vaccines_the week in review_21 june 2010

8/9/2019 Vaccines_The Week in Review_21 June 2010

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Vaccines: The Week in Review21 June 2010Center for Vaccine Ethics & Policy http://centerforvaccineethicsandpolicy.wordpress.com/

A program of- Center for Bioethics, University of Pennsylvania

http://www.bioethics.upenn.edu/

- The Wistar Institute Vaccine Centerhttp://www.wistar.org/vaccinecenter/default.html

- Childrens Hospital of Philadelphia, Vaccine Education Center http://www.chop.edu/consumer/jsp/microsite/microsite.jsp

This weekly summary targets news and events in the global vaccines field gatheredfrom key governmental, NGO and company announcements, key journals andevents. This summary provides support for ongoing initiatives of the Center forVaccine Ethics & Policy, and is not intended to be exhaustive in its coverage.

Vaccines: The Week in Review is now also posted in a blog format athttp://centerforvaccineethicsandpolicy.wordpress.com/. Each item is treated as an individual

post on the blog, allowing for more effective retrospective searching. Given emailsystem conventions and formats, you may find this alternative more effective. This

blog also allows for RSS feeds, etc.Comments and suggestions should be directed to

David R. Curry, MSEditor andExecutive DirectorCenter for Vaccine Ethics & Policy

[email protected]

GAVIs confirmed that it will hold its first replenishment

meeting on 6 October in New York as its Board agreed in principleto move forward with funding for applications from 15 developingcountries and also agreed in principle to call for a new round ofapplications to support country immunization programs, and. Donorsand potential donors will be invited to come with firm financial commitmentsto support GAVIs immunisation programmes. GAVI said its Board heardthat it (GAVI) needs US$4.3 billion between now and 2015 if it is to continueits current programmes and roll out new vaccines against pneumococcaldisease and rotavirus to more than 40 countries. This figure includes anadditional US$ 2.6 billion over and above current levels of funding.

GAVI Board Chair Mary Robinson. Children have a right to health and wehave it in our power to set them on a path to healthy and productive lives.

There comes a time to stop talking and start doing. I sincerely hope that wewill see donors put their money on the table. Without this funding forimmunisation, the world will not reach Millennium Development Goal 4 toreduce under-five mortality by two-thirds by 2015.http://www.gavialliance.org/media_centre/press_releases/2010_06_18_donors

_increased_funding.phpIn a Financial Times (15 June 2010) article, GAVI CEO Julian Lob-Levyt,commenting on the funding shortfall, said: The board has been prettyresponsible, but we will need to raise more funding if we are to roll out
http://centerforvaccineethicsandpolicy.wordpress.com/http://www.bioethics.upenn.edu/http://www.wistar.org/vaccinecenter/default.htmlhttp://www.chop.edu/consumer/jsp/microsite/microsite.jsphttp://centerforvaccineethicsandpolicy.wordpress.com/mailto:[email protected]://www.gavialliance.org/media_centre/press_releases/2010_06_18_donors_increased_funding.phphttp://www.gavialliance.org/media_centre/press_releases/2010_06_18_donors_increased_funding.phphttp://centerforvaccineethicsandpolicy.wordpress.com/http://www.bioethics.upenn.edu/http://www.wistar.org/vaccinecenter/default.htmlhttp://www.chop.edu/consumer/jsp/microsite/microsite.jsphttp://centerforvaccineethicsandpolicy.wordpress.com/mailto:[email protected]://www.gavialliance.org/media_centre/press_releases/2010_06_18_donors_increased_funding.phphttp://www.gavialliance.org/media_centre/press_releases/2010_06_18_donors_increased_funding.php


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vaccines as fast as planned. Did anyone anticipate the international financialcrisis? We have a prioritisation strategy that will focus on having themaximum impact. The article notes that to help maintain its plans, theboard may seek $500M-$700M in cost savings, including a $50M cut insupport it provides to the World Health Organisation, more aggressivenegotiations on vaccine prices with pharmaceutical companies, and demands

that richer developing countries make larger contributions to the cost of theimmunisation programmes.http://www.ft.com/cms/s/0/6b378748-7875-11df-942a-00144feabdc0.html

