Gates Open Research最新文献

{"title":"Developing and evaluating human-centered design solutions for enhancing maternal health service utilization among vulnerable pregnant women in Oromia, Ethiopia: Study protocol for a quasi-experimental study.","authors":"Bee-Ah Kang, Habtamu Tamene, Yihunie Lakew, Daryl Stephens, Rajiv Rimal","doi":"10.12688/gatesopenres.16277.3","DOIUrl":"10.12688/gatesopenres.16277.3","url":null,"abstract":"<p><strong>Background: </strong>Disproportionate uptake of and access to maternal and child health services remain significant challenges across and within countries. Differing geographic, economic, environmental, and social factors contribute to varying degrees of vulnerabilities among individuals, which manifest as disparities in maternal and newborn health outcomes. Designing solutions according to need is vital to improve maternal and child health outcomes. In this paper, we describe our study protocol on developing and evaluating the effectiveness of human-centered design (HCD) solutions to improve maternal health service uptake among vulnerable pregnant women in rural areas of Ethiopia.</p><p><strong>Methods: </strong>The study has two distinct phases. In Phase 1, HCD solutions were developed through co-design workshops with vulnerable pregnant women and key stakeholders. Final solutions included home visit education, audio programs promoting couple discussion, and print materials, implemented in collaboration with community health workers and health officers. A community-based, quasi-experimental, mixed-method study design was used to assess differences between intervention and control arms. A panel sample was enrolled after screening for pregnancy and vulnerability level and surveyed at baseline and midline in Phase 1. Phase 2 adopts an identical design approach with a focus on refining Phase 1 solutions. Newly recruited pregnant women will receive refined solutions for six months, which will be evaluated using post-only end-line surveys and in-depth interviews.</p><p><strong>Conclusions and implications: </strong>Our sequential approach to evaluating initial solutions, which in turn will inform the enhancement of solutions, will provide practical insights into how solutions are accepted among vulnerable women and how they can be better integrated into women's lives and health systems. This will inform equity-focused practice and policies targeting populations experiencing greater barriers to accessing care and provide insights into system strengthening in rural areas. Our findings will be disseminated to the Ethiopian Ministry of Health and its partners to inform large-scale implementation at the national level.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"93"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the feasibility, acceptability, and impact of Group Antenatal Care at the health post level on continuation in antenatal care and facility based delivery in Ethiopia using a cluster randomized stepped-wedge design: Study protocol.","authors":"Walelegn W Yallew, Rediet Fasil, Della Berhanu, Konjit Wolde, Dedefo Teshite, Reena Sethi, Gayane Yenokyan, Yenealem Woldemariam, Stephanie Suhowatsky, Anne Hyre, Lisa Noguchi, Alemayehu Worku","doi":"10.12688/gatesopenres.15190.3","DOIUrl":"https://doi.org/10.12688/gatesopenres.15190.3","url":null,"abstract":"<p><strong>Background: </strong>Adequate antenatal care (ANC) and facility-based delivery are linked to improved maternal and neonatal outcomes. Adequate ANC attendance and facility birth rates are increasing in Ethiopia but remain well below national goals and global recommendations. Group ANC (G-ANC), when implemented at higher-level facilities, is associated with improved quality and experience of ANC and increased ANC retention and facility-based delivery. The objectives of this study are to evaluate the acceptability, feasibility, and effectiveness of G-ANC delivered by health extension workers at the health-post level compared to conventional ANC on ANC attendance and facility-based delivery.</p><p><strong>Methods: </strong>Group ANC will be piloted in five purposively selected health posts. The study design is a stepped-wedge trial to be conducted in 36 health posts within the catchment of six health centers, with randomization of the order of the intervention introduction done at the health-center level (clusters). The design includes three time periods: a six-month control period with no G-ANC implementation, followed by another six-month period when G-ANC will be introduced in half (n=18) of the study health posts, then a final six-month period when G-ANC will be implemented in the remaining 18 health posts. Each health post will form one cohort and conduct six monthly G-ANC meetings on a fixed day/time. The study will use quantitative and qualitative data collection approaches. The study has \"pause and reflect\" points designed for intervention iteration before rolling out to the next set of sites. The primary outcomes are the proportion of women with at least four ANC visits and the proportion who delivered in a health facility. Qualitative research will be conducted using in-depth interviews with pregnant women, health workers, facility managers, and regional health managers. The study will enroll 770 women across all phases.