Displaying publications 21 - 40 of 43 in total

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  1. Sharma PK, Fuloria S, Ali M, Singh A, Kushwaha SP, Sharma VK, et al.
    Pak J Pharm Sci, 2021 Jul;34(4):1397-1401.
    PMID: 34799313
    The current research was aimed to isolate newer phyto-metabolites from rhizomes of Alpinia galanga plant. Study involved preparation of Alpinia galanga rhizome methanolic extract, followed by normal phase column chromatography assisted isolation of new phytometabolites (using different combinations of chloroform and methanol), and characterization (by UV, FTIR, 13C-NMR, 1H-NMR, COSY, DEPT and Mass spectrometry). The isolation and characterization experiment offered two phytometabolites: an ester (Ag-1) and tetrahydronapthalene type lactone (Ag-2). Present study concludes and reports the two phytometabolites, benzyl myristate (Ag-1) and 3-Methyl-6α, 8β-diol-7-carboxylic acid tetralin-11, 9β-olide (Ag-2) for the first time in Alpinia galanga rhizome. The study recommends that these phytometabolites Ag-1 and Ag-2 can be utilized as effective analytical biomarkers for identification, purity and quality control of this plant in future.
  2. Trache D, Tarchoun AF, Abdelaziz A, Bessa W, Thakur S, Hussin MH, et al.
    Int J Biol Macromol, 2024 Apr 18;268(Pt 2):131633.
    PMID: 38641279 DOI: 10.1016/j.ijbiomac.2024.131633
    Nanostructured materials are fascinating since they are promising for intensely enhancing materials' performance, and they can offer multifunctional features. Creating such high-performance nanocomposites via effective and mild approaches is an inevitable requirement for sustainable materials engineering. Nanocomposites, which combine two-star nanomaterials, namely, cellulose nanofibrils (CNFs) and graphene derivatives (GNMs), have recently revealed interesting physicochemical properties and excellent performance. Despite numerous studies on the production and application of such systems, there is still a lack of concise information on their practical uses. In this review, recent progress in the production, modification, properties, and emerging uses of CNFs/GNMs hybrid-based nanocomposites in various fields such as flexible energy harvesting and storage, sensors, adsorbents, packaging, and thermal management, among others, are comprehensively examined and described based on recent investigations. Nevertheless, numerous challenges and gaps need to be addressed to successfully introduce such nanomaterials in large-scale industrial applications. This review will certainly help readers understand the design approaches and potential applications of CNFs/GNMs hybrid-based nanocomposites for which new research directions in this emerging topic are discussed.
  3. Akbari E, Arora VK, Enzevaee A, Ahmadi MT, Saeidmanesh M, Khaledian M, et al.
    Beilstein J Nanotechnol, 2014;5:726-34.
    PMID: 24991510 DOI: 10.3762/bjnano.5.85
    Carbon, in its variety of allotropes, especially graphene and carbon nanotubes (CNTs), holds great potential for applications in variety of sensors because of dangling π-bonds that can react with chemical elements. In spite of their excellent features, carbon nanotubes (CNTs) and graphene have not been fully exploited in the development of the nanoelectronic industry mainly because of poor understanding of the band structure of these allotropes. A mathematical model is proposed with a clear purpose to acquire an analytical understanding of the field-effect-transistor (FET) based gas detection mechanism. The conductance change in the CNT/graphene channel resulting from the chemical reaction between the gas and channel surface molecules is emphasized. NH3 has been used as the prototype gas to be detected by the nanosensor and the corresponding current-voltage (I-V) characteristics of the FET-based sensor are studied. A graphene-based gas sensor model is also developed. The results from graphene and CNT models are compared with the experimental data. A satisfactory agreement, within the uncertainties of the experiments, is obtained. Graphene-based gas sensor exhibits higher conductivity compared to that of CNT-based counterpart for similar ambient conditions.
  4. Wong CY, Tham JS, Foo CN, Ng FL, Shahar S, Zahary MN, et al.
    Biosaf Health, 2023 Feb;5(1):37-44.
    PMID: 36588928 DOI: 10.1016/j.bsheal.2022.12.005
    Vaccination is crucial in controlling the spread of the coronavirus disease 2019 (COVID-19) that triggered the pandemic, but herd immunity can only work with high vaccination coverage in the population. This study aims to measure the COVID-19 knowledge level and determine the factors influencing COVID-19 vaccination intention among university students in Malaysia. A cross-sectional online survey was carried out with 1,274 Malaysian university students in July 2021. Univariate and multivariate analyses were employed to examine the relationships between the study variables. Results showed that the majority of university students had an acceptable level of knowledge of COVID-19. The knowledge, risk perception of COVID-19, social norms, and perceived benefit of COVID-19 vaccination were positively associated with vaccination intention. However, perceived trust in information sources of COVID-19 vaccination and the government's response to COVID-19 did not affect the university students' desire to receive the vaccination. These findings are essential for health policymakers and healthcare providers to implement evidence-based interventions to increase COVID-19 vaccination uptake among university students.
  5. Suppan VKL, Wei CY, Siong TC, Mei TM, Chern WB, Nanta Kumar VK, et al.
    J Orthop Surg (Hong Kong), 2017 9 28;25(3):2309499017731627.
    PMID: 28946838 DOI: 10.1177/2309499017731627
    BACKGROUND: Intra-articular hyaluronic acid (HA) injection is used in management of knee, hand and hip osteoarthritis. While HA injection is included in the list of evaluated therapies, its efficacy and optimum dosing still have no consensus. This study was conducted to explore the possibility of using single injection HA to increase patient convenience while maintaining the therapeutic efficacy.

