Interplay between the gut microbiome and typhoid fever: insights from endemic countries and a controlled human infection model.

Background: Typhoid fever is a systemic infection caused by Salmonella enterica serovar Typhi (S. Typhi) invasion from the gut lumen. Transmission between people occurs through ingestion of contaminated food and water, particularly in settings with poor water and sanitation infrastructure, resulting in over 10 million illnesses annually.

Epidemiological and Clinical Features of Enterotoxigenic (ETEC) Diarrhea in an Urban Slum in Dhaka, Bangladesh.

Background: Enterotoxigenic (ETEC) is a major cause of diarrheal illness, and population-based data on the incidence of clinically significant ETEC diarrhea in developing countries are limited. We provide insight into ETEC epidemiology; we followed a population-based cohort in a vaccine trial.

Methods: We analyzed data from a cluster-randomized controlled trial of an oral cholera vaccine conducted in an urban slum in Dhaka, Bangladesh.

Evaluating the effectiveness of COVID-19 vaccines during a period of Omicron variant predominance among Bangladeshi population: A test-negative design measurement.

The study was conducted to estimate the protective effectiveness (PE) of complete primary or booster dose regimens of COVID-19 vaccines deployed in Bangladesh. The study was conducted in four hospitals in Dhaka between December 30, 2021, and August 31, 2022 following a test-negative design. Patients aged ≥18 years attended with COVID-like symptoms were enrolled and tested for RT-PCR.

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.

Background: Typhoid fever remains a substantial public health challenge in low-income and middle-income countries. By 2023, typhoid conjugate vaccines (TCVs) had been introduced in six countries globally, with more than 50 million doses distributed. Now that TCVs are being deployed, there is a need for observational studies to assess vaccine effectiveness in the field.

Immunogenicity and safety of an Escherichia coli-produced bivalent human papillomavirus vaccine (Cecolin) in girls aged 9-14 years in Ghana and Bangladesh: a randomised, controlled, open-label, non-inferiority, phase 3 trial.

Background: Human papillomavirus (HPV) vaccines have been available for nearly 20 years. However, the overall coverage of girls aged 15 years and younger is low, especially in low-resource settings, where the burden of cervical cancer is highest. Increasing access and facilitating implementation of HPV vaccination will contribute to cervical cancer elimination efforts.

Shigellosis in an Urban Slum in Kenya: Risk Factors and Antimicrobial Resistance.

Background: spp are among the notable causes of global diarrheal disease and death, accounting for 13.2% of deaths in 2016. Antimicrobial resistance complicates shigellosis management.

Evaluation of oral cholera vaccine (Euvichol-Plus) effectiveness against in Bangladesh: an interim analysis.

Introduction: Millions of Euvichol-Plus doses have been deployed from the global oral cholera vaccine stockpile in over 20 cholera-affected countries. However, information on Euvichol-Plus's effectiveness is limited. Using this vaccine in a cholera epidemic in Dhaka, Bangladesh, provided the opportunity to evaluate the vaccine effectiveness (VE) using a test-negative design.

Evaluation of naturally occurring IgG anti-Vi antibody titers as predictors and correlates of typhoid fever in Dhaka, Bangladesh.

Background: When delivered through vaccination Vi-polysaccharide antigen of Salmonella enterica serotype Typhi protects against typhoid by inducing IgG anti-Vi antibodies. We aimed to determine whether the presence of antibodies following natural infection is associated with a lower incidence of typhoid fever in endemic regions.

Methods: We analyzed data from a cohort study of typhoid fever conducted in Dhaka, Bangladesh.

Protection by natural cholera against later episodes of cholera over 10 years of follow-up in Matlab, Bangladesh: a retrospective cohort study.

Background: Patients with cholera have been shown to be protected against subsequent cholera for 3 years after their initial episode. We aimed to assess protection at 10 years of follow-up.

Methods: In this retrospective cohort study, cohorts of patients treated for cholera (index patients) and contemporaneously selected age-matched individuals without cholera (controls), randomly selected from the population of Matlab, Bangladesh, were assembled between 1990 and 2009 and followed for up to 10 years.

Cytokine Storm among Bangladeshi adults with COVID-19: A prospective cohort study.

Objective: In COVID-19, cytokine storms (CS) result in higher mortality and morbidity. Our study evaluated the rate of cytokine storms among COVID-positive Bangladeshi adults.

Methods: From October 2020 to March 2022, this cohort study enrolled both COVID-positive and COVID-negative healthy adults.

Receipt of hepatitis E vaccine and fetal loss in rural Bangladesh: further analysis of a double-blind, cluster-randomised, controlled trial.

Background: Vaccination constitutes an attractive control measure for hepatitis E virus (HEV), a major cause of maternal and perinatal mortality globally. Analysis of pregnant participants in an effectiveness trial of the HEV vaccine HEV239 showed possible HEV239-associated fetal losses. We aimed to conduct a detailed analysis of this safety signal.

Spatial and temporal clustering of typhoid fever in an urban slum of Dhaka City: Implications for targeted typhoid vaccination.

Background: Salmonella enterica serotype Typhi (Salmonella Typhi) causes severe and occasionally life-threatening disease, transmitted through contaminated food and water. Humans are the only reservoir, inadequate water, sanitation, and hygiene infrastructure increases risk of typhoid. High-quality data to assess spatial and temporal relationships in disease dynamics are scarce.

Impact of SARS-CoV-2 vaccines on Covid-19 incidence and mortality in the United States.

