Publications by authors named "William Oswald"

Article Synopsis
  • Mozambique is progressing in eliminating trachoma, but some districts still have TF prevalence above the 5% threshold despite interventions like antibiotic distribution.
  • A study in August 2022 tested residents in four districts for trachoma and other factors like water and hygiene, focusing on children aged 1-9 years.
  • Findings showed TF prevalence between 1.1% and 6.0%, with lower prevalence in three districts, while seroprevalence and transmission rates varied, providing valuable data for monitoring trachoma programs.
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Background: Soil-transmitted helminths (STH) affect approximately 1.5 billion people globally. The current STH control strategy is annual or twice-annual preventive chemotherapy, typically school-based deworming targeting children and women of reproductive age.

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  • - The study assessed the prevalence of childhood disability in Tamil Nadu, India, focusing on how functional difficulties affect school enrollment among 29,044 children aged 5 to 17 years.
  • - Out of the children surveyed, 1.0% were found to have functional difficulties, with common issues being related to understanding and walking, and this disability significantly impacted their likelihood of enrolling in school (Prevalence ratio 4.59).
  • - The findings reveal substantial differences across age and socioeconomic groups concerning the effect of functional difficulty on school enrollment, emphasizing a critical need for targeted interventions to improve educational access for affected children.
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  • School-based health services may inadvertently exclude children with disabilities, while community-based approaches provide a more inclusive option for addressing their needs.
  • The study focuses on assessing disability prevalence among children aged 5-17 in Malawi and compares the effectiveness of school-based deworming (SBD) versus community-based deworming (CBD) for treating soil-transmitted helminths in these children.
  • Findings show a 3.3% disability prevalence, mainly affecting hearing, remembering, and communication, with boys more likely to have disabilities, which corresponded with lower school attendance and poorer health outcomes.
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  • * Researchers developed a sensitive method to detect STH DNA in soil samples (20 g) from households in Kenya, Benin, and India, using advanced techniques like qPCR and ddPCR to identify specific STH species.
  • * The study found a significant association between STH detection in soil and human infections, highlighting that soil tests could be more reliable than microscopy, which often underestimated or overestimated STH prevalence.
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Background: Between 2000 and 2017/2018, Morocco reduced its maternal mortality ratio by 68% and its neonatal mortality rate by 52%-a higher improvement than other North African countries. We conducted the Exemplars in Maternal and Neonatal Health study to systematically and comprehensively research factors associated with this rapid reduction in mortality over the past two decades.

Methods: The study was conducted from September 2020 to December 2021 using mixed methods, including: literature, database and document reviews, quantitative analyses of national data sets and qualitative key-informant interviews at national and district levels.

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Introduction: Maternal mortality in Nepal dropped from 553 to 186 per 100 000 live births during 2000-2017 (66% decline). Neonatal mortality dropped from 40 to 21 per 1000 live births during 2000-2018 (48% decline). Stillbirths dropped from 28 to 18 per 1000 births during 2000-2019 (34% decline).

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Article Synopsis
  • A study in Tamil Nadu, India, aimed to assess the prevalence of childhood disabilities and their impact on school enrollment for children aged 5 to 17 years.
  • Out of 29,044 children surveyed, 1.0% had functional difficulties, which were more common in walking and being understood, and these disabilities significantly affected school enrollment rates.
  • The findings indicated that management of functional difficulties can differ based on age and socioeconomic factors, emphasizing the urgent need for targeted interventions to improve school access for affected children.
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Observational evidence suggests that household floors may be an important domain for the transmission of enteric and parasitic infections. However, little work has been done to investigate how household floors can become contaminated with human and animal faeces. This study uses a mixed methods approach to postulate the proximal and distal determinants of household floor contamination with faeces in groups of rural villages in 3 counties in Kenya (Bungoma, Kwale and Narok).

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Objectives: Kenya has implemented a national school-based deworming program, which has led to substantial decline in the prevalence of soil-transmitted helminths (STHs), although some pockets of infections remain. To effectively design an STH control program that leads to significant reductions of there is a need to understand the drivers of persistent infection despite ongoing treatment programs.

Methods: This study was conducted between July and September 2019 at the south coast of Kenya, using a two-stage sampling design.

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Background: The DeWorm3 trial is a multi-country study testing the feasibility of interrupting transmission of soil-transmitted helminths by community-wide mass drug administration (cMDA). Treatment coverage during cMDA delivery was validated by in-person coverage evaluation surveys (CES) after each round of treatment. A mobile phone-based CES was carried out in India when access to households was restricted during the COVID-19 lockdown.

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Objectives: With increasing mobile phone subscriptions, phone-based surveys are gaining popularity with public health programmes. Despite advantages, systematic exclusion of participants may limit representativeness. Similar to control programmes for neglected tropical diseases (NTDs), the DeWorm3 trial of biannual community-wide mass drug administration (MDA) for elimination of soil-transmitted helminth infection used in-person coverage evaluation surveys to measure the proportion of the at-risk population treated during MDA.

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Background: There continues to be a need for COVID-19 testing that is pragmatic, community-centered, and sustainable. This study will refine and test implementation strategies prioritized by community partners: (1) walk-up no-cost testing, (2) community health worker (promotores)-facilitated testing and preventive care counseling, (3) vending machines that dispense no-cost, self-testing kits.

Methods: A co-designed Theory of Change from an earlier study phase and the Practical, Robust Implementation and Sustainment Model (PRISM) will guide the study design, measures selection, and evaluation.

