A free-roaming dog population remains one of the major public health problems in many developing countries. In this study, we investigated the potential impact of owned roaming and stray dogs on the persistence and possible eradication of Guinea worm disease (GWD) in Chad. We developed and analysed a multi-host of Guinea worm; and considered dogs as the definitive hosts, and fish as the intermediate hosts. Currently, GWD cases in the human population are low; hence, we ignored the human population in this study. We derived the reproduction number and explored how it depends on different model parameters that define it. We calibrated the proposed model with data from literature and validated it with recently reported GWD monthly data for dog infection in Chad from 2019 to 2022. Results show that detection and tethering of infectious owned free-roaming dogs combined with culling of stray dogs are effective disease management strategies. Hence, attainment of certain threshold levels for these interventions could lead to disease eradication. Overall, the study revealed how different factors could be applied to effectively manage GWD transmission in the dog population. Findings from this study could be used to support decision-making in GWD control strategies. Mathematics Subject Classification (2010): 92B05, 93A30, 93C15.

The global spread of avian influenza A viruses in domestic birds is causing increasing socioeconomic devastation. Various mechanistic models have been developed to better understand avian influenza transmission and evaluate the effectiveness of control measures in mitigating the socioeconomic losses caused by these viruses. However, the results of models of avian influenza transmission and control have not yet been subject to a comprehensive review. Such a review could help inform policy makers and guide future modeling work. To help fill this gap, we conducted a systematic review of the mechanistic models that have been applied to field outbreaks. Our three objectives were to: (1) describe the type of models and their epidemiological context, (2) list estimates of commonly used parameters of low pathogenicity and highly pathogenic avian influenza transmission, and (3) review the characteristics of avian influenza transmission and the efficacy of control strategies according to the mechanistic models. We reviewed a total of 46 articles. Of these, 26 articles estimated parameters by fitting the model to data, one evaluated the effectiveness of control strategies, and 19 did both. Values of the between-individual reproduction number ranged widely: from 2.18 to 86 for highly pathogenic avian influenza viruses, and from 4.7 to 45.9 for low pathogenicity avian influenza viruses, depending on epidemiological settings, virus subtypes and host species. Other parameters, such as the durations of the latent and infectious periods, were often taken from the literature, limiting the models\' potential insights. Concerning control strategies, many models evaluated culling (n = 15), while vaccination received less attention (n = 6). According to the articles reviewed, optimal control strategies varied between virus subtypes and local conditions, and depended on the overall objective of the intervention. For instance, vaccination was optimal when the objective was to limit the overall number of culled flocks. In contrast, pre-emptive culling was preferred for reducing the size and duration of an epidemic. Early implementation consistently improved the overall efficacy of interventions, highlighting the need for effective surveillance and epidemic preparedness.

The production of biopharmaceutical products carries an inherent risk of contamination by adventitious viruses. Historically, these manufacturing processes have incorporated a dedicated virus filtration step to ensure product safety. However, challenging process conditions can lead to passage of small viruses to the permeate pool and an overall decrease in the desired virus logarithmic reduction value (LRV) for the process. The implementation of serial virus filtration has improved the robustness of such processes, albeit concerns about increased operating times and process complexity have limited its implementation. This work focused on optimizing a serial filtration process and identifying process control strategies to provide maximum efficiency while ensuring proper controls for process complexity. Constant TMP was identified as the optimal control strategy, which combined with the optimal filter ratio, resulted in a robust and faster virus filtration process. To demonstrate this hypothesis, data with two filters connected in series (1:1 filter ratio) are presented for a representative non-fouling molecule. Similarly, for a fouling product, the optimal setup was a combination of a filter connected in series to two filters operated in parallel (2:1 filter ratio). The optimized filter ratios bring cost- and time-savings benefits to the virus filtration step, thereby offering improved productivity. The results of risk and cost analyses performed as part of this study combined with the control strategy, offer companies a toolbox of strategies to accommodate products with different filterability profiles in their downstream processes. This work demonstrates that the safety advantages of performing filters in series can be achieved with minimal increases in time, cost, and risk.

There is a current global push to identify and implement best practice for delivering maximum impact from development research in low-income and middle-income countries. Here, we describe a model of research and capacity building that challenges traditional approaches taken by western funders in Africa. Tackling Infections to Benefit Africa (TIBA) is a global health research and delivery partnership with a focus on strengthening health systems to combat neglected tropical diseases, malaria and emerging pathogens in Africa. Partners are academic and research institutions based in Ghana, Sudan, Rwanda, Uganda, Kenya, Tanzania, Zimbabwe, Botswana, South Africa and the UK. Fifteen other African countries have participated in TIBA activities. With a starting budget of under £7 million, and in just 4 years, TIBA has had a verified impact on knowledge, policy practice and capacity building, and on national and international COVID-19 responses in multiple African countries. TIBA\'s impact is shown in context-specific metrics including: strengthening the evidence base underpinning international policy on neglected tropical diseases; 77% of research publications having Africa-based first and/or last authors; postgraduate, postdoctoral and professional training; career progression for African researchers and health professionals with no net brain drain from participating countries; and supporting African institutions. Training in real-time SARS-CoV-2 viral genome sequencing provided new national capabilities and capacities that contributed to both national responses and global health security through variant detection and tracking. TIBA\'s experience confirms that health research for Africa thrives when the agenda and priorities are set in Africa, by Africans, and the work is done in Africa. Here, we share 10 actionable recommendations for researchers and funders from our lessons learnt.

