James Meiring

The validity of test-negative design for assessment of typhoid conjugate vaccine protection: comparison of estimates by different study designs using data from a cluster-randomised controlled trial Our findings suggests that the TND provides reliable estimates of TCV effectiveness, whereas the cohort design can bias vaccine effectiveness estimates, possibly due to unmeasured confounding effects,...

Fantastic data from @icddr_b and @OxfordVacGroup using a cluster trial to explore validity of #TestNegativeDesign w. use of -ve control exposures & outcomes to explore bias.

The incidence of typhi was double in JE vax group vs non-vax group!

www.thelancet.com/journals/lan...

Aetiologies, neuroradiological features, and risk factors for mortality and long-term neurosequelae of febrile coma in Malawian children: a prospective cohort study Despite malaria control efforts, cerebral malaria remains the most common cause of febrile coma in Malawi. However, non-malarial coma causes a greater disease burden (death and disability), and a high...

Aetiology of febrile coma in Malawian children

>350 of the sickest children recruited over 2 years with clinical, microbiological, radiological and long-term outcome characterisation.

A huge amount of very valuable work.

www.thelancet.com/journals/lan...

📊 85 studies reviewed on antibiotic use in LMICs post-AWaRe launch. Only 14.1% met UNGA's 70% Access target; 68.2% overused Watch antibiotics. Urgent need for AWaRe-based ASPs! 🦠

#idsky

Severe Tropical Storm #Jude has formed near Madagascar. Jude will likely continue to intensify before making landfall over #Mozambique near Nacala.

Live tracker here: zoom.earth/storms/jude-...

‘Devastating’: Malawi left in dire straits by Trump’s decision to freeze aid African nation relies on US and other foreign donors to help fund healthcare projects and schools

www.theguardian.com/world/2025/f...

A systematised review and evidence synthesis on the broader societal impact of vaccines against Salmonella - npj Vaccines npj Vaccines - A systematised review and evidence synthesis on the broader societal impact of vaccines against Salmonella

#Salmonellae infections largely assoc. with negative broader societal impacts, but quality of evidence is low, so hard to make a full value vaccine assessment.

Need to start thinking about clinical vaccine trials that measure diverse outcomes beyond disease incidence

www.nature.com/articles/s41...

A framework for managing infectious diseases in rural areas in low- and middle-income countries in the face of climate change—East Africa as a case study Climate change is having unprecedented impacts on human health, including increasing infectious disease risk. Despite this, health systems across the world are currently not prepared for novel disease...

Building health system resilience through improving surveillance to react to climactic shocks in real time.

#IDSky #EpiSky

journals.plos.org/globalpublic...

Disseminated mpox in an immunocompromised patient in DR Congo: a call for a shift from disease-focused to person-centred outbreak response This Correspondence examines a complex case of an immunocompromised patient at an mpox treatment centre in South Kivu, DR Congo, highlighting the shortcomings of outbreak-focused care models and their...

Vertical disease programmes to horizontal improvements in healthcare.

Disseminated mpox in an immunocompromised patient in DR Congo - The Lancet Infectious Diseases

#IDSky

www.thelancet.com/journals/lan...

Typhinder: Rapid, low-cost colorimetric detection of Salmonella Typhi bacteriophages for environmental surveillance

Pre-print - Typhinder: Rapid, low-cost colorimetric detection of Salmonella Typhi bacteriophages for environmental surveillance

High pick up from sewerage outlets in densely populated cities.

@jasonandrews.bsky.social

#EpiSky

www.medrxiv.org/content/10.1...

Water, sanitation, handwashing, and nutritional interventions can reduce child antibiotic use: evidence from Bangladesh and Kenya - Nature Communications In this work, authors show that randomized water, sanitation, hygiene and nutrition interventions reduced child antibiotic use in Bangladesh (in parallel with high intervention uptake and reduced infe...

Effect of WASH and nutritional interventions on child antibiotic use in Bangladesh and Kenya.

Significant impact in Bangladesh from all interventions.
No impact in Kenya.

Significant impact in female children in Bangladesh.
No impact in male children.

#EpiSky #AMR

www.nature.com/articles/s41...

Benefits of environmental microbiological surveillance.

Non-typhoidal salmonella isolated from river and waste water in Blantyre, Malawi

verixiv.org/articles/2-1

Early-Life Infections and Subsequent Risk and Antibiotics Use in Childhood This cohort study examines whether early-life infection burden is associated with a later risk of infection and systemic antibiotic treatment episodes in childhood.

Early-life infection is an independent risk for infection and antibiotic use later in life.

Birth cohort from Denmark.

#IDSky #PaedsID

jamanetwork.com/journals/jam...

System vaccinology analysis of predictors and mechanisms of antibody response durability to multiple vaccines in humans - Nature Immunology Pulendran and colleagues define a molecular signature that can be used to predict the durability of antibody responses to vaccination and reveal important insights into the mechanisms by which vaccine...

www.nature.com/articles/s41...

Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization Since 1974 substantial gains in childhood survival have occurred in every global region. We estimate that EPI has provided the single greatest contribution to improved infant survival over the past 50 years. In the context of strengthening primary health care, our results show that equitable universal access to immunisation remains crucial to sustain health gains and continue to save future lives from preventable infectious mortality.