A range of stakeholders formally launched a new 2010-12 polioeradication strategic plan in Geneva. Last month, the World HealthAssembly welcomed the new plan while expressing deep concern about theUS$ 1.3 billion funding shortfall (out of a budget of US$ 2.6 billion) over thenext three years. This financing shortfall is a serious risk to the eradication ofpolio activities are already being cut back or postponed due to a lack of

funds. The meting was co-hosted by WHO and UNICEF and attended by theMinisters of Health of Nigeria, Afghanistan, Angola and Senegal, among anumber of other senior health ministry officials; existing and potentialfunders; vaccine manufacturers, and key partner organizations. Tachi

Yamada, president of global health at the Bill & Melinda Gates Foundation,commented, Polio eradication remains an urgent priority for our foundation.We call on donor governments to also prioritize polio as we seek to eliminatethese last, most difficult cases.

The Global Polio Eradication Initiative (GPEI) is spearheaded by nationalgovernments, WHO, Rotary International, the US Centers for Disease Controland Prevention (CDC) and UNICEF. Since 1988 (the year the GPEI waslaunched), the incidence of polio has been reduced by more than 99%. In1988, more than 350 000 children were paralyzed each year in more than125 endemic countries. In 2009, 1 595 children were paralyzed in 24countries. Only four countries remain endemic: Afghanistan, India, Nigeria,and Pakistan.http://www.who.int/mediacentre/news/releases/2010/polio_eradication_20100616/en/index.html

The WHO continues to issue weekly updates and occasional briefing noteson the H1N1 pandemic athttp://www.who.int/csr/disease/swineflu/en/index.htmlPandemic (H1N1) 2009 - update 105Weekly update18 June 2010 -- As of 13 June, worldwide more than 214 countries andoverseas territories or communities have reported laboratory confirmedcases of pandemic influenza H1N1 2009, including over 18172 deathsSituation update:

The situation remains largely unchanged since the last update. Overallpandemic influenza activity remains low worldwide with geographically
http://www.ft.com/cms/s/0/6b378748-7875-11df-942a-00144feabdc0.htmlhttp://www.who.int/mediacentre/news/releases/2010/polio_eradication_20100616/en/index.htmlhttp://www.who.int/mediacentre/news/releases/2010/polio_eradication_20100616/en/index.htmlhttp://www.who.int/csr/disease/swineflu/en/index.htmlhttp://www.ft.com/cms/s/0/6b378748-7875-11df-942a-00144feabdc0.htmlhttp://www.who.int/mediacentre/news/releases/2010/polio_eradication_20100616/en/index.htmlhttp://www.who.int/mediacentre/news/releases/2010/polio_eradication_20100616/en/index.htmlhttp://www.who.int/csr/disease/swineflu/en/index.html


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limited circulation of pandemic influenza virus in parts of the tropics,particularly in parts of Central America and the Caribbean and in parts ofSouth and Southeast Asia. Seasonal influenza type B viruses continue tocirculate at low levels across Asia and to a lesser extent across parts of Africaand South America. Recently re-emerged seasonal influenza H3N2 virusescontinue to circulate in East Africa. As countries of the temperate southern

hemisphere enter winter, overall only sporadic influenza activity has beendetected so farMore at: http://www.who.int/csr/don/2010_06_18/en/index.htmlPandemic (H1N1) 2009 briefing note 2110 JUNE 2010The international response to the influenza pandemic: WHOresponds to the criticsBackgroundOn Friday 4 June 2010, the BMJ, formerly British Medical Journal, and theParliamentary Assembly of the Council of Europe (PACE) simultaneouslyreleased reports critical of the World Health Organization's handling of theH1N1 pandemic. WHO provided a response organized around key questions

as below:- Did WHO remove severity from the definition of a pandemic?- Did WHO exaggerate the threat?- Were any WHO pandemic decisions made to increase industry profits?- What safeguards are in place to guard against conflicts of interest?- What is the function of the Emergency Committee and why have the namesof its members not been disclosed?- What evidence supports a role for antiviral drugs during an influenzapandemic?- Was a WHO meeting held in 2002 on influenza vaccines and antiviral drugsinfluenced by industry?

