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News Article | November 22, 2016
Site: www.eurekalert.org

Giving preventive antimalarial drugs to children up to age 10 during active malaria season reduced the cases of malaria in that age group and lowered the malaria incidence in adults, according to a randomized trial carried out in Senegal and published in PLOS Medicine by researchers from the Université Cheikh Anta Diop, Senegal, the London School of Hygiene & Tropical Medicine, UK, and other collaborators. In 2012, the World Health Organization recommended that children under 5 years of age living in central Africa receive Seasonal Malaria Chemoprevention (SMC) with sulfadoxine-pyrimethamine and amodiaquine for up to 4 months of the year to prevent malaria. However, in many areas there is a substantial burden of disease in older children. The investigators designed a study in which 54 health posts in central Senegal were randomized to provide SMC to children up to age 10, or act as controls. For the years of the study, between 2008 and 2011, malaria cases and deaths in each community were monitored at outpatient clinics and hospitals. Over three years, 780,000 SMC treatments were given to children. Mortality, the primary study endpoint, was similar between the test and control areas (4.6 and 4.5 per 1000 respectively in children under 5 years and 1.3 and 1.2 per 1000 in children 5-9 years of age, with a mortality rate ratio 0.90; 95 percent confidence interval 0.68-1.2, p=0.496). However, SMC was found to reduce the incidence of malaria in those under age 10 by 60% (95 percent confidence interval 54-64%, p "Apart from in Senegal, SMC is currently being provided only for children up to 5 years of age, but in many areas the burden in older children may justify extending this range," says author Paul Milligan of the London School of Hygiene & Tropical Medicine. "Our study shows that in some areas expanding the age range for SMC could have a substantial impact on the malaria burden and could contribute to reducing malaria transmission." In an accompanying Perspective, Robert Snow of the Kenya Medical Research Institute/Wellcome Trust Research Programme discusses the history of SMC in Africa and compares the costs and benefits of expanding the targeted age range. "[Seasonal malaria chemoprevention] is notable for incorporating the idea that different approaches may be appropriate in different settings," he notes. "Even if a fraction of the costs of delivering SMC were dedicated to intensive surveillance and a sustained research agenda, national malaria programmes could adapt to a changing epidemiology, parasite resistance and community acceptability." This study was funded by the Bill and Melinda Gates Foundation, grant number 40099. MC received support through a Population Health Scientist Fellowship jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID). JLN is supported by a Wellcome Trust Intermediate Fellowship in Public Health and Tropical Medicine. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have declared that no competing interests exist. Cissé B, Ba EH, Sokhna C, NDiaye JL, Gomis JF, Dial Y, et al. (2016) Effectiveness of Seasonal Malaria Chemoprevention in Children under Ten Years of Age in Senegal: A Stepped-Wedge Cluster-Randomised Trial. PLoS Med 13(11): e1002175. doi:10.1371/journal.pmed.1002175 IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:http://journals. RWS is funded as a Principal Research Fellow by the Wellcome Trust wellcome.ac.uk (# 103602). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The author has declared that no competing interests exist. KEMRI-Wellcome Trust Collaborative Programme, Nairobi, Kenya Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:http://journals.


