Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-7 (of 7 Records) |
Query Trace: Barth L [original query] |
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The long-term impact of the Leprosy Post-Exposure Prophylaxis (LPEP) program on leprosy incidence: A modelling study
Blok DJ , Steinmann P , Tiwari A , Barth-Jaeggi T , Arif MA , Banstola NL , Baskota R , Blaney D , Bonenberger M , Budiawan T , Cavaliero A , Gani Z , Greter H , Ignotti E , Kamara DV , Kasang C , Manglani PR , Mieras L , Njako BF , Pakasi T , Saha UR , Saunderson P , Smith WCS , Stäheli R , Suriyarachchi ND , Tin Maung A , Shwe T , van Berkel J , van Brakel WH , Vander Plaetse B , Virmond M , Wijesinghe MSD , Aerts A , Richardus JH . PLoS Negl Trop Dis 2021 15 (3) e0009279 BACKGROUND: The Leprosy Post-Exposure Prophylaxis (LPEP) program explored the feasibility and impact of contact tracing and the provision of single dose rifampicin (SDR) to eligible contacts of newly diagnosed leprosy patients in Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka and Tanzania. As the impact of the programme is difficult to establish in the short term, we apply mathematical modelling to predict its long-term impact on the leprosy incidence. METHODOLOGY: The individual-based model SIMCOLEP was calibrated and validated to the historic leprosy incidence data in the study areas. For each area, we assessed two scenarios: 1) continuation of existing routine activities as in 2014; and 2) routine activities combined with LPEP starting in 2015. The number of contacts per index patient screened varied from 1 to 36 between areas. Projections were made until 2040. PRINCIPAL FINDINGS: In all areas, the LPEP program increased the number of detected cases in the first year(s) of the programme as compared to the routine programme, followed by a faster reduction afterwards with increasing benefit over time. LPEP could accelerate the reduction of the leprosy incidence by up to six years as compared to the routine programme. The impact of LPEP varied by area due to differences in the number of contacts per index patient included and differences in leprosy epidemiology and routine control programme. CONCLUSIONS: The LPEP program contributes significantly to the reduction of the leprosy incidence and could potentially accelerate the interruption of transmission. It would be advisable to include contact tracing/screening and SDR in routine leprosy programmes. |
Leprosy post-exposure prophylaxis with single-dose rifampicin (LPEP): an international feasibility programme
Richardus JH , Tiwari A , Barth-Jaeggi T , Arif MA , Banstola NL , Baskota R , Blaney D , Blok DJ , Bonenberger M , Budiawan T , Cavaliero A , Gani Z , Greter H , Ignotti E , Kamara DV , Kasang C , Manglani PR , Mieras L , Njako BF , Pakasi T , Pandey BD , Saunderson P , Singh R , Smith WCS , Stäheli R , Suriyarachchi ND , Tin Maung A , Shwe T , van Berkel J , van Brakel WH , Vander Plaetse B , Virmond M , Wijesinghe MSD , Aerts A , Steinmann P . Lancet Glob Health 2020 9 (1) e81-e90 BACKGROUND: Innovative approaches are required for leprosy control to reduce cases and curb transmission of Mycobacterium leprae. Early case detection, contact screening, and chemoprophylaxis are the most promising tools. We aimed to generate evidence on the feasibility of integrating contact tracing and administration of single-dose rifampicin (SDR) into routine leprosy control activities. METHODS: The leprosy post-exposure prophylaxis (LPEP) programme was an international, multicentre feasibility study implemented within the leprosy control programmes of Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka, and Tanzania. LPEP explored the feasibility of combining three key interventions: systematically tracing contacts of individuals newly diagnosed with leprosy; screening the traced contacts for leprosy; and administering SDR to eligible contacts. Outcomes were assessed in terms of number of contacts traced, screened, and SDR administration rates. FINDINGS: Between Jan 1, 2015, and Aug 1, 2019, LPEP enrolled 9170 index patients and listed 179 769 contacts, of whom 174 782 (97·2%) were successfully traced and screened. Of those screened, 22 854 (13·1%) were excluded from SDR mainly because of health reasons and age. Among those excluded, 810 were confirmed as new patients (46 per 10 000 contacts screened). Among the eligible screened contacts, 1182 (0·7%) refused prophylactic treatment with SDR. Overall, SDR was administered to 151 928 (86·9%) screened contacts. No serious adverse events were reported. INTERPRETATION: Post-exposure prophylaxis with SDR is safe; can be integrated into different leprosy control programmes with minimal additional efforts once contact tracing has been established; and is generally well accepted by index patients, their contacts, and health-care workers. The programme has also invigorated local leprosy control through the availability of a prophylactic intervention; therefore, we recommend rolling out SDR in all settings where contact tracing and screening have been established. FUNDING: Novartis Foundation. |