The full response is available at:http://www.who.int/csr/disease/swineflu/notes/briefing_20100610/en/index.html

The International Federation of Pharmaceutical Manufacturers &Associations (IFPMA) said it delivered a formal statement to theUnited Nations General Assembly Hearings with NGOs, Civil Societyand the Private Sector on the UN Millennium Development Goals. TheIFPMA said it is the only industry body selected to make such a statement,which outlined its members major contributions to the health-related UNMDGs, their observations on the lessons learnt from their wide range ofprograms to help improve health in developing countries, andrecommendations for advancing progress in this area. IFPMA DirectorGeneral Eduardo Pisani said: The scale of the challenge posed by the UNMDGs is large. We can only hope to achieve them through globalpartnerships, with contributions from countries of all levels of economicdevelopment, and the active participation of governments,intergovernmental organizations, NGOs, philanthropic groups and the privatesector. The R&D-based pharmaceutical industry contributes to global health
http://www.who.int/csr/don/2010_06_18/en/index.htmlhttp://www.who.int/csr/disease/swineflu/notes/briefing_20100610/en/index.htmlhttp://www.who.int/csr/disease/swineflu/notes/briefing_20100610/en/index.htmlhttp://www.who.int/csr/don/2010_06_18/en/index.htmlhttp://www.who.int/csr/disease/swineflu/notes/briefing_20100610/en/index.htmlhttp://www.who.int/csr/disease/swineflu/notes/briefing_20100610/en/index.html


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through its normal business activity of developing new medicines, but it alsomakes additional contributions to improving developing country health,through an extensive range of not-for-profit and philanthropic partnershipprograms to improve access to health care, strengthen health care capacityand develop new medicines for diseases of the developing world.http://www.ifpma.org/News/NewsReleaseDetail.aspx?nID=13802

The U.S. Department of State, U.S. Agency for InternationalDevelopment and U.S. Department of Health and Human Services

jointly announced the first round of "GHI Plus" countries under theU.S. Global Health Initiative (GHI). GHI is described as a six-year, $63billion initiative to help partner countries improve measurable healthoutcomes by strengthening health systems and building upon proven results.It places a particular focus on improving the health of women, newborns andchildren. GHI includes programs addressing HIV/AIDS, malaria, tuberculosis,maternal and child health, nutrition, family planning and reproductive health,

and neglected tropical diseases.GHI activities are being implemented in the more than 80 countries where

U.S. government global health dollars are already at work. Under GHI, theU.S. government will coordinate with partner country governments to ensurethat investments align with national priorities and build capacity. Eightcountries have been selected as the first set of "GHI Plus" countries:Bangladesh, Ethiopia, Guatemala, Kenya, Malawi, Mali, Nepal, and Rwanda.

These countries will receive additional technical and management resourcesto quickly implement GHI's approach, including integrated programs andinvestments across the spectrum of infectious diseases, maternal and childhealth, family planning, and health systems activities. GHI Plus countries willprovide enhanced opportunities to build upon existing public healthprograms; improve program performance; and work in close collaborationwith partner governments, across U.S. government agencies, and with globalpartners. Through GHI, the U.S. government said it is pursuing acomprehensive "whole-of-government" approach to global health and healthassistance. More at: www.cdc.gov/globalhealth/.http://www.cdc.gov/media/pressrel/2010/r100618.htm

The Weekly Epidemiological Record (WER) for 18 June 2010, vol. 85,25 (pp 236248)Includes: Monitoring the coverage and impact of human papillomavirusvaccine report of WHO meeting, November 2009; Performance of acuteflaccid paralysis (AFP) surveillance and incidence of poliomyelitis, 2010;Monthly report on dracunculiasis cases, January April 2010http://www.who.int/wer/2010/wer8525.pdf

Journal Watch[Editors Note]
http://www.ifpma.org/News/NewsReleaseDetail.aspx?nID=13802http://www.cdc.gov/globalhealth/http://www.cdc.gov/media/pressrel/2010/r100618.htmhttp://www.who.int/wer/2010/wer8525.pdfhttp://www.ifpma.org/News/NewsReleaseDetail.aspx?nID=13802http://www.cdc.gov/globalhealth/http://www.cdc.gov/media/pressrel/2010/r100618.htmhttp://www.who.int/wer/2010/wer8525.pdf