</p><p><strong>Conclusions: </strong>The study will inform decision-makers locally and globally on whether G-ANC is a feasible service delivery model at the health-post level. Effectiveness of G-ANC at increasing ANC retention and facility-based delivery and its acceptability to pregnant women and health extension workers will be reported. Registration NCT05054491, ClinicalTrials.gov (September 23, 2021).</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"29"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated post-run analysis of arrayed quantitative PCR amplification curves using machine learning.","authors":"Ben J Brintz, Darwin J Operario, David Garrett Brown, Shanrui Wu, Lan Wang, Eric R Houpt, Daniel T Leung, Jie Liu, James A Platts-Mills","doi":"10.12688/gatesopenres.16313.1","DOIUrl":"10.12688/gatesopenres.16313.1","url":null,"abstract":"<p><strong>Background: </strong>The TaqMan Array Card (TAC) is an arrayed, high-throughput qPCR platform that can simultaneously detect multiple targets in a single reaction. However, the manual post-run analysis of TAC data is time consuming and subject to interpretation. We sought to automate the post-run analysis of TAC data using machine learning models.</p><p><strong>Methods: </strong>We used 165,214 qPCR amplification curves from two studies to train and test two eXtreme Gradient Boosting (XGBoost) models. Previous manual analyses of the amplification curves by experts in qPCR analysis were used as the gold standard. First, a classification model predicted whether amplification occurred or not, and if so, a second model predicted the cycle threshold (Ct) value. We used 5-fold cross-validation to tune the models and assessed performance using accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and mean absolute error (MAE). For external validation, we used 1,472 reactions previously analyzed by 17 laboratory scientists as part of an external quality assessment for a multisite study.</p><p><strong>Results: </strong>In internal validation, the classification model achieved an accuracy of 0.996, sensitivity of 0.997, specificity of 0.993, PPV of 0.998, and NPV of 0.991. The Ct prediction model achieved a MAE of 0.590. In external validation, the automated analysis achieved an accuracy of 0.997 and a MAE of 0.611, and the automated analysis was more accurate than manual analyses by 14 of the 17 laboratory scientists.</p><p><strong>Conclusions: </strong>We automated the post-run analysis of highly-arrayed qPCR data using machine learning models with high accuracy in comparison to a manual gold standard. This approach has the potential to save time and improve reproducibility in laboratories using the TAC platform and other high-throughput qPCR approaches.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"9 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Open Letter on Advancing HIV prevention: Augmenting an ecosystem-based approach to understand prevention decision-making.","authors":"Nishan Gantayat, James Baer, Alok Gangaramany, Rosemary Pierce-Messick","doi":"10.12688/gatesopenres.16067.2","DOIUrl":"10.12688/gatesopenres.16067.2","url":null,"abstract":"<p><p>In the last two decades, HIV programs have been able to avert millions of AIDS-related deaths and reduce HIV incidence. However, the 1.3 million new HIV infections in 2022 remain significantly above the UNAIDS target of fewer than 370,000 new infections by 2025. HIV programs worldwide also did not achieve the UN's 90-90-90 target for testing and treatment set for 2020. Within this broader picture, HIV continues to disproportionately affect key and at-risk populations, including gay men and other men who have sex with men, female sex workers, and adolescent girls and young women. As HIV incidence declines and biomedical advances continue, it will become critical for public-health practitioners to reach key and at-risk populations with prevention services and limit primary transmission. In this Open Letter, we focus on factors that influence uptake of HIV prevention products and thereby demand for HIV prevention products and services. These factors exist at three levels of the decision-making ecosystem - the individual level, interaction level and systemic level. We argue that approaching HIV prevention solely through the lens of these levels creates a static view of prevention decision-making. There is a need instead for a dynamic viewpoint that can mirror the changing contexts in which users find themselves and make prevention decisions. We demonstrate that the current ecosystem viewpoint is useful to understand the gaps that exist in program implementation, but does not provide adequate insights into the underlying behaviors that contribute to these gaps. To address this, we suggest an approach to include dynamic aspects of decision-making with factors that influence the individual's assessment of risk, their evaluation of the opportunities to use HIV prevention, and their effective use of prevention products.