    METHODS: We present a prospective, open label, non-blinded, randomized controlled trial performed in accordance with guidelines in principles of good clinical practice. Block randomization was done for patients to receive either single 5 ml GO-ON injection or the conventional three injections of 2.5 ml GO-ON at weekly interval. Baseline Western Ontario McMaster University Osteoarthritis (WOMAC) scores were evaluated and recorded. All subjects were re-evaluated at 3 months and the WOMAC score recorded again as primary end points. Data analyses were performed with IBM SPSS Statistics for Windows software (version 21.0, IBM Corp, Armonk, New York, USA).

    RESULTS: In the cohort of 127 patients, 33 were males and 94 females. The mean age was 59.1 years (standard deviation (SD) = 7.25) in single injection arm and 60.1 years (SD = 7.72) in triple injection arm. The two groups were recorded to have no significant difference in age ( p = 0.46) and Kellgren-Lawrence radiological grade ( p = 0.694). There was significant increase in the WOMAC scores from the baseline (pre-injection) to that recorded 3 months after injection ( p < 0.001) in patients of both groups. However, there was no statistically significant difference noticed in this clinical improvement between the two arms ( p = 0.889).

    CONCLUSION: The study shows single 5 ml dose regime comparing well with conventional three doses of 2.5 ml of intra-articular GO-ON HA injected at weekly intervals and confirms good efficacy, tolerability and safety of single larger dose of GO-ON knee intra-articular injection.
  6. Usmani Z, Sharma M, Tripathi M, Lukk T, Karpichev Y, Gathergood N, et al.
    Sci Total Environ, 2023 Jul 10;881:163002.
    PMID: 37003333 DOI: 10.1016/j.scitotenv.2023.163002
    The increasing emphasis on the development of green replacements to traditional organic solvents and ionic liquids (ILs) can be attributed to the rising concerns over human health and detrimental impacts of conventional solvents towards the environment. A new generation of solvents inspired by nature and extracted from plant bioresources has evolved over the last few years, and are referred to as natural deep eutectic solvents (NADES). NADES are mixtures of natural constituents like sugars, polyalcohols, sugar-based alcohols, amino acids and organic acids. Interest in NADES has exponentially grown over the last eight years, which is evident from an upsurge in the number of research projects undertaken. NADES are highly biocompatible as they can be biosynthesized and metabolized by nearly all living organisms. These solvents pose several noteworthy advantages, such as easy synthesis, tuneable physico-chemical properties, low toxicity, high biodegradability, solute sustainability and stabilization and low melting point. Research on the applicability of NADES in diverse areas is gaining momentum, which includes as - media for chemical and enzymatic reactions; extraction media for essential oils; anti-inflammatory and antimicrobial agent; extraction of bioactive composites; as chromatographic media; preservatives for labile compounds and in drug synthesis. This review gives a complete overview of the properties, biodegradability and toxicity of NADES which we propose can assist in further knowledge generation on their significance in biological systems and usage in green and sustainable chemistry. Information on applications of NADES in biomedical, therapeutic and pharma-biotechnology fields is also highlighted in the current article along with the recent progress and future perspectives in novel applications of NADES.
  7. Chattu VK, Knight WA, Adisesh A, Yaya S, Reddy KS, Di Ruggiero E, et al.
    Health Promot Perspect, 2021;11(1):20-31.
    PMID: 33758752 DOI: 10.34172/hpp.2021.04
