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• Journal article
  Cidade JP, Taccone FS, Reyes LF, Merson L, Lefevre B, Citarella BW, fatoni AZ, Póvoa P, Zucman D, Zoufaly A, Zayyad H, Zaynah N, Zawadka K, Zanella A, Zambrano M, Zambon M, Zaidan NZB, Zahid M, Zabbe M, Zaaqoq A, Yuliarto S, Yousif O, Yonis H, Yiaye T, Yeoh CH, Yelnik C, Abdelaal AYM, Hing NYL, Yazdanpanah Y, Yarad E, Yamazaki M, Yakop SRBM, Xynogalas I, Xian LS, Wong C, Wong TF, Wong YS, Wong XC, Wittman J, Witt K, Wils EJ, Williams B, Williams PJ, Williams V, Wijaya SO, Wiedemann A, White N, Whelan B, Wham M, Wesselius S, Wen TP, Webb S, Walsh L, Wainstein M, Wahid NA, Wahab NH, Wahab SA, Vuotto F, Vongsouvath M, Villoldo A, Villar J, Vijayan D, Vieira C, Verbon A, Ventura S, Veislinger A, Veeran S, Vauchy C, Vasudayan SR, Varrone M, Vanel N, van Willigen H, van Twillert G, van Someren Gréve F, van Netten C, van Hattem J, van Gulik L, van Gorp E, Van Der Werf S, Van der Voort P, van der Feltz M, van den Berge M, Val-Flores L, Vajdovics C, Uyeki TM, Usman A, Uribe A, Ullrich R, Udy A, Udayanga PGI, Uchiyama M, Twardowski P, Tveita A, Turtle LCW, Turgeon AF, Tuite H, Tubiana S, Tual C, Truong J, Trontzas Iet al., 2026,
  , Intensive Care Medicine Experimental, Vol: 14

  Objective: Immune dysregulation plays a pivotal role in the pathophysiology of sepsis and COVID-19, with lymphopenia emerging as a consistent marker of severity and poor prognosis. However, most existing studies have assessed lymphocyte counts at isolated time points, limiting insights into their temporal behavior and prognostic value. The dynamics of lymphocyte recovery or persistence of lymphopenia remain largely unexplored in large populations, as well as the impact of adjunctive therapies such as corticosteroids. We hypothesized that the persistence or recovery of lymphopenia may be key to understanding disease progression and predicting outcomes. Using the multinational ISARIC cohort, we investigated longitudinal lymphocyte trajectories in hospitalized patients and the clinical determinants associated with their evolution over time. Methods: We conducted a multinational prospective observational cohort study using data from the ISARIC-WHO Clinical Characterization Protocol. Patients with confirmed SARS-CoV-2 infection and at least four lymphocyte measurements during the first 28 days of hospitalization were included. We analyzed lymphocyte trajectories, Cox regression survival analyses and multivariable linear regression modelling. We also applied multistate models and joint modeling to assess the association between lymphocyte trajectories and 28-day mortality, incorporating corticosteroid use as a time-varying covariate. Results: Of 945,317 screened patients, 231,933 hospitalized adults with confirmed COVID-19 and sufficient lymphocyte data were included, with 56.6% classified as lymphopenic. Lymphopenia was independently associated with higher rates of ICU admission, organ support, and in-hospital mortality (OR = 1.52, 95% CI 1.48–1.55), and lower absolute lymphocyte counts were strongly linked to worse survival in adjusted Cox models (HR = 1.33 per 1 × 10⁹ cells/L decrease, 95% CI 1.28–1.38). Multistate modeling revealed that lymphope

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  • Citations: 3
• Journal article
  Ngwili N, Kachepa U, Korir M, Chavula M, Wood C, Chiphwanya J, Kafanikhale H, Glazer C, Juziwelo L, Munkhondia-Phiri P, Musaya J, Thomas LF, Dixon-Zegeye Met al., 2026,
  , One Health Outlook, Vol: 8, ISSN: 2524-4655

