Showing papers by "Pagbajabyn Nymadawa published in 2016"
University of Cambridge1, University of Bologna2, Estonian Biocentre3, University of Bristol4, Harvard University5, King Abdullah University of Science and Technology6, University of Tartu7, University of Montpellier8, University of Auckland9, Massey University10, Pennsylvania State University11, University of California, San Francisco12, Biodesign Institute13, Arizona State University14, University of Southampton15, University of Montana16, National Academy of Sciences of Belarus17, Wellcome Trust Sanger Institute18, Kuban State Medical University19, University of Georgia20, University of Copenhagen21, Griffith University22, Academy of Sciences of Uzbekistan23, L.N.Gumilyov Eurasian National University24, University of Dhaka25, University of Pennsylvania26, Georgia Institute of Technology27, Russian Academy of Sciences28, Academy of Medical Sciences, United Kingdom29, Royal Free Hospital30, University of Kharkiv31, Centre national de la recherche scientifique32, Eijkman Institute for Molecular Biology33, North-Eastern Federal University34, Josip Juraj Strossmayer University of Osijek35, Armenian National Academy of Sciences36, University of Winchester37, University Hospital Heidelberg38, Novosibirsk State University39, Bashkir State University40, International Burch University41, Russian Academy42, University College London43, James Cook University44, University of Papua New Guinea45, Max Planck Society46, University of California, Berkeley47, Estonian Academy of Sciences48
TL;DR: A genetic signature in present-day Papuans that suggests that at least 2% of their genome originates from an early and largely extinct expansion of anatomically modern humans (AMHs) out of Africa earlier than 75,000 years ago is found.
Abstract: High-coverage whole-genome sequence studies have so far focused on a limited number of geographically restricted populations, or been targeted at specific diseases, such as cancer. Nevertheless, the availability of high-resolution genomic data has led to the development of new methodologies for inferring population history and refuelled the debate on the mutation rate in humans. Here we present the Estonian Biocentre Human Genome Diversity Panel (EGDP), a dataset of 483 high-coverage human genomes from 148 populations worldwide, including 379 new genomes from 125 populations, which we group into diversity and selection sets. We analyse this dataset to refine estimates of continent-wide patterns of heterozygosity, long- and short-distance gene flow, archaic admixture, and changes in effective population size through time as well as for signals of positive or balancing selection. We find a genetic signature in present-day Papuans that suggests that at least 2% of their genome originates from an early and largely extinct expansion of anatomically modern humans (AMHs) out of Africa. Together with evidence from the western Asian fossil record, and admixture between AMHs and Neanderthals predating the main Eurasian expansion, our results contribute to the mounting evidence for the presence of AMHs out of Africa earlier than 75,000 years ago.
336 citations
RMIT University1, Centers for Disease Control and Prevention2, University of Edinburgh3, Public Health Foundation of India4, Children's Hospital at Westmead5, Chinese Center for Disease Control and Prevention6, Addis Ababa University7, University of Otago8, University of Auckland9, Medical Research Council10, University of Ghana11, National Institute of Virology12, Pasteur Institute13, Universidad Autónoma de San Luis Potosí14, Federal Ministry of Health15, Research Institute for Tropical Medicine16, University of Pretoria17, Thailand Ministry of Public Health18
TL;DR: Influenza-associated hospitalization rates were more than three times higher in developing countries than in industrialized countries (150/ 100,000 children/year versus 48/100,000); however, differences in hospitalization practices between settings are an important limitation in interpreting these findings.
Abstract: BACKGROUND: The global burden of pediatric severe respiratory illness is substantial, and influenza viruses contribute to this burden. Systematic surveillance and testing for influenza among hospitalized children has expanded globally over the past decade. However, only a fraction of the data has been used to estimate influenza burden. In this analysis, we use surveillance data to provide an estimate of influenza-associated hospitalizations among children worldwide. METHODS AND FINDINGS: We aggregated data from a systematic review (n = 108) and surveillance platforms (n = 37) to calculate a pooled estimate of the proportion of samples collected from children hospitalized with respiratory illnesses and positive for influenza by age group (<6 mo, <1 y, <2 y, <5 y, 5-17 y, and <18 y). We applied this proportion to global estimates of acute lower respiratory infection hospitalizations among children aged <1 y and <5 y, to obtain the number and per capita rate of influenza-associated hospitalizations by geographic region and socio-economic status. Influenza was associated with 10% (95% CI 8%-11%) of respiratory hospitalizations in children <18 y worldwide, ranging from 5% (95% CI 3%-7%) among children <6 mo to 16% (95% CI 14%-20%) among children 5-17 y. On average, we estimated that influenza results in approximately 374,000 (95% CI 264,000 to 539,000) hospitalizations in children <1 y-of which 228,000 (95% CI 150,000 to 344,000) occur in children <6 mo-and 870,000 (95% CI 610,000 to 1,237,000) hospitalizations in children <5 y annually. Influenza-associated hospitalization rates were more than three times higher in developing countries than in industrialized countries (150/100,000 children/year versus 48/100,000). However, differences in hospitalization practices between settings are an important limitation in interpreting these findings. CONCLUSIONS: Influenza is an important contributor to respiratory hospitalizations among young children worldwide. Increasing influenza vaccination coverage among young children and pregnant women could reduce this burden and protect infants <6 mo.
