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Search Results: 1 - 10 of 306895 matches for " Stephen J Connor "
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Improving the cost-effectiveness of IRS with climate informed health surveillance systems
Eve Worrall, Stephen J Connor, Madeleine C Thomson
Malaria Journal , 2008, DOI: 10.1186/1475-2875-7-263
Abstract: A climate driven model of malaria transmission was used to simulate cost-effectiveness of alternative IRS coverage levels over six epidemic and non-epidemic years. Decision rules for a potential MEWS system that triggers different IRS coverage are described. The average and marginal cost per case averted with baseline IRS coverage (24%) and under varying IRS coverage levels (50%, 75% and 100%) were calculated.Average cost-effectiveness of 24% coverage varies dramatically between years, from US$108 per case prevented in low transmission to US$0.42 in epidemic years. Similarly for higher coverage (24–100%) cost per case prevented is far higher in low than high transmission years ($108–$267 to $0.88–$2.26).Efficiency and health benefit gains could be achieved by implementing MEWS that provides timely, accurate information. Evidence from southern Africa, (especially Botswana) supports this.Advance knowledge of transmission severity can help managers make coverage decisions which optimise resource use and exploit efficiency gains if a fully integrated MEWS is in place alongside a health system with sufficient flexibility to modify control plans in response to information. More countries and programmes should be supported to use the best available evidence and science to integrate climate informed MEWS into decision making within malaria control programmes.Quantifying the burden of malaria remains a major challenge as many infections may be asymptomatic, inadequate diagnosis and reporting and the fact that a majority of febrile cases do not reach the formal health system make estimation imprecise. Recent estimates espouse the figures of 300–600 million infections and 1–3 million deaths per year [1]. Less contentious is the fact that Africa bears the brunt of the malaria burden, with estimates suggesting greater than 60% of the worlds clinical cases and more than 90% of the worlds malaria deaths [2].Africa's population is estimated to pass 1 billion people by 2010 [3]. The
Improving epidemic malaria planning, preparedness and response in Southern Africa
Joaquim DaSilva, Brad Garanganga, Vonai Teveredzi, Sabine M Marx, Simon J Mason, Stephen J Connor
Malaria Journal , 2004, DOI: 10.1186/1475-2875-3-37
Abstract: The SADC countries have adopted the Abuja targets for Roll Back Malaria in Africa, which include improved epidemic detection and response, i.e., that 60% of epidemics will be detected within two weeks of onset, and 60% of epidemics will be responded to within two weeks of detection. The SADC countries recognize that to achieve these targets they need improved information on where and when to look for epidemics. The WHO integrated framework for improved early warning and early detection of malaria epidemics has been recognized as a potentially useful tool for epidemic preparedness and response planning. Following evidence of successful adoption and implementation of this approach in Botswana, the SADC countries, the WHO Southern Africa Inter-Country Programme on Malaria Control, and the SADC Drought Monitoring Centre decided to organize a regional meeting where countries could gather to assess their current control status and community vulnerability, consider changes in epidemic risk, and develop a detailed plan of action for the forthcoming 2004–2005 season. The following is a report on the 1st Southern African Regional Epidemic Outlook Forum, which was held in Harare, Zimbabwe, 26th–29th September, 2004.The Southern African region has a long and varied history of malaria control with periodic epidemics occurring [1,2]. These epidemics can be regional in scale, as in 1996 and 1997, or much more focal, affecting specific districts or sub-districts. The countries of the Southern African Development Community are committed to the Abuja Targets for Roll Back Malaria in Africa, and this includes improved detection and response to epidemics [1]. To meet these targets countries are expected to detect 60% of malaria epidemics within two weeks of onset, and respond to 60% of epidemics within two weeks of their detection. The countries recognize that to achieve these targets they need improved information on where epidemics are most likely to occur, and ideally some indicatio
A Vectorial Capacity Product to Monitor Changing Malaria Transmission Potential in Epidemic Regions of Africa
Pietro Ceccato,Christelle Vancutsem,Robert Klaver,James Rowland,Stephen J. Connor
Journal of Tropical Medicine , 2012, DOI: 10.1155/2012/595948
Abstract: Rainfall and temperature are two of the major factors triggering malaria epidemics in warm semi-arid (desert-fringe) and high altitude (highland-fringe) epidemic risk areas. The ability of the mosquitoes to transmit Plasmodium spp. is dependent upon a series of biological features generally referred to as vectorial capacity. In this study, the vectorial capacity model (VCAP) was expanded to include the influence of rainfall and temperature variables on malaria transmission potential. Data from two remote sensing products were used to monitor rainfall and temperature and were integrated into the VCAP model. The expanded model was tested in Eritrea and Madagascar to check the viability of the approach. The analysis of VCAP in relation to rainfall, temperature and malaria incidence data in these regions shows that the expanded VCAP correctly tracks the risk of malaria both in regions where rainfall is the limiting factor and in regions where temperature is the limiting factor. The VCAP maps are currently offered as an experimental resource for testing within Malaria Early Warning applications in epidemic prone regions of sub-Saharan Africa. User feedback is currently being collected in preparation for further evaluation and refinement of the VCAP model. 