  Background Taenia solium, colloquially called the pork tapeworm, is a zoonotic parasite with a human definitive host and a porcine intermediate host. Humans can become an aberrant intermediate host due to accidental ingestion of parasite eggs from the environment or through autoinfection, resulting in human cysticercosis (HCC), neurocysticercosis (NCC) if the central nervous system is infected. Pigs become infected with the larval stage, porcine cysticercosis (PCC), through the ingestion of parasite eggs shed by humans through defecation. Malawi has been classified as endemic for T. solium by the WHO based on the presence of key risk factors; however, the subnational distribution is not known. To ensure the appropriate resources are mobilized to support targeted future T. solium control measures in Malawi, there is a need to understand the variation in T. solium endemicity status across the country.Methods The current study uses a systematic literature review (SLR) using a pre-registered protocol; (PROSPERO CRD42023411044) to collate all available evidence on T. solium in Malawi. A geospatial risk mapping approach was conducted based on data from Malawi demographic health surveys (MDHS), and pig density data from the Food and Agriculture Organization (FAO) database to create geospatial risk maps of endemic subnational areas for 2000, 2004, 2010, and 2016. To create a single composite risk factor map for the four years from the MDHS, each parameter was plotted as a binary variable with the high or low risk categories and overlaid into a single composite risk factor classification. Additional data from hospital records on NCC and meat inspection records across several Agricultural Development Divisions (ADDs) were also collected.

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• Journal article
  McCain K, Topazian HM, Challenger JD, Okell L, Winskill P, Ghani ACet al., 2026,
  , BMC Medicine, Vol: 24, ISSN: 1741-7015

  Background The malaria vaccine R21/Matrix-M is recommended for young children in malaria-endemic regions. However, the small vaccine-eligible population and waning vaccine efficacy mean that routine vaccination is unlikely to prevent severe cases in older children who experience significant malaria burden. As R21/Matrix-M vaccination expands, targeting older age groups may be warranted, depending on funding. Methods Using a stochastic, individual-based P. falciparum malaria transmission model, we estimate the impact of 1) one-off catch-up campaigns with R21/Matrix-M to previously unvaccinated age groups between age 6 months and 14 years, and/or 2) extra boosters at 2, 5 and/or 10 years after the primary series in low, moderate, and high transmission settings. We assume that vaccine immunogenicity in older children is equivalent to that of the standard target age group, though clinical trials have shown lower immunogenicity in older children.ResultsCatch-up campaigns in moderate-to-high transmission settings targeting younger children averted the most uncomplicated cases per 1000 additional doses (358 (95% Credible Interval (CI) 113-570) in children aged 6 months-2 years at 45% PfPR2-10), compared with targeting older children. In low transmission settings, the impact was similar across age groups, with a slightly higher impact when targeting school-aged children (373 (95% CrI 240-518) in children aged 5-9 years at 5% PfPR2-10). Across extra booster strategies, an extra booster 10 years post-primary series averted the most severe cases per 1000 additional doses at low transmission (12 (95% CrI 6-18) at 5% PfPR2-10), but the least at high transmission (-4 (95% CrI -11-3) at 45% PfPR2-10). Expanding the vaccine-eligible population in areas of moderate-to-high transmission often had higher incremental efficiency than routine age-based vaccination at low transmission. Sensitivity analyses assuming lower immunogenicity in older children modestly reduced the per-dose impac

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• Journal article
  Topazian HM, Morgan CE, Goel V, 2026,
  , One Health, Vol: 23, ISSN: 2352-7714

