The document discusses invasive bacterial disease (IBD) surveillance in West and Central Africa conducted by the MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine. It summarizes that the unit oversees the largest IBD surveillance network in the region, monitoring the impact of pneumococcal conjugate vaccines. Analysis of surveillance data from 2010-2016 shows declines in pneumococcal meningitis cases and deaths following vaccine introduction, though impact varies by country. Continued surveillance is needed to fully assess the effects of vaccination programs.
Dr Marie-Pierre Preziosi's presentation at Meningitis Research Foundation's 2013 conference, Meningitis & Septicaemia in Children & Adults http://www.meningitis.org/conference2013
Professor Michael Levin's presentation at Meningitis Research Foundation's 2013 conference Meningitis & Septicaemia in Children & Adults www.meningitis.org/conference2013
Novartis satellite breakfast session at the Meningitis Research Foundation 2013 conference, Meningitis & Septicaemia in Children & Adults presented by Emeritus Professor Richard Moxon, Dr Jamie Findlow and Dr Simon Nadel
Emergence of a virulent new meningococcal W sequence type 11 in South America: experience, control measures and impact
http://www.meningitis.org/conference2015
Dr Marie-Pierre Preziosi's presentation at Meningitis Research Foundation's 2013 conference, Meningitis & Septicaemia in Children & Adults http://www.meningitis.org/conference2013
Professor Michael Levin's presentation at Meningitis Research Foundation's 2013 conference Meningitis & Septicaemia in Children & Adults www.meningitis.org/conference2013
Novartis satellite breakfast session at the Meningitis Research Foundation 2013 conference, Meningitis & Septicaemia in Children & Adults presented by Emeritus Professor Richard Moxon, Dr Jamie Findlow and Dr Simon Nadel
Emergence of a virulent new meningococcal W sequence type 11 in South America: experience, control measures and impact
http://www.meningitis.org/conference2015
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Amanda Mocroft, UCL
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
Three months after the start of the COVID-19 pandemic in Wuhan (China), the African response could be labelled as impressive. Many lessons were learnt by African countries from Ebola epidemic which hit West Africa (2014-2016). Industrial resiliency (mask production at scale), Technological innovations (PCR test local production, machine learning and robotics) and Genomic Prowess (Genome sequence of COVID-19 virus) ; all showed Africa is ready to be part of the global solution to COVID-19. Yet, only 3 clinical trials for vaccine and medicine against the virus were ongoing across the continent at the time of this presentation. The presentation also discusses some of the public health and industrial strategies to build even more resiliency in the continent beyond the pandemic.
In light of the global health crisis, Imperial College Healthcare Club to host the second webinar discussion around Africa’s healthcare system resilience to COVID-19. We are honored to be joined by Dr. Kaouthar Lbiati, who are both currently working on the continent’s response to the pandemic.The event will be a discussion, where the speakers will be presenting their work as well as their views and perspectives around the Healthcare crisis in Africa.
The webinar will focus on :
1. How the healthcare actors based in Africa have been crucial in responding to the pandemic.
3. How the long-term consequences of this crisis can bring major changes in Africa.
Kaouthar Lbiati (MD, MSc) will be emphasising on the wider scope of the healthcare policy & industry and explore the strategies on both that Africa as a continent could
establish to build resilience.
