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Nontuberculous mycobacteria (NTM) are opportunistic environmental pathogens that can cause chronic lung disease (2,2). NTM are identified through laboratory testing for acid-fast bacilli, which test for all mycobacteria, including Mycobacterium [...]

Introduction: WHO/UNAIDS recommended Voluntary Medical Male Circumcision in 2007 based on systematic review of observational studies prior to 1999 and three randomized controlled trials (RCTs). To inform updated WHO guidance, we conducted a systematic review and meta-analysis of impact of circumcision on the risk of HIV infection among heterosexual men. Methods: Studies in PubMed of HIV incidence and changes in prevalence in heterosexual men by circumcision status were identified. Pooled incidence rate ratios were computed using fixed- and random-effects meta-analysis and risk of bias was assessed using the ROBINS-I tool. Results and Discussion: In three RCTs, the pooled incidence ratio was 0.41 (95% CI 0.30 to 0.56), with risk difference 10 (8 to 12) fewer infections per 1000 person-years (py). Pooled incidence ratios were 0.34 (0.24 to 0.49) in two post-RCT follow-up studies, 0.29 (0.19 to 0.43) in men at high HIV risk (five cohorts), 0.48 (0.33 to 0.70) in four community-based cohorts before circumcision scale-up, and 0.56 (0.49 to 0.64) (7 [6 to 8] fewer per 1000 py) in six community-based cohorts during circumcision and antiretroviral treatment scale-up. Heterogeneity between studies was low except in men at high HIV risk. We estimated 520,000 (425,000 to 605,000) fewer infections occurred in men by end of 2018 from 22.7 million circumcisions performed since 2008 and increasing by 155,000 (125,000 to 180,000) annually if epidemic conditions remain similar. After exclusion of studies with high risk of bias and those conducted outside Africa, pooled incidence ratios were similar. There was no evidence of confounding nor changes in risk behaviour following circumcision. In post-hoc exploratory analyses we observed a trend of decreasing effectiveness of circumcision in cohorts with lower HIV incidence. Conclusions: Efficacy of medical male circumcision on HIV incidence from randomized controlled trials was supported by effectiveness from observational studies in populations with diverse HIV risk and changing epidemic contexts. Voluntary Medical Male Circumcision remains an important evidence-based intervention for control of generalized HIV epidemics. Keywords: circumcision male; HIV incidence; HIV prevention; meta-analysis; review, 1 | INTRODUCTION Data suggesting a potential link between male circumcision and HIV infection at the individual and population levels were published in 1988 [1] and 1989 [2]. A meta-analysis [...]

Hantaviruses belonging to the genus Orthohantavirus, family Hantaviridae, are frequently zoonotic. Rodents are the usual reservoirs of human pathogenic hantaviruses and typically do not show obvious signs of disease (2,2). [...]

Nontuberculous mycobacteria (NTM) are common in the environment. NTM frequently are found in soil and are the most common bacteria on showerhead surfaces (2,2). Although many children likely have daily [...]

Tuberculosis (TB) remains the leading cause of death worldwide from a single infectious disease; in 2017, [approximately equal to]10 million incident cases and 1.7 million deaths were reported (1). The [...]

Buruli ulcer (BU) is a devastating necrotic human skin disease caused by Mycobacterium ulcerans (1). It is the third most common mycobacterial disease after tuberculosis and leprosy; [approximately equal to] [...]

Infectious diseases commonly spread among animal premises by different transmission pathways, including live-animal movement networks that can cause outbreaks in widespread locations or through proximity networks, leading to spatial clusters [...]

Methicillin-resistant Staphylococcus aureus (MRSA) continues to be a prominent healthcare-associated pathogen causing illness and death (1,2). As a result of the widespread implementation of infection control practices in acute-care hospitals, [...]

Rickettsia parkeri, part of the spotted fever group Rickettsia (SFGR), affects humans throughout much of the southern United States (1). Although R. parkeri in an engorged nymph was reported once [...]

