Aims: This study aims to evaluate the exposure-efficacy relationship of nilotinib and longitudinal BCR::ABL1 levels in patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukaemia in chronic phase (CML-CP) and those who are imatinib-resistant or intolerant using a semimechanistic disease model.
Methods: The analysis included 489 CML-CP patients from 3 nilotinib trials (NCT00109707; NCT00471497; NCT01043874) with duration of follow-up ranging from 2 to 9 years. The semimechanistic disease model of CML-CP consisted of quiescent leukaemic stem cells, proliferating drug-susceptible and -resistant bone marrow cells.
Background: There is widespread enthusiasm for scaling interventions to strengthen health systems. However, little is known about the scalability of such interventions in Africa. In this study, we seek to assess the scalability of interventions for improving the functionality of health systems in Africa, as a key to large-scale implementation strategy of interventions with potential for impact.
View Article and Find Full Text PDFBackground: In the World Health Organization (WHO) African Region, many cases of serious and preventable diseases remain unmanaged because appropriate and good quality diagnostic support is not available at all levels within countries' health systems. Diagnostic and laboratory services influence the efficiency and effectiveness of both clinical and public health functions, including diagnosis, treatment, health promotion, disease prevention, surveillance and response, and research. Essential to global health security, these services are vital to decision-making processes by clinicians, epidemiologists, public health specialists, and health policymakers.
View Article and Find Full Text PDFObjective: In this scoping review, we aim to consolidate the evidence on inequalities in service coverage in Africa using a comprehensive set of stratifiers. These stratifiers include place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status and social capital. Our approach provides a more holistic understanding of the different dimensions of inequality in the context of universal health coverage (UHC).
View Article and Find Full Text PDFBackground: A concern in high-income countries is that switching to 1-dose human papillomavirus (HPV) vaccination could cause a rebound in HPV infection and cervical cancer if 1-dose efficacy or duration were inferior to 2 doses. Using mathematical modeling and up-to-date trial-based data, we projected the population-level effectiveness of switching from 2-dose to 1-dose vaccination under different vaccine efficacy and duration assumptions in high-income countries.
Methods: We used HPV-ADVISE (Agent-based Dynamic model for VaccInation and Screening Evaluation), a transmission-dynamic model of HPV infection and cervical cancer, varying key model assumptions to identify those with the greatest impact on projections of HPV-16 and cervical cancer incidence over time: 1) 1-dose vaccine efficacy and vaccine duration, 2) mechanisms of vaccine efficacy and duration over time, 3) midadult (>30 years of age) sexual behavior, 4) progression to cervical cancer among midadults, and 5) vaccination coverage and programs.