Last data update: May 20, 2024. (Total: 46824 publications since 2009)
Records 1-7 (of 7 Records) |
Query Trace: O'Driscoll M[original query] |
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Naomi: a new modelling tool for estimating HIV epidemic indicators at the district level in sub-Saharan Africa.
Eaton JW , Dwyer-Lindgren L , Gutreuter S , O'Driscoll M , Stevens O , Bajaj S , Ashton R , Hill A , Russell E , Esra R , Dolan N , Anifowoshe YO , Woodbridge M , Fellows I , Glaubius R , Haeuser E , Okonek T , Stover J , Thomas ML , Wakefield J , Wolock TM , Berry J , Sabala T , Heard N , Delgado S , Jahn A , Kalua T , Chimpandule T , Auld A , Kim E , Payne D , Johnson LF , FitzJohn RG , Wanyeki I , Mahy MI , Shiraishi RW . J Int AIDS Soc 2021 24 Suppl 5 e25788 INTRODUCTION: HIV planning requires granular estimates for the number of people living with HIV (PLHIV), antiretroviral treatment (ART) coverage and unmet need, and new HIV infections by district, or equivalent subnational administrative level. We developed a Bayesian small-area estimation model, called Naomi, to estimate these quantities stratified by subnational administrative units, sex, and five-year age groups. METHODS: Small-area regressions for HIV prevalence, ART coverage and HIV incidence were jointly calibrated using subnational household survey data on all three indicators, routine antenatal service delivery data on HIV prevalence and ART coverage among pregnant women, and service delivery data on the number of PLHIV receiving ART. Incidence was modelled by district-level HIV prevalence and ART coverage. Model outputs of counts and rates for each indicator were aggregated to multiple geographic and demographic stratifications of interest. The model was estimated in an empirical Bayes framework, furnishing probabilistic uncertainty ranges for all output indicators. Example results were presented using data from Malawi during 2016-2018. RESULTS: Adult HIV prevalence in September 2018 ranged from 3.2% to 17.1% across Malawi's districts and was higher in southern districts and in metropolitan areas. ART coverage was more homogenous, ranging from 75% to 82%. The largest number of PLHIV was among ages 35 to 39 for both women and men, while the most untreated PLHIV were among ages 25 to 29 for women and 30 to 34 for men. Relative uncertainty was larger for the untreated PLHIV than the number on ART or total PLHIV. Among clients receiving ART at facilities in Lilongwe city, an estimated 71% (95% CI, 61% to 79%) resided in Lilongwe city, 20% (14% to 27%) in Lilongwe district outside the metropolis, and 9% (6% to 12%) in neighbouring Dowa district. Thirty-eight percent (26% to 50%) of Lilongwe rural residents and 39% (27% to 50%) of Dowa residents received treatment at facilities in Lilongwe city. CONCLUSIONS: The Naomi model synthesizes multiple subnational data sources to furnish estimates of key indicators for HIV programme planning, resource allocation, and target setting. Further model development to meet evolving HIV policy priorities and programme need should be accompanied by continued strengthening and understanding of routine health system data. |
Maternal colonization with group B streptococcus and serotype distribution worldwide: Systematic review and meta-analyses
Russell NJ , Seale AC , O'Driscoll M , O'Sullivan C , Bianchi-Jassir F , Gonzalez-Guarin J , Lawn JE , Baker CJ , Bartlett L , Cutland C , Gravett MG , Heath PT , Le Doare K , Madhi SA , Rubens CE , Schrag S , Sobanjo-Ter Meulen A , Vekemans J , Saha SK , Ip M . Clin Infect Dis 2017 65 S100-s111 Background: Maternal rectovaginal colonization with group B Streptococcus (GBS) is the most common pathway for GBS disease in mother, fetus, and newborn. This article, the second in a series estimating the burden of GBS, aims to determine the prevalence and serotype distribution of GBS colonizing pregnant women worldwide. Methods: We conducted systematic literature reviews (PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Literature [LILACS], World Health Organization Library Information System [WHOLIS], and Scopus), organized Chinese language searches, and sought unpublished data from investigator groups. We applied broad inclusion criteria to maximize data inputs, particularly from low- and middle-income contexts, and then applied new meta-analyses to adjust for studies with less-sensitive sampling and laboratory techniques. We undertook meta-analyses to derive pooled estimates of maternal GBS colonization prevalence at national and regional levels. Results: The dataset regarding colonization included 390 articles, 85 countries, and a total of 299924 pregnant women. Our adjusted