Cooperation for malaria control and elimination in the Guiana Shield.

The Guiana Shield, a small region of South America, is currently one of the main hotspots of malaria transmission on the continent. This Amazonian area is characterised by remarkable socioeconomic, cultural, health, and political heterogeneity and a high degree of regional and cross-border population mobility, which has contributed to the increase of malaria in the region in the past few years. In this context, regional cooperation to control malaria represents both a challenge and an indispensable initiative. This Viewpoint advocates for the creation of a regional cooperative mechanism for the elimination of malaria in the Guiana Shield. This strategy would help address operational and political obstacles to successful technical cooperation in the region and could contribute to reversing the regional upsurge in malaria incidence through creating a functional international control and elimination partnership.

Comparing the Performance of Three Models Incorporating Weather Data to Forecast Dengue Epidemics in Reunion Island, 2018-2019.

We developed mathematical models to analyze a large dengue virus (DENV) epidemic in Reunion Island in 2018-2019. Our models captured major drivers of uncertainty including the complex relationship between climate and DENV transmission, temperature trends, and underreporting. Early assessment correctly concluded that persistence of DENV transmission during the austral winter 2018 was likely and that the second epidemic wave would be larger than the first one. From November 2018, the detection probability was estimated at 10%-20% and, for this range of values, our projections were found to be remarkably accurate. Overall, we estimated that 8% and 18% of the population were infected during the first and second wave, respectively. Out of the 3 models considered, the best-fitting one was calibrated to laboratory entomological data, and accounted for temperature but not precipitation. This study showcases the contribution of modeling to strengthen risk assessments and planning of national and local authorities.

Risk Assessment and Virological Monitoring Following an Accidental Exposure to Concentrated Sabin Poliovirus Type 3 in France, November 2018.

The safe and secure containment of infectious poliovirus (PV) in facilities where live PV are handled is the condition to achieve and maintain poliomyelitis eradication. Despite precautions to minimize the risk of release of PV from such facilities to the environment, breaches of containment have already been documented. Here, we report the management of an incident that occurred on 30 November 2018 in a French vaccine manufacturing plant. Five adequately vaccinated operators were exposed to a Sabin poliovirus type 3 (PV3) spill. A microbiological risk assessment was conducted and the operators were monitored for PV shedding. On day 5 after exposure, Sabin PV3 was detected only in the stool sample of the most exposed worker. Shedding of Sabin PV3 (as detected by viral culture) was restricted to a very short period (less than 15 days). Monitoring of this incident was an opportunity to assess the relevance of our national response plan. We concluded that the measures undertaken and reported here were appropriate and proportional.

First cases of coronavirus disease 2019 (COVID-19) in France: surveillance, investigations and control measures, January 2020.

A novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) causing a cluster of respiratory infections (coronavirus disease 2019, COVID-19) in Wuhan, China, was identified on 7 January 2020. The epidemic quickly disseminated from Wuhan and as at 12 February 2020, 45,179 cases have been confirmed in 25 countries, including 1,116 deaths. Strengthened surveillance was implemented in France on 10 January 2020 in order to identify imported cases early and prevent secondary transmission. Three categories of risk exposure and follow-up procedure were defined for contacts. Three cases of COVID-19 were confirmed on 24 January, the first cases in Europe. Contact tracing was immediately initiated. Five contacts were evaluated as at low risk of exposure and 18 at moderate/high risk. As at 12 February 2020, two cases have been discharged and the third one remains symptomatic with a persistent cough, and no secondary transmission has been identified. Effective collaboration between all parties involved in the surveillance and response to emerging threats is required to detect imported cases early and to implement adequate control measures.

Early Detection of Public Health Emergencies of International Concern through Undiagnosed Disease Reports in ProMED-Mail.

We conducted a retrospective analysis of all reports in ProMED-mail that were initially classified as undiagnosed diseases during 2007-2018. We identified 371 cases reported in ProMED-mail; 34% were later diagnosed. ProMED-mail could be used to supplement other undiagnosed disease surveillance systems worldwide.

Vector-borne transmission of Zika virus in Europe, southern France, August 2019.

On 1 October 2019, a locally-acquired Zika virus disease case was laboratory confirmed in Hyères, Var department. Active case finding identified two additional locally-acquired cases living within 90 m, with symptom onset 8 days before the index case. Extensive patient interviews did not yield information supporting transmission through sexual contact or substances of human origin. Vector-borne transmission by local Aedes albopictus mosquitoes is the most likely mode of transmission. Here we describe the public health response.