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Vaccines: The Week in Review continues its weekly scanning of key journalsto identify and cite articles, commentary and editorials, books reviews andother content supporting our focus on vaccine ethics and policy.JournalWatch is not intended to be exhaustive, but indicative of themes andissues the Center is actively tracking. We selectively provide full text ofsome editorial and comment articles that are specifically relevant to our

work. Successful access to some of the links provided may requiresubscription or other access arrangement unique to the publisher. Our initialscan list includes the journals below. If you would like to suggest other titles,please write to David Curry [email protected]

Clinical Infectious Diseases15 July 2010 Volume 51, Number 2http://www.journals.uchicago.edu/toc/cid/current[No relevant content]

Emerging Infectious DiseasesVolume 16, Number 6June 2010http://www.cdc.gov/ncidod/EID/index.htm[Reviewed earlier]

Human VaccinesVolume 6, Issue 6 June 2010http://www.landesbioscience.com/journals/vaccines/toc/volume/6/issue/6/[Reviewed earlier]

JAMAVol. 303 No. 23, pp. 2323-2430, June 16, 2010http://jama.ama-assn.org/current.dtlThe Adult Hepatitis Vaccine ProjectCalifornia, 2007-2008JAMA. 2010;303(23):2351-2352.

Journal of Infectious Diseases15 July 2010 Volume 202, Number 2http://www.journals.uchicago.edu/toc/jid/currentMajor Articles and Brief Reports: Viruses

The Prevalence of Hepatitis B Virus Infection in the United States inthe Era of VaccinationAnnemarie Wasley, Deanna Kruszon-Moran, Wendi Kuhnert, Edgar P. Simard,Lyn Finelli, Geraldine McQuillan, and Beth Bell

Background. Our objective was to assess trends in the prevalence ofhepatitis B virus (HBV) infection in the United States after widespreadhepatitis B vaccination.

Methods. The prevalence of HBV infection and immunity was determinedin a representative sample of the US population for the periods 19992006
mailto:[email protected]://www.journals.uchicago.edu/toc/cid/currenthttp://www.cdc.gov/ncidod/EID/index.htmhttp://www.landesbioscience.com/journals/vaccines/toc/volume/6/issue/6/http://jama.ama-assn.org/current.dtlhttp://www.journals.uchicago.edu/toc/jid/currentmailto:[email protected]://www.journals.uchicago.edu/toc/cid/currenthttp://www.cdc.gov/ncidod/EID/index.htmhttp://www.landesbioscience.com/journals/vaccines/toc/volume/6/issue/6/http://jama.ama-assn.org/current.dtlhttp://www.journals.uchicago.edu/toc/jid/current


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and 19881994. National Health and Nutrition Examination Surveysparticipants 6 years of age were tested for antibody to hepatitis B coreantigen (anti-HBc), hepatitis B surface antigen (HBsAg), and antibody tohepatitis B surface antigen (anti-HBs). Prevalence estimates were weightedand age-adjusted.

Results. During the period 19992006, ageadjusted prevalences of anti

HBc (4.7%) and HBsAg (0.27%) were not statistically different from what theywere during 19881994 (5.4% and 0.38%, respectively). The prevalence ofanti-HBc decreased among persons 619 years of age (from 1.9% to 0.6%;

) and 2049 years of age (from 5.9% to 4.6%; ) but not amongpersons 50 years of age (7.2% vs 7.7%). During 19992006, the prevalenceof anti-HBc was higher among non-Hispanic blacks (12.2%) and persons ofOther race (13.3%) than it was among non-Hispanic whites (2.8%) orMexican Americans (2.9%), and it was higher among foreign-born participants(12.2%) than it was among USborn participants (3.5%). Prevalence amongUS-born children 619 years of age (0.5%) did not differ by race or ethnicity.Disparities between USborn and foreignborn children were smaller during19991996 (0.5% vs 2.0%) than during 19881994 (1.0% vs 12.8%). Among

children 619 years of age, 56.7% had markers of vaccine-induced immunity.Conclusions. HBV prevalence decreased among US children, which

reflected the impact of global and domestic vaccination, but it changed littleamong adults, and 730,000 US residents (95% confidence interval, 550,000940,000) are chronically infected.

