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{"title"=>"Simulated impact of RTS,S/AS01 vaccination programs in the context of changing malaria transmission", "type"=>"journal", "authors"=>[{"first_name"=>"Alan", "last_name"=>"Brooks", "scopus_author_id"=>"7202568641"}, {"first_name"=>"Olivier J.T.", "last_name"=>"Briët", "scopus_author_id"=>"55556414500"}, {"first_name"=>"Diggory", "last_name"=>"Hardy", "scopus_author_id"=>"54881047500"}, {"first_name"=>"Richard", "last_name"=>"Steketee", "scopus_author_id"=>"7007179922"}, {"first_name"=>"Thomas A.", "last_name"=>"Smith", "scopus_author_id"=>"55547140840"}], "year"=>2012, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-84857840686", "doi"=>"10.1371/journal.pone.0032587", "issn"=>"19326203", "pui"=>"364373492", "sgr"=>"84857840686", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)", "pmid"=>"22412892"}, "id"=>"0f1be39b-5c1f-3d04-8c93-93d42bee5972", "abstract"=>"INTRODUCTION: The RTS,S/AS01 pre-erythrocytic malaria vaccine is in phase III clinical trials. It is critical to anticipate where and how it should be implemented if trials are successful. Such planning may be complicated by changing levels of malaria transmission. METHODS/RESULTS: Computer simulations were used to examine RTS,S/AS01 impact, using a vaccine profile based on phase II trial results, and assuming that protection decays only slowly. Settings were simulated in which baseline transmission (in the absence of vaccine) was fixed or varied between 2 and 20 infectious mosquito bites per person per annum (ibpa) over ten years. Four delivery strategies were studied: routine infant immunization (EPI), EPI plus infant catch-up, EPI plus school-based campaigns, and EPI plus mass campaigns. Impacts in changing transmission settings were similar to those in fixed settings. Assuming a persistent effect of vaccination, at 2 ibpa, the vaccine averted approximately 5-7 deaths per 1000 doses of vaccine when delivered via mass campaigns, but the benefit was less at higher transmission levels. EPI, catch-up and school-based strategies averted 2-3 deaths per 1000 doses in settings with 2 ibpa. In settings where transmission was decreasing or increasing, EPI, catch-up and school-based strategies averted approximately 3-4 deaths per 1000 doses. DISCUSSION: Where transmission is changing, it appears to be sufficient to consider simulations of pre-erythrocytic vaccine impact at a range of initial transmission levels. At 2 ibpa, mass campaigns averted the most deaths and reduced transmission, but this requires further study. If delivered via EPI, RTS,S/AS01 could avert approximately 6-11 deaths per 1000 vaccinees in all examined settings, similar to estimates for pneumococcal conjugate vaccine in African infants. These results support RTS,S/AS01 implementation via EPI, for example alongside vector control interventions, providing that the phase III trials provide support for our assumptions about efficacy.", "link"=>"http://www.mendeley.com/research/simulated-impact-rtssas01-vaccination-programs-context-changing-malaria-transmission", "reader_count"=>39, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Researcher"=>13, "Student > Ph. D. Student"=>9, "Student > Postgraduate"=>2, "Student > Master"=>4, "Other"=>3, "Student > Bachelor"=>3, "Lecturer"=>2, "Student > Doctoral Student"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Researcher"=>13, "Student > Ph. D. Student"=>9, "Student > Postgraduate"=>2, "Student > Master"=>4, "Other"=>3, "Student > Bachelor"=>3, "Lecturer"=>2, "Student > Doctoral Student"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>1, "Biochemistry, Genetics and Molecular Biology"=>1, "Medicine and Dentistry"=>13, "Agricultural and Biological Sciences"=>15, "Veterinary Science and Veterinary Medicine"=>1, "Psychology"=>1, "Social Sciences"=>3, "Computer Science"=>1, "Immunology and Microbiology"=>2, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>13}, "Social Sciences"=>{"Social Sciences"=>3}, "Psychology"=>{"Psychology"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>2}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>15}, "Computer Science"=>{"Computer Science"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Unspecified"=>{"Unspecified"=>1}, "Veterinary Science and Veterinary Medicine"=>{"Veterinary Science and Veterinary Medicine"=>1}}, "reader_count_by_country"=>{"United States"=>2, "Brazil"=>1, "United Kingdom"=>1, "Spain"=>1, "Indonesia"=>1}, "group_count"=>8}

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• http://doi.org/10.1186/s12936-015-0805-1
• http://doi.org/10.1002/emmm.201403876
• http://doi.org/10.3389/fmicb.2014.00741
• http://doi.org/10.1186/s12916-015-0408-2