estimate for maternal GBS colonization worldwide was 18% (95% confidence interval [CI], 17%-19%), with regional variation (11%-35%), and lower prevalence in Southern Asia (12.5% [95% CI, 10%-15%]) and Eastern Asia (11% [95% CI, 10%-12%]). Bacterial serotypes I-V account for 98% of identified colonizing GBS isolates worldwide. Serotype III, associated with invasive disease, accounts for 25% (95% CI, 23%-28%), but is less frequent in some South American and Asian countries. Serotypes VI-IX are more common in Asia. Conclusions: GBS colonizes pregnant women worldwide, but prevalence and serotype distribution vary, even after adjusting for laboratory methods. Lower GBS maternal colonization prevalence, with less serotype III, may help to explain lower GBS disease incidence in regions such as Asia. High prevalence worldwide, and more serotype data, are relevant to prevention efforts. |
Intrapartum antibiotic chemoprophylaxis policies for the prevention of group B streptococcal disease worldwide: Systematic review
Le Doare K , O'Driscoll M , Turner K , Seedat F , Russell NJ , Seale AC , Heath PT , Lawn JE , Baker CJ , Bartlett L , Cutland C , Gravett MG , Ip M , Madhi SA , Rubens CE , Saha SK , Schrag S , Sobanjo-Ter Meulen A , Vekemans J , Kampmann B . Clin Infect Dis 2017 65 S143-s151 Background: Intrapartum antibiotic chemoprophylaxis (IAP) prevents most early-onset group B streptococcal (GBS) disease. However, there is no description of how IAP is used around the world. This article is the sixth in a series estimating the burden of GBS disease. Here we aimed to review GBS screening policies and IAP implementation worldwide. Methods: We identified data through (1) systematic literature reviews (PubMed/Medline, Embase, Literature in the Health Sciences in Latin America and the Caribbean [LILACS], World Health Organization library database [WHOLIS], and Scopus) and unpublished data from professional societies and (2) an online survey and searches of policies from medical societies and professionals. We included data on whether an IAP policy was in use, and if so whether it was based on microbiological or clinical risk factors and how these were applied, as well as the estimated coverage (percentage of women receiving IAP where indicated). Results: We received policy information from 95 of 195 (49%) countries. Of these, 60 of 95 (63%) had an IAP policy; 35 of 60 (58%) used microbiological screening, 25 of 60 (42%) used clinical risk factors. Two of 15 (13%) low-income, 4 of 16 (25%) lower-middle-income, 14 of 20 (70%) upper-middle-income, and 40 of 44 (91%) high-income countries had any IAP policy. The remaining 35 of 95 (37%) had no national policy (25/33 from low-income and lower-middle-income countries). Coverage varied considerably; for microbiological screening, median coverage was 80% (range, 20%-95%); for clinical risk factor-based screening, coverage was 29% (range, 10%-50%). Although there were differences in the microbiological screening methods employed, the individual clinical risk factors used were similar. Conclusions: There is considerable heterogeneity in IAP screening policies and coverage worldwide. Alternative global strategies, such as maternal vaccination, are needed to enhance the scope of global prevention of GBS disease. |
Fate and transport of enteric microbes from septic systems in a coastal watershed
Schneeberger CL , O'Driscoll M , Humphrey C , Henry K , Deal N , Seiber K , Hill VR , Zarate-Bermudez M . J Environ Health 2015 77 (9) 22-30 Onsite wastewater treatment systems (OWTS) are commonly used in coastal areas to treat household wastewater. These systems represent potential sources of fecal pollution of groundwater and nearby surface water. OWTS are expected to reduce microbial concentrations in wastewater; however, system and environmental factors can affect treatment efficiency and impacts on ground and surface water. In the study of OWTS described in this article, the authors sampled septic tanks and groundwater at two households in coastal North Carolina between October 2009 and October 2011. Samples were tested for the fecal indicator microbes E. coli, enterococci, and Clostridium perfringens. Microbial source tracking was also performed in year two. Results showed that enteric microbe concentrations in groundwater significantly decreased with distance from the OWTS. Human markers of fecal contamination were also detected in the OWTS and downgradient groundwater, indicating that OWTS can impact the microbial quality of shallow groundwater. |
Meteorological influences on nitrogen dynamics of a coastal onsite wastewater treatment system
