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Search Results: 1 - 10 of 2219 matches for " Flahault Antoine "
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Editorial: Why a New Journal Called Public Health Reviews?
Flahault Antoine,Fried Linda
Public Health Reviews , 2010,
Abstract: Most public health journals focus on new scientific articles. Public Health Reviews was established to provide reviews of important topics in public health in order to assist in translation of science into practice, in Europe and globally. Our journal is aimed at policy makers, practitioners, scientists, teachers and students of public health. By making it readily available online, we hope to reach those who cannot afford printed journals and online subscriptions in countries and regions with little or no library resources but only internet access. We hope to help in bringing context and analytic capacity to adapt health systems to successful international standards, so as to meet the challenges of change in demography, epidemiology, disease patterns and societal conditions needed to achieve the long-sought goal of health for all.
Influenza pandemics: past, present and future challenges
Flahault Antoine,Zylberman Patrick
Public Health Reviews , 2010,
Abstract: Influenza epidemics occur regularly and prediction of their conversion to pandemics and their impact is difficult. Coordination of efforts on a global scale to control or reduce the impact is fraught with potential for under and overreaction. In light of the 1956 pandemic and more recently the SARS and H1N1 pandemics, the public health community took steps toward strengthening global surveillance and a coordinated response in keeping with the continuing memory of the tragedy seen in 1918. The scientific, professional, and technical resources of the 21st century are now advanced far beyond those then available. The H1N1 pandemic which commenced in 2009 progressed differently than predicted; its course was difficult to predict with any degree of certainty. Public responses to national immunization programs against the H1N1 virus have been weak. International movement of diseases can lead to creation of new endemic areas and continuous spread such as that which happened with West Nile Fever and Chikungunya. The lessons learned and the public and political responses to each actual or threatened pandemic will serve public health well in dealing with future challenges.
Preface: From Science to Public Health: The Helicobacter pylori Case
Flahault Antoine,Tulchinsky Theodore H
Public Health Reviews , 2010,
Abstract: The Nobel Prize for Medicine was awarded in 2005 to JR Warren and BJ Marshall for their identifi cation of the bacteria Helicobacter pylori as the cause of peptic ulcer diseases, establishing another link between infection and chronic diseases. This dramatic scientifi c breakthrough led to curative treatments which reduced suffering from many acute and chronic conditions previously managed with a wide array of medical and surgical care, mostly with poor results. This discovery also had major implications for public health and healthcare systems with reduction in hospitalisation and surgery as well as in gastric cancer. Potential future benefi ts for global health will be expanded through control of infection with this organism which affects half of the world population. Hopefully, a vaccine will soon be found to augment individual care and sanitary methods of control of this common bacterial infection. Professor Robin Warren here recalls the process of this monumental discovery.
Communicable Diseases: Achievements and Challenges for Public Health
Schlipk?ter Ursula,Flahault Antoine
Public Health Reviews , 2010,
Abstract: The past two centuries have seen enormous achievements in control of infectious diseases, previously the leading cause of death, in large measure due to sanitation and food safety, vaccines, antibiotics and improved nutrition. This has led people to put their faith in the notion that medical science would succeed in overcoming the remaining obstacles. Vaccination has eradicated smallpox, nearly eradicated poliomyelitis and greatly reduced many other highly dangerous infections such as diphtheria, tetanus and measles. New diseases such as HIV and new forms of influenza have taken both professional and popular opinion by surprise and have renewed the challenges before the world public health community. Emergence of antibiotic-resistant strains of common organisms due to overuse of antibiotics and lack of vaccines for many dangerous microorganisms poses problems to humanity. This stresses the need for new vaccines, effective antibiotics and strengthened environmental control measures. New knowledge of the microbiological origins of cancers such as that of the cervix, stomach and liver have strengthened primary prevention and brought hope that new cures will be found for other chronic diseases of infectious origin. Tragically long delays in adopting “new” and cost effective vaccines cause hundreds of thousands of preventable deaths each year in developing and mid-level developed countries. Gains are being made in control of many tropical diseases, but malaria, tuberculosis and other infectious diseases remain enormous global problems. Research and acquisition of new knowledge, risk communication, application of currently available means and fair distribution will be great challenges to public health in the coming decades.