The LancetJun 19, 2010 Volume 375 Number 9732 Pages 2121 - 2192http://www.thelancet.com/journals/lancet/issue/currentSeriesHealth-system strengthening and tuberculosis controlRifat Atun, Diana EC Weil, Mao Tan Eang, David MwakyusaWeak health systems are hindering global efforts for tuberculosis care andcontrol, but little evidence is available on effective interventions to addresssystem bottlenecks. This report examines published evidence, programmereviews, and case studies to identify innovations in system design andtuberculosis control to resolve these bottlenecks. We outline systembottlenecks in relation to governance, financing, supply chain management,human resources, health-information systems, and service delivery; andadverse effects from rapid introduction of suboptimum system designs.Scale-up of services and research priorities for diagnosis,management, and control of tuberculosis: a call to actionBen J Marais, Mario C Raviglione, Peter R Donald, Anthony D Harries, Afranio LKritski, Stephen M Graham, Wafaa M El-Sadr, Mark Harrington, GavinChurchyard, Peter Mwaba, Ian Sanne, Stefan HE Kaufmann, Christopher JMWhitty, Rifat Atun, Alimuddin Zumla

The Millennium Development Goal target for tuberculosis control is to halt thespread of tuberculosis by 2015, and begin to reverse the worldwideincidence. After the introduction of standard control practices in 1995, 36million people were cured and about 6 million deaths were averted. However,substantial scientific advances and innovative solutions are urgently needed
http://www.thelancet.com/journals/lancet/issue/currenthttp://removepreview%28%27previewright5%27%29/http://www.thelancet.com/journals/lancet/issue/current


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together with creative new strategies. Strong international and nationalpolitical commitment is essential. Urgent action is needed by nationalgovernments to fund their own programmes, and for the G8 countries andother donor governments and organisations to support governmental andnon-governmental efforts.

The Lancet Infectious DiseaseJul 2010 Volume 10 Number 7 Pages 441 - 504http://www.thelancet.com/journals/laninf/issue/currentLeading EdgeThe deadly synergy of HIV and tuberculosis

The Lancet Infectious DiseasesTo coincide with the International AIDS Conference being held this month inVienna, Austria, we publish in this issue of the journal six Review andPersonal View papers on a diversity of subjects related to HIV/AIDS. Inaddition, page 446 features a profile of Gottfried Hirnschall, the newlyappointed Director of WHO's HIV/AIDS Department.

ReviewEffect of treating co-infections on HIV-1 viral load: a systematicreviewKayvon Modjarrad, Sten H VermundCo-infections contribute to HIV-related pathogenesis and often increase viralload in HIV-infected people. We did a systematic review to assess the effectof treating key co-infections on plasma HIV-1-RNA concentrations in low-income countries. We identified 18 eligible studies for review: two ontuberculosis, two on malaria, six on helminths, and eight on sexuallytransmitted infections, excluding untreatable or non-pathogenic infections.Standardised mean plasma viral load decreased after the treatment of co-infecting pathogens in all 18 studies.Risk of resistance to highly active antiretroviral therapy among HIV-positive injecting drug users: a meta-analysisDaniel Werb, Edward J Mills, Julio SG Montaner, Evan WoodAlthough highly active antiretroviral therapy (HAART) is an effectivetreatment for HIV, many physicians withhold this treatment from HIV-positiveinjecting drug users (IDUs) because of fears of non-adherence andconsequent development of antiretroviral resistance. Little is known,however, about whether the rates of resistance differ between IDUs and non-IDUs. We did a meta-analysis of studies that compared antiretroviralresistance rates in IDUs (current or previous) with those in HIV-positivepatients infected by other routes and who had never injected drugs.HIV-associated psoriasis: pathogenesis, clinical features, andmanagementNilesh Morar, Saffron A Willis-Owen, Toby Maurer, Christopher B BunkerPsoriasis is a chronic papulosquamous skin disease that is thought to be a T-cell-mediated autoimmune disorder of keratinocyte proliferation. Theassociation between psoriasis and HIV infection seems paradoxical, butinsights into the role of T-cell subsets, autoimmunity, genetic susceptibility,and infections associated with immune dysregulation might clarify ourunderstanding of the pathogenesis of psoriasis with HIV in general. HIV-
http://www.thelancet.com/journals/laninf/issue/currenthttp://removepreview%28%27previewright3%27%29/http://removepreview%28%27previewleft1%27%29/http://www.thelancet.com/journals/laninf/issue/current