    Background: Africa is facing the triple burden of communicable diseases, non-communicable diseases (NCDs), and nutritional disorders. Multilateral institutions, bilateral arrangements, and philanthropies have historically privileged economic development over health concerns. That focus has resulted in weak health systems and inadequate preparedness when there are outbreaks of diseases. This review aims to understand the politics of disease control in Africa and global health diplomacy's (GHD's) critical role. Methods: A literature review was done in Medline/PubMed, Web of Science, Scopus, Embase, and Google scholar search engines. Keywords included MeSH and common terms related to the topics: "Politics," "disease control," "epidemics/ endemics," and "global health diplomacy" in the "African" context. The resources also included reports of World Health Organization, United Nations and resolutions of the World Health Assembly (WHA). Results: African countries continue to struggle in their attempts to build health systems for disease control that are robust enough to tackle the frequent epidemics that plague the continent. The politics of disease control requires the crafting of cooperative partnerships to accommodate the divergent interests of multiple actors. Recent outbreaks of COVID-19 and Ebola had a significant impact on African economies. It is extremely important to prioritize health in the African development agendas. The African Union (AU) should leverage the momentum of the rise of GHD to (i) navigate the politics of global health governance in an interconnected world(ii) develop robust preparedness and disease response strategies to tackle emerging and reemerging disease epidemics in the region (iii) address the linkages between health and broader human security issues driven by climate change-induced food, water, and other insecurities (iv) mobilize resources and capacities to train health officials in the craft of diplomacy. Conclusion: The AU, Regional Economic Communities (RECs), and African Centres for Disease Control should harmonize their plans and strategies and align them towards a common goal that integrates health in African development agendas. The AU must innovatively harness the practice and tools of GHD towards developing the necessary partnerships with relevant actors in the global health arena to achieve the health targets of the Sustainable Development Goals.
  8. Hoh BP, Zhang X, Deng L, Yuan K, Yew CW, Saw WY, et al.
    Genome Biol Evol, 2020 12 06;12(12):2245-2257.
    PMID: 33022050 DOI: 10.1093/gbe/evaa207
    North Borneo (NB) is home to more than 40 native populations. These natives are believed to have undergone local adaptation in response to environmental challenges such as the mosquito-abundant tropical rainforest. We attempted to trace the footprints of natural selection from the genomic data of NB native populations using a panel of ∼2.2 million genome-wide single nucleotide polymorphisms. As a result, an ∼13-kb haplotype in the Major Histocompatibility Complex Class II region encompassing candidate genes TSBP1-BTNL2-HLA-DRA was identified to be undergoing natural selection. This putative signature of positive selection is shared among the five NB populations and is estimated to have arisen ∼5.5 thousand years (∼220 generations) ago, which coincides with the period of Austronesian expansion. Owing to the long history of endemic malaria in NB, the putative signature of positive selection is postulated to be driven by Plasmodium parasite infection. The findings of this study imply that despite high levels of genetic differentiation, the NB populations might have experienced similar local genetic adaptation resulting from stresses of the shared environment.
  9. Suppan VKL, Tew MM, Wong BC, Chan HK, Chew YW, Tan CS, et al.
    J Orthop Surg (Hong Kong), 2020 3 5;28(1):2309499019895029.
    PMID: 32129141 DOI: 10.1177/2309499019895029
    PURPOSE: A recent 3-month randomized, open-label controlled trial found that the intra-articular hyaluronic acid injection (GO-ON®) given as a single dose of 5 mL is as effective and safe as three repeated doses of 2.5 mL in patients with knee osteoarthritis. However, the information on the long-term efficacy and economic implications of the single-dose regimen is still limited. Hence, this follow-up study was designed to compare the effectiveness and costs of the two regimens 12 months following the treatment.

    METHODS: All the 127 patients, who received either three repeated doses (n = 64) or a single dose (n = 63) of GO-ON in the previous trial, were followed up in month 12 following the treatment. The effectiveness of both the regimens was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the mean WOMAC scores were compared with those recorded at the baseline and in month 3. Additionally, the total treatment costs of the two regimens, taking account of both direct and indirect costs, were computed and compared.