UNASSIGNED: COVID-19 vaccines are vital tools for infection prevention and control of the pandemic. However, coronavirus immunization requires acceptance among healthcare workforces and by the community. In Ethiopia, studies focused on determinants of vaccine acceptance, knowledge, attitude, and prevention practices (KAP) contrary to the novel coronavirus among healthcare staff are limited. Hence, closing this gap requires research.
UNASSIGNED: A cross-sectional study was conducted on 844 governmental healthcare workers. A stratified, simple random sampling technique was used to select the respondents. Data were collected using a structured questionnaire. Binary and multivariable logistic regression statistical models were used to analyze the data.
UNASSIGNED: This study indicated that only 57.9% of the participants had good COVID-19 vaccine acceptance, meaning they took at least a dose of the vaccine themselves. We found that 65%, 60.9%, and 51.3% of the participants had good knowledge, prevention practices, and attitude against the pandemic. The novel coronavirus vaccine acceptance rate was 2.19 times more likely among females (adjusted odds ratio [AOR] = 2.19 with 95% confidence interval [CI]: 1.54-3.10) than among male participants. Further, respondents who did not report having any chronic diseases were 9.40 times higher to accept COVID-19 vaccines (AOR = 9.40 with 95% CI: 4.77, 18.53) than those who reported having a chronic condition. However, healthcare workers who had a habit of chewing khat at least once per week were 4% less likely to take the vaccine (AOR = 0.04 with 95% CI: 0.01, 0.32) than those who had no habit of chewing khat.
UNASSIGNED: Many core factors influencing COVID-19 vaccine acceptance were identified. A significant number of participants had poor vaccine acceptance, KAP against COVID-19. Therefore, the government should adopt urgent and effective public health measures, including public campaigns to enhance public trust in COVID-19 vaccines. In addition, continuous, timely, and practical training should be provided to healthcare workers.

With less than 20% of people with hypertension achieving their target blood pressure (BP) goals, uncontrolled hypertension remains a major public health problem in India. We conducted a study to assess the effectiveness of a community-based education and peer support programme led by women\'s self-help group (SHG) members in reducing the mean systolic BP among people with hypertension in urban slums of Kochi city, Kerala, India.
A cluster randomised controlled pragmatic trial was conducted where 20 slums were randomised to either the intervention or the control arms. In each slum, participants who had elevated BP (>140/90) or were on antihypertensive medications were recruited. The intervention was delivered through women\'s SHG members (1 per 20-30 households) who provided (1) assistance in daily hypertension management, (2) social and emotional support to encourage healthy behaviours and (3) referral to the primary healthcare system. Those in the control arm received standard of care. The primary outcome was change in mean systolic BP (SBP) after 6 months.
A total of 1952 participants were recruited-968 in the intervention arm and 984 in the control arm. Mean SBP was reduced by 6.26 mm Hg (SE 0.69) in the intervention arm compared with 2.16 mm Hg (SE 0.70) in the control arm; the net difference being 4.09 (95% CI 2.15 to 4.09), p<0.001.
This women\'s SHG members led community intervention was effective in reducing SBP among people with hypertension compared with those who received usual care, over 6 months in urban slums of Kerala, India.
CTRI/2019/12/022252.

BACKGROUND: Spread of resistant bacteria causes severe morbidity and mortality. Stringent control measures can be expensive and disrupt hospital organization. In the present study, we assessed the effectiveness and cost-effectiveness of control strategies to prevent the spread of Carbapenemase-producing Enterobacterales (CPE) in a general hospital ward (GW).
METHODS: A dynamic, stochastic model simulated the transmission of CPE by the hands of healthcare workers (HCWs) and the environment in a hypothetical 25-bed GW. Input parameters were based on published data; we assumed the prevalence at admission of 0.1%. 12 strategies were compared to the baseline (no control) and combined different prevention and control interventions: targeted or universal screening at admission (TS or US), contact precautions (CP), isolation in a single room, dedicated nursing staff (DNS) for carriers and weekly screening of contact patients (WSC). Time horizon was one year. Outcomes were the number of CPE acquisitions, costs, and incremental cost-effectiveness ratios (ICER). A hospital perspective was adopted to estimate costs, which included laboratory costs, single room, contact precautions, staff time, i.e. infection control nurse and/or dedicated nursing staff, and lost bed-days due to prolonged hospital stay of identified carriers. The model was calibrated on actual datasets. Sensitivity analyses were performed.
RESULTS: The baseline scenario resulted in 0.93 CPE acquisitions/1000 admissions and costs 32,050 €/1000 admissions. All control strategies increased costs and improved the outcome. The efficiency frontier was represented by: (1) TS with DNS at a 17,407 €/avoided CPE case, (2) TS + DNS + WSC at a 30,700 €/avoided CPE case and (3) US + DNS + WSC at 181,472 €/avoided CPE case. Other strategies were dominated. Sensitivity analyses showed that TS + CP might be cost-effective if CPE carriers are identified upon admission or if the cases have a short hospital stay. However, CP were effective only when high level of compliance with hand hygiene was obtained.
CONCLUSIONS: Targeted screening at admission combined with DNS for identified CPE carriers with or without weekly screening were the most cost-effective options to limit the spread of CPE. These results support current recommendations from several high-income countries.