Meningococcal carriage in the African meningitis belt and the impact of MenAfriVac: an overview of the MenAfriCar project
http://www.meningitis.org/conference2015
Malaria is still considered globally as a leading cause of morbidity with Nigeria carrying the highest burden of 19%. Coinfection of malaria and Human Immunodeficiency Virus (HIV) accelerate disease progression of HIV/AIDS subjects. This study investigated the prevalence and predictors of malaria among HIV infected subjects attending the antiretroviral therapy Clinic at Federal the Medical Centre, Keffi, Nigeria. After ethical clearance, 200 whole blood specimens were collected from patients who gave informed consent and completed a self-structured questionnaire. The specimens were examined for malarial parasite using rapid kits and microscopy. The overall prevalence of the infection was 78/200 (39.0%). The prevalence was higher in male (44.7%) than female (34.0%) subjects. Those subjects aged < 20 years (54.5), male gender (44.7%), non-formal education holders (61.5%), farmers (62.5%), stream water users (48.1%), those that lives in rural setting (43.6%), those that do not use Insecticides Treated Nets (ITNs) (39.4%) and swampy environment dwellers (41.7%) were identified predictors for malaria infection in the area. All the predictors studied did not show any statistically significant difference with the infection but some arithmetic difference exists (P > 0.05). The 39.0% prevalence of malaria in HIV infected subjects is a public health concern. Therefore, Public health surveillance and health education among HIV population should be advocated to help eradicate malaria comes 2030. Further study that will characterize the genes of the parasite should be carried out.
The International Journal of Engineering & Science is aimed at providing a platform for researchers, engineers, scientists, or educators to publish their original research results, to exchange new ideas, to disseminate information in innovative designs, engineering experiences and technological skills. It is also the Journal's objective to promote engineering and technology education. All papers submitted to the Journal will be blind peer-reviewed. Only original articles will be published.
The papers for publication in The International Journal of Engineering& Science are selected through rigorous peer reviews to ensure originality, timeliness, relevance, and readability.
Professor Quarraisha Abdool Karim will take you on a journey showing how knowledge and science have made an incredible impact on battling the HIV virus on the African content. Through empowering women to help fight this deadly disease, Professor Karim’s work has managed to translate scientific research and knowledge into people-centred solutions and prevention programmes to reduce the factors making young people so vulnerable to HIV infection. Be inspired by this story and prepared to embrace your own challenges to transform them into positive actions.
The meaning of meningococcal carriage - Slideset by Professor Adam FinnWAidid
Professor Finn on the risks of meningococcal
disease. The slideset face the effects of vaccines, the speculation about meningococcal infection and respiratory viruses, so as the epidemiology & evolving vaccine
strategies in Europe and Africa.
Prevalence of Hpv Infection in the Lekoumou and Niari Departments (Congo Braz...eshaasini
We carried out a descriptive and cross-sectional study over a period of 7 months from January to July 2019 in the department of Lekoumou. 100 women ranging in age from 16 to 73 years old. The variables studied were as follows: age, marital status, level of education, risk factors for the onset of HPV infection, age at first sexual intercourse, number of sexual partners, parity, gesture. The multivariate analysis was done between age, number of level of instruction, parity, age of first sexual intercourse and number of sexual Partners. The statistical analysis and the data processing were carried out by the Excel 2016 software and the graph pad prism version 5 software. The statistical test used was the chi-square test.
Prevalence of Hpv Infection in the Lekoumou and Niari Departments (Congo Braz...semualkaira
We carried out a descriptive and cross-sectional study over a period of 7 months from January to July 2019 in the department of Lekoumou. 100 women ranging in age from 16 to 73 years old. The variables studied were as follows: age, marital status, level of education, risk factors for the onset of HPV infection, age at first sexual intercourse, number of sexual partners, parity, gesture. The multivariate analysis was done between age, number of level of instruction, parity, age of first sexual intercourse and number of sexual Partners. The statistical analysis and the data processing were carried out by the Excel 2016 software and the graph pad prism version 5 software. The statistical test used was the chi-square test.
