Barcelona Institute for Global Health ISGlobal

Barcelona, Spain

Barcelona Institute for Global Health ISGlobal

Barcelona, Spain
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Allepuz A.,Autonomous University of Barcelona | Soler M.,Ramaderia | Selga I.,Ramaderia | Aranda C.,Servei de Control de Mosquits del Consell Comarcal del Baix Llobregat | And 3 more authors.
Zoonoses and Public Health | Year: 2014

To enhance early detection of West Nile virus (WNV) transmission, an integrated ecological surveillance system was implemented in Catalonia (north-eastern Spain) from 2007 to 2011. This system incorporated passive and active equine surveillance, periodical testing of chicken sentinels in wetland areas, serosurveillance wild birds and testing of adult mosquitoes. Samples from 298 equines, 100 sentinel chickens, 1086 wild birds and 39 599 mosquitoes were analysed. During these 5 years, no acute WNV infection was detected in humans or domestic animal populations in Catalonia. WNV was not detected in mosquitoes either. Nevertheless, several seroconversions in resident and migrant wild birds indicate that local WNV or other closely related flaviviruses transmission was occurring among bird populations. These data indicate that bird and mosquito surveillance can detect otherwise silent transmission of flaviviruses and give some insights regarding possible avian hosts and vectors in a European setting. © 2013 Blackwell Verlag GmbH.


PubMed | National University of Colombia, Tehran University of Medical Sciences, Genentech, National Cerebral and Cardiovascular Center and 106 more.
Type: Journal Article | Journal: JAMA pediatrics | Year: 2016

The literature focuses on mortality among children younger than 5 years. Comparable information on nonfatal health outcomes among these children and the fatal and nonfatal burden of diseases and injuries among older children and adolescents is scarce.To determine levels and trends in the fatal and nonfatal burden of diseases and injuries among younger children (aged <5 years), older children (aged 5-9 years), and adolescents (aged 10-19 years) between 1990 and 2013 in 188 countries from the Global Burden of Disease (GBD) 2013 study.Data from vital registration, verbal autopsy studies, maternal and child death surveillance, and other sources covering 14,244 site-years (ie, years of cause of death data by geography) from 1980 through 2013 were used to estimate cause-specific mortality. Data from 35,620 epidemiological sources were used to estimate the prevalence of the diseases and sequelae in the GBD 2013 study. Cause-specific mortality for most causes was estimated using the Cause of Death Ensemble Model strategy. For some infectious diseases (eg, HIV infection/AIDS, measles, hepatitis B) where the disease process is complex or the cause of death data were insufficient or unavailable, we used natural history models. For most nonfatal health outcomes, DisMod-MR 2.0, a Bayesian metaregression tool, was used to meta-analyze the epidemiological data to generate prevalence estimates.Of the 7.7 (95% uncertainty interval [UI], 7.4-8.1) million deaths among children and adolescents globally in 2013, 6.28 million occurred among younger children, 0.48 million among older children, and 0.97 million among adolescents. In 2013, the leading causes of death were lower respiratory tract infections among younger children (905.059 deaths; 95% UI, 810,304-998,125), diarrheal diseases among older children (38,325 deaths; 95% UI, 30,365-47,678), and road injuries among adolescents (115,186 deaths; 95% UI, 105,185-124,870). Iron deficiency anemia was the leading cause of years lived with disability among children and adolescents, affecting 619 (95% UI, 618-621) million in 2013. Large between-country variations exist in mortality from leading causes among children and adolescents. Countries with rapid declines in all-cause mortality between 1990 and 2013 also experienced large declines in most leading causes of death, whereas countries with the slowest declines had stagnant or increasing trends in the leading causes of death. In 2013, Nigeria had a 12% global share of deaths from lower respiratory tract infections and a 38% global share of deaths from malaria. India had 33% of the worlds deaths from neonatal encephalopathy. Half of the worlds diarrheal deaths among children and adolescents occurred in just 5 countries: India, Democratic Republic of the Congo, Pakistan, Nigeria, and Ethiopia.Understanding the levels and trends of the leading causes of death and disability among children and adolescents is critical to guide investment and inform policies. Monitoring these trends over time is also key to understanding where interventions are having an impact. Proven interventions exist to prevent or treat the leading causes of unnecessary death and disability among children and adolescents. The findings presented here show that these are underused and give guidance to policy makers in countries where more attention is needed.


