首页 > 最新文献

Gates Open Research最新文献

英文 中文
A comparison of acceptability of contraceptive vaginal rings, pills, and injectables among cisgender women in Kenya and Zimbabwe: protocol for a mixed-methods study.
Pub Date : 2025-03-03 eCollection Date: 2025-01-01 DOI: 10.12688/gatesopenres.16315.1
Chelsea B Polis, Francis O Obare, Irene V Bruce, Cynthia Banda, Lisa B Haddad, Antwanette Heyns, Petros Isaakidis, Mercy Kamupira, Terrance Kufakunesu, Zachary A Kwena, Farai Machinga, Regina F Magore, Aleck Mapangire, Mercy Marimirofa, Matheus Mathipa, Sanyukta Mathur, Mary Mudavanhu, Tatenda P Mujuru, Prisca Mutero, Betty Njoroge, Collen Nyatsambo, Sarah Okumu, Leah Omondi, Tevyne Omondi, Marlena G Plagianos, Greshon Rota, Samuel Sithole, Bruce Variano, J Brady Burnett-Zieman, Petina Musara, George Odwe, Gerald Hangaika, Serah Gitome, Elizabeth A Bukusi, Kuziwa Kuwenyi

Background: Expanding contraceptive options could better meet users' diverse needs and preferences. Annovera ® is a contraceptive vaginal ring that provides a year of pregnancy prevention while remaining under user control and allowing for regular menstrual cycles. This method may also help to reduce burdens on some health care and supply chain systems. However, knowledge gaps exist regarding initial and ongoing acceptability of contraceptive vaginal rings in African settings.

Methods: We will undertake an open-label, non-randomized, two-arm, parallel clinical acceptability study with an embedded qualitative component, based in clinics providing contraceptive services in Kenya and Zimbabwe. Women aged 18-45 interested in newly initiating or switching contraception will choose from among all available contraceptive options, including Annovera. We aim to enroll 200 participants selecting Annovera and 200 participants selecting either contraceptive injectables or pills. We will compare method uptake, continuation, and satisfaction over one year. Participants will complete questionnaires administered by study staff during two in-person visits (a screening/enrollment visit, and an end of study visit after 52 weeks of method use or at discontinuation) and four phone appointments (at 4, 12, 24, and 36 weeks of use). We will evaluate used rings for discoloration and residual drug levels. The qualitative component involve in-depth interviews with women in the clinical study, their sexual partners, and their service providers, to further examine drivers of and barriers to interest in and use of contraceptive vaginal rings.

Discussion: This study will explore acceptability of contraceptive vaginal rings in 'real-world' contraceptive service settings in two African countries. Findings will be based on actual ring use and contextualized via comparison to two other commonly available methods. As vaginal rings are being considered for multiple reproductive health indications, this work can fill key knowledge gaps and empower decision-makers with information needed to inform future investments in reproductive health.

{"title":"A comparison of acceptability of contraceptive vaginal rings, pills, and injectables among cisgender women in Kenya and Zimbabwe: protocol for a mixed-methods study.","authors":"Chelsea B Polis, Francis O Obare, Irene V Bruce, Cynthia Banda, Lisa B Haddad, Antwanette Heyns, Petros Isaakidis, Mercy Kamupira, Terrance Kufakunesu, Zachary A Kwena, Farai Machinga, Regina F Magore, Aleck Mapangire, Mercy Marimirofa, Matheus Mathipa, Sanyukta Mathur, Mary Mudavanhu, Tatenda P Mujuru, Prisca Mutero, Betty Njoroge, Collen Nyatsambo, Sarah Okumu, Leah Omondi, Tevyne Omondi, Marlena G Plagianos, Greshon Rota, Samuel Sithole, Bruce Variano, J Brady Burnett-Zieman, Petina Musara, George Odwe, Gerald Hangaika, Serah Gitome, Elizabeth A Bukusi, Kuziwa Kuwenyi","doi":"10.12688/gatesopenres.16315.1","DOIUrl":"10.12688/gatesopenres.16315.1","url":null,"abstract":"<p><strong>Background: </strong>Expanding contraceptive options could better meet users' diverse needs and preferences. Annovera <sup>®</sup> is a contraceptive vaginal ring that provides a year of pregnancy prevention while remaining under user control and allowing for regular menstrual cycles. This method may also help to reduce burdens on some health care and supply chain systems. However, knowledge gaps exist regarding initial and ongoing acceptability of contraceptive vaginal rings in African settings.</p><p><strong>Methods: </strong>We will undertake an open-label, non-randomized, two-arm, parallel clinical acceptability study with an embedded qualitative component, based in clinics providing contraceptive services in Kenya and Zimbabwe. Women aged 18-45 interested in newly initiating or switching contraception will choose from among all available contraceptive options, including Annovera. We aim to enroll 200 participants selecting Annovera and 200 participants selecting either contraceptive injectables or pills. We will compare method uptake, continuation, and satisfaction over one year. Participants will complete questionnaires administered by study staff during two in-person visits (a screening/enrollment visit, and an end of study visit after 52 weeks of method use or at discontinuation) and four phone appointments (at 4, 12, 24, and 36 weeks of use). We will evaluate used rings for discoloration and residual drug levels. The qualitative component involve in-depth interviews with women in the clinical study, their sexual partners, and their service providers, to further examine drivers of and barriers to interest in and use of contraceptive vaginal rings.</p><p><strong>Discussion: </strong>This study will explore acceptability of contraceptive vaginal rings in 'real-world' contraceptive service settings in two African countries. Findings will be based on actual ring use and contextualized via comparison to two other commonly available methods. As vaginal rings are being considered for multiple reproductive health indications, this work can fill key knowledge gaps and empower decision-makers with information needed to inform future investments in reproductive health.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"9 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Design and validation of a low-cost sugar-feeder for resource-poor insectaries.
Pub Date : 2025-03-03 eCollection Date: 2025-01-01 DOI: 10.12688/gatesopenres.16314.1
Zachary Thomas Stavrou-Dowd, Clair Rose, Álvaro Acosta-Serrano, Lee Rafuse Haines

Background: The emergence of insecticide resistance in insects has led researchers to develop new control tools so that historic gains made in reducing disease transmission are not lost. Attractive targeted sugar baits (ATSBs) are a vector control tool being widely trialled to target insects that feed on plant sugars and blood. We designed a field-friendly, economical and more environmentally responsible sugar feeder for maintaining mosquito colonies and screening potential ATSB candidates.