These are not new data, but the numbers are extraordinary - 154 million deaths averted and 10.2 billion years of full health gained since the inception of the extended programme of immunisation in 1974...

#IDSky #EpiSky #VaccinesWork

www.thelancet.com/journals/lan...

Seroprevalence and risk factors for Crimean-Congo hemorrhagic fever virus exposure among febrile patients in northern Tanzania - PubMed We show serologic evidence of prior exposure to Crimean-Congo hemorrhagic fever virus among humans in northern Tanzania. Similar to other settings, our results suggest that exposure is closely linked ...

CCHF prevalence in northern Tanzania at 3.1%! Associated with close animal contact.

pubmed.ncbi.nlm.nih.gov/39756807/

verixiv.org/articles/2-1

Environmental surveillance for Salmonella Typhi in rivers and wastewater from an informal sewage network in Blantyre, Malawi Author summary Typhoid fever is a major public health concern throughout many low- and middle-income countries, resulting in significant morbidity and mortality. In recent years, two typhoid-conjugate...

An increasing issue globally with climate effects causing both flooding and water scarcity but still surprising to see it in London.
Lots of environmental work being done here in Malawi - journals.plos.org/plosntds/art...

Typhoid—From Past to Future Abstract. Makinga Difference? brings together medical humanities and sciences experts to analyze how historical and new data on typhoid control can be brou

Most British cities sorted this problem out >100 years ago….

academic.oup.com/cid/article/...

E coli found in water supply of properties of south-east London Residents of properties in Brockley advised to boil water until results of tests by Thames Water are returned

From beaches to bathtubs - water quality in the #UK is not what it should be!

#IDSky #EpiSky

www.theguardian.com/world/2025/j...

9 countries said goodbye to a devastating disease in 2024 Nine countries eliminated a disease in 2024. Here's how Pakistan pulled it off — fulfilling a young boy's dream of eliminating blindness caused by bacterial infections.

WHO-certified Neglected Tropical Diseases Eliminated in 2024

🇨🇻 🇪🇬-Malaria
🇧🇷 🇹🇱 - Lymphatic filariasis
🇯🇴-Leprosy
🇹🇩-African Trypanosomiasis
🇵🇰 🇮🇳 🇻🇳- Trachoma

www.npr.org/sections/goa...

#IDSky

This is the levofloxacin TPT Xmas double issue #TBsky

Health associated quality of life impairment in People who inject drugs (PWID) after blood stream infection. People who inject drugs (PWID) have high rates of blood stream infections (BSI) with Staphylococcus aureus (SA) and group A streptococcus (GAS). Little is known about health related quality of life outcomes after BSI.

#IDSky - first paper from us on bluesky. What are the longer term quality of life issues after bloodstream infection in people who inject drugs? Here are some data!
www.journalofinfection.com/article/S016...

Sepsis in northern Tanzania: a prospective observational study of clinical characteristics, management, and outcomes for adolescents and adults with sepsis AbstractBackground. Despite a high burden of sepsis in sub-Saharan Africa, clinical data for adolescent and adult sepsis in this setting are limited. We so

High mortality from sepsis in #Tanzania, almost 30%.

Interestingly, not assoc with hypotension and timing of antimicrobials and IV fluids not associated with survival.

#IDSky

academic.oup.com/ofid/advance...

Inequalities in uptake of childhood vaccination in England, 2019-23: longitudinal study Objective To quantify changes in inequalities in uptake of childhood vaccination during a period of steadily declining overall childhood vaccination rates in England. Design Longitudinal study. Sett...

Overall reduction in #Vaccine uptake in #England from 2019-2023, with increasing inequality in uptake between areas of lowest and highest deprivation.

Substantially below the @who.int target of 95% for #Measles vaccination with outbreaks in higher deprivation areas.

www.bmj.com/content/387/....

The fight to rid Pakistan’s coal pits of diseases that plagued British miners a century ago Ultra-portable, AI driven x-rays have been used to find undiagnosed TB, as miners inhaling soot in Victorian-era conditions are at high risk

The fight to rid Pakistan’s coal pits of diseases that plagued British miners a century ago.

Ultra-portable, AI driven x-rays have been used to find undiagnosed TB, as miners inhaling soot in Victorian-era conditions are at high risk.

✍️ @sneweyy.bsky.social
www.telegraph.co.uk/global-healt...

Evolution of Salmonella Chromosomes and Its Influence on Gene Expression and Chromosomal Conformation https://www.biorxiv.org/content/10.1101/2024.12.10.627768v1

A liver transplant recipient developed ST361 NDM-5-producing E. coli bacteraemia with ATM/AVI & FDC resistance
High-level resistance was selected after CZA/ATM therapy & was mediated by baseline PBP3 mutations
New PBP3 & CMY-145 mutations emerged during therapy
https://doi.org/10.1093/jacamr/dlae141

Global trends in antibiotic consumption during 2016–2023 and future projections through 2030.

Consumption post-pandemic increasing across LMICs in line with improving economic wealth.

Of note - there is no data from almost all of southern, central and eastern #Africa.

www.pnas.org/doi/10.1073/...

Dude!
Have you transformed into a marvel character!?

Thanks, from experience once it’s on your radar you start seeing it a lot.