    RESULTS: A total of 125 patients (98.4%) completed the assessment. Despite the reduction of the overall mean WOMAC score from 39.24 to 19.93 (p < 0.001) in the first 3 months following the treatment with GO-ON, no further changes were observed up to month 12 (p > 0.95). In the meantime, the two regimens did not differ in the mean WOMAC scores (p = 0.749) and in the subscale scores for pain (p = 0.970), stiffness (p = 0.526), and physical functioning (p = 0.667) in month 12. The cost for single-dose injection was found to be approximately 30% lower compared to the repeated doses.

    CONCLUSION: These findings indicate that the single larger dose of GO-ON is as effective as the repeated doses over 12 months, and yet the total treatment cost is lowered.

  10. Kuziel A, Dzido G, Jędrysiak RG, Kolanowska A, Jóźwiak B, Beunat J, et al.
    ACS Sustain Chem Eng, 2022 May 23;10(20):6596-6608.
    PMID: 35634268 DOI: 10.1021/acssuschemeng.2c00226
    Water-based processing of graphene-typically considered as physicochemically incompatible with water in the macroscale-emerges as the key challenge among the central postulates of green nanotechnology. These problematic concerns are derived from the complex nature of graphene in the family of sp2-carbon nanoallotropes. Indeed, nanomaterials hidden under the common "graphene" signboard are very rich in morphological and physicochemical variants. In this work, inspired by the adhesion chemistry of mussel biomaterials, we have synthesized novel, water-processable graphene-polylevodopa (PDOPA) hybrids. Graphene and PDOPA were covalently amalgamated via the "growth-from" polymerization of l-DOPA (l-3,4-dihydroxyphenylalanine) monomer in air, yielding homogeneously PDOPA-coated (23 wt %) (of thickness 10-20 nm) hydrophilic flakes. The hybrids formed >1 year stable and water-processable aqueous dispersions and further conveniently processable paints of viscosity 0.4 Pa·s at 20 s-1 and a low yield stress τ0 up to 0.12 Pa, hence exhibiting long shelf-life stability and lacking sagging after application. Demonstrating their applicability, we have found them as surfactant-like nanoparticles stabilizing the larger, pristine graphene agglomerates in water in the optimized graphene/graphene-PDOPA weight ratio of 9:1. These characteristics enabled the manufacture of conveniently paintable coatings of low surface resistivity of 1.9 kΩ sq-1 (0.21 Ω·m) which, in turn, emerge as potentially applicable in textronics, radar-absorbing materials, or electromagnetic interference shielding.
  11. Aralappanavar VK, Mukhopadhyay R, Yu Y, Liu J, Bhatnagar A, Praveena SM, et al.
    Sci Total Environ, 2024 May 10;924:171435.
    PMID: 38438042 DOI: 10.1016/j.scitotenv.2024.171435
    The harmful effects of microplastics (MPs) pollution in the soil ecosystem have drawn global attention in recent years. This paper critically reviews the effects of MPs on soil microbial diversity and functions in relation to nutrients and carbon cycling. Reports suggested that both plastisphere (MP-microbe consortium) and MP-contaminated soils had distinct and lower microbial diversity than that of non-contaminated soils. Alteration in soil physicochemical properties and microbial interactions within the plastisphere facilitated the enrichment of plastic-degrading microorganisms, including those involved in carbon (C) and nutrient cycling. MPs conferred a significant increase in the relative abundance of soil nitrogen (N)-fixing and phosphorus (P)-solubilizing bacteria, while decreased the abundance of soil nitrifiers and ammonia oxidisers. Depending on soil types, MPs increased bioavailable N and P contents and nitrous oxide emission in some instances. Furthermore, MPs regulated soil microbial functional activities owing to the combined toxicity of organic and inorganic contaminants derived from MPs and contaminants frequently encountered in the soil environment. However, a thorough understanding of the interactions among soil microorganisms, MPs and other contaminants still needs to develop. Since currently available reports are mostly based on short-term laboratory experiments, field investigations are needed to assess the long-term impact of MPs (at environmentally relevant concentration) on soil microorganisms and their functions under different soil types and agro-climatic conditions.
  12. Shukhairi SS, Mazlan N, Subbiah VK, Abd Rahman NN, Nazahuddin MNA, Shawel AS, et al.
    Bull Environ Contam Toxicol, 2024 Dec 03;114(1):2.
    PMID: 39627569 DOI: 10.1007/s00128-024-03980-0
    Microplastics (MPs) are tiny plastic pieces having a diameter of less than 5 mm. They can arise from larger plastic debris that degrades over time, synthetic fibres from clothing, microbeads in personal care items and even larger plastic debris. Sea cucumbers are marine creatures vital to the ocean's ecosystem as they assist in maintaining a clean seabed and recycle nutrients. The aim of this research was to characterize the types of MPs isolated from the sea cucumber Holothuria scabra from Pulau Jambongan, Sabah. A total of 30 H. scabra were collected. Their gastrointestinal tracts were removed and digested using NaOH. The digestates were filtrated several times to extract the MPs. MPs were observed under microscope and categorized into shapes and colours. To determine the functional group of polymers, further analysis using Fourier Transform-Infrared Spectroscopy (FTIR) was performed. The samples contained a total of 7403 MPs. Majority of MPs were black colored (72.25%) and in the form of fibres (99.05%). Two types of polymers were detected: polycarbonate (PC) found in 4% of the population and polymethyl methacrylate (PMMA) present in 96%. In conclusion, the presence of MPs in the gastrointestinal tract of H. scabra suggests that the animals and their habitat have been contaminated. Further study is required to comprehend the effects of MPs on sea cucumbers and other marine organisms as well as to develop prevention strategies.