• http://doi.org/10.1186/1475-2875-13-426
• http://doi.org/10.1016/S0140-6736(15)00693-5
• http://doi.org/10.1586/erv.12.51
• http://doi.org/10.1371/journal.pone.0228469
• http://doi.org/10.1186/1475-2875-13-263
• http://doi.org/10.1186/s12961-017-0187-7
• http://doi.org/10.1016/j.exppara.2013.06.009
• http://doi.org/10.1186/1475-2875-13-470

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• {"type"=>"COMMENT", "annotationUri"=>"info:doi/10.1371/annotation/d1227197-28db-46ea-ad64-91072c9df2a2", "title"=>"Clive Shiff", "body"=>"I read this with interest, but ask as a caveat why you imply reductions to the EIR should be included. As the cut off for clinical malaria as decided in the scope of work still accepts significant parasitaemia, one cannot assume that transmission will be reduced. As such EIR should be left constant, in which case my comment wouldnt the 3 billion be better spent on reducing transmission, as we have an excellent drug and mortality due to malaria can easily and cheaply be reduced to low levels.", "isRemoved"=>false, "created"=>"2012-03-09T18:54:29Z", "lastModified"=>"2012-03-09T18:54:29Z", "creator"=>{"userId"=>"155791"}, "highlightedText"=>"", "competingInterestStatement"=>{"creatorWasPrompted"=>true, "hasCompetingInterests"=>false}, "parentArticle"=>{"doi"=>"info:doi/10.1371/journal.pone.0032587", "state"=>"published", "journals"=>{"PLoSONE"=>{"journalKey"=>"PLoSONE", "eIssn"=>"1932-6203", "title"=>"PLOS ONE"}}}, "replyTreeSize"=>0, "mostRecentActivity"=>"2012-03-09T18:54:29Z", "replies"=>[]}

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Figshare

• {"files"=>["https://ndownloader.figshare.com/files/671506"], "description"=>"<p>Legend: a (dashed purple line): EIR = 11 ibpa; b (dashed black line): EIR = 2 ibpa; c (solid black line): EIR decreasing from 20 down to 2 ibpa over 10 years; d (solid green line): EIR increasing after brief suppression from 2 to 20 ibpa over 10 years; e (solid orange line): EIR increasing from 2 to 20 ibpa after being suppressed for 10 years; f (solid purple line): EIR suppressed from 20 down to 2 ibpa, and subsequently maintained at 2 ibpa; g (dashed orange line): EIR = 20 ibpa.</p>", "links"=>[], "tags"=>["public health and epidemiology", "Infectious diseases", "Computational biology", "computer science"], "article_id"=>341994, "categories"=>["Information And Computing Sciences", "Biological Sciences", "Infectious Diseases", "Biotechnology"], "users"=>["Alan Brooks", "Olivier J. T. Briët", "Diggory Hardy", "Richard Steketee", "Thomas A. Smith"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0032587.g001", "stats"=>{"downloads"=>3, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Simulated_transmission_settings_/341994", "title"=>"Simulated transmission settings.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-03-06 00:33:14"}
• {"files"=>["https://ndownloader.figshare.com/files/671672"], "description"=>"<p><b>Legend</b>: EPI = Expanded Programme on Immunization; ibpa = infectious bites per annum.</p>", "links"=>[], "tags"=>["scenarios"], "article_id"=>342165, "categories"=>["Information And Computing Sciences", "Biological Sciences", "Infectious Diseases", "Biotechnology"], "users"=>["Alan Brooks", "Olivier J. T. Briët", "Diggory Hardy", "Richard Steketee", "Thomas A. Smith"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0032587.t001", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_scenarios_used_in_simulations_/342165", "title"=>"Summary of scenarios used in simulations.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-03-06 00:36:05"}
• {"files"=>["https://ndownloader.figshare.com/files/671736"], "description"=>"<p><b>Legend</b>: The first column presents transmission settings. The second column presents the total estimated cases in the all-ages population of 100,000 people per person-year in the absence of vaccination. The estimate is the average over a 10 year period. The remaining columns present the percentage of cases averted by each delivery strategy, as the median and (range) estimated from 14 models.</p>", "links"=>[], "tags"=>["cases", "averted"], "article_id"=>342225, "categories"=>["Information And Computing Sciences", "Biological Sciences", "Infectious Diseases", "Biotechnology"], "users"=>["Alan Brooks", "Olivier J. T. Briët", "Diggory Hardy", "Richard Steketee", "Thomas A. Smith"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0032587.t002", "stats"=>{"downloads"=>1, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Uncomplicated_cases_averted_with_RTS_S_by_transmission_setting_and_delivery_strategy_/342225", "title"=>"Uncomplicated cases averted with RTS,S by transmission setting and delivery strategy.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-03-06 00:37:05"}