Methods: We simultaneously tested, in both male and female Anopheles gambiae mosquitoes, the effect of adding three water-soluble medical and food dyes (Allura Red, fluorescein and tartrazine) to the sugar solution to identify those insects that had ingested sugar from the feeder. To test feeder efficacy to deliver a toxic substance, we assessed the killing using boric acid, which kills both male and female mosquitoes when ingested. Using microscopy techniques compatible with fieldwork, including the use of a mobile phone camera, we documented the efficacy and tissue specificity of the dyes on mosquitoes after they were continuously fed dyed sugar solutions.

Results: The easy-to-construct sugar feeder is an economical option for testing the efficacy of ATSB components on Anopheles gambiae mosquitoes . Allura Red AC was the preferred dye as it has low toxicity to mosquitoes and allows the researcher to quickly visualise the imbibed sugar meal within the abdomen. Feeding 1% fluorescein dye, but not 0.1%, for longer than five days induced systemic dye distribution, where the mosquito's wing veins, antennae and legs brightly fluoresced when examined by a handheld black light torch (395-400nm emission).

Discussion: Developing an affordable sugar feeder to maintain insectary-reared insects and test the efficacy of ATSB candidates involves designing a dye-labelled sugar bait station that is of low-toxicity, reusable and easy to construct using components available in low resource settings such as field stations.

{"title":"Design and validation of a low-cost sugar-feeder for resource-poor insectaries.","authors":"Zachary Thomas Stavrou-Dowd, Clair Rose, Álvaro Acosta-Serrano, Lee Rafuse Haines","doi":"10.12688/gatesopenres.16314.1","DOIUrl":"10.12688/gatesopenres.16314.1","url":null,"abstract":"<p><strong>Background: </strong>The emergence of insecticide resistance in insects has led researchers to develop new control tools so that historic gains made in reducing disease transmission are not lost. Attractive targeted sugar baits (ATSBs) are a vector control tool being widely trialled to target insects that feed on plant sugars and blood. We designed a field-friendly, economical and more environmentally responsible sugar feeder for maintaining mosquito colonies and screening potential ATSB candidates.</p><p><strong>Methods: </strong>We simultaneously tested, in both male and female <i>Anopheles gambiae</i> mosquitoes, the effect of adding three water-soluble medical and food dyes (Allura Red, fluorescein and tartrazine) to the sugar solution to identify those insects that had ingested sugar from the feeder. To test feeder efficacy to deliver a toxic substance, we assessed the killing using boric acid, which kills both male and female mosquitoes when ingested. Using microscopy techniques compatible with fieldwork, including the use of a mobile phone camera, we documented the efficacy and tissue specificity of the dyes on mosquitoes after they were continuously fed dyed sugar solutions.</p><p><strong>Results: </strong>The easy-to-construct sugar feeder is an economical option for testing the efficacy of ATSB components on <i>Anopheles gambiae</i> mosquitoes <i>.</i> Allura Red AC was the preferred dye as it has low toxicity to mosquitoes and allows the researcher to quickly visualise the imbibed sugar meal within the abdomen. Feeding 1% fluorescein dye, but not 0.1%, for longer than five days induced systemic dye distribution, where the mosquito's wing veins, antennae and legs brightly fluoresced when examined by a handheld black light torch (395-400nm emission).</p><p><strong>Discussion: </strong>Developing an affordable sugar feeder to maintain insectary-reared insects and test the efficacy of ATSB candidates involves designing a dye-labelled sugar bait station that is of low-toxicity, reusable and easy to construct using components available in low resource settings such as field stations.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"9 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Developing and evaluating human-centered design solutions for enhancing maternal health service utilization among vulnerable pregnant women in Oromia, Ethiopia: Study protocol for a quasi-experimental study. 制定和评估以人为本的设计解决方案,以提高埃塞俄比亚奥罗米亚弱势孕妇对孕产妇保健服务的利用:准实验研究的研究方案。
Pub Date : 2025-02-21 eCollection Date: 2024-01-01 DOI: 10.12688/gatesopenres.16277.2
Bee-Ah Kang, Habtamu Tamene, Yihunie Lakew, Daryl Stephens, Rajiv Rimal

Background: Disproportionate uptake of and access to maternal and child health services remain significant challenges across and within countries. Differing geographic, economic, environmental, and social factors contribute to varying degrees of vulnerabilities among individuals, which manifest as disparities in maternal and newborn health outcomes. Designing solutions according to need is vital to improve maternal and child health outcomes. In this paper, we describe our study protocol on developing and evaluating the effectiveness of human-centered design (HCD) solutions to improve maternal health service uptake among vulnerable pregnant women in rural areas of Ethiopia.

Methods: The study has two distinct phases. In Phase 1, HCD solutions were developed through co-design workshops with vulnerable pregnant women and key stakeholders. Final solutions included home visit education, audio programs promoting couple discussion, and print materials, implemented in collaboration with community health workers and health officers. A community-based, quasi-experimental, mixed-method study design was used to assess differences between intervention and control arms. A panel sample was enrolled after screening for pregnancy and vulnerability level and surveyed at baseline and midline in Phase 1. Phase 2 adopts an identical design approach with a focus on refining Phase 1 solutions. Newly recruited pregnant women will receive refined solutions for six months, which will be evaluated using post-only end-line surveys and in-depth interviews.

Conclusions and implications: Our sequential approach to evaluating initial solutions, which in turn will inform the enhancement of solutions, will provide practical insights into how solutions are accepted among vulnerable women and how they can be better integrated into women's lives and health systems. This will inform equity-focused practice and policies targeting populations experiencing greater barriers to accessing care and provide insights into system strengthening in rural areas. Our findings will be disseminated to the Ethiopian Ministry of Health and its partners to inform large-scale implementation at the national level.

