; Qadri F; Baqar S; Kosek M; Kang G; Lanata C; Armah G; Wierzba T; Hasso-Agopsowicz M; Giersing B; Louis Bourgeois A; WHO, Switzerland.; Universidad Nacional Autónoma de México, Mexico.; NMRC, USA.; University of Gothenburg, Sweden.; National Institute of Allergy and Infectious Diseases, National Institutes of Health, USA.; Christian Medical College Vellore, India.; Instituto de Investigacion Nutricional, Peru.; Wake Forest School of Medicine, USA.; icddr, b, Bangladesh.; Centre for Infectious Disease Research in Zambia, Zambia.; PATH, USA.; WHO, Switzerland. Electronic address: ikhalil@uw.edu.; University of Virginia, USA.; Noguchi Memorial Institute for Medical Research, Ghana.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
Diarrhoeal disease attributable to enterotoxigenic Escherichia coli (ETEC) causes substantial morbidity and mortality predominantly in paediatric populations in low- and middle-income countries. In addition to acute illness, there is an increasing appreciation of the long-term consequences of enteric infections, including ETEC, on childhood growth and development. Provision of potable water and sanitation and appropriate clinical care for acute illness are critical to reduce the ETEC burden. However, these interventions are not always practical and may not achieve equitable and sustainable coverage. Vaccination may be the most cost-effective and equitable means of primary prevention; however, additional data are needed to accelerate the investment and guide the decision-making process for ETEC vaccines. First, to understand and quantify the ETEC disease burden, additional data are needed on the association between ETEC infection and physical and cognitive stunting as well as delayed educational attainment. Furthermore, the role of inappropriate or inadequate antibiotic treatment of ETEC-attributable diarrhoea may contribute to the development of antimicrobial resistance (AMR) and needs further elucidation. An ETEC vaccine that mitigates acute diarrhoeal illness and minimizes the longer-term disease manifestations could have significant public health impact and be a cost-effective countermeasure. Herein we review the ETEC vaccine pipeline, led by candidates compatible with the general parameters of the Preferred Product Characteristics (PPC) recently developed by the World Health Organization. Additionally, we have developed an ETEC Vaccine Development Strategy to provide a framework to underpin priority activities for researchers, funders and vaccine manufacturers, with the goal of addressing globally unmet data needs in the areas of research, product development, and policy, as well as commercialization and delivery. The strategy also aims to guide prioritization and co-ordination of the priority activities needed to minimize the timeline to licensure and use of ETEC vaccines, especially in in low- and middle-income countries, where they are most urgently needed.
Immunogenicity and safety of two monovalent rotavirus vaccines, ROTAVAC® and ROTAVAC 5D® in Zambian infants.
(2021-Jun-16) Chilengi R; Mwila-Kazimbaya K; Chirwa M; Sukwa N; Chipeta C; Velu RM; Katanekwa N; Babji S; Kang G; McNeal MM; Meyer N; Gompana G; Hazra S; Tang Y; Flores J; Bhat N; Rathi N; The Wellcome Trust Research Laboratory, Vellore, India.; Centre for Infectious Disease Research in Zambia, Zambia.; PATH, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.; PATH, India. Electronic address: nrathi@path.org.; PATH, India.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND AND AIMS: ROTAVAC® (frozen formulation stored at -20 °C) and ROTAVAC 5D® (liquid formulation stable at 2-8 °C) are rotavirus vaccines derived from the 116E human neonatal rotavirus strain, developed and licensed in India. This study evaluated and compared the safety and immunogenicity of these vaccines in an infant population in Zambia. METHODS: We conducted a phase 2b, open-label, randomized, controlled trial wherein 450 infants 6 to 8 weeks of age were randomized equally to receive three doses of ROTAVAC or ROTAVAC 5D, or two doses of ROTARIX®. Study vaccines were administered concomitantly with routine immunizations. Blood samples were collected pre-vaccination and 28 days after the last dose. Serum anti-rotavirus IgA antibodies were measured by ELISA, with WC3 and 89-12 rotavirus strains as viral lysates in the assays. The primary analysis was to assess non-inferiority of ROTAVAC 5D to ROTAVAC in terms of the geometric mean concentration (GMC) of serum IgA (WC3) antibodies. Seroresponse and seropositivity were also determined. Safety was evaluated as occurrence of immediate, solicited, unsolicited, and serious adverse events after each dose. RESULTS: The study evaluated 388 infants in the per-protocol population. All three vaccines were well tolerated and immunogenic. The post-vaccination GMCs were 14.0 U/mL (95% CI: 10.4, 18.8) and 18.1 U/mL (95% CI: 13.7, 24.0) for the ROTAVAC and ROTAVAC 5D groups, respectively, yielding a ratio of 1.3 (95% CI: 0.9, 1.9), thus meeting the pre-set non-inferiority criteria. Solicited and unsolicited adverse events were similar across all study arms. No death or intussusception case was reported during study period. CONCLUSIONS: Among Zambian infants, both ROTAVAC and ROTAVAC 5D were well tolerated and the immunogenicity of ROTAVAC 5D was non-inferior to that of ROTAVAC. These results are consistent with those observed in licensure trials in India and support use of these vaccines across wider geographical areas.
Spatiotemporal variation in risk of Shigella infection in childhood: a global risk mapping and prediction model using individual participant data.