Potential for a global dynamic of Influenza A (H1N1)
Antoine Flahault, Elisabeta Vergu, Pierre-Yves Bo?lle
BMC Infectious Diseases , 2009, DOI: 10.1186/1471-2334-9-129
Abstract: We attempted to quantify the possible spread of the pandemic across a network of 52 major cities and to predict the effect of vaccination against the pandemic strain, if available. Predictions are based on simulations from a stochastic SEIR model. Parameters used in the simulations are set to values consistent with recent estimations from the outbreak in Mexico.We show that a two-wave pandemic dynamic may be observed in Southern hemisphere because of seasonal constraints for a maximum value of the basic reproductive number (R0, max) within a city equal to 1.5 and a mean generation interval (GI) of 2 days. In this case and in the absence of vaccination, attack rates may reach 46% when considering a completely susceptible population. More severe scenarios characterized by higher values of R0, max (2.2) and GI (3.1) yield an attack rate of 77%. By extrapolation, we find that mass vaccination in all countries (i.e. up to 50% of the population) implemented 6 months after the start of the pandemic may reduce the cumulative number of cases by 91% in the case of the low transmissible strain (R0, max = 1.5). This relative reduction is only 44% for R0, max = 2.2 since most of the cases occur in the first 6 months and so before the vaccination campaign.Although uncertainties remain about the epidemiological and clinical characteristics of the new influenza strain, this study provides the first analysis of the potential spread of the pandemic and first assessment of the impact of different immunization strategies.Within 15 days of the WHO's raising the pandemic threat level to 6, more countries are affected by the new Swine Origin Influenza Virus (S-OIV) further raising concerns that S-OIV may be the next pandemic influenza strain. Active autonomous chains of transmission have been reported in several countries, such as Mexico, the USA, Canada, Spain and the UK. Most information about the virus and disease so far suggests a regular influenza process with many characteristics si
The unexpected importance of mosquito oviposition behaviour for malaria: non-productive larval habitats can be sources for malaria transmission
Arnaud Menach, F Ellis McKenzie, Antoine Flahault, David L Smith
Malaria Journal , 2005, DOI: 10.1186/1475-2875-4-23
Abstract: Biting and host seeking, not oviposition, have been the focus of most previous studies of mosquitoes and malaria transmission. This study presents a mathematical model that incorporates mosquito oviposition behaviour.The model demonstrates that oviposition is one potential factor explaining heterogeneous biting and vector distribution in a landscape with a heterogeneous distribution of larval habitat. Adult female mosquitoes tend to aggregate around places where they oviposit, thereby increasing the risk of malaria, regardless of the suitability of the habitat for larval development. Thus, a water body may be unsuitable for adult mosquito emergence, but simultaneously, be a source for human malaria.Larval density may be a misleading indicator of a habitat's importance for malaria control. Even if mosquitoes could be lured to oviposit in sprayed larval habitats, this would not necessarily mitigate – and might aggravate – the risk of malaria transmission. Forcing mosquitoes to fly away from humans in search of larval habitat may be a more efficient way to reduce the risk of malaria than killing larvae. Thus, draining, fouling, or filling standing water where mosquitoes oviposit can be more effective than applying larvicide.Malaria is responsible for 700,000 to 2.3 million deaths each year, mainly among children [1]. It is caused by four species of Plasmodium, protozoan parasites that are most common in the tropics, especially Africa, and are transmitted between humans by the bites of female Anopheles mosquitoes. Thus, the distribution of Anopheles mosquitoes is an important factor in determining the prevalence of Plasmodium infections in humans. At large spatial scales (i.e. 100–1,000 kilometers), the distribution of malaria is best described by climate: warm, humid places with standing water support large mosquito populations and high malaria prevalence. At local scales (i.e. 100 metres to one kilometre), the risk of malaria is determined by mosquito behaviour and ec
European Accreditation of Public Health Education
Robert Otok,Ilana Levin,Stojgniew Sitko,Antoine Flahault
Public Health Reviews , 2011,
Abstract: The European Agency for Accreditation in Public Health Education (APHEA) was launched in 2011. This followed nearly two decades of efforts in a variety of programmes supported by international donor agencies, and others that provided experience and field testing of peer review systems for schools of public health in Europe. The Association of Schools of Public Health in the European Region (ASPHER) Public Health Education European Review (PEER) project, devised with the aid of WHO EURO in the early 1990s and later by the Open Society Institute (OSI) within the framework of a joint ASPHER-OSI Program from 2000-2005, helped to develop a cadre of expertise on the process of international peer review and standards that are compatible with a full accreditation process.The purpose of this paper is to provide a brief overview of the background, criteria and current pilot phase of European accreditation for the Master of Public Health degree and equivalent study programmes. Undergoing the accreditation process will help longstanding and new schools review their programmes to meet new European accreditation system standards and provide students, graduates and potential employers with confidence in the future acceptability of their credentials. The new accreditation agency was established by a consortium of European public health organisations and represents a new phase for development of standards and quality of education systems in Europe to face the challenges of workforce development for a “New Public Health” era in the 21st century.
Does the Effectiveness of Control Measures Depend on the Influenza Pandemic Profile?