  13. Nor Fazirah Jamal, Zaw Lin, Zainal Arifin Mustafa, Ahmad Faris Abdullah, Naing Oo Tha, Nor Amalina Emran, et al.
    MyJurnal
    Introduction: Tuberculosis (TB) is the ninth leading cause of mortality in the world while it is the most prevalent infection which is ranked abolve HIV/AIDS. In Malaysia, tuberculosis is still a public health problem. Sabah State on Malaysian Borneo had 20-30% of total TB cases of the country. In Sabah, case notification rate of almost 200 per 100,000 population was still present in the last 10 years. Hotspots are defined as TB notification rate more than 100/100.000 in a district or TB notification rate more than 100/100,000 in the squatters’ area. In this study, cycle threshold (ct) values in GeneXpertMTB/RIF (Xpert) were tried to be correlated with growth in Mycobacterim growth indicator tubes (MGIT) by measurement of time to detection (TTD). Methods: Sputum samples from six hotspots of Kota Kinabalu were studied by Xpert as well as MGIT culture after processing of sputum samples. The correlation between Mean ct value of Xpert and TTD in MGIT was analysed by using IBM SPSS Statistic 25 and the statistical test used was Pearson Correlation test. Results: The results of Xpert indicated 35 of 204 sputum samples were pos-itive whereas only one sample was rifampicin resistant. The mean ct values were very low, low and medium in all the hotspots with sputum from one hotspot showed medium ct values predominantly. The sputum from remaining hotspots showed mainly very low and low ct values. MGIT results showed no growth in five samples with two very low, two low and one medium mean ct values. Conclusion: The finding indicated that there were correlations be-tween mean ct values of Xpert and TTD in MGIT with a few exceptions.
  14. Dey AD, Bigham A, Esmaeili Y, Ashrafizadeh M, Moghaddam FD, Tan SC, et al.
    Semin Cancer Biol, 2022 11;86(Pt 2):396-419.
    PMID: 35700939 DOI: 10.1016/j.semcancer.2022.06.003
    Chemotherapy is the first choice in the treatment of cancer and is always preferred to other approaches such as radiation and surgery, but it has never met the need of patients for a safe and effective drug. Therefore, new advances in cancer treatment are now needed to reduce the side effects and burdens associated with chemotherapy for cancer patients. Targeted treatment using nanotechnology are now being actively explored as they could effectively deliver therapeutic agents to tumor cells without affecting normal cells. Dendrimers are promising nanocarriers with distinct physiochemical properties that have received considerable attention in cancer therapy studies, which is partly due to the numerous functional groups on their surface. In this review, we discuss the progress of different types of dendrimers as delivery systems in cancer therapy, focusing on the challenges, opportunities, and functionalities of the polymeric molecules. The paper also reviews the various role of dendrimers in their entry into cells via endocytosis, as well as the molecular and inflammatory pathways in cancer. In addition, various dendrimers-based drug delivery (e.g., pH-responsive, enzyme-responsive, redox-responsive, thermo-responsive, etc.) and lipid-, amino acid-, polymer- and nanoparticle-based modifications for gene delivery, as well as co-delivery of drugs and genes in cancer therapy with dendrimers, are presented. Finally, biosafety concerns and issues hindering the transition of dendrimers from research to the clinic are discussed to shed light on their clinical applications.
  15. Nor Azman NS, Hossan MS, Nissapatorn V, Uthaipibull C, Prommana P, Jin KT, et al.
    Exp Parasitol, 2018 Nov;194:67-78.
    PMID: 30268422 DOI: 10.1016/j.exppara.2018.09.020
    Treatment of drug resistant protozoa, bacteria, and viruses requires new drugs with alternative chemotypes. Such compounds could be found from Southeast Asian medicinal plants. The present study examines the cytotoxic, antileishmanial, and antiplasmodial effects of 11 ethnopharmacologically important plant species in Malaysia. Chloroform extracts were tested for their toxicity against MRC-5 cells and Leishmania donovani by MTT, and chloroquine-resistant Plasmodium falciparum K1 strain by Histidine-Rich Protein II ELISA assays. None of the extract tested was cytotoxic to MRC-5 cells. Extracts of Uvaria grandiflora, Chilocarpus costatus, Tabernaemontana peduncularis, and Leuconotis eugenifolius had good activities against L. donovani with IC50 
  16. Kanneganti A, Tan BYQ, Nik Ab Rahman NH, Leow AS, Denning M, Goh ET, et al.
    Singapore Med J, 2023 Nov;64(11):667-676.
    PMID: 35139631 DOI: 10.11622/smedj.2022014
    INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact in Asia and has placed significant burden on already stretched healthcare systems. We examined the impact of COVID-19 on the safety attitudes among healthcare workers (HCWs), as well as their associated demographic and occupational factors, and measures of burnout, depression and anxiety.