Prevalence of Hpv Infection in the Lekoumou and Niari Departments (Congo Braz...semualkaira
We carried out a descriptive and cross-sectional study over a period of 7 months from January to July 2019 in the department of Lekoumou. 100 women ranging in age from 16 to 73 years old. The variables studied were as follows: age, marital status, level of education, risk factors for the onset of HPV infection, age at first sexual intercourse, number of sexual partners, parity, gesture. The multivariate analysis was done between age, number of level of instruction, parity, age of first sexual intercourse and number of sexual Partners. The statistical analysis and the data processing were carried out by the Excel 2016 software and the graph pad prism version 5 software. The statistical test used was the chi-square test.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Prof Martin Antonio @ MRF's Meningitis and Septicaemia 2019
1. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
PCV Impact and the paediatric meningitis
surveillance in West Africa
Martin Antonio
Medical Research Council Unit The Gambia at
London School of Hygiene & Tropical Medicine
Meningitis Research Foundation’s 12th International Conference
The British Museum, London
6th November, 2019
2. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Africa’s meningitis belts
• Long history (>100 years) of periodic meningitis outbreaks
associated with meningococcus (Greenwood, 2006)
Strategy for managing
meningitis epidemics in
Africa
The WHO strategy for the
control of epidemic
meningitis is based on three
key pillars:
• Surveillance
• Treatment and care
• Vaccination
4. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
IBD surveillance
IBD surveillance is part of:
• The global VP-IBD surveillance network
• Collects data related to the detection of 3 vaccine-preventable
organisms: Haemophilus influenzae, Streptococcus pneumoniae and
Neisseria meningitidis.
The global VP-IBD sentinel surveillance utilizes a 3-tiered
approach:
• Tier 1: surveillance targets children under-five with suspected meningitis
• Tier 2: surveillance also targets children under-five with pneumonia
and/or sepsis
• Tier 3: Population-based Surveillance (seeks to determine incidence
rates of VP-IBD) e.g. MRC Basse, The Gambia
5. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Goal: IBD surveillance
• Production of high quality, local information on the
causes of two major killers of children in West Africa;
Meningitis and Pneumonia.
• Enable decision makers to assess the possible value of
new vaccines using the best local evidence – their own
data not estimates
• Monitor the effect of vaccines post- introduction; sharing
information widely
• All West Africa countries are using PCV-13 except
Nigeria (PCV10)
6. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
WHO Member States that reported data to the Global Invasive Bacterial
Vaccine-Preventable Disease Surveillance Network, 2018
7. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Standardized Structure
8. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Study population
• Sentinel surveillance at the largest paediatric hospitals in
West & Central Africa
• Children <5 years of age admitted to the hospital with
signs & symptoms of probable bacterial meningitis &/or
symptoms of invasive bacterial disease (e.g. sepsis) were
recruited into the study.
• Probable meningitis is a suspected case with examination
of CSF showing at least Turbid appearance or WBC
(>100 cells/mm3) or WBC (10-100 cells/mm3) AND either
an elevated protein (>100 mg/dl) or decreased glucose
(<40 mg/dl)
9. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Summary of specimens received and processed 2010 - 2016
Suspected cases at
sentinel sites
38,404(100%)
CSF samples
collected
18034(48%)
Confirmed & probable
Screened by PCR
1171(7%)
PCR +ve