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"73"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exploration of unusual antimicrobial resistance phenotypes in Salmonella Typhi from Blantyre, Malawi reveals the ongoing role of IncHI1 plasmids.","authors":"Allan Zuza, Alexander M Wailan, Catherine Anscombe, Nicholas A Feasey, Eva Heinz","doi":"10.12688/gatesopenres.16311.1","DOIUrl":"10.12688/gatesopenres.16311.1","url":null,"abstract":"<p><p>Typhoid fever is a significant public health problem endemic in Southeast Asia and Sub-Saharan Africa. Antimicrobial treatment of typhoid is however threatened by the increasing prevalence of antimicrobial resistant (AMR) <i>S.</i> Typhi, especially in the globally successful lineage (4.3.1) which has rapidly spread in East and Southern Africa. AMR elements can be found either on plasmids or in one of the three chromosomal integration sites, and there is variability of this across the lineage. Several previous studies with Malawian isolates indicated a clonal, locally spreading lineage with chromosomally integrated resistance genes. In a recent study however we noted three isolates with predicted resistance genes unusual for the region, and we here present the resolved genomes of these isolates using long- and short-read sequencing. Our work shows that these isolates are potentially imported cases, most closely related to the recently described sub-lineage 4.3.1.EA1, although they encode IncHI1 plasmids with reduced resistance gene repertoire compared to the main IncHI1 plasmids spreading in East Africa. Similar reduced plasmids were reported in a recent large-scale study in five isolates from Tanzania, highlighting the urgency for better coverage of the African continent in genome studies to better understand the dynamics of these potentially co-circulating plasmids.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"143"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unpacking WHO and CDC Bottle Bioassay Methods: A Comprehensive Literature Review and Protocol Analysis Revealing Key Outcome Predictors.","authors":"Giorgio Praulins, Annabel Murphy-Fegan, Jack Gillespie, Frank Mechan, Katherine Gleave, Rosemary Lees","doi":"10.12688/gatesopenres.15433.2","DOIUrl":"https://doi.org/10.12688/gatesopenres.15433.2","url":null,"abstract":"<p><strong>Background: </strong>Resistance monitoring is a key element in controlling vector-borne diseases. The World Health Organization (WHO) and Centres for Disease Control and Prevention (CDC) have each developed bottle bioassay methods for determining insecticide susceptibility in mosquito vectors which are used globally.</p><p><strong>Methods: </strong>This study aimed to identify variations in bottle bioassay methodologies and assess the potential impact on the data that is generated. Our approach involved a systematic examination of existing literature and protocols from WHO and CDC, with a focus on the specifics of reported methodologies, variation between versions, and reported outcomes. Building on this, we experimentally evaluated the impact of several variables on bioassay results.</p><p><strong>Results: </strong>Our literature review exposed a significant inconsistency in the how bioassay methods are reported, hindering reliable interpretation of data and the ability to compare results between studies. The experimental research provided further insight by specifically identifying two key factors that influence the outcomes of bioassays: mosquito dry weight and relative humidity (RH). This finding not only advances our comprehension of these assays but also underscores the importance of establishing precisely defined methodologies for resistance monitoring. The study also demonstrates the importance of controlling bioassay variables, noting the significant influence of wing length, as an indicator of mosquito size, on mortality rates in standardized bioassays.</p><p><strong>Conclusions: </strong>Generating data with improved protocol consistency and precision will not only deepen our understanding of resistance patterns but also better inform vector control measures. We call for continued research and collaboration to refine and build consensus on bioassay techniques, to help bolster the global effort against vector-borne diseases like malaria.