The intention-to-treat (ITT) analysis of the Applying Wolbachia to Eliminate Dengue (AWED) trial estimated a protective efficacy of 77.1% for participants resident in areas randomised to receive releases of wMel-infected Aedes aegypti mosquitoes, an emerging dengue preventive intervention. The limiting assumptions of ITT analyses in cluster randomised trials and the mobility of mosquitoes and humans across cluster boundaries indicate the primary analysis is likely to underestimate the full public health benefit.
View Article and Find Full Text PDFPacific Island countries have experienced periodic dengue, chikungunya and Zika outbreaks for decades. The prevention and control of these mosquito-borne diseases rely heavily on control of Aedes aegypti mosquitoes, which in most settings are the primary vector. Introgression of the intracellular bacterium Wolbachia pipientis (wMel strain) into Ae.
View Article and Find Full Text PDFAntimicrob Steward Healthc Epidemiol
November 2023
Objective: We explored the utility of the standardized infection ratio (SIR) for surgical site infection (SSI) reporting in an Australian jurisdiction.
Design: Retrospective chart review.
Setting: Statewide SSI surveillance data from 2013 to 2019.
Background: The introduction of Wolbachia (wMel strain) into Aedes aegypti mosquitoes reduces their capacity to transmit dengue and other arboviruses. Randomised and non-randomised studies in multiple countries have shown significant reductions in dengue incidence following field releases of wMel-infected Ae. aegypti.
View Article and Find Full Text PDFBackground: Releases of Wolbachia (Mel)-infected Aedes aegypti mosquitoes significantly reduced the incidence of virologically confirmed dengue in a previous cluster randomised trial in Yogyakarta City, Indonesia. Following the trial, Mel releases were extended to the untreated control areas, to achieve city-wide coverage of Wolbachia.
Objective: In this predefined analysis, we evaluated the impact of the wMel deployments in Yogyakarta on dengue hemorrhagic fever (DHF) case notifications and on the frequency of perifocal insecticide spraying by public health teams.
Dengue exhibits focal clustering in households and neighborhoods, driven by local mosquito population dynamics, human population immunity, and fine scale human and mosquito movement. We tested the hypothesis that spatiotemporal clustering of homotypic dengue cases is disrupted by introduction of the arbovirus-blocking bacterium Wolbachia (wMel-strain) into the Aedes aegypti mosquito population. We analysed 318 serotyped and geolocated dengue cases (and 5921 test-negative controls) from a randomized controlled trial in Yogyakarta, Indonesia of wMel deployments.
View Article and Find Full Text PDFThe Applying Wolbachia to Eliminate Dengue (AWED) trial was a parallel cluster randomised trial that demonstrated Wolbachia (wMel) introgression into Ae. aegypti populations reduced dengue incidence. In this predefined substudy, we compared between treatment arms, the relative abundance of Ae.
View Article and Find Full Text PDFBackground: The introduction of the bacterium Wolbachia (wMel strain) into Aedes aegypti mosquitoes reduces their capacity to transmit dengue and other arboviruses. Evidence of a reduction in dengue case incidence following field releases of wMel-infected Ae. aegypti has been reported previously from a cluster randomised controlled trial in Indonesia, and quasi-experimental studies in Indonesia and northern Australia.
View Article and Find Full Text PDFBackground: mosquitoes infected with the Mel strain of are less susceptible than wild-type to dengue virus infection.
Methods: We conducted a cluster-randomized trial involving releases of Mel-infected mosquitoes for the control of dengue in Yogyakarta, Indonesia. We randomly assigned 12 geographic clusters to receive deployments of Mel-infected (intervention clusters) and 12 clusters to receive no deployments (control clusters).
Background: Histological and epidemiological data suggest that increased signal intensity at the proximal patellar tendon on magnetic resonance imaging is a response to tendon loading. As patellofemoral geometry is a mediator of loading, we examined the association between patellofemoral geometry and the prevalence of increased signal intensity at the patellar tendon in community-based middle-aged adults.
Methods: Two hundred-one adults aged 25-60 years in a study of obesity and musculoskeletal health had the patellar tendon assessed from magnetic resonance imaging.
mosquitoes stably transfected with the intracellular bacterium ( Mel strain) have been deployed for biocontrol of dengue and related arboviral diseases in multiple countries. Field releases in northern Australia have previously demonstrated near elimination of local dengue transmission from -treated communities, and pilot studies in Indonesia have demonstrated the feasibility and acceptability of the method. We conducted a quasi-experimental trial to evaluate the impact of scaled releases on dengue incidence in an endemic setting in Indonesia.
View Article and Find Full Text PDFBackground: The AWED (Applying Wolbachia to Eliminate Dengue) trial is a parallel, two-arm, non-blinded cluster randomised controlled trial that is under way in Yogyakarta, Indonesia, with the aim of measuring the efficacy of Wolbachia-infected Aedes aegypti deployments in reducing dengue incidence in an endemic setting. Enrolment began in January 2018 and is ongoing. The original study protocol was published in April 2018.