  Use of zooprophylaxis as a malaria control strategy has been recommended historically, but a complex relationship exists between animal ownership and malaria infection, with mixed associations described in the literature. We sought to characterize this relationship spatially and temporally in malaria-endemic regions of Africa. We used data from 392,843 individuals from 66 Demographic and Health surveys from countries within Africa to investigate the association between household animal ownership and Plasmodium infection. We used Bayesian models with Integrated Nested Laplace Approximation to incorporate spatially varying coefficient processes, allowing the association of interest to vary over space, time, and within strata of vector species occurrence, land cover, and number of animals owned by households. Spatially varying intercept models showed that ownership of cattle, chickens/poultry, goats, horses/donkeys/mules, pigs, and sheep was broadly associated with malaria infection, with odds ratios ranging from 1.55 to 1.67. However, spatially varying slope models revealed considerable heterogeneity, with odds ratio estimates for all animal types demonstrating both protective and harmful effects varying from 0.33 to 3.33 both subnationally and across time. We found no evidence that modification by vector species, number of animals owned, and land cover fully explained the variation in estimates. Unobserved localized cultural, behavioral, or ecological factors likely modify the association between animal ownership and malaria prevalence. Further exploring the nature of this relationship over space and time will be important to understanding how context-specific One Health dynamics between humans, animals and the environment affect malaria prevention and control efforts.

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• Journal article
  Lopes BC, Dutra JVR, Moreira FRR, Chen W, Bibby K, Faria N, de Aguiar RS, Mota Filho CRet al., 2026,
  , Water Res, Vol: 300

  This study evaluated wastewater-based epidemiology (WBE) for monitoring dengue virus (DENGV) and chikungunya virus (CKV) during Brazil's most severe arbovirus epidemic, focusing on the city of Belo Horizonte, Minas Gerais. From March 2022 to August 2024, 24-hour composite raw sewage samples were collected weekly from two major wastewater treatment plants, encompassing over 80% of the city's population. Viral RNA was quantified via RT-qPCR and positive samples underwent genome sequencing for genotype characterization. DENGV and CKV RNA were detected in over 90% of samples across both wastewater treatment plants (WWTPs), demonstrating sustained and widespread viral circulation throughout epidemic and inter-epidemic periods. Although CHIKV concentrations varied significantly across years, DENGV concentrations remained statistically stable, and no significant correlations were observed between wastewater viral loads and reported clinical cases. A considerable proportion of samples presented concentrations below the limit of quantification, indicating that while WBE is highly sensitive for qualitative detection of arboviruses, quantitative interpretation remains methodologically constrained. Sequencing confirmed the presence of DENGV-1 sorotype I and CKV genotype V, clustering with contemporaneous Brazilian strains and reflecting regional transmission dynamics. Wastewater-based modelling further suggested that reported clinical cases may substantially underestimate true infection burden, although quantitative estimates were highly sensitive to assumptions regarding viral shedding variability. These findings demonstrate that WBE provides a sensitive, non- invasive, population level approach for tracking arboviral circulation and viral diversity during large-scale outbreaks and could complement public health surveillance frameworks, especially in regions with limited diagnostic capacity or high levels of underreporting, to enhance epidemic response and control strategies.

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• Journal article
  Botwright S, Munira SL, Megiddo I, El Desouky N, Ngwira LG, Turner HC, Teerawattananon Yet al., 2026,
  , PharmacoEconomics, ISSN: 1170-7690
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• Journal article
  Odufuwa OG, Sheppard RJ, Ngonyani S, Mpelepele AB, Kobe D, Njohole A, Moore J, Lusoli JL, Muganga JB, Bosselmann R, Skovmand O, Mboma ZM, Mbuba E, Philipo R, Stevenson JC, Sherrard-Smith E, Bradley J, Moore SJet al., 2026,
  , BMC Public Health