Childhood malnutrition is associated with high morbidity and mortality globally.sup.1. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood.sup.2. Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years of age (0-59 months), is a specific subset of undernutrition characterized by insufficient height or weight against age-specific growth reference standards.sup.3-5. The prevalence of stunting, wasting, or underweight in children under five is the proportion of children with a height-for-age, weight-for-height, or weight-for-age z-score, respectively, that is more than two standard deviations below the World Health Organization's median growth reference standards for a healthy population.sup.6. Subnational estimates of CGF report substantial heterogeneity within countries, but are available primarily at the first administrative level (for example, states or provinces).sup.7; the uneven geographical distribution of CGF has motivated further calls for assessments that can match the local scale of many public health programmes.sup.8. Building from our previous work mapping CGF in Africa.sup.9, here we provide the first, to our knowledge, mapped high-spatial-resolution estimates of CGF indicators from 2000 to 2017 across 105 low- and middle-income countries (LMICs), where 99% of affected children live.sup.1, aggregated to policy-relevant first and second (for example, districts or counties) administrative-level units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and progress exist across and within countries; our maps identify high-prevalence areas even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where the highest-need populations reside, these geospatial estimates can support policy-makers in planning interventions that are adapted locally and in efficiently directing resources towards reducing CGF and its health implications. High-resolution subnational mapping of child growth failure indicators for 105 low- and middle-income countries between 2000 and 2017 shows that, despite considerable progress, substantial geographical inequalities still exist in some countries., Author(s): Damaris K. Kinyoki [sup.1] [sup.1] [sup.2] , Aaron E. Osgood-Zimmerman [sup.1] , Brandon V. Pickering [sup.1] , Lauren E. Schaeffer [sup.1] , Laurie B. Marczak [sup.1] , Alice Lazzar-Atwood [...]

Background An ecological relationship between economic development and reduction in tuberculosis prevalence has been observed. Between 2007 and 2017, Viá»t Nam experienced rapid economic development with equitable distribution of resources and a 37% reduction in tuberculosis prevalence. Analysing consecutive prevalence surveys, we examined how the reduction in tuberculosis (and subclinical tuberculosis) prevalence was concentrated between socioeconomic groups. Methods and findings We combined data from 2 nationally representative Viá»t Nam tuberculosis prevalence surveys with provincial-level measures of poverty. Data from 94,156 (2007) and 61,763 (2017) individuals were included. Of people with microbiologically confirmed tuberculosis, 21.6% (47/218) in 2007 and 29.0% (36/124) in 2017 had subclinical disease. We constructed an asset index using principal component analysis of consumption data. An illness concentration index was estimated to measure socioeconomic position inequality in tuberculosis prevalence. The illness concentration index changed from -0.10 (95% CI -0.08, -0.16; p = 0.003) in 2007 to 0.07 (95% CI 0.06, 0.18; p = 0.158) in 2017, indicating that tuberculosis was concentrated among the poorest households in 2007, with a shift towards more equal distribution between rich and poor households in 2017. This finding was similar for subclinical tuberculosis. We fitted multilevel models to investigate relationships between change in tuberculosis prevalence, individual risks, household socioeconomic position, and neighbourhood poverty. Controlling for provincial poverty level reduced the difference in prevalence, suggesting that changes in neighbourhood poverty contribute to the explanation of change in tuberculosis prevalence. A limitation of our study is that while tuberculosis prevalence surveys are valuable for understanding socioeconomic differences in tuberculosis prevalence in countries, given that tuberculosis is a relatively rare disease in the population studied, there is limited power to explore socioeconomic drivers. However, combining repeated cross-sectional surveys with provincial deprivation estimates during a period of remarkable economic growth provides valuable insights into the dynamics of the relationship between tuberculosis and economic development in Viá»t Nam. Conclusions We found that with equitable economic growth and a reduction in tuberculosis burden, tuberculosis became less concentrated among the poor in Viá»t Nam., Author(s): Nicola Foster 1,2,*, Hai V. Nguyen 3,4,5, Nhung V. Nguyen 3, Hoa B. Nguyen 3, Edine W. Tiemersma 6, Frank G. J. Cobelens 4,5, Matthew Quaife 1,2, Rein M. [...]