Gascon J.,Barcelona Center for International Health Research | Gascon J.,Barcelona Institute for Global Health ISGlobal | Vilasanjuan R.,Barcelona Institute for Global Health ISGlobal | Lucas A.,Barcelona Institute for Global Health ISGlobal
Expert Review of Anti-Infective Therapy | Year: 2014

Chagas disease has a unique history where the confluence of rural and marginalized populations affected, the deeply rooted attitudes, clinical practices and an underfunded research area has resulted in one of the most current neglected health issues. Globalization has changed the epidemiology of the disease, which is now found throughout the Americas but also in Europe and Japan. Thus, Chagas disease is a global public health problem. In this new paradigm, a strong partnership aimed to coordinate actions to scale up diagnostics and treatments, to engage communities and health practitioners in implementation and advocating for sustained funding for the development of improved tools, can play a critical role to leave behind this story of neglect. Even with the imperfect tools currently available, still much can be done. © 2014 Informa UK, Ltd.


Chaccour C.,University of Navarra | Chaccour C.,Barcelona Institute for Global Health ISGlobal | Kaur H.,London School of Hygiene and Tropical Medicine | Del Pozo J.L.,University of Navarra
Expert Review of Anti-Infective Therapy | Year: 2015

Malaria is a curable disease, provided timely access to efficacious drugs is sought. Poor quality and, in particular, falsified antimalarial drugs harm the population of malaria endemic areas; they put lives in peril, cause economic losses to patients, families, industry, and generally undermine the trust in health systems. The extent of the problem is not easily assessed, and although a prevalence of up to 35% of poor-quality antimalarials has been reported, this number should be interpreted with caution given the heterogeneity of methods used to measure it. The trade in falsified antimalarials can be curtailed by putting in place drug quality surveillance, better legislation and improving the access and affordability of these essential drugs. © 2015 Informa UK, Ltd.


Moore B.R.,University of Western Australia | Moore B.R.,Papua New Guinea Institute of Medical Research | Benjamin J.M.,Papua New Guinea Institute of Medical Research | Auyeung S.O.,University of Western Australia | And 10 more authors.
British Journal of Clinical Pharmacology | Year: 2016

Aims: The aim of the present study was to investigate the safety, tolerability and pharmacokinetics of coadministered azithromycin (AZI) and piperaquine (PQ) for treating malaria in pregnant Papua New Guinean women. Methods: Thirty pregnant women (median age 22 years; 16–32 weeks' gestation) were given three daily doses of 1 g AZI plus 960 mg PQ tetraphosphate with detailed monitoring/blood sampling over 42 days. Plasma AZI and PQ were assayed using liquid chromatography–mass spectrometry and high-performance liquid chromatography, respectively. Pharmacokinetic analysis was by population-based compartmental models. Results: The treatment was well tolerated. The median (interquartile range) increase in the rate-corrected electrocardiographic QT interval 4 h postdose [12 (6–26) ms0 .5] was similar to that found in previous studies of AZI given in pregnancy with other partner drugs. Six women with asymptomatic malaria cleared their parasitaemias within 72 h. Two apararasitaemic women developed late uncomplicated Plasmodium falciparum infections on Days 42 and 83. Compared with previous pregnancy studies, the area under the concentration–time curve (AUC0–∞) for PQ [38818 (24354–52299) μg h l−1] was similar to published values but there was a 52% increase in relative bioavailability with each dose. The AUC0–∞ for AZI [46799 (43526–49462) μg h l−1] was at least as high as reported for higher-dose regimens, suggesting saturable absorption and/or concentration-dependent tissue uptake and clearance from the central compartment. Conclusions: AZI–PQ appears to be well tolerated and safe in pregnancy. Based on the present/other data, total AZI doses higher than 3 g for the treatment and prevention of malaria may be unnecessary in pregnant women, while clearance of parasitaemia could improve the relative bioavailability of PQ. © 2016 The British Pharmacological Society