Leprosy post-exposure prophylaxis with single-dose rifampicin: Toolkit for implementation
Barth-Jaeggi T , Cavaliero A , Aerts A , Anand S , Arif M , Ay SS , Aye TM , Banstola NL , Baskota R , Blaney D , Bonenberger M , Van Brakel W , Cross H , Das VK , Budiawan T , Fernando N , Gani Z , Greter H , Ignotti E , Kamara D , Kasang C , Komm B , Kumar A , Lay S , Mieras L , Mirza F , Mutayoba B , Njako B , Pakasi T , Richardus JH , Saunderson P , Smith CS , Staheli R , Suriyarachchi N , Shwe T , Tiwari A , Wijesinghe MSD , Van Berkel J , Plaetse BV , Virmond M , Steinmann P . Lepr Rev 2019 90 (4) 356-363 Objective: Leprosy post-exposure prophylaxis with single-dose rifampicin (SDRPEP) has proven effective and feasible, and is recommended by WHO since 2018. This SDR-PEP toolkit was developed through the experience of the leprosy postexposure prophylaxis (LPEP) programme. It has been designed to facilitate and standardise the implementation of contact tracing and SDR-PEP administration in regions and countries that start the intervention. Result(s): Four tools were developed, incorporating the current evidence for SDRPEP and the methods and learnings from the LPEP project in eight countries. (1) the SDR-PEP policy/advocacy PowerPoint slide deck which will help to inform policy makers about the evidence, practicalities and resources needed for SDR-PEP, (2) the SDR-PEP field implementation training PowerPoint slide deck to be used to train front line staff to implement contact tracing and PEP with SDR, (3) the SDR-PEP generic field guide which can be used as a basis to create a location specific field protocol for contact tracing and SDR-PEP serving as a reference for frontline field staff. Finally, (4) the SDR-PEP toolkit guide, summarising the different components of the toolkit and providing instructions on its optimal use. Conclusion(s): In response to interest expressed by countries to implement contact tracing and leprosy PEP with SDR in the light of the WHO recommendation of SDRPEP, this evidence-based, concrete yet flexible toolkit has been designed to serve national leprosy programme managers and support them with the practical means to translate policy into practice. The toolkit is freely accessible on the Infolep homepages and updated as required: https://www.leprosy-information.org/keytopic/leprosy-postexposure-prophylaxis-lpep-programme. |
The Leprosy Post-Exposure Prophylaxis (LPEP) programme: Update and interim analysis
Steinmann P , Cavaliero A , Aerts A , Anand S , Arif M , Ay SS , Aye TM , Barth-Jaeggi T , Banstola NL , Bhandari CM , Blaney D , Bonenberger M , Van Brakel W , Cross H , Das VK , Fahrudda A , Fernando N , Gani Z , Greter H , Ignotti E , Kamara D , Kasang C , Kömm B , Kumar A , Lay S , Mieras L , Mirza F , Mutayoba B , Njako B , Pakasi T , Saunderson P , Shengelia B , Smith CS , Stäheli R , Suriyarachchi N , Shwe T , Tiwari A , D Wijesinghe MS , Van Berkel J , Plaetse BV , Virmond M , Richardus JH . Lepr Rev 2018 89 (2) 102-116 Innovative approaches are required to further enhance leprosy control, reduce the number of people developing leprosy, and curb transmission. Early case detection, contact screening, and chemoprophylaxis currently is the most promising approach to achieve this goal. The Leprosy Post-Exposure Prophylaxis (LPEP) programme generates evidence on the feasibility of integrating contact tracing and single-dose rifampicin (SDR) administration into routine leprosy control activities in different settings. The LPEP programme is implemented within the leprosy control programmes of Brazil, Cambodia, India, Indonesia, Myanmar, Nepal, Sri Lanka and Tanzania. Focus is on three key interventions: tracing the contacts of newly diagnosed leprosy patients; screening the contacts for leprosy; and administering SDR to eligible contacts. Country-specific protocol adaptations refer to contact definition, minimal age for SDR, and staff involved. Central coordination, detailed documentation and rigorous supervision ensure quality evidence. Around 2 years of field work had been completed in seven countries by July 2017. The 5,941 enrolled index patients (89·4% of the registered) identified a total of 123,311 contacts, of which 99·1% were traced and screened. Among them, 406 new leprosy patients were identified (329/100,000), and 10,883 (8·9%) were excluded from SDR for various reasons. Also, 785 contacts (0·7%) refused the prophylactic treatment with SDR. Overall, SDR was administered to 89·0% of the listed contacts. Post-exposure prophylaxis with SDR is safe; can be integrated into the routines of different leprosy control programmes; and is generally well accepted by index patients, their contacts and the health workforce. The programme has also invigorated local leprosy control. |