When vaccines against the novel COVID-19 were available in Senegal, many questions were raised. How long should non-pharmaceutical interventions (NPIs) be maintained during vaccination roll-out? What are the best vaccination strategies?
In this study, we used an age-structured dynamic mathematical model. This model uses parameters based on SARS-CoV-2 virus, information on different types of NPIs, epidemiological and demographic data, some parameters relating to hospitalisations and vaccination in Senegal.
In all scenarios explored, the model predicts a larger third epidemic wave of COVID-19 in terms of new cases and deaths than the previous waves. In a context of limited vaccine supply, vaccination alone will not be sufficient to control the epidemic, and the continuation of NPIs is necessary to flatten the epidemic curve. Assuming 20% of the population have been vaccinated, the optimal period to relax NPIs would be a few days from the last peak. Regarding the prioritisation of age groups to be vaccinated, the model shows that it is better to vaccinate individuals aged 5-60 years and not just the elderly (over 60 years) and those in high-risk groups. This strategy could be more cost-effective for the government, as it would reduce the high costs associated with hospitalisation. In terms of vaccine distribution, the optimal strategy would be to allocate full dose to the elderly. If vaccine doses are limited, half dose followed by full dose would be sufficient for people under 40 years because whether they receive half or full dose, the reduction in hospitalisations would be similar and their death-to-case ratio is very low.
This study could be presented as a decision support tool to help devise strategies to control the COVID-19 pandemic and help the Ministry of Health to better manage and allocate the available vaccine doses.

The northern part of the Yangtze River Delta (YRD) region in China suffers from high concentrations of fine particular matter (PM2.5) during the past years yet received much less attention compared to the other parts of the YRD region. In this study, we integrated observational data, control policies and strategies, and air quality simulations to develop PM2.5 attainment demonstration by year 2030 for the city of Bengbu, which represents a typical non-compliant city in the northern YRD region. In 2018, the annual average PM2.5 concentration in Bengbu was 51.8 μg/m3, which was 48 % higher than the standard of 35 μg/m3 set by the National Ambient Air Quality Standards (NAAQS). Different future emission scenarios were developed for year 2025 as mid-term and year 2030 as long-term. Integrated meteorology and air quality modeling system together with monitoring data was applied to predict the air quality under the future emission scenarios. Results show that when a conservative emission reduction ratio of 40 % was assumed for surrounding regions, the annual average PM2.5 concentration in Bengbu could meet the target value by 2030, in which case emissions of SO2, NOx, PM2.5, VOCs, and NH3 need to be reduced by 70.6 %, 43.5 %, 47.2 %, 33.4 %, and 47.5 %, respectively. PM2.5 concentration in Bengbu is not only controlled by local emission reductions but also affected by emission reductions of surrounding regions as well as contribution from long-range transport. More attentions need to be paid to the control of VOCs emissions in the near future to avoid increase of ozone concentrations while reducing PM2.5. Our results provide scientific support for the local government to formulate future air pollution prevention and control strategies, sub-regional joint-control among surrounding cities, as well as trans-regional joint-control between the north China and the YRD region.

An outbreak of respiratory disease caused by a novel coronavirus is ongoing from December 2019. As of December 14, 2020, it has caused an epidemic outbreak with more than 73 million confirmed infections and above 1.5 million reported deaths worldwide. During this period of an epidemic when human-to-human transmission is established and reported cases of coronavirus disease 2019 (COVID-19) are rising worldwide, investigation of control strategies and forecasting are necessary for health care planning. In this study, we propose and analyze a compartmental epidemic model of COVID-19 to predict and control the outbreak. The basic reproduction number and the control reproduction number are calculated analytically. A detailed stability analysis of the model is performed to observe the dynamics of the system. We calibrated the proposed model to fit daily data from the United Kingdom (UK) where the situation is still alarming. Our findings suggest that independent self-sustaining human-to-human spread ( R 0 > 1 , R c > 1 ) is already present. Short-term predictions show that the decreasing trend of new COVID-19 cases is well captured by the model. Further, we found that effective management of quarantined individuals is more effective than management of isolated individuals to reduce the disease burden. Thus, if limited resources are available, then investing on the quarantined individuals will be more fruitful in terms of reduction of cases.