  BACKGROUND: Gaps in unimproved house structures, especially in eaves and windows, allow mosquito entry, increasing indoor vector-borne disease transmission. Simple modifications to such houses may reduce human exposure, and insecticide treatment may kill mosquitoes, benefiting all community members. This study evaluated insecticide-treated screening (ITS) for eaves and windows, incorporated with deltamethrin and piperonyl butoxide (PBO), compared to a permethrin and PBO-treated bednet in Tanzania. METHOD: A randomised Latin-square design (4 × 4) was used in four experimental huts within a large netting cage to allow mosquito recapture inside and outside of huts. Four treatments were evaluated: (1) new (12-month stored) ITS; (2) 12-month naturally-aged ITS; (3) 12-month field-used pyrethroid-PBO bednet (standard of care in Tanzania), and (4) no treatment. The study was performed for 32 nights using 30 mosquitoes per strain, per hut per night. Four laboratory-reared strains were used: malaria vectors (Anopheles arabiensis and An. funestus), dengue vector (Aedes aegypti), and nuisance biting (Culex quinquefasciatus). Recaptured mosquitoes were assessed for mortality at 72 h, blood-feeding, and hut entry. A simulation with a modified mechanistic model tracking Plasmodium falciparum malaria was used to illustrate potential epidemiological impact from these products. RESULTS: Against all mosquito species compared to 12-month aged pyrethroid-PBO-treated bednet, new ITS induced higher mortality [Odds Ratio:2.25(95%Confidence Interval:1.65-3.06),p < 0.0001], and aged-ITS was similar [OR:0.80(95%CI:0.59-1.08),p = 0.141]. Both new and aged ITS significantly (p < 0.0001) reduced mosquito blood-feeding [new OR:0.02(95% CI:0.01-0.03); aged OR:0.09(95%CI:0.05-0.14)] and hut entry [new IRR:0.10(95%CI:0.08-0.13); aged IRR:0.25(95%CI:0.21-0.31)]. Transmission model estimates indicate epidemiological impacts of I

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• Journal article
  Hicks J, Munsey A, Mousa A, Cairns M, Hill A, Gowelo S, Knock E, Baguelin M, Digre P, Gogue C, Matambisso G, Pujol A, Mayor A, Wagman J, Madanitsa M, Khairallah C, Kalilani-Phiri L, Mwapasa V, Kariuki S, Desai M, Maleta K, Phiri K, Taylor S, Wang D, Meshnick S, van Eijk A, Chandramohan D, Kayentao K, Williams J, Coulibaly S, Bojang K, Chacky F, Munisi K, Aaron S, Lazaro S, Tagbor H, Greenwood B, ter Kuile F, Fitzjohn R, Gutman J, Walker Pet al., 2026,

  Disentangling patterns of community malaria transmission and burden using malaria prevalence among pregnant women attending antenatal care: a modelling study

  , The Lancet Microbe, ISSN: 2666-5247

  Background Malaria prevalence measured among pregnant women at first antenatal care (ANC1) provides longitudinal estimates of malaria burden in pregnancy and correlates well with cross-sectional community prevalence, but additional analysis is required to estimate community incidence. We aimed to test whether ANC1-based malaria prevalence can, via an open-source, mechanistic, model-based framework, recover seasonal patterns of clinical incidence suitable for sub-regional programmatic decision-making. Methods We conducted a modelling study using monthly ANC1 malaria prevalence data from six previously published studies of malaria in pregnancy in six sub-Saharan African countries between May 2010 and August 2014. An extended, validated, age-structured malaria transmission model was fitted to monthly ANC1 malaria prevalence using particle Markov Chain Monte Carlo (pMCMC) to infer monthly clinical incidence and seasonality metrics. Agreement between model-derived incidence and independently observed time series was assessed using Markham Seasonality Index (MSI) and peak timing with concordance correlation coefficients (CCC) and 95% confidence intervals (CI). Findings Across the six ISTp datasets, total ANC1 sample sizes and positivity were: Ghana 622/1298 (47.9%); Burkina Faso 592/1413 (41.9%); Mali, 284/1308 (21.7%); The Gambia 105/1194 (8.8%); Kenya 323/1528 (21.1%); and Malawi 291/1825 (15.9%). Strong agreement was observed between model-derived incidence and independent cohort data for MSI (CCC = 0.82; 95% CI 0.31–0.97) and for peak timing (CCC = 0.98; 95% CI 0.87–0.997). Interpretation A mechanistic pMCMC framework applied to routine ANC1 data can recover clinically relevant seasonality in incidence for the broader community, enabling sub-regional timing of seasonal interventions (like seasonal malaria chemoprevention). These capabilities are especially valuable where high-quality case surveillance is limited, and household surveys are under-funded. Our