Chaccour C.,University of Navarra | Chaccour C.,Barcelona Institute for Global Health ISGlobal | Barrio A.I.,University of Navarra | Royo A.G.G.,University of Navarra | And 4 more authors.
Malaria Journal | Year: 2015

Background: The prospect of eliminating malaria is challenged by emerging insecticide resistance and vectors with outdoor and/or crepuscular activity. Ivermectin can simultaneously tackle these issues by killing mosquitoes feeding on treated animals and humans. A single oral dose, however, confers only short-lived mosquitocidal plasma levels. Methods: Three different slow-release formulations of ivermectin were screened for their capacity to sustain mosquito-killing levels of ivermectin for months. Thirty rabbits received a dose of one, two or three silicone implants containing different proportions of ivermectin, deoxycholate and sucrose. Animals were checked for toxicity and ivermectin was quantified periodically in blood. Potential impact of corresponding long-lasting formulation was mathematically modelled. Results: All combinations of formulation and dose released ivermectin for more than 12 weeks; four combinations sustained plasma levels capable of killing 50% of Anopheles gambiae feeding on a treated subject for up to 24 weeks. No major adverse effects attributable to the drug were found. Modelling predicts a 98% reduction in infectious vector density by using an ivermectin formulation with a 12-week duration. Conclusions: These results indicate that relatively stable mosquitocidal plasma levels of ivermectin can be safely sustained in rabbits for up to six months using a silicone-based subcutaneous formulation. Modifying the formulation of ivermectin promises to be a suitable strategy for malaria vector control. © 2015 Chaccour et al.; licensee BioMed Central.


Richie T.L.,Sanaria, Inc. | Billingsley P.F.,Sanaria, Inc. | Sim B.K.L.,Sanaria, Inc. | James E.R.,Sanaria, Inc. | And 13 more authors.
Vaccine | Year: 2015

Sanaria Inc. has developed methods to manufacture, purify and cryopreserve aseptic Plasmodium falciparum (Pf) sporozoites (SPZ), and is using this platform technology to develop an injectable PfSPZ-based vaccine that provides high-grade, durable protection against infection with Pf malaria. Several candidate vaccines are being developed and tested, including PfSPZ Vaccine, in which the PfSPZ are attenuated by irradiation, PfSPZ-CVac, in which fully infectious PfSPZ are attenuated in vivo by concomitant administration of an anti-malarial drug, and PfSPZ-GA1, in which the PfSPZ are attenuated by gene knockout. Forty-three research groups in 15 countries, organized as the International PfSPZ Consortium (I-PfSPZ-C), are collaborating to advance this program by providing intellectual, clinical, and financial support. Fourteen clinical trials of these products have been completed in the USA, Europe and Africa, two are underway and at least 12 more are planned for 2015-2016 in the US (four trials), Germany (2 trials), Tanzania, Kenya, Mali, Burkina Faso, Ghana and Equatorial Guinea. Sanaria anticipates application to license a first generation product as early as late 2017, initially to protect adults, and a year later to protect all persons >6 months of age for at least six months. Improved vaccine candidates will be advanced as needed until the following requirements have been met: long-term protection against natural transmission, excellent safety and tolerability, and operational feasibility for population-wide administration. Here we describe the three most developed whole PfSPZ vaccine candidates, associated clinical trials, initial plans for licensure and deployment, and long-term objectives for a final product suitable for mass administration to achieve regional malaria elimination and eventual global eradication. © 2015 The Authors.