背景:在各国之间和国家内部,孕产妇和儿童保健服务的接受和获取比例失调仍然是一项重大挑战。不同的地理、经济、环境和社会因素造成了个人不同程度的脆弱性,表现为孕产妇和新生儿健康结果的差异。根据需求设计解决方案对于改善孕产妇和儿童的健康状况至关重要。本文介绍了我们的研究方案,即开发和评估以人为本的设计(HCD)解决方案的有效性,以改善埃塞俄比亚农村地区弱势孕妇对孕产妇保健服务的接受程度:在不同国家和国家内部,孕产妇和儿童保健服务的使用率和获得率不均衡仍然是一项重大挑战。不同的地理、经济、环境和社会因素造成了个人不同程度的脆弱性,表现为孕产妇和新生儿健康结果的差异。根据需求设计解决方案对于改善孕产妇和儿童的健康状况至关重要。本文介绍了我们的研究方案,即开发和评估以人为本的设计(HCD)解决方案的有效性,以改善埃塞俄比亚农村地区弱势孕妇对孕产妇保健服务的接受程度:我们对初步解决方案进行评估的循序渐进的方法,反过来又将为改进解决方案提供信息,这将为了解弱势妇女如何接受解决方案以及如何将其更好地融入妇女的生活和医疗系统提供实用的见解。这将为以公平为重点的实践和政策提供信息,这些实践和政策的目标人群在获得医疗服务方面面临着更大的障碍,并为加强农村地区的医疗系统提供启示。我们的研究结果将分发给埃塞俄比亚卫生部及其合作伙伴,为在国家一级大规模实施提供信息。
{"title":"Developing and evaluating human-centered design solutions for enhancing maternal health service utilization among vulnerable pregnant women in Oromia, Ethiopia: Study protocol for a quasi-experimental study.","authors":"Bee-Ah Kang, Habtamu Tamene, Yihunie Lakew, Daryl Stephens, Rajiv Rimal","doi":"10.12688/gatesopenres.16277.2","DOIUrl":"10.12688/gatesopenres.16277.2","url":null,"abstract":"<p><strong>Background: </strong>Disproportionate uptake of and access to maternal and child health services remain significant challenges across and within countries. Differing geographic, economic, environmental, and social factors contribute to varying degrees of vulnerabilities among individuals, which manifest as disparities in maternal and newborn health outcomes. Designing solutions according to need is vital to improve maternal and child health outcomes. In this paper, we describe our study protocol on developing and evaluating the effectiveness of human-centered design (HCD) solutions to improve maternal health service uptake among vulnerable pregnant women in rural areas of Ethiopia.</p><p><strong>Methods: </strong>The study has two distinct phases. In Phase 1, HCD solutions were developed through co-design workshops with vulnerable pregnant women and key stakeholders. Final solutions included home visit education, audio programs promoting couple discussion, and print materials, implemented in collaboration with community health workers and health officers. A community-based, quasi-experimental, mixed-method study design was used to assess differences between intervention and control arms. A panel sample was enrolled after screening for pregnancy and vulnerability level and surveyed at baseline and midline in Phase 1. Phase 2 adopts an identical design approach with a focus on refining Phase 1 solutions. Newly recruited pregnant women will receive refined solutions for six months, which will be evaluated using post-only end-line surveys and in-depth interviews.</p><p><strong>Conclusions and implications: </strong>Our sequential approach to evaluating initial solutions, which in turn will inform the enhancement of solutions, will provide practical insights into how solutions are accepted among vulnerable women and how they can be better integrated into women's lives and health systems. This will inform equity-focused practice and policies targeting populations experiencing greater barriers to accessing care and provide insights into system strengthening in rural areas. Our findings will be disseminated to the Ethiopian Ministry of Health and its partners to inform large-scale implementation at the national level.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"93"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Automated post-run analysis of arrayed quantitative PCR amplification curves using machine learning.
Pub Date : 2025-01-20 eCollection Date: 2025-01-01 DOI: 10.12688/gatesopenres.16313.1
Ben J Brintz, Darwin J Operario, David Garrett Brown, Shanrui Wu, Lan Wang, Eric R Houpt, Daniel T Leung, Jie Liu, James A Platts-Mills

Background: The TaqMan Array Card (TAC) is an arrayed, high-throughput qPCR platform that can simultaneously detect multiple targets in a single reaction. However, the manual post-run analysis of TAC data is time consuming and subject to interpretation. We sought to automate the post-run analysis of TAC data using machine learning models.

Methods: We used 165,214 qPCR amplification curves from two studies to train and test two eXtreme Gradient Boosting (XGBoost) models. Previous manual analyses of the amplification curves by experts in qPCR analysis were used as the gold standard. First, a classification model predicted whether amplification occurred or not, and if so, a second model predicted the cycle threshold (Ct) value. We used 5-fold cross-validation to tune the models and assessed performance using accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and mean absolute error (MAE). For external validation, we used 1,472 reactions previously analyzed by 17 laboratory scientists as part of an external quality assessment for a multisite study.

Results: In internal validation, the classification model achieved an accuracy of 0.996, sensitivity of 0.997, specificity of 0.993, PPV of 0.998, and NPV of 0.991. The Ct prediction model achieved a MAE of 0.590. In external validation, the automated analysis achieved an accuracy of 0.997 and a MAE of 0.611, and the automated analysis was more accurate than manual analyses by 14 of the 17 laboratory scientists.

Conclusions: We automated the post-run analysis of highly-arrayed qPCR data using machine learning models with high accuracy in comparison to a manual gold standard. This approach has the potential to save time and improve reproducibility in laboratories using the TAC platform and other high-throughput qPCR approaches.