    METHODS: A cross-sectional survey study utilising snowball sampling was performed involving doctors, nurses and allied health professions from 23 hospitals in Singapore, Malaysia, India and Indonesia between 29 May 2020 and 13 July 2020. This survey collated demographic data and workplace conditions and included three validated questionnaires: the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory and Hospital Anxiety and Depression Scale. We performed multivariate mixed-model regression to assess independent associations with the SAQ total percentage agree rate (PAR).

    RESULTS: We obtained 3,163 responses. The SAQ total PARs were found to be 35.7%, 15.0%, 51.0% and 3.3% among the respondents from Singapore, Malaysia, India and Indonesia, respectively. Burnout scores were highest among respondents from Indonesia and lowest among respondents from India (70.9%-85.4% vs. 56.3%-63.6%, respectively). Multivariate analyses revealed that meeting burnout and depression thresholds and shifts lasting ≥12 h were significantly associated with lower SAQ total PAR.

    CONCLUSION: Addressing the factors contributing to high burnout and depression and placing strict limits on work hours per shift may contribute significantly towards improving safety culture among HCWs and should remain priorities during the pandemic.

  17. Cromwell EA, Osborne JCP, Unnasch TR, Basáñez MG, Gass KM, Barbre KA, et al.
    PLoS Negl Trop Dis, 2021 07;15(7):e0008824.
    PMID: 34319976 DOI: 10.1371/journal.pntd.0008824
    Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.
  18. GBD 2019 Lip, Oral, and Pharyngeal Cancer Collaborators, Cunha ARD, Compton K, Xu R, Mishra R, Drangsholt MT, et al.
    JAMA Oncol, 2023 Oct 01;9(10):1401-1416.
    PMID: 37676656 DOI: 10.1001/jamaoncol.2023.2960
    IMPORTANCE: Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.

    OBJECTIVE: To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.

    EVIDENCE REVIEW: The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.

    FINDINGS: In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.

    CONCLUSIONS AND RELEVANCE: In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts.

  19. Haeuser E, Serfes AL, Cork MA, Yang M, Abbastabar H, Abhilash ES, et al.
    BMC Med, 2022 Dec 19;20(1):488.
    PMID: 36529768 DOI: 10.1186/s12916-022-02639-z
    BACKGROUND: Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15-59 years across SSA.

    METHODS: We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units.

    RESULTS: We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group.

    CONCLUSIONS: As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.

  20. James SL, Castle CD, Dingels ZV, Fox JT, Hamilton EB, Liu Z, et al.
    Inj Prev, 2020 Oct;26(Supp 1):i125-i153.
    PMID: 32839249 DOI: 10.1136/injuryprev-2019-043531
    BACKGROUND: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria.

    METHODS: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced.

    RESULTS: GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes.

    CONCLUSIONS: GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.

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