1. Introduction Malaria is a major public health threat to the African continent and its control is critical to achieving the Millennium Development Goals in this region [1]. Although considerable progress has been made to reduce the malaria burden in sub-Saharan Africa by introducing control measures such as the provision of insecticide-treated mosquito nets, indoor residual spraying, and easier access to effective antimalarial drugs [2], malaria epidemics continue to occur. Periodic epidemics of malaria are a major public health problem for many sub-Saharan African countries. Populations in epidemic-prone areas have a poorly developed immunity to malaria and the disease remains life threatening to all age groups [3]. The impact of epidemics could be minimized through prediction, improved prevention through timely vector control, and deployment of appropriate control measures. The implementation of a Malaria Early Warning System enables regional health ministries to focus on epidemiological surveillance and be better prepared to take necessary actions. Rainfall and temperature anomalies are two of the major environmental factors triggering epidemics in warm semi-arid and altitude areas. Increases in epidemics often occur in these regions after excessive rains or increases in temperature [4, 5]. The ability
Raised temperatures over the Kericho tea estates: revisiting the climate in the East African highlands malaria debate
Judith A Omumbo, Bradfield Lyon, Samuel M Waweru, Stephen J Connor, Madeleine C Thomson
Malaria Journal , 2011, DOI: 10.1186/1475-2875-10-12
Abstract: Over 30 years (1 January 1979 to 31 December 2009) of quality controlled daily observations ( > 97% complete) of maximum, minimum and mean temperature were used in the analysis of trends at Kericho meteorological station, sited in a tea growing area of Kenya's western highlands. Inhomogeneities in all the time series were identified and corrected. Linear trends were identified via a least-squares regression analysis with statistical significance assessed using a two-tailed t-test. These 'gold standard' meteorological observations were compared with spatially interpolated temperature datasets that have been developed for regional or global applications. The relationship of local climate processes with larger climate variations, including tropical sea surface temperatures (SST), and El Ni?o-Southern Oscillation (ENSO) was also assessed.An upward trend of ≈0.2°C/decade was observed in all three temperature variables (P < 0.01). Mean temperature variations in Kericho were associated with large-scale climate variations including tropical SST (r = 0.50; p < 0.01). Local rainfall was found to have inverse effects on minimum and maximum temperature. Three versions of a spatially interpolated temperature data set showed markedly different trends when compared with each other and with the Kericho station observations.This study presents evidence of a warming trend in observed maximum, minimum and mean temperatures at Kericho during the period 1979 to 2009 using gold standard meteorological observations. Although local factors may be contributing to these trends, the findings are consistent with variability and trends that have occurred in correlated global climate processes. Climate should therefore not be dismissed as a potential driver of observed increases in malaria seen in the region during recent decades, however its relative importance compared to other factors needs further elaboration. Climate services, pertinent to the achievement of development targets such as the
An online operational rainfall-monitoring resource for epidemic malaria early warning systems in Africa
Emily Grover-Kopec, Mika Kawano, Robert W Klaver, Benno Blumenthal, Pietro Ceccato, Stephen J Connor
Malaria Journal , 2005, DOI: 10.1186/1475-2875-4-6
Abstract: Rainfall is one of the major factors triggering epidemics in warm semi-arid and desert-fringe areas. Explosive epidemics often occur in these regions after excessive rains and, where these follow periods of drought and poor food security, can be especially severe. Consequently, rainfall monitoring forms one of the essential elements for the development of integrated Malaria Early Warning Systems for sub-Saharan Africa, as outlined by the World Health Organization.The Roll Back Malaria Technical Resource Network on Prevention and Control of Epidemics recommended that a simple indicator of changes in epidemic risk in regions of marginal transmission, consisting primarily of rainfall anomaly maps, could provide immediate benefit to early warning efforts. In response to these recommendations, the Famine Early Warning Systems Network produced maps that combine information about dekadal rainfall anomalies, and epidemic malaria risk, available via their Africa Data Dissemination Service. These maps were later made available in a format that is directly compatible with HealthMapper, the mapping and surveillance software developed by the WHO's Communicable Disease Surveillance and Response Department. A new monitoring interface has recently been developed at the International Research Institute for Climate Prediction (IRI) that enables the user to gain a more contextual perspective of the current rainfall estimates by comparing them to previous seasons and climatological averages. These resources are available at no cost to the user and are updated on a routine basis.It is estimated that more than 110 million Africans live in areas prone to epidemics of malaria. Populations in these areas are infrequently challenged by malaria and, therefore, do not fully develop acquired immunity. As a result, the disease remains life threatening to all age groups. The impact of malaria epidemics could be greatly reduced by timely detection or, ideally, by prediction and prevention through
A combined phase I and II open label study on the effects of a seaweed extract nutrient complex on osteoarthritis
Stephen P Myers, Joan O’Connor, J Helen Fitton, et al.