{"title":"Automated post-run analysis of arrayed quantitative PCR amplification curves using machine learning.","authors":"Ben J Brintz, Darwin J Operario, David Garrett Brown, Shanrui Wu, Lan Wang, Eric R Houpt, Daniel T Leung, Jie Liu, James A Platts-Mills","doi":"10.12688/gatesopenres.16313.1","DOIUrl":"10.12688/gatesopenres.16313.1","url":null,"abstract":"<p><strong>Background: </strong>The TaqMan Array Card (TAC) is an arrayed, high-throughput qPCR platform that can simultaneously detect multiple targets in a single reaction. However, the manual post-run analysis of TAC data is time consuming and subject to interpretation. We sought to automate the post-run analysis of TAC data using machine learning models.</p><p><strong>Methods: </strong>We used 165,214 qPCR amplification curves from two studies to train and test two eXtreme Gradient Boosting (XGBoost) models. Previous manual analyses of the amplification curves by experts in qPCR analysis were used as the gold standard. First, a classification model predicted whether amplification occurred or not, and if so, a second model predicted the cycle threshold (Ct) value. We used 5-fold cross-validation to tune the models and assessed performance using accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and mean absolute error (MAE). For external validation, we used 1,472 reactions previously analyzed by 17 laboratory scientists as part of an external quality assessment for a multisite study.</p><p><strong>Results: </strong>In internal validation, the classification model achieved an accuracy of 0.996, sensitivity of 0.997, specificity of 0.993, PPV of 0.998, and NPV of 0.991. The Ct prediction model achieved a MAE of 0.590. In external validation, the automated analysis achieved an accuracy of 0.997 and a MAE of 0.611, and the automated analysis was more accurate than manual analyses by 14 of the 17 laboratory scientists.</p><p><strong>Conclusions: </strong>We automated the post-run analysis of highly-arrayed qPCR data using machine learning models with high accuracy in comparison to a manual gold standard. This approach has the potential to save time and improve reproducibility in laboratories using the TAC platform and other high-throughput qPCR approaches.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"9 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Open Letter on Advancing HIV prevention: Augmenting an ecosystem-based approach to understand prevention decision-making.
Pub Date : 2025-01-13 eCollection Date: 2024-01-01 DOI: 10.12688/gatesopenres.16067.2
Nishan Gantayat, James Baer, Alok Gangaramany, Rosemary Pierce-Messick

In the last two decades, HIV programs have been able to avert millions of AIDS-related deaths and reduce HIV incidence. However, the 1.3 million new HIV infections in 2022 remain significantly above the UNAIDS target of fewer than 370,000 new infections by 2025. HIV programs worldwide also did not achieve the UN's 90-90-90 target for testing and treatment set for 2020. Within this broader picture, HIV continues to disproportionately affect key and at-risk populations, including gay men and other men who have sex with men, female sex workers, and adolescent girls and young women. As HIV incidence declines and biomedical advances continue, it will become critical for public-health practitioners to reach key and at-risk populations with prevention services and limit primary transmission. In this Open Letter, we focus on factors that influence uptake of HIV prevention products and thereby demand for HIV prevention products and services. These factors exist at three levels of the decision-making ecosystem - the individual level, interaction level and systemic level. We argue that approaching HIV prevention solely through the lens of these levels creates a static view of prevention decision-making. There is a need instead for a dynamic viewpoint that can mirror the changing contexts in which users find themselves and make prevention decisions. We demonstrate that the current ecosystem viewpoint is useful to understand the gaps that exist in program implementation, but does not provide adequate insights into the underlying behaviors that contribute to these gaps. To address this, we suggest an approach to include dynamic aspects of decision-making with factors that influence the individual's assessment of risk, their evaluation of the opportunities to use HIV prevention, and their effective use of prevention products.

{"title":"An Open Letter on Advancing HIV prevention: Augmenting an ecosystem-based approach to understand prevention decision-making.","authors":"Nishan Gantayat, James Baer, Alok Gangaramany, Rosemary Pierce-Messick","doi":"10.12688/gatesopenres.16067.2","DOIUrl":"10.12688/gatesopenres.16067.2","url":null,"abstract":"<p><p>In the last two decades, HIV programs have been able to avert millions of AIDS-related deaths and reduce HIV incidence. However, the 1.3 million new HIV infections in 2022 remain significantly above the UNAIDS target of fewer than 370,000 new infections by 2025. HIV programs worldwide also did not achieve the UN's 90-90-90 target for testing and treatment set for 2020. Within this broader picture, HIV continues to disproportionately affect key and at-risk populations, including gay men and other men who have sex with men, female sex workers, and adolescent girls and young women. As HIV incidence declines and biomedical advances continue, it will become critical for public-health practitioners to reach key and at-risk populations with prevention services and limit primary transmission. In this Open Letter, we focus on factors that influence uptake of HIV prevention products and thereby demand for HIV prevention products and services. These factors exist at three levels of the decision-making ecosystem - the individual level, interaction level and systemic level. We argue that approaching HIV prevention solely through the lens of these levels creates a static view of prevention decision-making. There is a need instead for a dynamic viewpoint that can mirror the changing contexts in which users find themselves and make prevention decisions. We demonstrate that the current ecosystem viewpoint is useful to understand the gaps that exist in program implementation, but does not provide adequate insights into the underlying behaviors that contribute to these gaps. To address this, we suggest an approach to include dynamic aspects of decision-making with factors that influence the individual's assessment of risk, their evaluation of the opportunities to use HIV prevention, and their effective use of prevention products.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"73"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An exploration of unusual antimicrobial resistance phenotypes in Salmonella Typhi from Blantyre, Malawi reveals the ongoing role of IncHI1 plasmids. 对来自马拉维布兰太尔的伤寒沙门氏菌不寻常的抗菌素耐药性表型的探索揭示了IncHI1质粒的持续作用。
Pub Date : 2024-12-23 eCollection Date: 2024-01-01 DOI: 10.12688/gatesopenres.16311.1
Allan Zuza, Alexander M Wailan, Catherine Anscombe, Nicholas A Feasey, Eva Heinz

Typhoid fever is a significant public health problem endemic in Southeast Asia and Sub-Saharan Africa. Antimicrobial treatment of typhoid is however threatened by the increasing prevalence of antimicrobial resistant (AMR) S. Typhi, especially in the globally successful lineage (4.3.1) which has rapidly spread in East and Southern Africa. AMR elements can be found either on plasmids or in one of the three chromosomal integration sites, and there is variability of this across the lineage. Several previous studies with Malawian isolates indicated a clonal, locally spreading lineage with chromosomally integrated resistance genes. In a recent study however we noted three isolates with predicted resistance genes unusual for the region, and we here present the resolved genomes of these isolates using long- and short-read sequencing. Our work shows that these isolates are potentially imported cases, most closely related to the recently described sub-lineage 4.3.1.EA1, although they encode IncHI1 plasmids with reduced resistance gene repertoire compared to the main IncHI1 plasmids spreading in East Africa. Similar reduced plasmids were reported in a recent large-scale study in five isolates from Tanzania, highlighting the urgency for better coverage of the African continent in genome studies to better understand the dynamics of these potentially co-circulating plasmids.