(2023-Mar) Badr HS; Colston JM; Nguyen NH; Chen YT; Burnett E; Ali SA; Rayamajhi A; Satter SM; Van Trang N; Eibach D; Krumkamp R; May J; Adegnika AA; Manouana GP; Kremsner PG; Chilengi R; Hatyoka L; Debes AK; Ateudjieu J; Faruque ASG; Hossain MJ; Kanungo S; Kotloff KL; Mandomando I; Nisar MI; Omore R; Sow SO; Zaidi AKM; Lambrecht N; Adu B; Page N; Platts-Mills JA; Mavacala Freitas C; Pelkonen T; Ashorn P; Maleta K; Ahmed T; Bessong P; Bhutta ZA; Mason C; Mduma E; Olortegui MP; Peñataro Yori P; Lima AAM; Kang G; Humphrey J; Ntozini R; Prendergast AJ; Okada K; Wongboot W; Langeland N; Moyo SJ; Gaensbauer J; Melgar M; Freeman M; Chard AN; Thongpaseuth V; Houpt E; Zaitchik BF; Kosek MN; Programme for Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.; Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.; Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon; Department of Health Research, M A SANTE (Meileur Acces aux Soins en Santé), Yaoundé, Cameroon; Division of Health Operations Research, Cameroon Ministry of Public Health, Yaoundé, Cameroon.; Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.; Laboratory and Treatment Unit, Center for Malariology, Parasitology, and Entomology, Ministry of Health, Vientiane, Lao PDR.; Centre for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.; Hospital Pediátrico David Bernardino, Luanda, Angola.; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA.; Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.; Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil.; Department of Medical Sciences, National Institute of Health, Nonthaburi, Thailand.; Research Institute for Microbial Diseases, Osaka University, Osaka, Japan.; HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, Limpopo, South Africa.; Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Nyanza, Kenya.; New Children's Hospital, Pediatric Research Center and Helsinki University Hospital, Helsinki, Finland.; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.; Centro de Investigação em Saúde de Manhiça, Manhica, Mozambique.; College of Arts and Sciences, University of Virginia, VI, USA.; Centre for Nutrition & Food Security, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.; Institute of Public Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany.; Haydom Global Health Institute, Haydom, Tanzania.; Department of Clinical Science, University of Bergen, Bergen, Norway.; Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA.; National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam.; Department of Pediatrics, National Academy of Medical Sciences, Kanti Children's Hospital, Kathmandu, Nepal.; Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany.; Medical Research Council Unit, The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia.; Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand.; Centre pour le Développement des Vaccins, Mali, Bamako, Mali.; Division of Viral Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA.; Pediatric Infectious Diseases, Hospital Roosevelt, Guatemala City, Guatemala.; Asociacion Benefica PRISMA, Iquitos, Peru.; Center for Global Health, Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, 30322, GA, USA.; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.; Centre for Enteric Diseases, National Institute for Communicable Diseases, Pretoria, South Africa.; National Institute of Cholera and Enteric Diseases, Kolkota, India.; Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India.; Enteric diseases and Vaccines Unit, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany.; Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.; Department of Earth and Planetary Sciences, Johns Hopkins Krieger School of Arts and Sciences, Baltimore, MA, USA.; Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan.; Department of Earth and Planetary Sciences, Johns Hopkins Krieger School of Arts and Sciences, Baltimore, MA, USA. Electronic address: zaitchik@jhu.edu.; College of Medicine, University of Malawi, Blantyre, Malawi.; Blizard Institute, Queen Mary University of London, London, UK.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND: Diarrhoeal disease is a leading cause of childhood illness and death globally, and Shigella is a major aetiological contributor for which a vaccine might soon be available. The primary objective of this study was to model the spatiotemporal variation in paediatric Shigella infection and map its predicted prevalence across low-income and middle-income countries (LMICs). METHODS: Individual participant data for Shigella positivity in stool samples were sourced from multiple LMIC-based studies of children aged 59 months or younger. Covariates included household-level and participant-level factors ascertained by study investigators and environmental and hydrometeorological variables extracted from various data products at georeferenced child locations. Multivariate models were fitted and prevalence predictions obtained by syndrome and age stratum. FINDINGS: 20 studies from 23 countries (including locations in Central America and South America, sub-Saharan Africa, and south and southeast Asia) contributed 66 563 sample results. Age, symptom status, and study design contributed most to model performance followed by temperature, wind speed, relative humidity, and soil moisture. Probability of Shigella infection exceeded 20% when both precipitation and soil moisture were above average and had a 43% peak in uncomplicated diarrhoea cases at 33°C temperatures, above which it decreased. Compared with unimproved sanitation, improved sanitation decreased the odds of Shigella infection by 19% (odds ratio [OR]=0·81 [95% CI 0·76-0·86]) and open defecation decreased them by 18% (OR=0·82 [0·76-0·88]). INTERPRETATION: The distribution of Shigella is more sensitive to climatological factors, such as temperature, than previously recognised. Conditions in much of sub-Saharan Africa are particularly propitious for Shigella transmission, although hotspots also occur in South America and Central America, the Ganges-Brahmaputra Delta, and the island of New Guinea. These findings can inform prioritisation of populations for future vaccine trials and campaigns. FUNDING: NASA, National Institutes of Health-The National Institute of Allergy and Infectious Diseases, and Bill & Melinda Gates Foundation.