News Article | February 21, 2017
Site: www.eurekalert.org

Life expectancies in developed countries are projected to continue increasing, with women's life expectancy potentially surpassing 90 years old in South Korea by 2030, according to a study published in The Lancet. The study predicts life expectancy is likely to be highest in South Korea (90.8 years old), France (88.6 years old) and Japan (88.4 years old) for women, and in South Korea (84.1 years old), Australia (84.0 years old) and Switzerland (84.0 years old) for men. The researchers advise that increasing life expectancies will have major implications for health and social services that will need to adapt and will require policies to support healthy ageing, increase investment in health and social care, and possibly changes to retirement age. "As recently as the turn of the century, many researchers believed that life expectancy would never surpass 90 years," said lead author Professor Majid Ezzati, Imperial College London, UK. "Our predictions of increasing lifespans highlight our public health and healthcare successes. However, it is important that policies to support the growing older population are in place. In particular, we will need to both strengthen our health and social care systems and to establish alternative models of care such as technology-assisted home care." [1] In the study, researchers used a statistical technique used in weather forecasting to determine their projections and how certain they are. They developed 21 models to predict life expectancy in 35 developed countries - unlike most life expectancy projections which are based on a single model - and combined the results from these models based on how well they performed. All the predictions in the study come with a range of uncertainty. For instance, there is a 90% probability that life expectancy for South Korean women in 2030 will be higher than 86.7 years, and a 57% probability that it will be higher than 90 years. Although life expectancy is predicted to increase across all 35 countries, the extent of the increase varies by country. Comparing 2030 and 2010 life expectancies, female life expectancy is projected to increase most in South Korea, Slovenia and Portugal (6.6, 4.7 and 4.4 years, respectively). While for men life expectancy will increase most in Hungary, South Korea and Slovenia (7.5, 7.0 and 6.4 years). Life expectancy is predicted to increase least in Macedonia, Bulgaria, Japan and the USA (1.4, 1.5, 1.8 and 2.1 years) for women, and in Macedonia, Greece and Sweden and the USA (2.4, 2.7, 3.0 and 3.0 years) for men. The USA is predicted to see relatively small improvements in life expectancy (from 81.2 for in 2010 to 83.3 in 2030 for women and 76.5 to 79.5 for men). US life expectancy is already lower than most other high-income countries, and is expected to fall further behind in 2030, potentially as a result of its large inequalities, absence of universal health insurance and of the country having the highest homicide rate, body mass index (BMI) and death rates for children and mothers of all high-income countries. Conversely, South Korea's projected gains may be the result of continued improvements in economic status which has improved nutrition for children, access to healthcare and medical technology across the whole population. This has resulted in fewer deaths from infections and better prevention and treatment for chronic diseases, in a way that is more equitable than some Western countries. As well as calculating life expectancy at birth in 2030, the researchers projected how long those aged 65 years were likely to live in 2030. They found that women were likely to live an additional 24 years in 11 of the 35 countries, and that 65-year old men were likely to an additional 20 years in 22 countries [2] - illustrating that older populations are likely to continue growing across the developed world. With an ageing population it will be important to help people to age healthily and ease the impact of an ageing population on health systems through programmes that support healthy lifestyles and detect and treat diseases early. Providing assistive technology could also help older people remain in their homes by compensating for loss of mobility and senses, while building communities that are more accessible and providing good transportation services could help older people access amenities while staying in their community for longer. The social implications of this change will also likely require changes to pensions and retirement, with further payments of social security and pensions needed to support those living longer. As a result, the researchers propose changes to working practice through changing retirement age or creating schemes that allow a gradual transition to retirement. "Dealing with an ageing population will require a combination of strengthening and positioning our health and social care systems and our societies as a whole, so as to ensure that people age healthily, continue to contribute to society for longer, and receive appropriate pension and care once they age." said Professor Ezzati. [1] The researchers explain that the next step of their research will be to extend their model to specific diseases as well as to all countries to provide more accurate predictions of life expectancy globally. The study cannot take into account unprecedented events, such as major political change that affects social and health system determinants of health, in its forecasts because the effects of such events are unknown or highly uncertain. Writing in a linked Comment, Dr Ailiana Santosa, Umeå University, Sweden, said: "Countries are moving towards universal health coverage. Forecasting life expectancy at birth and at age 65 years can help governments and health services to make the right investments in health, such as averting deaths due to infectious diseases and reducing maternal and child mortality. Achieving universal health coverage is worthy, plausible, and needs to be continued." The study was funded by the UK Medical Research Council and the US Environmental Protection Agency. It was conducted by scientists from Imperial College London, the World Health Organisation, Northumbria University and the University of Washington. [1] Quote direct from author and cannot be found in the text of the Article. [2] The projected life expectancy for those aged over 65 in 2030 is higher than for those born in 2030 because the figure for those born in 2030 includes people who will die before the age of 65, which makes the life expectancy average lower. For interviews with author, Professor Majid Ezzati, Imperial College London, UK, please contact Kate Wighton, Research Media Officer at Imperial College London, on: E) k.wighton@imperial.ac.uk / press.office@imperial.ac.uk T) +44 (0)20 7594 2410 For interviews with Comment author, Dr Ailiana Santosa, Umeå University, Sweden, please contact E) ailiana.santosa@umu.se T) +46 738099213 A podcast interview is available, please see: http://press.


-- Despite living in strong and supportive families for over 20 years, many children exposed to severe early deprivation in Romanian institutions aged 0-3 experience a range of mental health problems in early adulthood. Experiencing severe deprivation and neglect in childhood can have a lasting psychological impact into early adulthood, according to a unique study which has followed the mental health of a group of children adopted from Romanian institutions to UK families in the 1990s. Published in The Lancet, this is the first large-scale study to follow a group of children who were subjected to extreme deprivation into adulthood, tracking how their mental health and cognition has developed as a result. The English and Romanian Adoptees study began shortly after the fall of the communist regime in Romania. Children living in institutions were subjected to extremely poor hygiene, insufficient food, little personalised care and no social or cognitive stimulation. The study, running since 1990, analyses the mental health of 165 children who spent time in Romanian institutions and who were adopted by families in the UK between the ages of two weeks and 43 months. In the UK, they joined socioeconomically advantaged, stable, caring and supportive families. Comparing against 52 children adopted within the UK, the study has followed them throughout their childhood using questionnaires, IQ tests and interviews with the children and their parents to analyse social, emotional and cognitive outcomes at ages 6, 11 and 15. The latest part of the study followed the adoptees to ages 22 to 25 years old. It includes around three-quarters of the original adoptees - 39 UK adoptees, 50 Romanian adoptees who had spent less than six months in an institution as children and 72 who had spent over six months. The researchers found that the amount of time spent in a Romanian institution was an important marker of children's future mental health. Romanian adoptees who had spent less than six months had similar rates of mental health symptoms as UK adoptees. However, adoptees who had spent more time in the institutions had higher rates of social, emotional and cognitive problems throughout their lives. People who had lived in Romanian institutions for more than six months as children had higher rates of social problems including autistic features, difficulties engaging with others, inattention and overactivity which persisted from childhood into adulthood. They were also three to four times more likely to experience emotional problems as adults, and had lower educational attainment and employment rates than the other UK and Romanian adoptees. This all despite living in strong and supportive families for over 20 years. As children, more adoptees who lived in Romanian institutions for over six months had an IQ of less than 80, but this recovered within normal levels (an IQ of 90 or above) by early adulthood, suggesting developmental delays but no permanent impact on general cognitive abilities. Additionally, one in five (21%, 15 children) adoptees who spent over six months in Romanian institutions did not experience any mental health problems throughout their lives. The next steps of the research will involve an in-depth genetic analysis of the most exposed adoptees who did not develop mental health problems to distinguish whether genetic and epigenetic differences contribute to resilience. "Being exposed to very severe conditions in childhood can be associated with lasting and deep-seated social, emotional and cognitive problems, which are complex and vary over time," said lead author Professor Edmund Sonuga-Barke, King's College London, UK, who conducted the follow-up study while at the University of Southampton. "This highlights the importance of assessing patients from deprived backgrounds when providing mental health support and carefully planning care when these patients transfer from child to adult mental health care. Although focussed on children adopted from Romanian institutions in the early 1990s, our findings may also be relevant to large numbers of children who are still exposed to abusive or neglectful conditions around the world." [1] Because the children were different ages when they entered institutions and lived there for different amounts of time, the study could not determine whether there is a window during childhood development when children may be more or less likely to be affected by deprivation. In addition, it cannot control for other early risk factors affecting the child's mental health, such as maternal smoking or substance abuse during pregnancy, but the authors argue that there are unlikely to be significant differences among the two groups of Romanian adoptees. Writing in a linked Comment, Professor Frank Verhulst, Erasmus University Medical Centre, The Netherlands, said: "Whatever the underlying mechanisms, the findings of Sonuga-Barke and colleagues' study elegantly support the rule of the earlier the better for improving the caregiving environment for young children whose basic needs are profoundly violated. This finding is true for millions of children around the world who are exposed to war, terrorism, violence, or mass migration. As a consequence, many young children face trauma, displacement, homelessness, or family disruption." From its beginning the study was funded by the UK Economic and Social Research Council, the UK Medical Research Council, the UK Department of Health, the Jacobs Foundation and the Nuffield Foundation. It was conducted by scientists from the University of Southampton, King's College London, Ruhr University Bochum, The Amy Winehouse Foundation and the Max Planck Institute for Empirical Aesthetics. [1] Quote direct from author and cannot be found in the text of the Article. IF YOU WISH TO PROVIDE A LINK FOR YOUR READERS, PLEASE USE THE FOLLOWING, WHICH WILL GO LIVE AT THE TIME THE EMBARGO LIFTS: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30045-4/fulltext