伤寒是东南亚和撒哈拉以南非洲流行的一个重大公共卫生问题。然而,伤寒的抗菌素治疗受到抗微生物药物耐药性(AMR)伤寒沙门氏菌日益流行的威胁,特别是在东非和南部非洲迅速蔓延的全球成功谱系(4.3.1)中。AMR元件既可以在质粒上发现,也可以在三个染色体整合位点之一上发现,并且在整个谱系中存在可变性。先前对马拉维分离株的几项研究表明,这是一种具有染色体整合抗性基因的克隆性、局部传播谱系。然而,在最近的一项研究中,我们注意到三个分离株具有该地区不寻常的预测抗性基因,我们在这里使用长读和短读测序提出了这些分离株的解析基因组。我们的工作表明,这些分离株可能是输入性病例,与最近描述的亚谱系4.3.1最密切相关。尽管与在东非传播的主要IncHI1质粒相比,它们编码的IncHI1质粒抗性基因库较少。最近在坦桑尼亚的5个分离株中进行的一项大规模研究报告了类似的减少质粒,这突出了在基因组研究中更好地覆盖非洲大陆的紧迫性,以便更好地了解这些可能共同循环的质粒的动态。
{"title":"An exploration of unusual antimicrobial resistance phenotypes in Salmonella Typhi from Blantyre, Malawi reveals the ongoing role of IncHI1 plasmids.","authors":"Allan Zuza, Alexander M Wailan, Catherine Anscombe, Nicholas A Feasey, Eva Heinz","doi":"10.12688/gatesopenres.16311.1","DOIUrl":"10.12688/gatesopenres.16311.1","url":null,"abstract":"<p><p>Typhoid fever is a significant public health problem endemic in Southeast Asia and Sub-Saharan Africa. Antimicrobial treatment of typhoid is however threatened by the increasing prevalence of antimicrobial resistant (AMR) <i>S.</i> Typhi, especially in the globally successful lineage (4.3.1) which has rapidly spread in East and Southern Africa. AMR elements can be found either on plasmids or in one of the three chromosomal integration sites, and there is variability of this across the lineage. Several previous studies with Malawian isolates indicated a clonal, locally spreading lineage with chromosomally integrated resistance genes. In a recent study however we noted three isolates with predicted resistance genes unusual for the region, and we here present the resolved genomes of these isolates using long- and short-read sequencing. Our work shows that these isolates are potentially imported cases, most closely related to the recently described sub-lineage 4.3.1.EA1, although they encode IncHI1 plasmids with reduced resistance gene repertoire compared to the main IncHI1 plasmids spreading in East Africa. Similar reduced plasmids were reported in a recent large-scale study in five isolates from Tanzania, highlighting the urgency for better coverage of the African continent in genome studies to better understand the dynamics of these potentially co-circulating plasmids.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"143"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Supporting contraceptive self-care and reproductive empowerment with a digital health game in Barbados: Development and Pre-implementation study for What's My Method?
Pub Date : 2024-11-21 eCollection Date: 2024-01-01 DOI: 10.12688/gatesopenres.15376.2
Elena Bertozzi, Clara Bertozzi-Villa, Erin Sabato, Nicole Alleyne, Sonia Watson-Miller, Tiffany Jordan, Anderson Langdon

Effective contraceptive education is essential to reducing unwanted pregnancy, increasing uptake of modern contraceptive methods, and thoughtfully planning desired births. New World Health Organization (WHO) and family planning organization guidelines recommend situating contraceptive education and counseling within a broader context of self-care that emphasizes individual agency and reproductive empowerment. Digital health interventions, and games for health specifically, have been validated as effective and scalable tools for self-guided and interactive health education, especially among younger tech-savvy individuals. Barbados currently supplements provider-based contraceptive counseling with analog materials (pamphlets and posters) and informational videos that play on a screen in the waiting room. As part of an implementation framework, this study seeks to conduct a formative evaluation of the What's My Method? (WMM) game intervention as a tool to support contraceptive counseling and increase reproductive empowerment among childbearing persons in Barbados. We test-deployed the WMM game in Bridgetown, Barbados, conducting playtests and unstructured discussions with prototypes of the WMM game among three groups of stakeholders (youth contraception ambassadors: n=8; healthcare providers: n=7; and nursing students: n=27) to determine acceptability of the intervention, efficacy of the game as a learning tool, and willingness to adopt the tool in their healthcare context. Feedback on acceptability of the game was largely positive. Detailed constructive comments informed modifications and improvements to the game. The questionnaire used to assess contraceptive knowledge gain did not prove effective. Results indicate that the WMM game is well-received and accepted by the healthcare professionals who would be deploying it. This pilot testing has informed the design of the modified WMM for a randomized controlled trial (RCT) to test the deployment of the game in a healthcare setting.

{"title":"Supporting contraceptive self-care and reproductive empowerment with a digital health game in Barbados: Development and Pre-implementation study for What's My Method?","authors":"Elena Bertozzi, Clara Bertozzi-Villa, Erin Sabato, Nicole Alleyne, Sonia Watson-Miller, Tiffany Jordan, Anderson Langdon","doi":"10.12688/gatesopenres.15376.2","DOIUrl":"10.12688/gatesopenres.15376.2","url":null,"abstract":"<p><p>Effective contraceptive education is essential to reducing unwanted pregnancy, increasing uptake of modern contraceptive methods, and thoughtfully planning desired births. New World Health Organization (WHO) and family planning organization guidelines recommend situating contraceptive education and counseling within a broader context of self-care that emphasizes individual agency and reproductive empowerment. Digital health interventions, and games for health specifically, have been validated as effective and scalable tools for self-guided and interactive health education, especially among younger tech-savvy individuals. Barbados currently supplements provider-based contraceptive counseling with analog materials (pamphlets and posters) and informational videos that play on a screen in the waiting room. As part of an implementation framework, this study seeks to conduct a formative evaluation of the What's My Method? (WMM) game intervention as a tool to support contraceptive counseling and increase reproductive empowerment among childbearing persons in Barbados. We test-deployed the WMM game in Bridgetown, Barbados, conducting playtests and unstructured discussions with prototypes of the WMM game among three groups of stakeholders (youth contraception ambassadors: n=8; healthcare providers: n=7; and nursing students: n=27) to determine acceptability of the intervention, efficacy of the game as a learning tool, and willingness to adopt the tool in their healthcare context. Feedback on acceptability of the game was largely positive. Detailed constructive comments informed modifications and improvements to the game. The questionnaire used to assess contraceptive knowledge gain did not prove effective. Results indicate that the WMM game is well-received and accepted by the healthcare professionals who would be deploying it. This pilot testing has informed the design of the modified WMM for a randomized controlled trial (RCT) to test the deployment of the game in a healthcare setting.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"47"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Developing a framework for understanding policy decision-making behaviors in the transition of an HIV prevention program towards sustainability: a case study from Zambia's voluntary medical male circumcision program. 为理解艾滋病预防计划向可持续性过渡过程中的政策决策行为制定一个框架:赞比亚自愿性包皮环切医疗计划案例研究。
Pub Date : 2024-11-21 eCollection Date: 2024-01-01 DOI: 10.12688/gatesopenres.15189.2
Nishan Gantayat, James Baer, Alok Gangaramany, Steve Kretschmer, Rasi Surana, Alick Samona, Njekwa Mukamba, Bright Jere, Tina Chinsenga, Ram Prasad, Stephen Goetschius, Saransh Sharma