274 citations
University of Nottingham1, Nottingham University Hospitals NHS Trust2, International Centre for Diarrhoeal Disease Research, Bangladesh3, Government Medical College, Thiruvananthapuram4, University of Brasília5, Centers for Disease Control and Prevention6, King Saud Medical City7, Ljubljana University Medical Centre8, University Hospital of Basel9, Institut de veille sanitaire10, Mexican Social Security Institute11, Capital Medical University12, University of Barcelona13, University of Colorado Denver14, State University of West Paraná15, Sheba Medical Center16, University of Manitoba17, Boston Children's Hospital18, Peking University19, Hospital General Universitario Gregorio Marañón20, Statens Serum Institut21, Imperial College London22, Kantonsspital St. Gallen23, Peking Union Medical College Hospital24, Dhaka Medical College and Hospital25, Gold Coast Hospital26, Tehran University of Medical Sciences27, Children's Hospital at Westmead28, University of Oxford29, University of Zagreb30, Pamela Youde Nethersole Eastern Hospital31, Stellenbosch University32, Shiraz University of Medical Sciences33, Tan Tock Seng Hospital34, University of Helsinki35, China Medical University (PRC)36, King Hussein Cancer Center37, University of Tsukuba38, University of Toronto39, Alfaisal University40, Erciyes University41, Military Medical Academy42, University of Bergen43, Haukeland University Hospital44, Johns Hopkins University School of Medicine45, Shahid Beheshti University of Medical Sciences and Health Services46, Yüzüncü Yıl University47, University of Birmingham48, Rambam Health Care Campus49, Medical University of Vienna50, Vanderbilt University51, Charité52, Oswaldo Cruz Foundation53, Rzeszów University54, Medical University of Warsaw55, University of Alberta Hospital56, University of Alberta57, National Center for Immunization and Respiratory Diseases58, VU University Medical Center59, Lithuanian University of Health Sciences60
TL;DR: The objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection.
Abstract: Background: The impact of neuraminidase inhibitors (NAIs) on influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. Methods: A worldwide meta-analysis of individual participant data from 20 634 hospitalised patients with laboratory-confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) 'pandemic influenza'. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. Results: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64-1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44-1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71-1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55-0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54-0·85; P = 0·001)]. Conclusions: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.
54 citations
TL;DR: Low overall influenza A burden in both groups was observed, though underestimation was likely due to point-of-care tests used, and RSV burden was more significant than influenza A.
Abstract: Background
Pregnant women and infants under 6 months are at risk of influenza-related complications. Limited information exists on their community burden of respiratory viruses.
Methods and Findings
This prospective, observational open cohort study was conducted in Baganuur district, Ulaanbaatar, Mongolia during 2013/14 and 2014/15 influenza seasons. Influenza-like illness (ILI) and severe acute respiratory infection (sARI) were identified by follow-up calls twice a week. For those identified, influenza and respiratory syncytical virus (RSV) were tested by point-of-care test kits. We calculated overall and stratified (by trimester or age group) incidence rates (IR) and used Cox proportional hazard regression for risk factor analyses. Among 1260 unvaccinated pregnant women enrolled, overall IRs for ILI, sARI and influenza A were 11.8 (95% confidence interval (C.I):11.2–12.4), 0.1 (95%C.I:0.0–0.4), and 1.7 (95%C.I:1.5–1.9) per 1,000person-days, respectively. One sARI case was influenza A positive. IRs and adjusted hazard ratios (Adj.HR) for ILI and influenza A were lowest in the third trimester. Those with co-morbidity were 1.4 times more likely to develop ILI [Adj.HR:1.4 (95%C.I:1.1–1.9)]. Among 1304 infants enrolled, overall ILI and sARI IRs were 15.2 (95%C.I:14.5–15.8) and 20.5 (95%C.I:19.7–21.3) per 1,000person-days, respectively. From the tested ILI (77.6%) and sARI (30.6%) cases, the overall positivity rates were 6.3% (influenza A), 1.1% (influenza B) and 9.3% (RSV). Positivity rates of influenza A and RSV tend to increase with age. sARI cases were 1.4 times more likely to be male [Adj.HR:1.4 (95%C.I:1.1–1.8)]. Among all influenza A and RSV positive infants, 11.8% and 68.0% were respectively identified among sARI hospitalized cases.