News Article | February 15, 2017
Site: www.nature.com

Life scientists keen to share their findings online before peer review are spoilt for choice. Whereas physicists gravitate to one repository — the ‘preprint’ server arXiv — life sciences has a fast-growing roster of venues for preprints. There’s the biology-focused bioRxiv, and a biology section on arXiv too. But other sites have sprouted up in the past year, or soon will do, and these too provide opportunities for life sciences: ChemRxiv for chemistry, psyArXiv for psychology; even AgriXiv for agricultural sciences and paleorXiv for palaeontology. Now, a coalition of biomedical funders and scientists is throwing its weight behind a ‘one-stop shop’ for all life-sciences preprints — a move that its backers argue should clarify any confusion and make it easier to mine the preprint literature for insights. On 13 February, ASAPbio, a grassroots group of biologists that advocates for preprints, issued a funding call to build a central preprint site; the US National Institutes of Health (NIH), the Wellcome Trust and several other leading funders announced their support for the concept. “The landscape could become fragmented very quickly,” says Robert Kiley, head of digital services at the London-based Wellcome Trust. “We want to find a way of ensuring that, although this content is distributed far and wide, there’s a central place that brings it all together”. The details of the service are inchoate: its scope will depend on specific scientific fields and their funders, says Jessica Polka, the director of ASAPbio. But as well as aggregating content from other biology-focused preprint sites, ASAPbio wants the site to mesh with arXiv and with ChemRxiv, which the American Chemical Society in Washington DC plans to launch soon. Proponents hope that a central site will lure biologists to embrace the practice as wholeheartedly as physical scientists have. Physics manuscripts routinely appear at arXiv.org months before publication in peer-reviewed journals, as researchers race to release their findings online before their rivals. And preprints are now accepted currency in determining priority for a discovery, as well as in winning grants and jobs. ArXiv handles more than 100,000 manuscripts each year in physics, mathematics and computer science. (The largest life-sciences preprint server, bioRxiv, posted around 5,000 manuscripts in 2016.) “One of the lessons of arXiv is that users prefer ‘one-stop shopping’,” says Paul Ginsparg, a theoretical physicist at Cornell University in Ithaca, New York, who founded the site in 1991. He could see a preprint aggregation site for life sciences working just as well, so long as disparate sites can agree on uniform technical standards. A central preprint service could also help scientists to use automated software to mine the literature for insights, says Ron Vale, a cell biologist at the University of California, San Francisco, and a founder of ASAPbio. At the moment, researchers who want to mine peer-reviewed papers face myriad hurdles, from publisher copyrights to disparate websites that make bulk-downloading difficult. “We’re trying to think of preprints as data,” says Vale. It would be both technically and legally straightforward for computers to crawl the collection of preprints on the central site, where they would appear under an open-access licence. Polka would not say how much ASAPbio expects the site to cost, but arXiv funding totals about US$925,000 a year, paid for by a global collective of more than 200 research institutions and funders; a large donation has come from the Simons Foundation, a private organization based in New York City. Ginsparg says expenses for the life-sciences site should be around $5 a manuscript, once it is publishing tens of thousands of manuscripts each year. Funders who support the site have not yet committed to paying for it, but Kiley expects that funders will do so once details are hashed out. Other funders that have come out in support of the central service include the UK Medical Research Council, the Howard Hughes Medical Institute (HHMI), the Canadian Institutes of Health Research and the European Research Council. “That’s going to send a strong message to the science community that this kind of communication is encouraged,” says Vale. Last month, the HHMI announced that it would consider preprints in deciding whether or not to renew the prestigious five-year grants it gives to investigators. Jason Hoyt, chief executive of the journal PeerJ (which also operates a preprint service), says he supports a central preprint site and that his company might bid to help create it. But such a site will succeed only if it can induce a large proportion of life scientists to view preprints as the dominant currency for career progression, he says. “The challenge is to overturn the thinking in biology.” ASAPbio and the funders supporting a central preprint service emphasize that it’s no replacement for peer-reviewed journals. They note that the vast majority (over 80% in some fields) of arXiv posts wind up in journals. “We really see this as a complement to the journal system, rather than anything that could be threatening,” says Polka, who adds that a central service will not attempt to organize peer review. That would be a missed opportunity, says Rebecca Lawrence, managing director of London-based F1000Research, which posts papers before they are peer reviewed at the journal (but does not consider these preprints). She would like to see peer review occur through a central preprint service, thereby reducing the influence that traditional journals have on scientists’ careers. “It’s a great shift in the right direction,” Lawrence says, “but I think we need to go a lot further.” Ginsparg ultimately envisions a "federated repository" that spans scientific disciplines and aggregates preprints from arXiv and other fields, including the life sciences. “Twenty-five years ago, I thought we’d be much closer to that point by now, but I still think it’s inevitable,” he says.