Faced with declining donor funding for HIV, low- and middle-income countries must identify efficient and cost-effective ways to integrate HIV prevention programs into public health systems for long-term sustainability. In Zambia, donor support to the voluntary medical male circumcision (VMMC) program, which previously funded non-governmental organizations as implementing partners, is increasingly being directed through government structures instead. We developed a framework to understand how the behaviors of individual decision-makers within the government could be barriers to this transition. We interviewed key stakeholders from the national, provincial, and district levels of the Ministry of Health, and from donors and partners funding and implementing Zambia's VMMC program, exploring the decisions required to attain a sustainable VMMC program and the behavioral dynamics involved at personal and institutional levels. Using pattern identification and theme matching to analyze the content of the responses, we derived three core decision-making phases in the transition to a sustainable VMMC program: 1) developing an alternative funding strategy, 2) developing a policy for early-infant (0-2 months) and early-adolescent (15-17 years) male circumcision, which is crucial to sustainable HIV prevention; and 3) identifying integrated and efficient implementation models. We formulated a framework showing how, in each phase, a range of behavioral dynamics can form barriers that hinder effective decision-making among stakeholders at the same level (e.g., national ministries and donors) or across levels (e.g., national, provincial and district). Our research methodology and the resulting framework offer a systematic approach for in-depth investigations into organizational decision-making in public health programs, as well as development programs beyond VMMC and HIV prevention. It provides the insights necessary to map organizational development and policy-making transition plans to sustainability, by explaining tangible factors such as organizational processes and systems, as well as intangibles such as the behaviors of policymakers and institutional actors.

面对艾滋病捐助资金的不断减少,中低收入国家必须找到高效且具有成本效益的方法,将艾滋病预防项目纳入公共卫生系统,以实现长期可持续性。在赞比亚,捐助方对自愿包皮环切术(VMMC)项目的支持以前是资助非政府组织作为实施伙伴,现在则越来越多地通过政府机构进行引导。我们制定了一个框架,以了解政府内部决策者的个人行为会如何阻碍这一转变。我们采访了卫生部在国家、省和地区层面的主要利益相关者,以及资助和实施赞比亚自愿监测和评价计划的捐助者和合作伙伴,探讨了实现可持续自愿监测和评价计划所需的决策,以及个人和机构层面的行为动态。利用模式识别和主题匹配来分析答复内容,我们得出了向可持续的自愿监测、评价和管理计划过渡的三个核心决策阶段:1)制定替代性筹资战略;2)制定婴儿早期(0-2 个月)和青少年早期(15-17 岁)包皮环切手术政策,这对可持续预防艾滋病至关重要;3)确定综合高效的实施模式。我们制定了一个框架,显示在每个阶段,一系列行为动态如何形成障碍,阻碍同一级别(如国家部委和捐助者)或跨级别(如国家、省和地区)利益相关者之间的有效决策。我们的研究方法和由此产生的框架为深入调查公共卫生项目中的组织决策提供了一种系统方法,也为 VMMC 和 HIV 预防以外的发展项目提供了一种系统方法。它通过解释组织流程和系统等有形因素以及决策者和机构参与者的行为等无形因素,为绘制组织发展和决策过渡计划的可持续性提供了必要的见解。
{"title":"Developing a framework for understanding policy decision-making behaviors in the transition of an HIV prevention program towards sustainability: a case study from Zambia's voluntary medical male circumcision program.","authors":"Nishan Gantayat, James Baer, Alok Gangaramany, Steve Kretschmer, Rasi Surana, Alick Samona, Njekwa Mukamba, Bright Jere, Tina Chinsenga, Ram Prasad, Stephen Goetschius, Saransh Sharma","doi":"10.12688/gatesopenres.15189.2","DOIUrl":"10.12688/gatesopenres.15189.2","url":null,"abstract":"<p><p>Faced with declining donor funding for HIV, low- and middle-income countries must identify efficient and cost-effective ways to integrate HIV prevention programs into public health systems for long-term sustainability. In Zambia, donor support to the voluntary medical male circumcision (VMMC) program, which previously funded non-governmental organizations as implementing partners, is increasingly being directed through government structures instead. We developed a framework to understand how the behaviors of individual decision-makers within the government could be barriers to this transition. We interviewed key stakeholders from the national, provincial, and district levels of the Ministry of Health, and from donors and partners funding and implementing Zambia's VMMC program, exploring the decisions required to attain a sustainable VMMC program and the behavioral dynamics involved at personal and institutional levels. Using pattern identification and theme matching to analyze the content of the responses, we derived three core decision-making phases in the transition to a sustainable VMMC program: 1) developing an alternative funding strategy, 2) developing a policy for early-infant (0-2 months) and early-adolescent (15-17 years) male circumcision, which is crucial to sustainable HIV prevention; and 3) identifying integrated and efficient implementation models. We formulated a framework showing how, in each phase, a range of behavioral dynamics can form barriers that hinder effective decision-making among stakeholders at the same level (e.g., national ministries and donors) or across levels (e.g., national, provincial and district). Our research methodology and the resulting framework offer a systematic approach for in-depth investigations into organizational decision-making in public health programs, as well as development programs beyond VMMC and HIV prevention. It provides the insights necessary to map organizational development and policy-making transition plans to sustainability, by explaining tangible factors such as organizational processes and systems, as well as intangibles such as the behaviors of policymakers and institutional actors.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial. 南非三个乡镇在校青少年的避孕知识和接受情况:Girls Achieve Power (GAP Year) Trial 的基线调查结果。
Pub Date : 2024-11-11 eCollection Date: 2022-01-01 DOI: 10.12688/gatesopenres.13636.2
Melanie Pleaner, Alison Kutywayo, Mags Beksinska, Khuthala Mabetha, Nicolette Naidoo, Saiqa Mullick

Background: South African adolescents experience barriers to sexual and reproductive health (SRH) knowledge and uptake. This study provides insight into contraceptive and other SRH service knowledge, perceptions, and uptake among adolescents in high HIV prevalence settings.