311(27%)
Serotyped
205(66%)
Suspected Screened
by PCR
7587(42%)
PCR +ve
606(8%)
Serotyped
418(69%)
Bacterial Isolates
327
Confirmed and
serotyped
270(82%)
Whole Genome
sequenced
176(65%)
10. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
11. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
12. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
WHO Regional Workshop & Capacity Building at
MRC Gambia @ LSHTM 28thOct -1st Nov 2019
Sheep blood collection for media preparation
13. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Baseline characteristics of suspected meningitis
cases in West & Central Africa: 2010 - 2016
Characteristic Category N %
Age
0-11m 18793 48.7%
12-23m 6570 17.0%
24-59m 12796 33.1%
Unknown 442 1.2%
Sex Female 16969 44.0%
Male 21464 55.6%
Unknown 168 0.4%
Antibiotic before admission
Yes 5516 14.3%
No 17055 44.2%
Unknown 16030 41.5%
Outcome
Discharged Alive 23829 61.7%
Died 2181 5.7%
Unknown 12591 32.6%
Sequelae
No 11758 30.5%
Yes 352 0.9%
Unknown 26491 68.6%
Case type* Confirmed 821 2.1%
Suspected 37780 97.9%
14. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Trends in meningitis and mortality among suspected
cases pre and post PCV in West & Central Africa (2010 –
2016)
200040006000
−4 −3 −2 −1 0 1 2 3 4 5
Years before/after vaccination
Suspectedmeningitis(count) A
100200300400
−4 −3 −2 −1 0 1 2 3 4 5
Years before/after vaccination
Mortality(count)
B
50100150200
−4 −3 −2 −1 0 1 2 3 4 5
Years before/after vaccination
Confirmedcases
C
234567
−4 −3 −2 −1 0 1 2 3 4 5
Years before/after vaccination
Casefatalityrate
D
15. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Trends in confirmed cases pre and post PCV
in West & Central Africa (2010 – 2016)
04080120
−4 −3 −2 −1 0 1 2 3 4 5
Years before/after vaccination
Confirmedcases
A
H. Influenzae
S. Pneumoniae
N. Meningitis
051020
−4 −3 −2 −1 0 1 2 3 4 5
Years before/after vaccination
Mortality(count)
B
H. Influenzae
S. Pneumoniae
N. Meningitis
051525
−4 −3 −2 −1 0 1 2 3 4 5
Years before/after vaccination
Numberofcases
C
PCV−13
Non−PCV13
• Sharp decline in S. pneumoniae
meningitis cases and deaths
• Steady decline in N. meningitidis
cases and deaths
• H. influenzae counts are stable
• Decline in meningitis caused by
PCV13 types
16. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
0100200300400500
2010 2011 2012 2013 2014 2015 2016
Benin
050100150200
2010 2011 2012 2013 2014 2015 2016
Cameroon
05101520
2010 2011 2012 2013 2014 2015 2016
Gambia
050100150
2010 2011 2012 2013 2014 2015 2016
Ghana
020406080
2010 2011 2012 2013 2014 2015 2016
Ivory Coast
050100150
2010 2011 2012 2013 2014 2015 2016
Niger
050100150
2010 2011 2012 2013 2014 2015 2016
Nigeria
051015202530
2010 2011 2012 2013 2014 2015 2016
Senegal
0102030
2010 2011 2012 2013 2014 2015 2016
Sierra Leone
020406080100
2010 2011 2012 2013 2014 2015 2016
Togo
SuspectedMeningitis(Count)
Year Year
• PCV impact appears variable
across different countries
• Benin and Ghana (high)
• Nigeria and Niger (low)
• Short surveillance period
post PCV implementation
Modelling pre and post PCV introduction trends in
suspected meningitis (2010-2016)
17. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
PVC impact by age
(2010 – 2016)
050100150200
2010 2011 2012 2013 2014 2015 2016
Benin
02060100
2010 2011 2012 2013 2014 2015 2016
Cameroon
0246810
2010 2011 2012 2013 2014 2015 2016
Gambia
020406080
2010 2011 2012 2013 2014 2015 2016
Ghana
01020304050
2010 2011 2012 2013 2014 2015 2016
Ivory Coast
020406080
2010 2011 2012 2013 2014 2015 2016
Niger
020406080100
2010 2011 2012 2013 2014 2015 2016
Nigeria
05101520
2010 2011 2012 2013 2014 2015 2016
Senegal
0510152025
2010 2011 2012 2013 2014 2015 2016
Sierra Leone
01020304050
2010 2011 2012 2013 2014 2015 2016
Togo
SuspectedMeningitis(Count)
Year Year
__
__
__
<12months
12−24months
24−59months
• Modelling pre and post PCV