News Article | February 15, 2017
Site: www.eurekalert.org

CORVALLIS, Ore. - A new study about the overwhelming importance of "superspreaders" in some infectious disease epidemics has shown that in the catastrophic 2014-15 Ebola epidemic in West Africa, about 3 percent of the people infected were ultimately responsible for infecting 61 percent of all cases. The issue of superspreaders is so significant, scientists say, that it's important to put a better face on just who these people are. It might then be possible to better reach them with public health measures designed to control the spread of infectious disease during epidemics. Findings were reported this week in Proceedings of the National Academy of Sciences. The researchers concluded that Ebola superspreaders often fit into certain age groups and were based more in the community than in health care facilities. They also continued to spread the disease after many of the people first infected had been placed in care facilities, where transmission was much better controlled. If superspreading had been completely controlled, almost two thirds of the infections might have been prevented, scientists said in the study. The researchers also noted that their findings were conservative, since they only focused on people who had been buried safely. This suggests that the role of superspreaders may have been even more profound than this research indicates. The research was led by Princeton University, in collaboration with scientists from Oregon State University, the London School of Hygiene and Tropical Medicine, the International Federation of Red Cross and Red Crescent Societies, the Imperial College London, and the National Institutes of Health. The concept of superspreaders is not new, researchers say, and it has evolved during the 2000s as scientists increasingly appreciate that not all individuals play an equal role in spreading an infectious disease. Superspreaders, for instance, have also been implicated in the spread of severe acute respiratory syndrome, or SARS, in 2003; and the more recent Middle East respiratory syndrome in 2012. But there's less understanding of who and how important these superspreaders are. "In the recent Ebola outbreak it's now clear that superspreaders were an important component in driving the epidemic," said Benjamin Dalziel, an assistant professor of population biology in the College of Science at Oregon State University, and co-author of the study. "We now see the role of superspreaders as larger than initially suspected. There wasn't a lot of transmission once people reached hospitals and care centers. Because case counts during the epidemic relied heavily on hospital data, those hospitalized cases tended to be the cases we 'saw.' "However, it was the cases you didn't see that really drove the epidemic, particularly people who died at home, without making it to a care center. In our analysis we were able to see a web of transmission that would often track back to a community-based superspreader." Superspreading has already been cited in many first-hand narratives of Ebola transmission. This study, however, created a new statistical framework that allowed scientists to measure how important the phenomenon was in driving the epidemic. It also allowed them to measure how superspreading changed over time, as the epidemic progressed, and as control measures were implemented. The outbreak size of the 2014 Ebola epidemic in Africa was unprecedented, and early control measures failed. Scientists believe that a better understanding of superspreading might allow more targeted, and effective interventions, instead of focusing on whole populations. "As we can learn more about these infection pathways, we should be better able to focus on the types of individual behavior and demographics that are at highest risk for becoming infected, and transmitting infection," Dalziel said. Researchers pointed out, for instance, that millions of dollars were spent implementing message strategies about Ebola prevention and control across entire countries. They suggest that messages tailored to individuals with higher risk and certain types of behavior may have been more successful, and prevented the epidemic from being so persistent. Lead author on the study was Max Lau at Princeton University. Support and funding was provided by the Bill and Melinda Gates Foundation, the National Institutes of Health, and the UK Medical Research Council.


