NEWS UPDATES

Paper entitled " Pandemic influenza H1N1 2009 in Thailand" is published in the WHO South-East Asia Journal of Public Health

Aronrag Meeyai and Richard Coker,et al. have published the paper on Pandemic influenza H1N1 2009 in Thailand in the WHO South-East Asia Journal of Public Health, Vol. 1 No. 1, January – March, 2012.

Abstract: 

Background: Developing a quantitative understanding of pandemic influenza dynamics in SouthEast Asia is important for informing future pandemic planning. Hence, transmission dynamics of influenza A/H1N1 were determined across space and time in Thailand.

Methods: Dates of symptom onset were obtained for all daily laboratory-confirmed cases of influenza A/H1N1pdm in Thailand from 3 May 2009 to 26 December 2010 for four different geographic regions (Central, North, North-East, and South). These data were analysed using a probabilistic epidemic reconstruction, and estimates of the effective reproduction number, R(t), were derived by region and over time.

Results: Estimated R(t) values for the first wave peaked at 1.54 (95% CI: 1.42-1.71) in the Central region and 1.64 (95% CI: 1.38-1.92) in the North, whilst the corresponding values in the North-East and the South were 1.30 (95% CI: 1.17-1.46) and 1.39 (95% CI: 1.32-1.45) respectively. As the R(t) in the Central region fell below one, the value of R(t) in the rest of Thailand increased above one. R(t) was above one for 30 days continuously through the first wave in all regions of Thailand. During the second wave R(t) was only marginally above one in all regions except the South.

Conclusions: In Thailand, the value of R(t) varied by region in the two pandemic waves. Higher R(t) estimates were found in Central and Northern regions in the first wave. Knowledge of regional variation in transmission potential is needed for predicting the course of future pandemics and for analysing the potential impact of control measures

Full text please visit: http://www.searo.who.int/LinkFiles/SEAJPH_SEAJPH-1-8.pdf 

Job Opportunity : Overseas Lecturer in Health Systems Analysis

We are seeking an enthusiastic Lecturer to join our CDPRG group, Department of Global Health and Development, based in Thailand.  The primary role for this post will be to work with the team to develop a research programme in health systems in SE Asia; in addition the post holder will support two GIZ funded projects undertaking health systems analyses in Cambodia and Indonesia.

We are looking for an applicant, to start as soon as possible, with a background in health systems and policy analysis, health economics, or related discipline, with experience in primarily quantitative research. As the GIZ projects involve development and simulation of healthcare “surge” scenarios, experience with mathematical modelling and/or programming is also desirable (but not essential).

The successful applicant will be based in Bangkok for the duration of the post, but will need to be able to travel between research partners and other collaborators in other SE Asian countries.

Salary will be on the Lecturer scale (£38,140-£44,165 per annum inclusive plus displacement allowance if applicable). The post will be subject to the LSHTM overseas terms and conditions of service, including membership of the Universities Superannuation Scheme.  The post is full time for one year in the first instance. 

Applications should be made on-line via our website at http://jobs.lshtm.ac.uk.The reference for this post is RC09.  

Applications should also include a CV and the names of two referees, one of whom should be the most recent employer and may be approached immediately if shortlisted, should also be included with the on-line application.  Any queries regarding the application process may be addressed to jobs@lshtm.ac.uk. 

The London School of Hygiene & Tropical Medicine is committed to being an equal opportunities employer.

Paper entitled " H5N1 Avian Influenza in Children" has been published in Clinical Infectious Diseases

15 March 2012:

Co authored by Prof Richard Coker, the paper H5N1 Avian Influenza in Children has been published in Clinical Infectious Diseases Journal and is available onlineclick here

Abstract

Background Avian influenza continues to pose a threat to humans and maintains the potential for greater transmissibility. Understanding the clinical presentation and prognosis in children will help guide effective diagnosis and treatment. 

Methods A global patient registry was created to enable systematic collection of clinical, exposure, treatment and outcomes data on confirmed cases of H5N1. Bivariate and multivariate statistical tools were used to describe clinical presentation and evaluate factors prognostic of survival. 

Results Data were available from 13 countries on 193 cases <18 years who were confirmed as having been infected with H5N1; 35.2% of cases were from Egypt. The case fatality rate (CFR) for children was 48.7%, with Egypt having very low pediatric CFR. Overall, children aged ≤5 years had the lowest CFR and were brought to hospital more quickly and treated sooner than older children. Pediatric cases who presented for medical care with a complaint of rhinorrhea had a 76% reduction in the likelihood of death compared with those who presented without rhinorrhea, even after statistical adjustment for age, having been infected in Egypt, and oseltamivir treatment (P=0.02). Delayed initiation of treatment with oseltamivir increases the likelihood of death, with an overall 75% increase in the adjusted odds ratio for death for each day of delay.

Conclusions The presence of rhinorrhea appears to indicate a better prognosis for children with H5N1, with most cases surviving regardless of age, country or treatment. For cases treated with oseltamivir, early initiation of treatment substantially enhances the chance of survival.