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"56"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting contraceptive self-care and reproductive empowerment with a digital health game in Barbados: Development and Pre-implementation study for What's My Method?","authors":"Elena Bertozzi, Clara Bertozzi-Villa, Erin Sabato, Nicole Alleyne, Sonia Watson-Miller, Tiffany Jordan, Anderson Langdon","doi":"10.12688/gatesopenres.15376.2","DOIUrl":"10.12688/gatesopenres.15376.2","url":null,"abstract":"<p><p>Effective contraceptive education is essential to reducing unwanted pregnancy, increasing uptake of modern contraceptive methods, and thoughtfully planning desired births. New World Health Organization (WHO) and family planning organization guidelines recommend situating contraceptive education and counseling within a broader context of self-care that emphasizes individual agency and reproductive empowerment. Digital health interventions, and games for health specifically, have been validated as effective and scalable tools for self-guided and interactive health education, especially among younger tech-savvy individuals. Barbados currently supplements provider-based contraceptive counseling with analog materials (pamphlets and posters) and informational videos that play on a screen in the waiting room. As part of an implementation framework, this study seeks to conduct a formative evaluation of the What's My Method? (WMM) game intervention as a tool to support contraceptive counseling and increase reproductive empowerment among childbearing persons in Barbados. We test-deployed the WMM game in Bridgetown, Barbados, conducting playtests and unstructured discussions with prototypes of the WMM game among three groups of stakeholders (youth contraception ambassadors: n=8; healthcare providers: n=7; and nursing students: n=27) to determine acceptability of the intervention, efficacy of the game as a learning tool, and willingness to adopt the tool in their healthcare context. Feedback on acceptability of the game was largely positive. Detailed constructive comments informed modifications and improvements to the game. The questionnaire used to assess contraceptive knowledge gain did not prove effective. Results indicate that the WMM game is well-received and accepted by the healthcare professionals who would be deploying it. This pilot testing has informed the design of the modified WMM for a randomized controlled trial (RCT) to test the deployment of the game in a healthcare setting.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"47"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a framework for understanding policy decision-making behaviors in the transition of an HIV prevention program towards sustainability: a case study from Zambia's voluntary medical male circumcision program.","authors":"Nishan Gantayat, James Baer, Alok Gangaramany, Steve Kretschmer, Rasi Surana, Alick Samona, Njekwa Mukamba, Bright Jere, Tina Chinsenga, Ram Prasad, Stephen Goetschius, Saransh Sharma","doi":"10.12688/gatesopenres.15189.3","DOIUrl":"10.12688/gatesopenres.15189.3","url":null,"abstract":"<p><p>Faced with declining donor funding for HIV, low- and middle-income countries must identify efficient and cost-effective ways to integrate HIV prevention programs into public health systems for long-term sustainability. In Zambia, donor support to the voluntary medical male circumcision (VMMC) program, which previously funded non-governmental organizations as implementing partners, is increasingly being directed through government structures instead. We developed a framework to understand how the behaviors of individual decision-makers within the government could be barriers to this transition. We interviewed key stakeholders from the national, provincial, and district levels of the Ministry of Health, and from donors and partners funding and implementing Zambia's VMMC program, exploring the decisions required to attain a sustainable VMMC program and the behavioral dynamics involved at personal and institutional levels. Using pattern identification and theme matching to analyze the content of the responses, we derived three core decision-making phases in the transition to a sustainable VMMC program: 1) developing an alternative funding strategy, 2) developing a policy for early-infant (0-2 months) and early-adolescent (15-17 years) male circumcision, which is crucial to sustainable HIV prevention; and 3) identifying integrated and efficient implementation models. We formulated a framework showing how, in each phase, a range of behavioral dynamics can form barriers that hinder effective decision-making among stakeholders at the same level (e.g., national ministries and donors) or across levels (e.g., national, provincial and district). Our research methodology and the resulting framework offer a systematic approach for in-depth investigations into organizational decision-making in public health programs, as well as development programs beyond VMMC and HIV prevention. It provides the insights necessary to map organizational development and policy-making transition plans to sustainability, by explaining tangible factors such as organizational processes and systems, as well as intangibles such as the behaviors of policymakers and institutional actors.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial.","authors":"Melanie Pleaner, Alison Kutywayo, Mags Beksinska, Khuthala Mabetha, Nicolette Naidoo, Saiqa Mullick","doi":"10.12688/gatesopenres.13636.3","DOIUrl":"10.12688/gatesopenres.13636.3","url":null,"abstract":"<p><strong>Background: </strong>South African adolescents experience barriers to sexual and reproductive health (SRH) knowledge and uptake. This study provides insight into contraceptive and other SRH service knowledge, perceptions, and uptake among adolescents in high HIV prevalence settings.