News Article | February 21, 2017
Site: www.eurekalert.org

Modern houses -- with metal roofs and finished walls--are associated with a more than 9 percent reduction in the odds of malaria in children in sub-Saharan Africa when compared to more traditional thatched houses, according to a study published in PLOS Medicine by Lucy Tusting of the University of Oxford, UK, and colleagues at the London School of Hygiene & Tropical Medicine, UK, Durham University, UK, and the University of Southampton, UK. Insecticide-treated bednets and house spraying have been effective in reducing the prevalence of malaria since the turn of the 21st century, but other approaches are needed for sustainable elimination of the mosquito-transmitted, parasitic disease. Some evidence has suggested that modern houses may protect against the parasite but few studies have rigorously evaluated the association between improved housing and malaria risk. In the new work, researchers analyzed data on malaria prevalence and housing using data collected in 29 surveys carried out in 21 African countries between 2008 and 2015. Information on malaria status -- as tested using a blood smear or rapid test -- was available for 139,318 children under age 5 living in 84,153 households. The proportion of children with malaria detectable in their blood varied by survey, ranging from 0.4% to 45.5% among children living in modern houses and from 0.4% to 70.6% among children living in traditional homes. Across all surveys, modern housing was associated with a 9% to 14% reduction in the odds of malaria infection, after controlling for household wealth and use of insecticides. By comparison, children sleeping under insecticide-treated bednets had a 15% to 16% reduction in odds of testing positive for the disease. Lead author Lucy Tusting from the University of Oxford, said: "Good housing is a core pillar of public health, but is not used widely for malaria control. Well-built housing can block mosquitoes from entering homes and prevent them from transmitting malaria to the people who live there. "This is the first study to compare housing and insecticide-treated nets for malaria control across a range of countries in sub-Saharan Africa. Our study suggests good housing could be an important tool in tackling malaria. This is a welcome finding at a time when we are facing increasing resistance to our most effective insecticides and drugs. We now need to assess the impact of housing improvements on malaria in field trials and to work with architects and urban planners to incorporate protective designs into housing in regions at risk of malaria." The authors note that the effectiveness of improving housing will vary depending on the location. While many mosquitoes enter homes to bite humans at night, outdoor malaria transmission is more common in some places, meaning interventions centered on the home will have less impact. LST is a Skills Development Fellow (#N011570) jointly funded by the UK Medical Research Council and the UK Department for International Development under the MRC/DFID Concordat agreement. PWG is a Career Development Fellow (#K00669X) jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement, also part of the EDCTP2 programme supported by the European Union, and receives support from the Bill and Melinda Gates Foundation (#OPP1068048, #OPP1106023, #OPP1132415). AJT is supported by funding from NIH/NIAID (U19AI089674) , the Bill & Melinda Gates Foundation (OPP1106427, 1032350, OPP1134076, OPP1094793) , the Wellcome Trust (106866/Z/15/Z) and the Clinton Health Access Initiative . SWL is supported by the Global Health Trials funded by the MRC-DfID-Wellcome Trust, and The Bill & Melinda Gates Foundation (OPP1053338). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have declared that no competing interests exist. Tusting LS, Bottomley C, Gibson H, Kleinschmidt I, Tatem AJ, Lindsay SW, et al. (2017) Housing Improvements and Malaria Risk in Sub-Saharan Africa: A Multi-Country Analysis of Survey Data. PLoS Med 14(2): e1002234. doi:10.1371/journal.pmed.1002234 Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom School of Health Sciences, University of Witwatersrand, Johannesburg, South Africa WorldPop, Department of Geography and Environment, University of Southampton, Southampton, United Kingdom Flowminder Foundation, Stockholm, Sweden, 7 Department of Biosciences, Durham University, Durham, United Kingdom IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://journals.