View Article and Find Full Text PDFThe Mel strain of has been successfully introduced into mosquitoes and subsequently shown in laboratory studies to reduce transmission of a range of viruses including dengue, Zika, chikungunya, yellow fever, and Mayaro viruses that cause human disease. Here we report the entomological and epidemiological outcomes of staged deployment of across nearly all significant dengue transmission risk areas in Australia. The Mel strain of was backcrossed into the local genotype (Cairns and Townsville backgrounds) and mosquitoes were released in the field by staff or via community assisted methods.
View Article and Find Full Text PDF: A number of new technologies are under development for the control of mosquito transmitted viruses, such as dengue, chikungunya and Zika that all require the release of modified mosquitoes into the environment. None of these technologies has been able to demonstrate evidence that they can be implemented at a scale beyond small pilots. Here we report the first successful citywide scaled deployment of in the northern Australian city of Townsville.
View Article and Find Full Text PDFDengue, chikungunya and Zika are viral infections transmitted by mosquitoes, and present major public health challenges in tropical regions. Traditional vector control methods have been ineffective at halting disease transmission. The World Mosquito Program has developed a novel approach to arbovirus control using stably transfected with the bacterium, which have significantly reduced ability to transmit dengue, Zika and chikungunya in laboratory experiments.
View Article and Find Full Text PDFRio de Janeiro and Niterói are neighbouring cities in southeastern Brazil which experience large dengue epidemics every 2 to 5 years, with >100,000 cases notified in epidemic years. Costs of vector control and direct and indirect costs due to the -borne diseases dengue, chikungunya and Zika were estimated to total $650 million USD in 2016, but traditional vector control strategies have not been effective in preventing mosquito-borne disease outbreaks. The method is a novel and self-sustaining approach for the biological control of -borne diseases, in which the transmission potential of mosquitoes is reduced by stably transfecting them with the bacterium ( Mel strain).
View Article and Find Full Text PDFAims: The impact of introducing new classes of glucose-lowering medication (GLM) on diabetes management remains unclear, especially outside North America and Western Europe. Therefore, we aimed to analyse trends in glycaemic control and the usage of new and old GLMs in people with type 2 diabetes from 2006 to 2015.
Methods: Summary data from clinical services from nine countries outside North America and Western Europe were collected and pooled for statistical analysis.
Introduction: Little is known about the association of urine metabolites with structural lesions in persons with diabetes.
Objectives: We examined the relationship between 12 urine metabolites and kidney structure in American Indians with type 2 diabetes.
Methods: Data were from a 6-year clinical trial that assessed renoprotective efficacy of losartan, and included a kidney biopsy at the end of the treatment period.
Aim: Optimal treatment of cardiovascular disease is essential to decrease mortality among people with diabetes, but information is limited on how actual treatment relates to guidelines. We analysed changes in therapeutic approaches to anti-hypertensive and lipid-lowering medications in people with Type 2 diabetes from 2006 and 2015.
Methods: Summary data from clinical services in seven countries outside North America and Western Europe were collected for 39 684 people.
Objectives: The risk of early-onset type 2 diabetes associated with the severity of obesity in youth is not well understood. This study aims to determine metabolic alterations and type 2 diabetes risk among American Indian children who are obese or severely obese.
Methods: Incidence rates of diabetes before 20 years (youth-onset) and 45 years were computed in 2728 children who were from 5 to <10 years and 4317 adolescents who were from 10 to <18 years without diabetes examined between 1965 and 2007.
Unlabelled: Population monitoring of obesity is most commonly conducted using body mass index (BMI). We test the hypothesis that because of increases in waist circumference (WC) independent of increases in weight, BMI alone detects an increasingly smaller proportion of the population with obesity.
Methods: Australian adults with measured height, weight, and WC were selected from three nationally representative cross-sectional surveys (1989, 1999-2000, 2011-12; n=8313, 5903 & 3904).
Objectives: To illustrate the difficulties in optimal growth monitoring of children with severe obesity or underweight by using the Centers for Disease Control and Prevention (CDC) 2000 age- and sex-specific BMI percentile growth charts. We also aimed to examine the utility of a new modified CDC BMI score chart to monitor growth in children with normal and extreme BMI percentiles by using real-life clinical scenarios.
Methods: Modified BMI score charts were created by using the 2000 CDC algorithm.
J Diabetes Complications
January 2018
Background: In Caucasians, lower triglycerides (TG), total or LDL cholesterol and high HDL cholesterol are generally associated with lower mortality. However, low cholesterol is associated with higher mortality in some Asian populations. This study examines the relationship between serum lipids and mortality in American Indians.
View Article and Find Full Text PDFModern epidemiological studies collect data on time-varying individual-specific characteristics, such as body mass index and blood pressure. Incorporation of such time-dependent covariates in time-to-event models is of great interest, but raises some challenges. Of specific concern are measurement error, and the non-synchronous updating of covariates across individuals, due for example to missing data.
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