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Background: COVID-19 inequities are abundant in low-income communities of color. Addressing COVID-19 vaccine hesitancy to promote equitable and sustained vaccination for underserved communities requires a multi-level, scalable, and sustainable approach. It is also essential that efforts acknowledge the broader healthcare needs of these communities including engagement in preventive services.

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Introduction: : This mixed methods study describes processes to actively engage underserved, immigrant, and refugee communities in COVID-19 vaccine efforts to co-create culturally relevant resources and dissemination.

Methods: : A survey on health care characteristics and COVID-19 attitudes was deployed between March-November 2021 followed by listening sessions conducted in December 2021. All participants were recruited through the project's Community Advisory Board.

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Objective: To describe the early activities and lessons of the Share, Trust, Organize, Partner -19 California Alliance (STOP COVID-19 CA), the California awardee of the NIH-funded multi-state Community Engagement Alliance (CEAL) against COVID-19. The Alliance was established to ensure equity in Coronavirus-19 disease (COVID-19) research, clinical practice, and public health for communities most impacted by the COVID-19 pandemic.

Study Setting: The STOP COVID-19 CA Alliance network of 11 universities and affiliated partner community-based organizations (CBOs) across California.

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Background: Community Advisory Boards (CABs) have been frequently used to engage diverse partners to inform research projects. Yet, evaluating the quality of engagement has not been routine. We describe a multi-method ethnographic approach documenting and assessing partner engagement in two "virtual" CABs, for which we conducted all meetings remotely.

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Objectives: Investigate risk factors for SARS-CoV-2 infections in school students and staff.

Methods: In the 2020/2021 school year, we administered polymerase chain reaction, antibody tests, and questionnaires to a sample of primary and secondary school students and staff, with data linkage to COVID-19 surveillance. We fitted logistic regression models to identify the factors associated with infection.

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Background: We examined fidelity and feasibility of implementation of COVID-19 preventive measures in schools, and explored associations between adherence to these measures and staff well-being, to inform policy on sustainable implementation and staff wellbeing.

Methods: Surveys were conducted across 128 schools in England with 107 headteachers and 2698 staff-members with reference to autumn term 2020, examining school-level implementation of preventive measures, adherence, and teacher burnout (response rates for headteacher and staff surveys were 84% and 59%, respectively).

Results: The median number of measures implemented in primary and secondary schools was 33 (range 23-41), and 32 (range 22-40), respectively; most measures presented challenges.

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Background: Meaningful community engagement is instrumental to effective implementation and sustainment of equitable public health interventions. Significant resources are necessary to ensure that community engagement takes place in culturally sensitive, trusted ways that optimize positive public health outcomes. However, the types and costs of resources best suited to enable meaningful community engagement in implementation research are not well-documented.

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Background: There remains uncertainty about the epidemiology of SARS-CoV-2 among school students and staff and the extent to which non-pharmaceutical-interventions reduce the risk of school settings.

Methods: We conducted an open cohort study in a sample of 59 primary and 97 secondary schools in 15 English local authority areas that were implementing government guidance to schools open during the pandemic. We estimated SARS-CoV-2 infection prevalence among those attending school, antibody prevalence, and antibody negative to positive conversion rates in staff and students over the school year (November 2020-July 2021).

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Background: One of the most debated questions in the COVID-19 pandemic has been the role of schools in SARS-CoV-2 transmission. The COVID-19 Schools Infection Survey (SIS) aims to provide much-needed evidence addressing this issue.

Objective: We present the study protocol and participation profile for the SIS study, aimed at assessing the role of schools in SARS-CoV-2 infection and transmission within school settings, and investigating how transmission within and from schools could be mitigated through the implementation of school COVID-19 control measures.

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Objectives: To describe the use of a Theory of Change to meaningfully engage community members from or support underserved communities in two National Institutes of Health-funded implementation science projects aimed at promoting equitable access to COVID-19 testing and vaccination for underserved communities.

Study Setting: Both projects focused on Latino, Black, and immigrant and refugee communities in South/Central San Diego and/or individuals accessing care at a federally qualified health center near the US/Mexico border during December 2020-April 2021.

Study Design: By using a participatory action research design, Community Advisory Boards (CABs) were established for each project with 11 and 22 members.

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Background: Following the full re-opening of schools in England and emergence of the SARS-CoV-2 Alpha variant, we investigated the risk of SARS-CoV-2 infection in students and staff who were contacts of a confirmed case in a school bubble (school groupings with limited interactions), along with their household members.

Methods: Primary and secondary school bubbles were recruited into sKIDsBUBBLE after being sent home to self-isolate following a confirmed case of COVID-19 in the bubble. Bubble participants and their household members were sent home-testing kits comprising nasal swabs for RT-PCR testing and whole genome sequencing, and oral fluid swabs for SARS-CoV-2 antibodies.

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Malawi has successfully leveraged multiple delivery platforms to scale-up and sustain the implementation of preventive chemotherapy (PCT) for the control of morbidity caused by soil-transmitted helminths (STH). Sentinel monitoring demonstrates this strategy has been successful in reducing STH infection in school-age children, although our understanding of the contemporary epidemiological profile of STH across the broader community remains limited. As part of a multi-site trial evaluating the feasibility of interrupting STH transmission across three countries, this study aimed to describe the baseline demographics and the prevalence, intensity and associated risk factors of STH infection in Mangochi district, southern Malawi.

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