News Article | November 22, 2016
Site: www.eurekalert.org

The large randomised study of 200,000 children was led by the London School of Hygiene & Tropical Medicine and Université Cheikh Anta Diop, Senegal. It found Seasonal Malaria Chemoprevention (SMC) also reduced cases in those above 10 years of age by a quarter, demonstrating that the intervention had contributed to reducing transmission of the disease. SMC provides a high degree of personal protection but until now it was assumed that it would not contribute to community-wide reduction in the transmission of malaria. There were approximately 214 million malaria cases and an estimated 438,000 malaria deaths in 2015 -- 89% of cases and 91% of deaths occurred in Sub Saharan Africa¹. SMC is a relatively new tool in the fight against malaria. It involves treating children with antimalarial drugs sulfadoxine-pyrimethamine and amodiaquine once a month during the rainy season, to prevent malaria where the disease is highly seasonal. Following a series of successful studies² by the School and its partners in West Africa, the World Health Organization recommended that children under five years of age living in the African Sahel and sub-Sahel should receive SMC. National malaria control programmes have been quick to respond and SMC has now been rolled out to 11 countries, reaching about 15 million children in 2016. However, with the relative number of malaria cases in the region's older children increasing, this new study was undertaken to examine the effectiveness of SMC extended to include children up to age 10. Between 2008 and 2011, 54 local health centres in central Senegal were randomised to provide SMC to children up to age 10, or act as controls. Over three years 780,000 SMC treatments were given to children. Malaria cases in each community were then monitored at outpatient clinics and hospitals, and deaths were recorded through surveys. Dr Paul Milligan, lead investigator from the London School of Hygiene & Tropical Medicine, said: "Although progress is being made to tackle malaria, it remains one of the biggest killers of children in sub Saharan Africa. Seasonal Malaria Chemoprevention is designed specifically for situations where the malaria is intense but confined to a short period each year. We wanted to know if it was practical to include older children in SMC programmes, and discover what the subsequent effect on their health and malaria transmission would be. "We found that SMC delivered by district health teams using community health workers reduced the incidence of malaria in the under 10s by 60% and the incidence of severe malaria³ by 45%. The intervention also led to a 26% decrease in cases of malaria in those above 10 years of age, showing that SMC could contribute to reducing malaria transmission. Although this effect was modest it is essential to winning the long-term fight against the disease. It is important now to strengthen national surveillance systems so we can define the regions where expanding the age range for SMC would have the greatest benefit." Importantly, the team found that including older children did not greatly increase the time needed to deliver the intervention each month. The treatments also provided a high degree of protection for an average cost of $0.50 per child each month and no severe side effects were recorded. Dr Badara Cisse, lead investigator from the Université Cheikh Anta Diop, said: "The SMC intervention in Senegal is an example of a locally-adapted approach to malaria control that could be a blueprint for an effective strategy to tackle malaria in this part of Africa. The development of the SMC intervention illustrates the value of partnerships between researchers in endemic countries, malaria control programmes, and the London School of Hygiene & Tropical Medicine." The authors acknowledge limitations of the study, including the need to better understand the effect of SMC on antimalarial drug resistance and the fact that they weren't able to demonstrate an effect on mortality. However, since the study was completed, Senegal has started to introduce SMC for children up to 10 years of age as part of its national malaria control strategy. The monitoring and evaluation of this new programme includes assessments of drug safety and efficacy, and measuring the impact on malaria and child survival. The study was funded by the Bill & Melinda Gates Foundation. Embargoed press preview PDF: http://plos. (this link is for journalists only) The article will be accessible via the following URL upon publication: http://journals. For more information or to request interviews please contact the London School of Hygiene & Tropical Medicine press office on 44-0-20-7927-2802 or email press@lshtm.ac.uk Badara Cisse, El Hadj Ba, Cheikh Sokhna, Jean Louis NDiaye, Jules F. Gomis, Yankhoba Dial, Catherine Pitt, Mouhamed NDiaye, Matthew Cairns, Ernest Faye Magatte NDiaye, Aminata Lo, Roger Tine, Sylvain Faye, Babacar Faye, Ousmane Sy, Lansana Konate, Ekoue Kouevijdin, Clare Flach, Ousmane Faye, Jean-Francois Trape, Colin Sutherland, Fatou Ba Fall, Pape M. Thior, Oumar K. Faye, Brian Greenwood, Oumar Gaye, Paul Milligan. Effectiveness of Seasonal Malaria Chemoprevention in Children under Ten Years of Age in Senegal: A Stepped-Wedge Cluster-Randomised Trial. PLOS Medicine. DOI:10.1371/journal.pmed.1002175 Matthew Cairns received support through a Population Health Scientist Fellowship jointly funded by the UK Medical Research Council and the UK Department for International Development. Jean Louis NDiaye is supported by a Wellcome Trust Intermediate Fellowship in Public Health and Tropical Medicine. ² Cissé, B, Sokhna, C, Boulanger, D, Milet, J, Bâ, elH, Richardson, K, Hallett, R, Sutherland, C, Simondon, K, Simondon, F, Alexander, N, Gaye, O, Targett, G, Lines, J, Greenwood, B and Trape, JF. Seasonal intermittent preventive treatment with artesunate and sulfadoxine- pyrimethamine for prevention of malaria in Senegalese children: a randomised, placebo-controlled, double-blind trial. Lancet.DOI:10.1016/S0140-6736(06)68264-0 Dicko, A, Diallo, AI, Tembine, I, Dicko, Y, Dara, N, Sidibe, Y, Santara, G, Diawara, H, Conaré, T, Djimde, A, Chandramohan, D, Cousens, S, Milligan, PJ, Diallo, DA, Doumbo, OK and Greenwood, B. Intermittent preventive treatment of malaria provides substantial protection against malaria in children already protected by an insecticide-treated bednet in Mali: a randomised, double-blind, placebo-controlled trial. PLoS Medicine. DOI:10.1371/journal.pmed.1000407. Konaté, AT, Yaro, JB, Ouédraogo, AZ, Diarra, A, Gansané, A, Soulama, I, Kangoyé, DT, Kaboré, Y, Ouédraogo, E, Ouédraogo, A, Tiono, AB, Ouédraogo, IN, Chandramohan, D, Cousens, S, Milligan, PJ, Sirima, SB, Greenwood, B and Diallo, DA. Intermittent preventive treatment of malaria provides substantial protection against malaria in children already protected by an insecticide-treated bednet in Burkina Faso: a randomised, double-blind, placebo-controlled trial. PLoS Medicine.DOI:10.1371/journal.pmed.1000408. Cairns, M, Roca-Feltrer, A, Garske, T, Wilson, AL, Diallo, D, Milligan, PJ, Ghani, AC and Greenwood, BM.Estimating the potential public health impact of seasonal malaria chemoprevention in African children. Nature Communications. DOI: 10.1038/ncomms1879 About the London School of Hygiene & Tropical Medicine The London School of Hygiene & Tropical Medicine is a world-leading centre for research and postgraduate education in public and global health, with more than 4,000 students and 1,000 staff working in over 100 countries. The School is one of the highest-rated research institutions in the UK, and among the world's leading schools in public and global health. Our mission is to improve health and health equity in the UK and worldwide; working in partnership to achieve excellence in public and global health research, education and translation of knowledge into policy and practice. http://www.