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associated psoriasis can be clinically confusing because several comorbidskin disorders in patients with HIV can mimic psoriasis.Central Asia: hotspot in the worldwide HIV epidemicClaire Thorne, Nina Ferencic, Ruslan Malyuta, Jadranka Mimica, TomaszNiemiecThe HIV epidemic in central Asia (Kazakhstan, Kyrgyzstan, Tajikistan,

Turkmenistan, and Uzbekistan) has accelerated since 2000. This expansion inthe epidemic is largely attributable to escalating injection drug use, reflectingcentral Asia's geographic position along major drug trafficking routes.Although up to 75% of cumulative HIV cases have been among injection drugusers (IDUs) so far, HIV infections are increasing in other population groups,including female sex workers and their clients, prisoners, and migrants.

NatureVolume 465 Number 7300 pp845-974 17 June 2010http://www.nature.com/nature/current_issue.html[No relevant content]

New England Journal of MedicineVolume 362 June 17, 2010 Number 24http://content.nejm.org/current.shtmlPerspectiveEnrolling Pregnant Women in Research Lessons from the H1N1Influenza PandemicS. F. Goldkind, L. Sahin, and B. Gallauresi

The global H1N1 influenza pandemic disproportionately affected pregnantwomen, drawing attention to the fact that although they need safe andeffective medical treatment, they have always been a marginalized studypopulation. Antiviral agents for treating influenza have been available in theUnited States for more than 10 years and are widely prescribed for pregnantwomen. Despite the understanding that physiological changes associatedwith pregnancy (e.g., changes in renal and hepatic function) can markedlyalter pharmacokinetics, pharmacokinetic studies have not routinely beenconducted in this population.

The Pediatric Infectious Disease JournalJune 2010 - Volume 29 - Issue 6http://journals.lww.com/pidj/pages/currenttoc.aspx[Reviewed earlier]

PediatricsJune 2010 / VOLUME 125 / ISSUE 6http://pediatrics.aappublications.org/current.shtml[No relevant content]
http://www.nature.com/nature/current_issue.htmlhttp://content.nejm.org/current.shtmlhttp://journals.lww.com/pidj/pages/currenttoc.aspxhttp://pediatrics.aappublications.org/current.shtmlhttp://removepreview%28%27previewright4%27%29/http://www.nature.com/nature/current_issue.htmlhttp://content.nejm.org/current.shtmlhttp://journals.lww.com/pidj/pages/currenttoc.aspxhttp://pediatrics.aappublications.org/current.shtml


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PLoS Medicine(Accessed 21 June 2010)http://medicine.plosjournals.org/perlserv/?request=browse&issn=1549-1676&method=pubdate&search_fulltext=1&order=online_date&row_start=1&limit=10&document_count=1533&ct=1&SESSID=aac96924d41874935d8e1c2a2501181c#results

Estimating the Global Clinical Burden of Plasmodium falciparumMalaria in 2007Simon I. Hay, Emelda A. Okiro, Peter W. Gething, Anand P. Patil, Andrew J.

Tatem, Carlos A. Guerra, Robert W. SnowBackground

The epidemiology of malaria makes surveillance-based methods ofestimating its disease burden problematic. Cartographic approaches haveprovided alternative malaria burden estimates, but there remains widespreadmisunderstanding about their derivation and fidelity. The aims of this studyare to present a new cartographic technique and its application for derivingglobal clinical burden estimates of Plasmodium falciparum malaria for 2007,and to compare these estimates and their likely precision with those derived