</p><p><strong>Methods: </strong>A baseline cross sectional survey was conducted among 3432 grade 8s enrolled into the Girls Achieve Power (GAP Year) trial from 26 public high schools across three South African townships (Soweto, Thembisa and Khayelitsha) (2017 - 2018). An interviewer-led survey collected information on SRH knowledge and perceptions; an audio computer-assisted self-interviewing technique gathered SRH service uptake. Descriptive analysis indicates frequency distribution of socio-demographics and knowledge, uptake and perceptions of SRH services. Chi-square test tested for associations between age and sex and selected variables that measure SRH knowledge and uptake.</p><p><strong>Results: </strong>In total, 2383 participants completed both survey components. Of these, 63.1% (n=1504) were female and 81.4% (n=1938) aged 12-14. Almost a fifth (18.3%, n=436) had ever had sex and less than 1% had accessed SRH services in the last year. Of the 157 females who had ever had sex, 50.9% had ever used contraception. Of those who had sex in the last three months, 59.0% reported using a contraceptive method. Condom use was inconsistent: almost all females said they had not used or could not remember if a condom was used at last sex.</p><p><strong>Conclusion: </strong>This paper contributes to the evidence strengthening learner SRH education, including the national Integrated School Health Programme. Key themes include the need for age-appropriate, differentiated comprehensive sexuality education (CSE) for the range of ages found in the same grade in South African schools. Education on different contraceptive methods, informed decision-making, and emergency contraception is key. School-based interventions should embrace integrated HIV, STI, and pregnancy prevention messages. Closer links with health services need to be constantly fostered and reinforced.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"6 ","pages":"67"},"PeriodicalIF":0.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10213203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9546461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using models and maps to inform Target Product Profiles and Preferred Product Characteristics: the example of <i>Wolbachia</i> replacement.","authors":"Katie Tiley, Julian Entwistle, Bruce Thomas, Laith Yakob, Oliver Brady","doi":"10.12688/gatesopenres.14300.3","DOIUrl":"https://doi.org/10.12688/gatesopenres.14300.3","url":null,"abstract":"<p><strong>Background: </strong>The global prevalence of diseases transmitted by <i>Aedes aegypti</i> mosquitoes, such as dengue, Zika and Yellow Fever, is increasing, but development of promising new mosquito control technologies could reverse this trend. Target Product Profiles (TPPs) and Preferred Product Characteristics (PPCs) documents issued by the World Health Organization can guide the research and development pathways of new products and product combinations transitioning from proof of concept to operational use.</p><p><strong>Methods: </strong>We used high resolution global maps of the case and economic burden of dengue to derive programmatic cost targets to support a TPP for <i>Wolbachia</i> replacement. A compartmental entomological model was used to explore how release size, spacing and timing affect replacement speed and acceptability. To support a PPC for a hybrid suppress-then-replace approach we tested whether <i>Wolbachia</i> replacement could be achieved faster, more acceptably or at a lower cost if preceded by a mosquito suppression programme.</p><p><strong>Results: </strong>We show how models can reveal trade-offs, identify quantitative thresholds and prioritise areas and intervention strategies for further development. We estimate that for <i>Wolbachia</i> replacement to be deployable in enough areas to make major contributions to reducing global dengue burden by 25% (in line with 2030 WHO targets), it must have the potential for cost to be reduced to between $7.63 and $0.24 (USD) per person protected or less. Suppression can reduce the number of <i>Wolbachia</i> mosquitoes necessary to achieve replacement fixation by up to 80%. A hybrid approach can also achieve fixation faster and potentially improve acceptability, but may not justify their cost if they require major new investments in suppression technologies.</p><p><strong>Conclusions: </strong>Here we demonstrate the value dedicated modelling can provide for interdisciplinary groups of experts when developing TPPs and PPCs. These models could be used by product developers to prioritise and shape development decisions for new <i>Wolbachia</i> replacement products.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"7 ","pages":"68"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}