News Article | March 1, 2017
Site: www.eurekalert.org

As cannabis laws become liberalised in many countries, experts writing in The Lancet Psychiatry argue that there is an urgent need to explore how cannabis use can be made safer. The authors say that policy makers and researchers should consider regulating cannabis potency, reducing the use of tobacco (e.g. by using vapourisers), and exploring how the chemical composition of cannabis could be modified to reduce harm without altering the pleasurable effects of the drug. In the past 40 years, the potency of cannabis has on average doubled worldwide and there is evidence of a greater number of people seeking help for cannabis use disorders in the UK, Europe, and USA. Despite prohibitive laws on possession and use of cannabis being introduced in the 1960s, cannabis use has increased in most parts of the world, suggesting the laws have had little effect on use and abuse. Uruguay and a number of US states, including California, Oregon, Alaska, Maine, Massachusetts, Washington, Nevada, and Colorado allow cannabis to be sold for recreational purposes. Canada is set to legalise its recreational use in 2017 and several European countries, including Portugal, Spain and the Netherlands, have lessened or abolished sanctions on possession and use [1]. The main active compounds found in cannabis are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). High potency cannabis is high in THC with low (or absent) levels of CBD. This variety is commonly known as sinsemilla (Spanish meaning "without seed") or sometimes "skunk". Recent evidence suggests that CBD may protect against some of the detrimental effects of THC such as memory impairment and paranoia. Writing in a Personal View, the authors, from the Institute of Psychiatry, Psychology and Neuroscience at King's College London and UCL (UK), argue that the time has come to consider harm reduction in cannabis use. First, the authors say more focus on the harms of tobacco is needed since cannabis is frequently used with tobacco, particularly in Europe. For instance, smoke-free vapourisers could help reduce the harmful effects of smoke and avoid the highly addictive properties of tobacco. Secondly, they say that in countries where cannabis is legalised, the potency of cannabis could potentially be addressed. In parts of the USA where cannabis is legalised, THC is not regulated and extremely potent cannabis products (up to 75% THC) have gained popularity. Some policy makers in the Netherlands and Uruguay have suggested introducing a cap to limit THC content to 15% and more evidence is needed on the effect of these measures. Alternative options might include taxing cannabis according to THC content. However, the authors argue that these strategies might not be entirely successful, as cannabis users tend to prefer cannabis with a relatively high THC content. Instead, they argue that increasing the levels of CBD could reduce some of the harmful effects of cannabis, without compromising the effects users seek. More research into the harms posed by different levels of THC and CBD content is needed, and this information could potentially contribute to guidelines on safer cannabis use, similar to alcohol. "Although most users will not develop problems from their cannabis use, it is vital, especially now that cannabis is becoming increasingly liberalised, that we explore alternative and innovative ways by which we can reduce and mitigate cannabis related harms" says Dr Amir Englund, lead author from King's College London. "With the rapidly changing political climate around cannabis, the demand to effectively reduce cannabis-related harms has never been greater, and more research is urgently needed to inform policy decisions. A strategy based on increasing the content of CBD in cannabis might be especially promising because CBD can offset several harms associated with cannabis without compromising its rewarding effects." [2] Dr Tom Freeman, a co-author and Senior Research Fellow for the Society for the Study of Addiction said: "In the last eight years, the number of people in the UK entering specialist treatment for cannabis increased by over 50%. During the same time period, street cannabis has become increasingly strong with high levels of THC and little or no CBD. Further research on CBD is now needed - both to investigate its potential role in mitigating the harmful effects of THC in cannabis, but also as a potential treatment for the minority of people who develop problematic cannabis use. Efforts to reduce the common practice of mixing cannabis with tobacco could potentially prevent people progressing to nicotine dependence, providing a substantial benefit for public health." [2] This work was supported by a grant from the UK Medical Research Council, and the research team have been awarded a study grant from the MRC to explore how different levels of cannabidiol impact the harmful effects of THC. [1] Cannabis use prevalence in the UK: 10.6% in 2003/4 and 6.6% in 2013/2014 https:/ Drug treatment figures for cannabis in the UK: 7,579 new admissions in 2005/6 and 11,821 in 2013/4 https:/ [2] Quote direct from author and cannot be found in the text of the Personal View. IF YOU WISH TO PROVIDE A LINK FOR YOUR READERS, PLEASE USE THE FOLLOWING, WHICH WILL GO LIVE AT THE TIME THE


News Article | October 7, 2016
Site: www.techtimes.com

If you're a night owl but decided to work a day shift because of the possibility of developing breast cancer while working during the night, it's time you reconsidered that. An assessment back in 2007 suggested that the effect of night shift work on the body is probably carcinogenic, influencing the incidence of breast cancer in women. However, data from three recent studies and a review published in the Journal of the National Cancer Institute show that, on the contrary, night shifts have little or no influence on the occurrence of breast cancer. Ruth Travis and colleagues from the Cancer Epidemiology Unit at Oxford University followed 800,000 women in their three large-scale UK studies. The purpose of the researches was to examine and identify the risks of night shift work. The three studies involved 522,246 participants in the Million Women Study, another 22,559 women who participated in the EPIC-Oxford study and 251,045 UK Biobank volunteers. The subjects answered questions regarding their shift work, then they were followed for incident cancer. There was no increased risk of breast cancer development due to working at night, not even long-term night shifts, according to these studies. The study was funded by the UK Health and Safety Executive, along with Cancer Research UK and the UK Medical Research Council, and it analyzed data from 10 separate previous researches conducted in the UK, the United States, China, Sweden and the Netherlands. The researchers compared breast cancer risks for women who didn't work night shifts to women who did for long periods of time, up to 20 or even 30 years. The comparative analysis reported that there was little or no difference between the breast cancer incidence of the two groups of subjects. "We found that women who had worked night shifts, including long-term night shifts, were not more likely to develop breast cancer, either in the three new UK studies or when we combined results from all 10 studies that had published relevant data," explained Travis, lead author of the research. The incidence of developing breast cancer for women who had worked any night shifts was found to be 0.99, while the one for women who worked 20 or more years was 1.01 and the combined relative risks for those who have done night shifts for more than 30 years was 1.00. Approximately 14 percent of the women in the United Kingdom worked night shifts at least once, while 2 percent have done this for more than two decades. The study was conducted as, in the UK, there are more than 53,000 women annually diagnosed with breast cancer, out of which an average of 11,500 die every year because of the disease. This problem is especially serious in the UK, where 27,000 women are being denied affordable breast cancer treatment. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.