Methods: A baseline cross sectional survey was conducted among 3432 grade 8s enrolled into the Girls Achieve Power (GAP Year) trial from 26 public high schools across three South African townships (Soweto, Thembisa and Khayelitsha) (2017 - 2018). An interviewer-led survey collected information on SRH knowledge and perceptions; an audio computer-assisted self-interviewing technique gathered SRH service uptake. Descriptive analysis indicates frequency distribution of socio-demographics and knowledge, uptake and perceptions of SRH services. Chi-square test tested for associations between age and sex and selected variables that measure SRH knowledge and uptake.

Results: In total, 2383 participants completed both survey components. Of these, 63.1% (n=1504) were female and 81.4% (n=1938) aged 12-14. Almost a fifth (18.3%, n=436) had ever had sex and less than 1% had accessed SRH services in the last year. Of the 157 females who had ever had sex, 50.9% had ever used contraception. Of those who had sex in the last three months, 59.0% reported using a contraceptive method. Condom use was inconsistent: almost all females said they had not used or could not remember if a condom was used at last sex.

Conclusion: This paper contributes to the evidence strengthening learner SRH education, including the national Integrated School Health Programme. Key themes include the need for age-appropriate, differentiated comprehensive sexuality education (CSE) for the range of ages found in the same grade in South African schools. Education on different contraceptive methods, informed decision-making, and emergency contraception is key. School-based interventions should embrace integrated HIV, STI, and pregnancy prevention messages. Closer links with health services need to be constantly fostered and reinforced.

背景:南非青少年在性与生殖健康(SRH)知识的了解和接受方面存在障碍。本研究旨在深入了解艾滋病高发地区青少年对避孕药具和其他性与生殖健康服务的了解、认知和接受情况。研究方法在南非三个乡镇(索韦托、Thembisa 和 Khayelitsha)26 所公立高中的 3432 名八年级学生中开展了基线横断面调查(2017 - 2018 年)。由访谈员主导的调查收集了有关性健康和生殖健康知识及看法的信息;由计算机辅助的音频自我访谈技术收集了性健康和生殖健康服务的接受情况。描述性分析表明了社会人口统计学、性健康和生殖健康服务知识、接受情况和看法的频率分布。卡方检验测试了年龄和性别与衡量性健康和生殖健康知识和接受程度的选定变量之间的关联。结果共有 2383 名学生完成了两项调查内容。其中,63.1%(n=1504)为女性,81.4%(n=1938)年龄在 12-14 岁之间。近五分之一(18.3%,n=436)的学生有过性行为,不到 1%的学生在过去一年中接受过性健康和生殖健康服务。在 157 名曾经有过性行为的女性中,50.9%曾经使用过避孕措施。在最近三个月内有过性行为的女性中,59.0%的人表示使用过避孕方法。避孕套的使用情况并不一致:几乎所有女性都说她们没有使用过或记不清上次性生活时是否使用过避孕套。结论本文有助于加强学习者性健康和生殖健康教育的证据,包括国家综合学校健康计划。关键主题包括:需要针对南非学校同一年级的不同年龄段,开展与年龄相适应的、有区别的全面性教育(CSE)。关于不同避孕方法、知情决策和紧急避孕的教育是关键。以学校为基础的干预措施应包含预防艾滋病毒、性传播感染和怀孕的综合信息。需要不断促进和加强与保健服务机构的密切联系。
{"title":"Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial.","authors":"Melanie Pleaner, Alison Kutywayo, Mags Beksinska, Khuthala Mabetha, Nicolette Naidoo, Saiqa Mullick","doi":"10.12688/gatesopenres.13636.2","DOIUrl":"10.12688/gatesopenres.13636.2","url":null,"abstract":"<p><strong>Background: </strong>South African adolescents experience barriers to sexual and reproductive health (SRH) knowledge and uptake. This study provides insight into contraceptive and other SRH service knowledge, perceptions, and uptake among adolescents in high HIV prevalence settings.</p><p><strong>Methods: </strong>A baseline cross sectional survey was conducted among 3432 grade 8s enrolled into the Girls Achieve Power (GAP Year) trial from 26 public high schools across three South African townships (Soweto, Thembisa and Khayelitsha) (2017 - 2018). An interviewer-led survey collected information on SRH knowledge and perceptions; an audio computer-assisted self-interviewing technique gathered SRH service uptake. Descriptive analysis indicates frequency distribution of socio-demographics and knowledge, uptake and perceptions of SRH services. Chi-square test tested for associations between age and sex and selected variables that measure SRH knowledge and uptake.</p><p><strong>Results: </strong>In total, 2383 participants completed both survey components. Of these, 63.1% (n=1504) were female and 81.4% (n=1938) aged 12-14. Almost a fifth (18.3%, n=436) had ever had sex and less than 1% had accessed SRH services in the last year. Of the 157 females who had ever had sex, 50.9% had ever used contraception. Of those who had sex in the last three months, 59.0% reported using a contraceptive method. Condom use was inconsistent: almost all females said they had not used or could not remember if a condom was used at last sex.</p><p><strong>Conclusion: </strong>This paper contributes to the evidence strengthening learner SRH education, including the national Integrated School Health Programme. Key themes include the need for age-appropriate, differentiated comprehensive sexuality education (CSE) for the range of ages found in the same grade in South African schools. Education on different contraceptive methods, informed decision-making, and emergency contraception is key. School-based interventions should embrace integrated HIV, STI, and pregnancy prevention messages. Closer links with health services need to be constantly fostered and reinforced.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"6 ","pages":"67"},"PeriodicalIF":0.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10213203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9546461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Using models and maps to inform Target Product Profiles and Preferred Product Characteristics: the example of Wolbachia replacement. 利用模型和地图为 "目标产品简介 "和 "首选产品特征 "提供信息:以 Wolbachia 替代品为例。
Pub Date : 2024-10-31 eCollection Date: 2023-01-01 DOI: 10.12688/gatesopenres.14300.3
Katie Tiley, Julian Entwistle, Bruce Thomas, Laith Yakob, Oliver Brady