Biologics: Targets and Therapy , 2010, DOI: http://dx.doi.org/10.2147/BTT.S8354
Abstract: combined phase I and II open label study on the effects of a seaweed extract nutrient complex on osteoarthritis Original Research (7562) Total Article Views Authors: Stephen P Myers, Joan O’Connor, J Helen Fitton, et al. Published Date February 2010 Volume 2010:4 Pages 33 - 44 DOI: http://dx.doi.org/10.2147/BTT.S8354 Stephen P Myers1,2, Joan O’Connor1,2, J Helen Fitton3, Lyndon Brooks4, Margaret Rolfe4, Paul Connellan5, Hans Wohlmuth2,5,6, Phil A Cheras1,2, Carol Morris5 1NatMed-Research, 2Centre for Health and Wellbeing, 4Graduate Research College, 5Centre for Phytochemistry and Pharmacology, 6Medicinal Plant Herbarium, Southern Cross University, Lismore, NSW, Australia; 3Marinova Pty Ltd, Hobart, Tasmania, Australia Background: Isolated fucoidans from brown marine algae have been shown to have a range of anti-inflammatory effects. Purpose: This present study tested a Maritech extract formulation, containing a blend of extracts from three different species of brown algae, plus nutrients in an open label combined phase I and II pilot scale study to determine both acute safety and efficacy in osteoarthritis of the knee. Patients and methods: Participants (n = 12, five females [mean age, 62 ± 11.06 years] and seven males [mean age, 57.14 ± 9.20 years]) with a confirmed diagnosis of osteoarthritis of the knee were randomized to either 100 mg (n = 5) or 1000 mg (n = 7) of a Maritech extract formulation per day. The formulation contained Maritech seaweed extract containing Fucus vesiculosis (85% w/w), Macrocystis pyrifera (10% w/w) and Laminaria japonica (5% w/w) plus vitamin B6, zinc and manganese. Primary outcome was the average comprehensive arthritis test (COAT) score which is comprised of four sub-scales: pain, stiffness, difficulty with physical activity and overall symptom severity measured weekly. Safety measures included full blood count, serum lipids, liver function tests, urea, creatinine and electrolytes determined at baseline and week 12. All adverse events were recorded. Results: Eleven participants completed 12 weeks and one completed 10 weeks of the study. Using a multilevel linear model, the average COAT score was reduced by 18% for the 100 mg treatment and 52% for the 1000 mg dose at the end of the study. There was a clear dose response effect seen between the two treatments (P ≤ 0.0005) on the average COAT score and each of the four COAT subscales (pain, stiffness, difficulty with physical activity and overall symptom severity) (P ≤ 0.05). The preparation was well tolerated and the few adverse events were unlikely to be related to the study medication. There were no changes in blood parameters measured over the course of the study with the exception of an increase in serum albumin which was not clinically significant. Conclusion: The seaweed extract nutrient complex when taken orally over twelve weeks decreased the symptoms of osteoarthritis in a dose-dependent manner. It was demonstrated to be safe to use over the study period a
A combined Phase I and II open-label study on the immunomodulatory effects of seaweed extract nutrient complex
Stephen P Myers, Joan O'Connor, J Helen Fitton, et al
Biologics: Targets and Therapy , 2011, DOI: http://dx.doi.org/10.2147/BTT.S12535
Abstract: combined Phase I and II open-label study on the immunomodulatory effects of seaweed extract nutrient complex Original Research (4586) Total Article Views Authors: Stephen P Myers, Joan O'Connor, J Helen Fitton, et al Published Date February 2011 Volume 2011:5 Pages 45 - 60 DOI: http://dx.doi.org/10.2147/BTT.S12535 Stephen P Myers1, Joan O'Connor1, J Helen Fitton2, Lyndon Brooks3, Margaret Rolfe3, Paul Connellan4, Hans Wohlmuth4,5, Phil A Cheras1, Carol Morris4 1NatMed-Research Unit, Research Cluster for Health and Wellbeing, Southern Cross University, Lismore, NSW, Australia; 2Marinova Pty Ltd, Cambridge, TAS, Australia; 3Graduate Research College, Southern Cross University, Lismore, NSW, Australia; 4Centre for Phytochemistry and Pharmacology, Southern Cross University, Lismore, NSW, Australia; 5Medicinal Plant Herbarium, Southern Cross University, Lismore, NSW, Australia Background: Isolated fucoidans from brown marine algae have been shown to have a range of immune-modulating effects. This exploratory study aimed to