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• Journal article
  Naidoo T, Morgenstern C, Doohan P, Earl R, Rawson T, Sheppard R, Hicks J, Radhakrishnan S, Johnson R, Hartner A-M, Cattarino L, McCain K, Vicco A, Imai-Eaton N, van Elsland S, Cori A, McCabe R, Bhatia S, the Pathogen Epidemiology Review Groupet al., 2026,
  , The Lancet Infectious Diseases, ISSN: 1473-3099

  We conducted a systematic review, following PRISMA guidelines (PROSPERO CRD42023393345), characterising the epidemiology, outbreaks and mathematical models of Nipah virus (NiV), an important public health threat in South and Southeast Asia. We searched PubMed and Web of Science from database inception through to 14 March 2025, and extracted 243 parameters, 89 risk factors, 39 models and 23 distinct outbreaks from 119 papers. IgG seroprevalence estimates in the general population ranged from 0% to 12.5%. NiV causes severe disease, with pooled case-fatality ratio estimates ranging widely from 9.1% (95%CI: 0.2%-41.3%) in Singapore to 81.9% (95%CI: 71.9%-88.9%) in Bangladesh. NiV's infection timeline and clinical course remain poorly characterised; we estimated a median incubation period of 8.77 days (n=165, 95%CI: 7.53-10.02) from 8 estimates in 7 articles with sufficient information. Transmission parameter estimates were scarce, and all but one of five central estimates of the basic reproduction number were below 1. NiV mathematical models (n=39) were rarely fitted to data (n=8). All extracted information is accessible via our R package, epireview.

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• Journal article
  Dennis TPW, Sulieman JE, Nouredayem M, Ashine T, Ebstie Y, Eyasu A, Simma EA, Zemene E, Negash N, Yigeremu A, Assefa M, Elzack H, Dagne A, Lukas B, Bulto MG, Fontaine MC, Talignani L, Enayati A, Nikpoor F, Al-Nazawi AM, Al-Zahrani MH, Khaireh BA, Guelleh S, Abdi A-IA, Allan R, Omondi S, Abong'o B, Milanoi S, Ochomo E, Ahmed A, Samake JN, Gimnig JE, Rafferty C, Ashraf F, Pignatelli P, Morris M, Nagi SC, Lucas ER, Hernandez-Koutoucheva A, Clarkson CS, Doumbe-Belisse P, Epstein A, Brown R, Wilson AL, Reynolds AM, Sherrard-Smith E, Yewhalaw D, Gadisa E, Malik E, Kafy HT, Donnelly MJ, Weetman Det al., 2026,
  , Science, Vol: 393

  The invasive urban malaria vector Anopheles stephensi threatens 126 million city dwellers in Africa. Controlling An. stephensi requires greater understanding of its origin, invasion dynamics, and insecticide resistance mechanisms. Analysis of 645 whole genomes sampled across Africa, the Middle East, and Asia supports an invasion scenario in which an initial South Asian introduction established a bridgehead population in Djibouti, which seeded distinct invasion fronts in Sudan, Ethiopia/Kenya, and Yemen. These incursions show contrasting rates and routes of spread shaped by landscape topology. Insecticide resistance is predominantly mediated by metabolic detoxification genes, with resistance haplotypes and copy-number amplifications introduced from South Asia. These findings, alongside a companion genomic resource, enable genomic surveillance of An. stephensi spread and resistance to aid control strategies.

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