PubMed | Kochi University, University of Edinburgh, Spanish National Cancer Research Center, Tokyo Medical University and 3 more.
Type: Journal Article | Journal: Nature genetics | Year: 2016

High rates of APOBEC-signature mutations are found in many tumors, but factors affecting this mutation pattern are not well understood. Here we explored the contribution of two common germline variants in the APOBEC3 region. SNP rs1014971 was associated with bladder cancer risk, increased APOBEC3B expression, and enrichment with APOBEC-signature mutations in bladder tumors. In contrast, a 30-kb deletion that eliminates APOBEC3B and creates an APOBEC3A-APOBEC3B chimera was not important in bladder cancer, whereas it was associated with breast cancer risk and enrichment with APOBEC-signature mutations in breast tumors. In vitro, APOBEC3B expression was predominantly induced by treatment with a DNA-damaging drug in bladder cancer cell lines, and APOBEC3A expression was induced as part of the antiviral interferon-stimulated response in breast cancer cell lines. These findings suggest a tissue-specific role of environmental oncogenic triggers, particularly in individuals with germline APOBEC3 risk variants.


PubMed | University of Tübingen, University of Maryland Baltimore County, Swiss Tropical and Public Health Institute, Ifakara Health Institute and 6 more.
Type: Journal Article | Journal: Vaccine | Year: 2015

Sanaria Inc. has developed methods to manufacture, purify and cryopreserve aseptic Plasmodium falciparum (Pf) sporozoites (SPZ), and is using this platform technology to develop an injectable PfSPZ-based vaccine that provides high-grade, durable protection against infection with Pf malaria. Several candidate vaccines are being developed and tested, including PfSPZ Vaccine, in which the PfSPZ are attenuated by irradiation, PfSPZ-CVac, in which fully infectious PfSPZ are attenuated in vivo by concomitant administration of an anti-malarial drug, and PfSPZ-GA1, in which the PfSPZ are attenuated by gene knockout. Forty-three research groups in 15 countries, organized as the International PfSPZ Consortium (I-PfSPZ-C), are collaborating to advance this program by providing intellectual, clinical, and financial support. Fourteen clinical trials of these products have been completed in the USA, Europe and Africa, two are underway and at least 12 more are planned for 2015-2016 in the US (four trials), Germany (2 trials), Tanzania, Kenya, Mali, Burkina Faso, Ghana and Equatorial Guinea. Sanaria anticipates application to license a first generation product as early as late 2017, initially to protect adults, and a year later to protect all persons >6 months of age for at least six months. Improved vaccine candidates will be advanced as needed until the following requirements have been met: long-term protection against natural transmission, excellent safety and tolerability, and operational feasibility for population-wide administration. Here we describe the three most developed whole PfSPZ vaccine candidates, associated clinical trials, initial plans for licensure and deployment, and long-term objectives for a final product suitable for mass administration to achieve regional malaria elimination and eventual global eradication.


PubMed | Tokyo Metroplitan University, Tokyo Women's Medical University, Tokyo University of Agriculture and Technology, Barcelona Institute for Global Health ISGlobal and Japan National Institute of Information and Communications Technology
Type: | Journal: Journal of exposure science & environmental epidemiology | Year: 2016

This study examined changes in recall accuracy for mobile phone calls over a long period. Japanese students actual call statuses were monitored for 1 month using software-modified phones (SMPs). Three face-to-face interviews were conducted to obtain information regarding self-reported call status during the monitoring period: first interview: immediately after the monitoring period; second interview: after 10-12 months; third interview: after 48-55 months. Using the SMP records as the gold standard, phone call recall accuracy was assessed for each interview. Data for 94 participants were analyzed. The number of calls made was underestimated considerably and the duration of calls was overestimated slightly in all interviews. Agreement between self-report and SMP records regarding the number of calls, duration of calls and laterality (i.e., use of the dominant ear while making calls) gradually deteriorated with the increase in the interval following the monitoring period (number of calls: first interview: Pearsons r=0.641, third interview: 0.396; duration of calls: first interview: Pearsons r=0.763, third interview: 0.356; laterality: first interview: weighted-=0.677, third interview: 0.448). Thus, recall accuracy for mobile phone calls would be consistently imperfect over a long period, and the results of related epidemiological studies should be interpreted carefully.Journal of Exposure Science and Environmental Epidemiology advance online publication, 21 December 2016; doi:10.1038/jes.2016.73.

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