Age-Dependent Prevalence of Nasopharyngeal Carriage of Streptococcus pneumoniae before Conjugate Vaccine Introduction: A Prediction Model Based on a Meta-Analysis

Introduction

Data on the prevalence of nasopharyngeal carriage of S.pneumoniae in all age groups are important to help predict the impact of introducing pneumococcal conjugate vaccines (PCV) into routine infant immunization, given the important indirect effect of the vaccine. Yet most carriage studies are limited to children under five years of age. We here explore the association between carriage prevalence and serotype distribution in children aged ≥5 years and in adults compared to children.

Methods

We conducted a systematic review of studies providing carriage estimates across age groups in healthy populations not previously exposed to PCV, using MEDLINE and Embase. We used Bayesian linear meta-regression models to predict the overall carriage prevalence as well as the prevalence and distribution of vaccine and nonvaccine type (VT and NVT) serotypes in older age groups as a function of that in <5 y olds.

Results

Twenty-nine studies compromising of 20,391 individuals were included in the analysis. In all studies nasopharyngeal carriage decreased with increasing age. We found a strong positive linear association between the carriage prevalence in pre-school childen (<5 y) and both that in school aged children (5–17 y olds) and in adults. The proportion of VT serotypes isolated from carriers was consistently lower in older age groups and on average about 73% that of children <5 y among 5–17 y olds and adults respectively. We provide a prediction model to infer the carriage prevalence and serotype distribution in 5–17 y olds and adults as a function of that in children <5 years of age.

Conclusion

Such predictions are helpful for assessing the potential population-wide effects of vaccination programmes, e.g. via transmission models, and thus assist in the design of future pneumococcal conjugate vaccination strategies.     

Social contact patterns in Vietnam and implications for the control of infectious diseases

Background

The spread of infectious diseases from person to person is determined by the frequency and nature of contacts between infected and susceptible members of the population. Although there is a long history of using mathematical models to understand these transmission dynamics, there are still remarkably little empirical data on contact behaviors with which to parameterize these models. Even starker is the almost complete absence of data from developing countries. We sought to address this knowledge gap by conducting a household based social contact diary in rural Vietnam.

Methods and Findings

A diary based survey of social contact patterns was conducted in a household-structured community cohort in North Vietnam in 2007. We used generalized estimating equations to model the number of contacts while taking into account the household sampling design, and used weighting to balance the household size and age distribution towards the Vietnamese population. We recorded 6675 contacts from 865 participants in 264 different households and found that mixing patterns were assortative by age but were more homogenous than observed in a recent European study. We also observed that physical contacts were more concentrated in the home setting in Vietnam than in Europe but the overall level of physical contact was lower. A model of individual versus household vaccination strategies revealed no difference between strategies in the impact on R ₀.

Conclusions and Significance

This work is the first to estimate contact patterns relevant to the spread of infections transmitted from person to person by non-sexual routes in a developing country setting. The results show interesting similarities and differences from European data and demonstrate the importance of context specific data.     

Coral reef calcifiers buffer their response to ocean acidification using both bicarbonate and carbonate

Central to evaluating the effects of ocean acidification (OA) on coral reefs is understanding how calcification is affected by the dissolution of CO₂ in sea water, which causes declines in carbonate ion concentration [CO₃²⁻] and increases in bicarbonate ion concentration [HCO₃⁻]. To address this topic, we manipulated [CO₃²⁻] and [HCO₃⁻] to test the effects on calcification of the coral Porites rus and the alga Hydrolithon onkodes, measured from the start to the end of a 15-day incubation, as well as in the day and night. [CO₃²⁻] played a significant role in light and dark calcification of P. rus, whereas [HCO₃⁻] mainly affected calcification in the light. Both [CO₃²⁻] and [HCO₃⁻] had a significant effect on the calcification of H. onkodes, but the strongest relationship was found with [CO₃²⁻]. Our results show that the negative effect of declining [CO₃²⁻] on the calcification of corals and algae can be partly mitigated by the use of HCO₃⁻ for calcification and perhaps photosynthesis. These results add empirical support to two conceptual models that can form a template for further research to account for the calcification response of corals and crustose coralline algae to OA.     

Coping with Pleistocene climatic fluctuations: Demographic responses in remote endemic reef fishes

Elucidating demographic history during the settlement of ecological communities is crucial for properly inferring the mechanisms that shape patterns of species diversity and their persistence through time. Here, we used genomic data and coalescent‐based approaches to elucidate for the first time the demographic dynamics associated with the settlement by endemic reef fish fauna of one of the most remote peripheral islands of the Pacific Ocean, Rapa Nui (Easter Island). We compared the demographic history of nine endemic species in order to explore their demographic responses to Pleistocene climatic fluctuations. We found that species endemic to Rapa Nui share a common demographic history, as signatures of population expansions were retrieved for almost all of the species studied here, and synchronous demographic expansions initiated during the last glacial period were recovered for more than half of the studied species. These results suggest that eustatic fluctuations associated with Milankovitch cycles have played a central role in species demographic histories and in the final stage of the community assembly of many Rapa Nui reef fishes. Specifically, sea level lowstands resulted in the maximum reef habitat extension for Rapa Nui endemic species; we discuss the potential role of seamounts in allowing endemic species to cope with Pleistocene climatic fluctuations, and we highlight the importance of local historical processes over regional ones. Overall, our results shed light on the mechanisms by which endemism arises and is maintained in peripheral reef fish fauna.     

Pyrimido[4,5-d]azepines as potent and selective 5-HT2C receptor agonists: design, synthesis, and evaluation of PF-3246799 as a treatment for urinary incontinence

New pyrimido[4,5-d]azepines 7 are disclosed as potent 5-HT_2C receptor agonists. A preferred example, 7b had minimal activation at either the 5-HT_2A or 5-HT_2B receptors combined with robust efficacy in a preclinical canine model of stress urinary incontinence (SUI) and attractive pharmacokinetic and safety properties. Based on this profile, 7b (PF-3246799) was identified as a candidate for clinical development for the treatment of SUI. In addition, it proved to be critical to build an understanding of the translation between recombinant cell-based systems, native tissue preparations and in vivo preclinical models. This was a significant undertaking and proved to be crucial in compound selection.     

The effects of storms,heavy rain,and sedimentation on the shallow coral reefs of St. John,US Virgin Islands

Efforts to limit plant growth in streams by reducing nutrients would benefit from an understanding of the relative influences of nutrients, streamflow, light, and other potentially important factors. We measured macrophytes, benthic algae, nutrients in water and sediment, discharge, and shading from 30 spring-fed or runoff-influenced streams in the upper Snake River basin, ID, USA. We hypothesized that in hydrologically stable, spring-fed streams with clear water, macrophyte and benthic algae biomass would be a function of bioavailable nutrients in water or sediments, whereas in hydrologically dynamic, runoff-influenced streams, macrophyte and benthic algae biomass would further be constrained by flow disturbance and light. These hypotheses were only partly supported. Nitrogen, both in sediment and water, was positively correlated with macrophyte biomass, as was loosely sorbed phosphorus (P) in sediment. However, P in water was not. Factors other than nutrient enrichment had the strongest influences on macrophyte species composition. Benthic algal biomass was positively correlated with loosely sorbed sediment P, lack of shade, antecedent water temperatures, and bicarbonate. These findings support the measurement of bioavailable P fractions in sediment and flow histories in streams, but caution against relying on macrophyte species composition or P in water in nutrient management strategies for macrophytes in streams.