Peer reviewers identified spin in manuscripts of nonrandomized studies assessing therapeutic interventions, but their impact on spin in abstract conclusions was limited.

OBJECTIVES: To describe the impact of peer reviewers on spin in reports of nonrandomized studies assessing a therapeutic intervention. STUDY DESIGN AND SETTING: This is a systematic review and retrospective before-after study. The sample consists of primary reports (n = 128) published in BioMed Central Medical Series journals between January 1, 2011, and December 31, 2013. The main outcome measures are the following: number and type of spin examples identified, deleted, or added by peer reviewers in the whole manuscript; number of reports with spin in abstract conclusions not detected by peer reviewers; the level of spin (i.e., no, low, moderate, and high level of spin) in the abstract conclusions before and after the peer review. RESULTS: For 70 (55%) submitted manuscripts, peer reviewers identified at least one example of spin. Of 123 unique examples of spin identified by peer reviewers, 82 (67%) were completely deleted by the authors. For 19 articles (15%), peer reviewers requested adding some spin, and for 11 (9%), the spin was added by the authors. Peer reviewers failed to identify spin in abstract conclusions of 97 (76%) reports. CONCLUSION: Peer reviewers identified many examples of spin in submitted manuscripts. However, their influence on changing spin in the abstract conclusions was low.

Classification and prevalence of spin in abstracts of non-randomized studies evaluating an intervention.

BACKGROUND: Spin represents specific reporting strategies, either intentional or unintentional, to convince the reader that the beneficial effect of the experimental intervention in terms of efficacy and safety is greater than that shown by the results. The objectives of this study were to 1) develop a classification of spin specific to non-randomized studies assessing an intervention and 2) estimate the prevalence of spin in abstracts of reports of such studies. METHODS: In a first step, we developed a specific classification of spin for non-randomized studies by a literature review and pilot study. In a second step, 2 researchers trained in the field of methodology evaluated the prevalence of spin in the abstract of all non-randomized studies assessing an intervention published in the BioMed Central Medical Series journals between January 1, 2011 and December 31, 2013. All disagreements were resolved by consensus. We also determined whether the level of spin in abstract conclusions was high (spin reported without uncertainty or recommendations for further trials), moderate (spin reported with some uncertainty or recommendations for further trials) or low (spin reported with uncertainty and recommendations for further trials). RESULTS: Among the 128 assessed articles assessed, 107 (84%) had at least one example of spin in their abstract. The most prevalent strategy of spin was the use of causal language, identified in 68 (53%) abstracts. Other frequent strategies were linguistic spin, inadequate implications for clinical practice, and lack of focus on harm, identified in 33 (26%), 25 (20%), and 34 (27%) abstracts respectively. Abstract conclusions of 61 (48%) articles featured a high level of spin. CONCLUSION: Abstract of reports of non-randomized studies assessing an intervention frequently includes spin. Efforts to reduce the prevalence of spin in abstract for such studies are needed.

Interpretation of Results of Studies Evaluating an Intervention Highlighted in Google Health News: A Cross-Sectional Study of News.

BACKGROUND: Mass media through the Internet is a powerful means of disseminating medical research. We aimed to determine whether and how the interpretation of research results is misrepresented by the use of "spin" in the health section of Google News. Spin was defined as specific way of reporting, from whatever motive (intentional or unintentional), to emphasize that the beneficial effect of the intervention is greater than that shown by the results. METHODS: We conducted a cross-sectional study of news highlighted in the health section of US, UK and Canada editions of Google News between July 2013 and January 2014. We searched for news items for 3 days a week (i.e., Monday, Wednesday, and Friday) during 6 months and selected a sample of 130 news items reporting a scientific article evaluating the effect of an intervention on human health. RESULTS: In total, 78% of the news did not provide a full reference or electronic link to the scientific article. We found at least one spin in 114 (88%) news items and 18 different types of spin in news. These spin were mainly related to misleading reporting (59%) such as not reporting adverse events that were reported in the scientific article (25%), misleading interpretation (69%) such as claiming a causal effect despite non-randomized study design (49%) and overgeneralization/misleading extrapolation (41%) of the results such as extrapolating a beneficial effect from an animal study to humans (21%). We also identified some new types of spin such as highlighting a single patient experience for the success of a new treatment instead of focusing on the group results. CONCLUSIONS: Interpretation of research results was frequently misrepresented in the health section of Google News. However, we do not know whether these spin were from the scientific articles themselves or added in the news.