under existing surveillance-based approaches.Methods and Findings

In seven of the 87 countries endemic for P. falciparum malaria, the healthreporting infrastructure was deemed sufficiently rigorous for case reports tobe used verbatim. In the remaining countries, the mapped extent of unstableand stable P. falciparum malaria transmission was first determined. Estimatesof the plausible incidence range of clinical cases were then calculated withinthe spatial limits of unstable transmission. A modelled relationship betweenclinical incidence and prevalence was used, together with new maps of P.falciparum malaria endemicity, to estimate incidence in areas of stabletransmission, and geostatistical joint simulation was used to quantifyuncertainty in these estimates at national, regional, and global scales.Combining these estimates for all areas of transmission risk resulted in 451million (95% credible interval 349552 million) clinical cases of P. falciparummalaria in 2007. Almost all of this burden of morbidity occurred in areas ofstable transmission. More than half of all estimated P. falciparum clinicalcases and associated uncertainty occurred in India, Nigeria, the DemocraticRepublic of the Congo (DRC), and Myanmar (Burma), where 1.405 billionpeople are at risk.Recent surveillance-based methods of burden estimation were then reviewedand discrepancies in national estimates explored. When thesecartographically derived national estimates were ranked according to theirrelative uncertainty and replaced by surveillance-based estimates in the leastcertain half, 98% of the global clinical burden continued to be estimated bycartographic techniques.

Conclusions and SignificanceCartographic approaches to burden estimation provide a globally consistentmeasure of malaria morbidity of known fidelity, and they represent the onlyplausible method in those malaria-endemic countries with nonfunctionalnational surveillance. Unacceptable uncertainty in the clinical burden ofmalaria in only four countries confounds our ability to evaluate needs andmonitor progress toward international targets for malaria control at the global
http://medicine.plosjournals.org/perlserv/?request=browse&issn=1549-1676&method=pubdate&search_fulltext=1&order=online_date&row_start=1&limit=10&document_count=1533&ct=1&SESSID=aac96924d41874935d8e1c2a2501181c#resultshttp://medicine.plosjournals.org/perlserv/?request=browse&issn=1549-1676&method=pubdate&search_fulltext=1&order=online_date&row_start=1&limit=10&document_count=1533&ct=1&SESSID=aac96924d41874935d8e1c2a2501181c#resultshttp://medicine.plosjournals.org/perlserv/?request=browse&issn=1549-1676&method=pubdate&search_fulltext=1&order=online_date&row_start=1&limit=10&document_count=1533&ct=1&SESSID=aac96924d41874935d8e1c2a2501181c#resultshttp://medicine.plosjournals.org/perlserv/?request=browse&issn=1549-1676&method=pubdate&search_fulltext=1&order=online_date&row_start=1&limit=10&document_count=1533&ct=1&SESSID=aac96924d41874935d8e1c2a2501181c#resultshttp://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000290http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000290http://medicine.plosjournals.org/perlserv/?request=browse&issn=1549-1676&method=pubdate&search_fulltext=1&order=online_date&row_start=1&limit=10&document_count=1533&ct=1&SESSID=aac96924d41874935d8e1c2a2501181c#resultshttp://medicine.plosjournals.org/perlserv/?request=browse&issn=1549-1676&method=pubdate&search_fulltext=1&order=online_date&row_start=1&limit=10&document_count=1533&ct=1&SESSID=aac96924d41874935d8e1c2a2501181c#resultshttp://medicine.plosjournals.org/perlserv/?request=browse&issn=1549-1676&method=pubdate&search_fulltext=1&order=online_date&row_start=1&limit=10&document_count=1533&ct=1&SESSID=aac96924d41874935d8e1c2a2501181c#resultshttp://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000290http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000290


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scale. National prevalence surveys in each nation would reduce thisuncertainty profoundly. Opportunities for further reducing uncertainty inclinical burden estimates by hybridizing alternative burden estimationprocedures are also evaluated.

Science18 June 2010 Vol 328, Issue 5985, Pages 1437-1598http://www.sciencemag.org/current.dtl[No relevant content]

Science Translational Medicine16 June 2010 vol 2, issue 36http://stm.sciencemag.org/content/current[No relevant content]

VaccineVolume 28, Issue 29, Pages 4539-4686 (23 June 2010)http://www.sciencedirect.com/science/journal/0264410X[Reviewed last week]
http://www.sciencemag.org/current.dtlhttp://stm.sciencemag.org/content/currenthttp://www.sciencedirect.com/science/journal/0264410Xhttp://www.sciencemag.org/current.dtlhttp://stm.sciencemag.org/content/currenthttp://www.sciencedirect.com/science/journal/0264410X

vaccines_the week in review_21 june 2010

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