Sealpox virus in marine mammal rehabilitation facilities, North America, 2007-2009
Roess AA , Levine RS , Barth L , Monroe BP , Carroll DS , Damon IK , Reynolds MG . Emerg Infect Dis 2011 17 (12) 2203-8 Sealpox, a zoonotic disease affecting pinnipeds (seals and sea lions), can occur among captive and convalescing animals. We surveyed 1 worker each from 11 marine mammal centers and interviewed 31 other marine mammal workers to ascertain their knowledge of and experience with sealpox virus and to identify factors associated with sealpox virus outbreaks among pinnipeds in marine rehabilitation facilities. Demographic and health data were obtained for 1,423 pinnipeds at the 11 facilities. Among the 23 animals in which sealpox was clinically diagnosed, 4 arrived at the facility ill, 11 became ill <5 weeks after arrival, and 2 became ill >5 weeks after arrival; the timing of illness onset was unknown for 6 animals. Most infections occurred in pinnipeds <1 year of age. Nine affected animals were malnourished; 4 had additional illnesses. Sealpox had also occurred among workers at 2 facilities. Sealpox is a noteworthy zoonosis of rehabilitating convalescing pinnipeds; workplace education can help to minimize risks for human infection. |
Both innate and adaptive immunity mediate protective immunity against hepatitis C virus infection in chimpanzees
Barth H , Rybczynska J , Patient R , Choi Y , Sapp RK , Baumert TF , Krawczynski K , Liang TJ . Hepatology 2011 54 (4) 1135-48 Understanding the immunological correlates associated with protective immunity following hepatitis C virus (HCV) reexposure is a prerequisite for the design of effective HCV vaccines and immunotherapeutics. In this study we performed a comprehensive analysis of innate and adaptive immunity following HCV reexposure of two chimpanzees that had previously recovered from HCV-JFH1 infection. One of the chimpanzees, CH10274, became protected from active viremia by repeated challenges with homologous HCV-JFH1 and developed neutralizing antibodies, but was later infected with high-level viremia by a heterologous challenge with the HCV H77 virus that persisted for more than 1 year. The other chimpanzee, CH10273, was protected from a similar, heterologous H77 challenge without any evidence of neutralizing antibodies. Peripheral HCV-specific T-cell responses were present in both chimpanzees after challenges and, interestingly, the overall magnitude of response was lower in uninfected CH10273, which, however, exhibited a more robust CD8+ T-cell response. CH10273 showed higher hepatic expression of CD8 and CD56 (natural killer) markers than CH10274 did shortly after inoculation with H77. The heightened T-cell response was associated with an enhanced hepatic production of interferons (both type I and II) and interferon-stimulated genes (ISGs) in CH10273. Therefore, protection or clearance of HCV reinfection upon heterologous rechallenge depends on the activation of both intrahepatic innate and cellular immune responses. Furthermore, our results suggest that serum neutralizing antibodies may contribute to early control of viral replication and spread after homologous HCV rechallenges but may not be sufficient for a long-term protective immunity. CONCLUSION: Our study shows that protective immunity against HCV reinfection is orchestrated by a complex network of innate and adaptive immune responses. (HEPATOLOGY 2011;). |
Standard terminology for fetal, infant, and perinatal deaths
Barfield WD , Papile LA , Baley JE , Bhutani VK , Carlo WA , Cummings JJ , Kumar P , Polin RA , Tan RC , Watterberg KL , Barth Jr WH , Jeffries AL , Mainous RO , Raju TNK , Wang KS , Couto J . Pediatrics 2011 128 (1) (1) 177-181 Accurately defining and reporting perinatal deaths (ie, fetal and infant deaths) is a critical first step in understanding the magnitude and causes of these important events. In addition to obstetric health care providers, neonatologists and pediatricians should know the current US definitions and reporting requirements for live births, fetal deaths, and infant deaths. Correct identification of these vital events will improve our local, state, and national data so that these deaths can be better addressed and reduced. Copyright 2011 by the American Academy of Pediatrics. |
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