determine whether a seaweed nutrient complex containing a blend of extracts from three different species of brown algae plus nutrients is safe to administer and has biological potential as an immune modulator. The study was undertaken as an open-label combined Phase I and II study. Methods: Participants (n = 10) were randomized to receive the study medication at either a 100 mg (n = 5) or 1000 mg (n = 5) dose over 4 weeks. The primary outcome measurement was in vivo changes in lymphocyte subsets. The secondary outcome measures were ex vivo changes in T-lymphocyte (CD4 and CD8) activation, phagocytosis of granulocytes and monocytes, T helper 1/T helper 2 cytokines, and serum oxygen radical absorbance capacity. Results: The preparation was found to be safe over the 4 weeks at both doses tested. There were no clinically relevant changes to blood measurements of hemopoietic, hepatic, or renal function. Immunomodulatory measurements showed no dose response between the two doses. The combined results from the two doses demonstrated a significant increase in cytotoxic T cell numbers and phagocytic capacity in monocytes, and a significant decrease in levels of the inflammatory cytokine interleukin 6. A separate analysis of the 100 mg dose (n = 5) alone showed a significant linear component over time (P < 0.05) for phagocytosis by both granulocytes and monocytes. Conclusion: The seaweed nutrient complex was safe to use when taken orally over 4 weeks. The preparation was demonstrated to have potential as an immune modulator, and this bioactivity deserves further exploration.
A combined Phase I and II open-label study on the immunomodulatory effects of seaweed extract nutrient complex
Stephen P Myers,Joan O'Connor,J Helen Fitton,et al
Biologics: Targets and Therapy , 2011,
Abstract: Stephen P Myers1, Joan O'Connor1, J Helen Fitton2, Lyndon Brooks3, Margaret Rolfe3, Paul Connellan4, Hans Wohlmuth4,5, Phil A Cheras1, Carol Morris41NatMed-Research Unit, Research Cluster for Health and Wellbeing, Southern Cross University, Lismore, NSW, Australia; 2Marinova Pty Ltd, Cambridge, TAS, Australia; 3Graduate Research College, Southern Cross University, Lismore, NSW, Australia; 4Centre for Phytochemistry and Pharmacology, Southern Cross University, Lismore, NSW, Australia; 5Medicinal Plant Herbarium, Southern Cross University, Lismore, NSW, AustraliaBackground: Isolated fucoidans from brown marine algae have been shown to have a range of immune-modulating effects. This exploratory study aimed to determine whether a seaweed nutrient complex containing a blend of extracts from three different species of brown algae plus nutrients is safe to administer and has biological potential as an immune modulator. The study was undertaken as an open-label combined Phase I and II study.Methods: Participants (n = 10) were randomized to receive the study medication at either a 100 mg (n = 5) or 1000 mg (n = 5) dose over 4 weeks. The primary outcome measurement was in vivo changes in lymphocyte subsets. The secondary outcome measures were ex vivo changes in T-lymphocyte (CD4 and CD8) activation, phagocytosis of granulocytes and monocytes, T helper 1/T helper 2 cytokines, and serum oxygen radical absorbance capacity.Results: The preparation was found to be safe over the 4 weeks at both doses tested. There were no clinically relevant changes to blood measurements of hemopoietic, hepatic, or renal function. Immunomodulatory measurements showed no dose response between the two doses. The combined results from the two doses demonstrated a significant increase in cytotoxic T cell numbers and phagocytic capacity in monocytes, and a significant decrease in levels of the inflammatory cytokine interleukin 6. A separate analysis of the 100 mg dose (n = 5) alone showed a significant linear component over time (P < 0.05) for phagocytosis by both granulocytes and monocytes.Conclusion: The seaweed nutrient complex was safe to use when taken orally over 4 weeks. The preparation was demonstrated to have potential as an immune modulator, and this bioactivity deserves further exploration.Keywords: seaweed, fucoidan, immune system, complementary medicine, nutraceutical
A combined phase I and II open label study on the effects of a seaweed extract nutrient complex on osteoarthritis
Stephen P Myers,Joan O’Connor,J Helen Fitton
Biologics: Targets and Therapy , 2010,