Background: The global prevalence of diseases transmitted by Aedes aegypti mosquitoes, such as dengue, Zika and Yellow Fever, is increasing, but development of promising new mosquito control technologies could reverse this trend. Target Product Profiles (TPPs) and Preferred Product Characteristics (PPCs) documents issued by the World Health Organization can guide the research and development pathways of new products and product combinations transitioning from proof of concept to operational use.

Methods: We used high resolution global maps of the case and economic burden of dengue to derive programmatic cost targets to support a TPP for Wolbachia replacement. A compartmental entomological model was used to explore how release size, spacing and timing affect replacement speed and acceptability. To support a PPC for a hybrid suppress-then-replace approach we tested whether Wolbachia replacement could be achieved faster, more acceptably or at a lower cost if preceded by a mosquito suppression programme.

Results: We show how models can reveal trade-offs, identify quantitative thresholds and prioritise areas and intervention strategies for further development. We estimate that for Wolbachia replacement to be deployable in enough areas to make major contributions to reducing global dengue burden by 25% (in line with 2030 WHO targets), it must have the potential for cost to be reduced to between $7.63 and $0.24 (USD) per person protected or less. Suppression can reduce the number of Wolbachia mosquitoes necessary to achieve replacement fixation by up to 80%. A hybrid approach can also achieve fixation faster and potentially improve acceptability, but may not justify their cost if they require major new investments in suppression technologies.

Conclusions: Here we demonstrate the value dedicated modelling can provide for interdisciplinary groups of experts when developing TPPs and PPCs. These models could be used by product developers to prioritise and shape development decisions for new Wolbachia replacement products.

背景:登革热、寨卡病和黄热病等由埃及伊蚊传播的疾病在全球的流行率正在上升,但开发前景广阔的新型灭蚊技术可以扭转这一趋势。世界卫生组织发布的目标产品简介(TPPs)和首选产品特征(PPCs)文件可以指导新产品和产品组合从概念验证过渡到实际使用的研发途径:方法:我们利用登革热病例和经济负担的高分辨率全球地图,得出支持沃尔巴克氏菌替代品技术方案的计划成本目标。方法:我们利用全球登革热病例和经济负担的分辨率地图,得出了支持沃尔巴克氏体替代技术方案的计划成本目标,并利用分区昆虫学模型探讨了释放规模、间隔和时机如何影响替代速度和可接受性。为了支持 "先抑制后替代 "混合方法的方案规划,我们测试了如果先实施蚊虫抑制计划,是否能以更快、更可接受或更低的成本实现沃尔巴克氏体替代:结果:我们展示了模型是如何揭示权衡、确定定量阈值并为进一步发展确定优先领域和干预策略的。我们估计,若要在足够多的地区部署沃尔巴克氏菌替代品,为将全球登革热负担降低 25%(符合 2030 年世界卫生组织的目标)做出重大贡献,就必须有可能将每名受保护者的成本降至 7.63 美元至 0.24 美元(USD)或更低。抑制可将实现替代固定所需的沃尔巴克氏体蚊子数量减少高达 80%。混合方法也可以更快地实现固定,并有可能提高可接受性,但如果需要对抑制技术进行大量新投资,则可能无法证明其成本合理:在此,我们展示了在开发 TPP 和 PPC 时,专门建模可为跨学科专家组提供的价值。产品开发商可利用这些模型来确定新的沃尔巴克氏体替代产品开发的优先次序和决策。
{"title":"Using models and maps to inform Target Product Profiles and Preferred Product Characteristics: the example of <i>Wolbachia</i> replacement.","authors":"Katie Tiley, Julian Entwistle, Bruce Thomas, Laith Yakob, Oliver Brady","doi":"10.12688/gatesopenres.14300.3","DOIUrl":"https://doi.org/10.12688/gatesopenres.14300.3","url":null,"abstract":"<p><strong>Background: </strong>The global prevalence of diseases transmitted by <i>Aedes aegypti</i> mosquitoes, such as dengue, Zika and Yellow Fever, is increasing, but development of promising new mosquito control technologies could reverse this trend. Target Product Profiles (TPPs) and Preferred Product Characteristics (PPCs) documents issued by the World Health Organization can guide the research and development pathways of new products and product combinations transitioning from proof of concept to operational use.</p><p><strong>Methods: </strong>We used high resolution global maps of the case and economic burden of dengue to derive programmatic cost targets to support a TPP for <i>Wolbachia</i> replacement. A compartmental entomological model was used to explore how release size, spacing and timing affect replacement speed and acceptability. To support a PPC for a hybrid suppress-then-replace approach we tested whether <i>Wolbachia</i> replacement could be achieved faster, more acceptably or at a lower cost if preceded by a mosquito suppression programme.</p><p><strong>Results: </strong>We show how models can reveal trade-offs, identify quantitative thresholds and prioritise areas and intervention strategies for further development. We estimate that for <i>Wolbachia</i> replacement to be deployable in enough areas to make major contributions to reducing global dengue burden by 25% (in line with 2030 WHO targets), it must have the potential for cost to be reduced to between $7.63 and $0.24 (USD) per person protected or less. Suppression can reduce the number of <i>Wolbachia</i> mosquitoes necessary to achieve replacement fixation by up to 80%. A hybrid approach can also achieve fixation faster and potentially improve acceptability, but may not justify their cost if they require major new investments in suppression technologies.</p><p><strong>Conclusions: </strong>Here we demonstrate the value dedicated modelling can provide for interdisciplinary groups of experts when developing TPPs and PPCs. These models could be used by product developers to prioritise and shape development decisions for new <i>Wolbachia</i> replacement products.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"7 ","pages":"68"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Gates Open Research
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1