Conclusion
We observed low overall influenza A burden in both groups, though underestimation was likely due to point-of-care tests used. For infants, RSV burden was more significant than influenza A. These findings would be useful for establishing control strategies for both viruses in Mongolia.
28 citations
TL;DR: Doctors from major regions of Mongolia noted low screening for viral hepatitis, even lower treatment rates, financial barriers and the need for increased educational efforts, and advocate broad-based medical education tailored to local needs and based on needs assessment and outcome measurements.
Abstract: Background According to Globocan, Mongolia has the highest worldwide hepatocellular carcinoma (HCC) incidence (78.1/100 000, 3.5× higher than China). Aims and methods We conducted an anonymous survey of physicians from major provinces who attended an educational liver symposium, analysing their demography, practice, knowledge, perceptions and proposed solutions. Multivariate logistic regression was used to estimate OR relating demography and practice factors with higher provider knowledge and improvement. Results Of the 121 attendees, 44–95 (36–79%) responded to each question. Most were female (87%), young (79% age 80%) noted that <50% of patients who need hepatitis or HCC screening receive it. The main perceived barriers to screening were inability...
8 citations
TL;DR: Estimation of rates of screening, antiviral therapy, and barriers to care in Mongolia found low screening for viral hepatitis and even lower treatment rates, and top proposed solutions were universal screening policies, removal of financial barriers, and provider education.
Abstract: : 1.043_NEP Low rates of screening and treatment of chronic hepatitis B, C, D (HBV, HCV, HDV), and hepatocellular carcinoma (HCC), associated barriers, and proposed solutions: results of a survey of physicians from all major provinces of Mongolia J. Estevez, Y.A. Kim, A. Le, D. Israelski, O. Baatarkhuu, T. Sarantuya, S. Narantsetseg, P. Nymadawa, H. Le, M.F. Yuen, G. Dusheiko, M. Rizzetto, M.H. Nguyen; Division of Gastroenterology and Hepatology at Stanford University, California, USA, Center for Innovation In Global Health at Stanford University, California, USA, Department of Infectious Diseases at Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia, Internal Medicine Department at United Family Intermed Hospital, Ulaanbaatar, Mongolia, The Third State Central Hospital of Mongolia, Ulaanbaatar, Mongolia, Public Health Branch, Mongolian Academy of Medical Sciences, Ulaanbaatar, Mongolia, Division of Gastroenterology and Hepatology at Queen Mary Hospital, Hong Kong, Royal Free Hospital and University College London School of Medicine in London, United Kingdom, Department of Gastroenterology at the University of Torino, Torino, Italy Background: Mongolia has the highest reported HCC incidence (78.1/100,000) in the world, in addition to some of the highest prevalence of HBV, HCV, and HDV infection. However, it is unclear whether there is sufficient screening and access to care for these diseases. We aim to estimate rates of screening, antiviral therapy, and barriers to care in Mongolia. Methods: Anonymous surveys of 121 physicians from major provinces of Mongolia, who attended a two-day continuing medical education and training workshop for viral hepatitis, cirrhosis, and HCC in Ulaanbaatar, on 9/2015. Findings: A total of 70-95 of 121 (58%-79%) physicians responded to our survey questions. Most participants were female (87%), age <50 (79%), and sub-specialists (76%). The majority practiced in urban areas (61% vs. 39% rural practices). Over 80% of respondents noted significant limitations to viral hepatitis or HCC screening, such as lack of financial resources, management guidelines, and patient awareness (Figure 1). More than 50% of patients were thought to no undergo necessary screening. Financial concerns were also the main barrier for viral hepatitis patients seeking care (40-46%). Hepatitis treatment rates were very low with 83% of respondents reporting treatment of <10 patients with HCV in the past year, and 86% reporting treatment of <10 HBV patients/month. Treatment barriers were multifactorial with medication cost as the principle barrier, followed by lack of both drug availability and management guidelines consensus, if financial barriers were not a concern (Figure 2). Top proposed solutions were universal screening policies (46%), removal of financial barriers (28%), and provider education (20%). Interpretation: Mongolian physicians, representing all major provinces, noted low screening for viral hepatitis and even lower treatment rates. Also, most surveyed physicians noted the need to remove financial barriers and increase educational efforts in order to improve access to care. Funding: Gilead Sciences, Inc. co-supported by Mongolia Ministry of Health, Ombol, LLC, Stanford University. Abstract #: 1.044_NEP: 1.044_NEP Prevalence and correlates of intimate partner violence among women attending child health services, Enugu State,
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