Abstract: Stephen P Myers1,2, Joan O’Connor1,2, J Helen Fitton3, Lyndon Brooks4, Margaret Rolfe4, Paul Connellan5, Hans Wohlmuth2,5,6, Phil A Cheras1,2, Carol Morris51NatMed-Research, 2Centre for Health and Wellbeing, 4Graduate Research College, 5Centre for Phytochemistry and Pharmacology, 6Medicinal Plant Herbarium, Southern Cross University, Lismore, NSW, Australia; 3Marinova Pty Ltd, Hobart, Tasmania, AustraliaBackground: Isolated fucoidans from brown marine algae have been shown to have a range of anti-inflammatory effects.Purpose: This present study tested a Maritech extract formulation, containing a blend of extracts from three different species of brown algae, plus nutrients in an open label combined phase I and II pilot scale study to determine both acute safety and efficacy in osteoarthritis of the knee. Patients and methods: Participants (n = 12, five females [mean age, 62 ± 11.06 years] and seven males [mean age, 57.14 ± 9.20 years]) with a confirmed diagnosis of osteoarthritis of the knee were randomized to either 100 mg (n = 5) or 1000 mg (n = 7) of a Maritech extract formulation per day. The formulation contained Maritech seaweed extract containing Fucus vesiculosis (85% w/w), Macrocystis pyrifera (10% w/w) and Laminaria japonica (5% w/w) plus vitamin B6, zinc and manganese. Primary outcome was the average comprehensive arthritis test (COAT) score which is comprised of four sub-scales: pain, stiffness, difficulty with physical activity and overall symptom severity measured weekly. Safety measures included full blood count, serum lipids, liver function tests, urea, creatinine and electrolytes determined at baseline and week 12. All adverse events were recorded.Results: Eleven participants completed 12 weeks and one completed 10 weeks of the study. Using a multilevel linear model, the average COAT score was reduced by 18% for the 100 mg treatment and 52% for the 1000 mg dose at the end of the study. There was a clear dose response effect seen between the two treatments (P ≤ 0.0005) on the average COAT score and each of the four COAT subscales (pain, stiffness, difficulty with physical activity and overall symptom severity) (P ≤ 0.05). The preparation was well tolerated and the few adverse events were unlikely to be related to the study medication. There were no changes in blood parameters measured over the course of the study with the exception of an increase in serum albumin which was not clinically significant.Conclusion: The seaweed extract nutrient complex when taken orally over twelve weeks decreased the symptoms of osteoarthritis in a dose-de
T Cells at the Site of Autoimmune Inflammation Show Increased Potential for Trogocytosis
Bettina Haastert, Richard J. Mellanby, Stephen M. Anderton, Richard A. O'Connor
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0081404
Abstract: CD4+ T cells acquire membrane fragments from antigen-presenting-cells via a process termed trogocytosis. Identifying which CD4+ T cells undergo trogocytosis in co-culture with Ag-loaded APC can enrich for antigen-reactive T cells without knowledge of their fine specificity or cytokine-production profiles. We sought to assess the suitability of this method to identify disease relevant effector and regulatory T cells during autoimmune inflammation. Trogocytosis efficiently identified MBP-reactive T cells in vitro and ex-vivo following immunization. However, Foxp3+ regulatory T cells constitutively displayed a higher rate of trogocytosis than their Foxp3- counterparts which limits the potential of trogocytosis to identify antigen-reactive Treg cells. During inflammation a locally elevated rate of trogocytosis (seen in both effector and regulatory T cells isolated from the inflamed CNS) precludes the use of trogocytosis as a measure of antigenic reactivity among cells taken from inflammatory sites. Our results indicate trogocytosis detection can enrich for Ag-reactive conventional T cells in the periphery but is limited in its ability to identify Ag-reactive Treg or T effector cells at sites of inflammation. Increased trogocytosis potential at inflammatory sites also draws into the question the biological significance of this phenomenon during inflammation, in Treg mediated suppression and for the maintenance of tolerance in health and disease.
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