News Article | February 21, 2017
Site: www.eurekalert.org

Average life expectancy is set to increase in many countries by 2030 -- and will exceed 90 years in South Korea, according to new research Average life expectancy is set to increase in many countries by 2030 - and will exceed 90 years in South Korea, according to new research. The study, led by scientists from Imperial College London in collaboration with the World Health Organization, analysed long-term data on mortality and longevity trends to predict how life expectancy will change in 35 industrialised countries by 2030. Nations in the study included both high-income countries, such as the USA, Canada, UK, Germany, Australia, and emerging economies such as Poland, Mexico and the Czech Republic. The study, published in The Lancet and funded by the UK Medical Research Council, revealed all nations in the study can expect to see an increase in life expectancy by 2030. The results also found that South Koreans may have the highest life expectancy in the world in 2030. The team calculated life expectancy at birth, and predicted a baby girl born in South Korea in 2030 will expect to live 90.8 years. Life expectancy at birth for South Korean men will be 84.1 years. The researchers also calculated how long a 65-year-old person may expect to live in 2030. The results revealed that the average 65-year-old woman in South Korea in 2030 may live an additional 27.5 years. Scientists once thought an average life expectancy of over 90 was impossible, explained Professor Majid Ezzati, lead researcher from the School of Public Health at Imperial: "We repeatedly hear that improvements in human longevity are about to come to an end. Many people used to believe that 90 years is the upper limit for life expectancy, but this research suggests we will break the 90-year-barrier. I don't believe we're anywhere near the upper limit of life expectancy -if there even is one." Professor Ezzati explained that South Korea's high life expectancy may be due to a number of factors including good nutrition in childhood, low blood pressure, low levels of smoking, good access to healthcare, and uptake of new medical knowledge and technologies. French women and Swiss men were predicted to have the highest life expectancies at birth in Europe in 2030, with an average life expectancy of 88.6 years for French women and nearly 84 years for Swiss men. The results also revealed that the USA is likely to have the lowest life expectancy at birth in 2030 among high-income countries. The nation's average life expectancy at birth of men and women in 2030 (79.5 years and 83.3 years), will be similar to that of middle-income countries like Croatia and Mexico. The research team say this may be due to a number of factors including a lack of universal healthcare, as well as the highest child and maternal mortality rate, homicide rate and obesity among high-income countries. The UK's average life expectancy at birth for women will be 85.3 years in 2030. This places them at 21st in the table of 35 countries. The average life expectancy of a UK man meanwhile will be 82.5 years in 2030. This places them at 14th in the table of 35 countries. The team also predicted a 65-year-old UK man in 2030 could expect to live an additional 20.9 years (12th in the table of countries), while a 65-year-old woman in the UK could expect to live an additional 22.7 years, up (22nd in the table of countries). The research also suggested the gap in life expectancy between women and men is closing. Professor Ezzati explained: "Men traditionally had unhealthier lifestyles, and so shorter life expectancies. They smoked and drank more, and had more road traffic accidents and homicides. However as lifestyles become more similar between men and women, so does their longevity." Along with the US, other countries who may see only small increases in life expectancy by 2030 included Japan, Sweden and Greece, while Macedonia and Serbia were projected to have the lowest life expectancies at birth for women and men respectively in 2030. Life expectancy is calculated by assessing the age at which people die across the whole population. For instance if a country has high childhood mortality rate, this will make average national life expectancy much lower, as would a country in which many young people die in injuries and violence. Professor Colin Mathers, co-author from the World Health Organization explained: "The increase in average life expectancy in high income countries is due to the over-65s living longer than ever before. In middle-income countries, the number of premature deaths - i.e. people dying in their forties and fifties, will also decline by 2030." The team developed a new method to predict longevity, similar to the methods used for weather forecasting, which takes into account numerous different models for forecasting mortality and life expectancy. All the predictions in the study come with some uncertainty range. For instance, there is a 90 per cent probability that life expectancy for South Korean women in 2030 will be higher than 86.7 years, and a 57 per cent probability that it will be higher than 90 years. The researchers chose the 35 industrialised countries in the study as they all had reliable data on deaths since at least 1985. The team then used this data, together with their new methodology to predict life expectancy to 2030. Professor Ezzati added that these results suggest we need to be thinking carefully about the needs of an ageing population: "The fact that we will continue to live longer means we need to think about strengthening the health and social care systems to support an ageing population with multiple health needs. This is the opposite of what is being done in the era of austerity. We also need to think about whether current pension systems will support us, or if we need to consider working into later life."

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