introduction trends in suspected
meningitis by age
• Red: 0-11 months
• Blue: 12-23 months
• Green: 23 – 59 months
• PCV impact appears consistent
across age strata < 5 years old
18. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Trend estimates for PCV impact across West
and Central Africa (2010 – 2016)
RE Model, All
0 1 2 3 4 5
Togo
Nigeria
Niger
Ivory Coast
Sierra Leone
Senegal
Ghana
Gambia
Cameroon
Benin
1.241 [0.854, 1.804]
0.700 [0.362, 1.356]
1.491 [0.740, 3.006]
0.851 [0.547, 1.325]
1.416 [0.412, 4.868]
0.838 [0.652, 1.078]
0.722 [0.637, 0.817]
0.428 [0.303, 0.604]
0.213 [0.166, 0.275]
0.282 [0.206, 0.385]
0.650 [0.430, 0.981]
Long post vaccine follow up
Short post vaccine follow up
A) Suspected Meniningitis Ratio [95% CI]
0.487 [0.290, 0.817]RE Model, Subgroup
1.035 [0.776, 1.381]RE Model, Subgroup
Post/Pre vaccine trend ratio
Long post vaccine follow up
B) Mortality Ratio [95% CI]
Post/Pre vaccine trend ratio
19. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Trend estimates for PCV impact on mortality
across West and Central Africa (2010 – 2016)
20. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Trend estimates for PCV impact on mortality
across West and Central Africa (2010 – 2016)
RE Model, All
0 5 10 15 20
Togo 1.099 [0.448, 2.700]
0.737 [0.464, 1.172]
1.286 [0.719, 2.300]RE Model, Subgroup
Post/Pre vaccine trend ratio
RE Model for All Countries
0 1 2 3 4 5
Togo
Nigeria
Niger
Ivory Coast
Senegal
Ghana
Gambia
Cameroon
Benin
1.265 [0.324, 4.938]
0.367 [0.085, 1.584]
0.032 [0.004, 0.297]
0.534 [0.106, 2.680]
0.836 [0.410, 1.705]
0.707 [0.398, 1.255]
0.133 [0.030, 0.576]
0.886 [0.568, 1.382]
0.989 [0.403, 2.429]
0.728 [0.554, 0.957]
Long post vaccine follow up
Short post vaccine follow up
C) Confirmed Meniningitis Ratio [95% CI]
0.777 [0.581, 1.040]RE Model, Subgroup
0.360 [0.094, 1.379]RE Model, Subgroup
Post/Pre vaccine trend ratio
Post/Pre vaccine trend ratio
21. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
PCV in
15/17 countries except
Guinee: Gavi country
Capo Verde: Non Gavi country
21
PCV vaccine introduction and coverage in WA 2018
( WUENIC)
22. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
22
PCV vaccine introduction and coverage in WA 2018
( WUENIC)
23. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
• PCV has had an impact on suspected meningitis and
mortality among across the sub-region
• The impact is greater in some countries than others
• Short post-PCV surveillance in some countries is a
problem
• Overall, counts of N. meningitidis meningitis have also
declined while H. influenzae has remained stable.
Concluding remarks
24. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Love them
or loathe them
25. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Martin Antonio, Isaac Adewole, Chikwe Ihekweazu
26. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
UK Secretary of State for Foreign and Commonwealth
Affairs Rt Hon Boris Johnson MP visits MRC Unit The Gambia
27. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
UK Secretary of State for Foreign and Commonwealth Affai
Rt Hon Boris Johnson MP visits MRC Unit The Gambia
28. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
UK Secretary of State for Foreign and Commonwealth Affairs
Rt Hon Boris Johnson MP visits MRC Unit The Gambia
29. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
30. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Acknowledgements
MRC @ LSHTM
• Brenda Kwambana-Adams
• Catherine Okoi
• Sheikh Jarju
• Archibald Worwui
• Research Molecular
Microbiology Team
Countries
• Country Ministries of Health
• WHO Country Offices
WHO
• Jason Mwenda
• Fatima Serhan
• Adam Cohen
NICD
• Anne Von Gottberg
• Linda de Gouveia
• Mignon d Plessis
CDC
• Fernanda Lessa
• Stephanie Schwartz
• Mahamoudou Ouattara
31. MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine
Acknowledgements