Background: Given the waning of vaccine effectiveness and the shifting of the most dominant strains in the U.S., it is imperative to understand the association between vaccination coverage and Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) disease and mortality at the community levels and whether that association might vary according to the dominant SARS-CoV-2 strains in the U.

The Enterics for Global Health (EFGH) Surveillance Study in Bangladesh.

Background: is an important cause of diarrhea in Bangladeshi children <5 years of age, with an incidence rate of 4.6 per 100 person-years. However, the report was more than a decade old, and data on consequences are similarly outdated and heterogeneously collected.

Effectiveness of bubble continuous positive airway pressure for treatment of children aged 1-59 months with severe pneumonia and hypoxaemia in Ethiopia: a pragmatic cluster-randomised controlled trial.

Background: The safety and efficacy of bubble continuous positive airway pressure (bCPAP) for treatment of childhood severe pneumonia outside tertiary care hospitals is uncertain. We did a cluster-randomised effectiveness trial of locally made bCPAP compared with WHO-recommended low-flow oxygen therapy in children with severe pneumonia and hypoxaemia in general hospitals in Ethiopia.

Methods: This open, cluster-randomised trial was done in 12 general (secondary) hospitals in Ethiopia.

Incidence of typhoid fever in Burkina Faso, Democratic Republic of the Congo, Ethiopia, Ghana, Madagascar, and Nigeria (the Severe Typhoid in Africa programme): a population-based study.

Background: Typhoid Fever remains a major cause of morbidity and mortality in low-income settings. The Severe Typhoid in Africa programme was designed to address regional gaps in typhoid burden data and identify populations eligible for interventions using novel typhoid conjugate vaccines.

Methods: A hybrid design, hospital-based prospective surveillance with population-based health-care utilisation surveys, was implemented in six countries in sub-Saharan Africa.

Do Oral Cholera Vaccine and Water, Sanitation, and Hygiene Combine to Provide Greater Protection Against Cholera? Results From a Cluster-Randomized Trial of Oral Cholera Vaccine in Kolkata, India.

Background: Oral cholera vaccine (OCV) and incremental improvements in household water, sanitation, and hygiene (WASH) within cholera-endemic areas can reduce cholera risk. However, we lack empiric evaluation of their combined impact.

Methods: We evaluated a cluster-randomized, placebo-controlled trial of OCV (Shanchol) in Kolkata, India.

Implementation of bubble continuous positive airway pressure for children with severe pneumonia and hypoxemia in intensive care unit of Dhaka Hospital, Bangladesh-Effect on pneumonia mortality.

Background: After the completion of a randomized trial at Dhaka Hospital in 2013, bubble continuous positive airway pressure (BCPAP) oxygen therapy was incorporated as the part of the standard treatment for children with severe pneumonia with hypoxemia in an intensive care unit at Dhaka Hospital in August 2013 instead of World Health Organization (WHO) standard low flow oxygen therapy.

Objective: To understand the long-term effectiveness of the introduction of bCPAP oxygen therapy by comparing pneumonia mortality in the post-trial period (August 2013 to December 2017) with the pre-trial (February 2009 to July 2011) and trial periods (August 2011 to July 2013).

Methods: It was a retrospective analysis of prospectively collected hospital data of all admissions.

Better Existing Water, Sanitation, and Hygiene Can Reduce the Risk of Cholera in an Endemic Setting: Results From a Prospective Cohort Study From Kolkata, India.

Background: Global cholera control efforts rely heavily on effective water, sanitation, and hygiene (WASH) interventions in cholera-endemic settings.

Methods: Using data from a large, randomized controlled trial of oral cholera vaccine conducted in Kolkata, India, we evaluated whether natural variations in WASH in an urban slum setting were predictive of cholera risk. From the control population (n = 55 086), baseline WASH data from a randomly selected "training subpopulation" (n = 27 634) were analyzed with recursive partitioning to develop a dichotomous ("better" vs "not better") composite household WASH variable from several WASH features collected at baseline, and this composite variable was then evaluated in a mutually exclusive "validation population" (n = 27 452).

Evaluation of feasibility phase of adaptive version of locally made bubble continuous positive airway pressure oxygen therapy for the treatment of COVID-19 positive and negative adults with severe pneumonia and hypoxaemia.

Background: Bubble continuous positive airway pressure (bCPAP) oxygen therapy has been shown to be safe and effective in treating children with severe pneumonia and hypoxaemia in Bangladesh. Due to lack of adequate non-invasive ventilatory support during coronavirus disease 2019 (COVID-19) crisis, we aimed to evaluate whether bCPAP was safe and feasible when adapted for use in adults with similar indications.

Methods: Adults (18-64 years) with severe pneumonia and moderate hypoxaemia (80 to <90% oxygen saturation (SpO) in room air) were provided bCPAP via nasal cannula at a flow rate of 10 litres per minute (l/min) oxygen at 10 centimetres (cm) HO pressure, in two tertiary hospitals in Dhaka, Bangladesh.

Association Among Household Water, Sanitation, and Hygiene (WASH) Status and Typhoid Risk in Urban Slums: Prospective Cohort Study in Bangladesh.

Background: Typhoid fever, or enteric fever, is a highly fatal infectious disease that affects over 9 million people worldwide each year, resulting in more than 110,000 deaths. Reduction in the burden of typhoid in low-income countries is crucial for public health and requires the implementation of feasible water, sanitation, and hygiene (WASH) interventions, especially in densely populated urban slums.

Objective: In this study, conducted in Mirpur, Bangladesh, we aimed to assess the association between household WASH status and typhoid risk in a training subpopulation of a large prospective cohort (n=98,087), and to evaluate the performance of a machine learning algorithm in creating a composite WASH variable.