O'Driscoll MA , Humphrey CP , Deal NE , Lindbo DL , Zarate-Bermudez MA . J Environ Qual 2014 43 (6) 1873-1885 On-site wastewater treatment systems (OWTS) can contribute nitrogen (N) to coastal waters. In coastal areas with shallow groundwater, OWTS are likely affected by meteorological events. However, the meteorological influences on temporal variability of N exports from OWTS are not well documented. Hydrogeological characterization and seasonal monitoring of wastewater and groundwater quality were conducted at a residence adjacent to the Pamlico River Estuary, North Carolina, during a 2-yr field study (October 2009-2011). Rainfall was elevated during the first study year, relative to the annual mean. In the second year, drought was followed by extreme precipitation from Hurricane Irene. Recent meteorological conditions influenced N speciation and concentrations in groundwater. Groundwater total dissolved nitrogen (TDN) beneath the OWTS drainfield was dominated by nitrate during the drought; during wetter periods, ammonium and organic N were common. Effective precipitation (precipitation [P] minus evapotranspiration [ET]) affected OWTS TDN exports because of its influence on groundwater recharge and discharge. Groundwater nitrate-N concentrations beneath the drainfield were typically higher than 10 mg/L when total biweekly precipitation was less than evapotranspiration (precipitation deficit: P < ET). Overall, groundwater TDN concentrations were elevated above background concentrations at distances > 15 m downgradient of the drainfield. Although OWTS nitrate inputs caused elevated groundwater nitrate concentrations between the drainfield and the estuary, the majority of nitrate was attenuated via denitrification between the OWTS and 48 m to the estuary. However, DON originating from the OWTS was mobile and contributed to elevated TDN concentrations along the groundwater flowpath to the estuary. |
Onsite wastewater system nitrogen contributions to groundwater in coastal North Carolina
Humphrey Jr C , O'Driscoll M; , Deal N , Lindbo D , Thieme S , Zarate-Bermudez M . J Environ Health 2013 76 (5) 16-22 The objective of the study described in this article was | to evaluate the nitrogen contributions from two onsite wastewater systems (sites 1 and 2) to groundwater and adjacent surface waters in coastal Beaufort County, North Carolina. Groundwater levels and water quality parameters including total nitrogen, nitrogen species, temperature, and pH were monitored from October 2009 to May 2010. Nitrogen was also tested in groundwater from deeper irrigation or drinking water wells from the two sites and six additional neighboring residences. Mean total nitrogen concentrations | in groundwater beneath onsite wastewater systems 1 and 2 were | 34.3 ± 16.7 mg/L and 12.2 ± 2.9 mg/L, respectively, and significantly higher than background groundwater concentrations (<1 mg/L). Groundwater in the deeper wells appeared not to be influenced by the onsite systems. Groundwater nitrogen concentrations typically decreased with distance down-gradient from the systems, but were still elevated relative to background conditions more than 15 m from the systems and near the estuary. This was a pioneering effort to better understand the link of onsite systems, the fate of nitrogen in the environment, and public health. |
Evaluation of on-site wastewater system Escherichia coli contributions to shallow groundwater in coastal North Carolina
Humphrey Jr CP , O'Driscoll MA , Zarate MA . Water Sci Technol 2011 63 (4) 789-95 The study goal was to determine if on-site wastewater systems (OSWWS) installed in coastal areas were effective at reducing indicator bacteria densities before discharge to groundwater. Groundwater Escherichia coli (E. coli) densities and groundwater levels adjacent to 16 OSWWS in three different soil groups (sand, sandy loam, and sandy clay loam) were monitored and compared to background groundwater conditions on four occasions between March 2007 and February 2008 in coastal North Carolina. Groundwater beneath OSWWS had significantly (p≤0.05) lower densities of E. coli than septic tank effluent, but significantly higher densities of E. coli than background conditions for each soil type. Twenty three percent of all groundwater samples near OSWWS had E. coli densities that exceeded the EPA freshwater contact standards (single sample 235 cfu/100 mL) for surface waters. Groundwater E. coli densities near OSWWS were highest during shallow water table periods. The results indicate that increasing the required vertical separation distance from drainfield trenches to seasonal high water table could improve shallow groundwater quality. |
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