Solen Kernéis, Rebecca F. Grais, Pierre-Yves Bo?lle, Antoine Flahault, Elisabeta Vergu
PLOS ONE , 2008, DOI: 10.1371/journal.pone.0001478
Abstract: Background Although strategies to contain influenza pandemics are well studied, the characterization and the implications of different geographical and temporal diffusion patterns of the pandemic have been given less attention. Methodology/Main Findings Using a well-documented metapopulation model incorporating air travel between 52 major world cities, we identified potential influenza pandemic diffusion profiles and examined how the impact of interventions might be affected by this heterogeneity. Clustering methods applied to a set of pandemic simulations, characterized by seven parameters related to the conditions of emergence that were varied following Latin hypercube sampling, were used to identify six pandemic profiles exhibiting different characteristics notably in terms of global burden (from 415 to >160 million of cases) and duration (from 26 to 360 days). A multivariate sensitivity analysis showed that the transmission rate and proportion of susceptibles have a strong impact on the pandemic diffusion. The correlation between interventions and pandemic outcomes were analyzed for two specific profiles: a fast, massive pandemic and a slow building, long-lasting one. In both cases, the date of introduction for five control measures (masks, isolation, prophylactic or therapeutic use of antivirals, vaccination) correlated strongly with pandemic outcomes. Conversely, the coverage and efficacy of these interventions only moderately correlated with pandemic outcomes in the case of a massive pandemic. Pre-pandemic vaccination influenced pandemic outcomes in both profiles, while travel restriction was the only measure without any measurable effect in either. Conclusions Our study highlights: (i) the great heterogeneity in possible profiles of a future influenza pandemic; (ii) the value of being well prepared in every country since a pandemic may have heavy consequences wherever and whenever it starts; (iii) the need to quickly implement control measures and even to anticipate pandemic emergence through pre-pandemic vaccination; and (iv) the value of combining all available control measures except perhaps travel restrictions.
Predicting Pneumonia and Influenza Mortality from Morbidity Data
Lise Denoeud, Clément Turbelin, Séverine Ansart, Alain-Jacques Valleron, Antoine Flahault, Fabrice Carrat
PLOS ONE , 2007, DOI: 10.1371/journal.pone.0000464
Abstract: Background Few European countries conduct reactive surveillance of influenza mortality, whereas most monitor morbidity. Methodology/Principal Findings We developed a simple model based on Poisson seasonal regression to predict excess cases of pneumonia and influenza mortality during influenza epidemics, based on influenza morbidity data and the dominant types/subtypes of circulating viruses. Epidemics were classified in three levels of mortality burden (“high”, “moderate” and “low”). The model was fitted on 14 influenza seasons and was validated on six subsequent influenza seasons. Five out of the six seasons in the validation set were correctly classified. The average absolute difference between observed and predicted mortality was 2.8 per 100,000 (18% of the average excess mortality) and Spearman's rank correlation coefficient was 0.89 (P = 0.05). Conclusions/Significance The method described here can be used to estimate the influenza mortality burden in countries where specific pneumonia and influenza mortality surveillance data are not available.
Chikungunya Fever: A Clinical and Virological Investigation of Outpatients on Reunion Island, South-West Indian Ocean
Simon-Djamel Thiberville ,Veronique Boisson,Jean Gaudart,Fabrice Simon,Antoine Flahault,Xavier de Lamballerie
PLOS Neglected Tropical Diseases , 2013, DOI: 10.1371/journal.pntd.0002004
Abstract: Background Chikungunya virus (CHIKV) is responsible for acute febrile polyarthralgia and, in a proportion of cases, severe complications including chronic arthritis. CHIKV has spread recently in East Africa, South-West Indian Ocean, South-Asia and autochthonous cases have been reported in Europe. Although almost all patients are outpatients, medical investigations mainly focused on hospitalised patients. Methodology/Principal Findings Here, we detail clinico-biological characteristics of Chikungunya (CHIK) outpatients in Reunion Island (2006). 76 outpatients with febrile arthralgia diagnosed within less than 48 hours were included by general practitioners during the CuraChik clinical trial. CHIK was confirmed in 54 patients and excluded in 22. A detailed clinical and biological follow-up was organised, that included analysis of viral intrahost diversity and telephone survey until day 300. The evolution of acute CHIK included 2 stages: the ‘viral stage’ (day 1–day 4) was associated with rapid decrease of viraemia and improvement of clinical presentation; the ‘convalescent stage’ (day 5–day 14) was associated with no detectable viraemia but a slower clinical improvement. Women and elderly had a significantly higher number of arthralgia at inclusion and at day 300. Based on the study clinico-biological dataset, scores for CHIK diagnosis in patients with recent febrile acute polyarthralgia were elaborated using arthralgia on hands and wrists, a minor or absent myalgia and the presence of lymphopenia (<1G/L) as major orientation criteria. Finally, we observed that CHIKV intra-host genetic diversity increased over time and that a higher viral amino-acid complexity at the acute stage was associated with increased number of arthralgia and intensity of sequelae at day 300. Conclusions/Significance This study provided a detailed picture of clinico-biological CHIK evolution at the acute phase of the disease, allowed the elaboration of scores to assist CHIK diagnosis and investigated for the first time the impact of viral intra-host genetic diversity on the disease course.
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