• {"files"=>["https://ndownloader.figshare.com/files/343423"], "description"=>"<div><h3>Introduction</h3><p>The RTS,S/AS01 pre-erythrocytic malaria vaccine is in phase III clinical trials. It is critical to anticipate where and how it should be implemented if trials are successful. Such planning may be complicated by changing levels of malaria transmission.</p> <h3>Methods/results</h3><p>Computer simulations were used to examine RTS,S/AS01 impact, using a vaccine profile based on phase II trial results, and assuming that protection decays only slowly. Settings were simulated in which baseline transmission (in the absence of vaccine) was fixed or varied between 2 and 20 infectious mosquito bites per person per annum (ibpa) over ten years. Four delivery strategies were studied: routine infant immunization (EPI), EPI plus infant catch-up, EPI plus school-based campaigns, and EPI plus mass campaigns. Impacts in changing transmission settings were similar to those in fixed settings. Assuming a persistent effect of vaccination, at 2 ibpa, the vaccine averted approximately 5–7 deaths per 1000 doses of vaccine when delivered via mass campaigns, but the benefit was less at higher transmission levels. EPI, catch-up and school-based strategies averted 2–3 deaths per 1000 doses in settings with 2 ibpa. In settings where transmission was decreasing or increasing, EPI, catch-up and school-based strategies averted approximately 3–4 deaths per 1000 doses.</p> <h3>Discussion</h3><p>Where transmission is changing, it appears to be sufficient to consider simulations of pre-erythrocytic vaccine impact at a range of initial transmission levels. At 2 ibpa, mass campaigns averted the most deaths and reduced transmission, but this requires further study. If delivered via EPI, RTS,S/AS01 could avert approximately 6–11 deaths per 1000 vaccinees in all examined settings, similar to estimates for pneumococcal conjugate vaccine in African infants. These results support RTS,S/AS01 implementation via EPI, for example alongside vector control interventions, providing that the phase III trials provide support for our assumptions about efficacy.</p> </div>", "links"=>[], "tags"=>["simulated", "vaccination", "programs", "malaria"], "article_id"=>127883, "categories"=>["Cancer", "Biological Sciences", "Information And Computing Sciences", "Biotechnology"], "users"=>["Alan Brooks", "Olivier J. T. Briët", "Diggory Hardy", "Richard Steketee", "Thomas A. Smith"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0032587", "stats"=>{"downloads"=>12, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Simulated_Impact_of_RTS_S_AS01_Vaccination_Programs_in_the_Context_of_Changing_Malaria_Transmission/127883", "title"=>"Simulated Impact of RTS,S/AS01 Vaccination Programs in the Context of Changing Malaria Transmission", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-03-06 02:11:23"}
• {"files"=>["https://ndownloader.figshare.com/files/671596"], "description"=>"<p>Legend: Black = EPI; Yellow = EPI plus catch-up of children up to 18 months of age; Brown = EPI plus school-based immunization of children 6–11 years of age; Green = Mass campaigns in entire population. The per capita estimates assume a dynamic population, modeled upon the age distribution in rural Tanzania.</p>", "links"=>[], "tags"=>["doses"], "article_id"=>342090, "categories"=>["Information And Computing Sciences", "Biological Sciences", "Infectious Diseases", "Biotechnology"], "users"=>["Alan Brooks", "Olivier J. T. Briët", "Diggory Hardy", "Richard Steketee", "Thomas A. Smith"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0032587.g002", "stats"=>{"downloads"=>1, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Cumulative_doses_per_capita_by_delivery_strategy_in_a_dynamic_population_/342090", "title"=>"Cumulative doses per capita, by delivery strategy, in a dynamic population.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-03-06 00:34:50"}
• {"files"=>["https://ndownloader.figshare.com/files/671703"], "description"=>"<p>Legend: The first column presents transmission settings. The second column presents the total estimated malaria deaths in the all-ages population of 100,000 people per person-year in the absence of vaccination. The estimate is the average over a 10 year period. The remaining columns present the percentage of deaths averted by each delivery strategy, as the median and (range) estimated from 14 models.</p>", "links"=>[], "tags"=>["averted"], "article_id"=>342197, "categories"=>["Information And Computing Sciences", "Biological Sciences", "Infectious Diseases", "Biotechnology"], "users"=>["Alan Brooks", "Olivier J. T. Briët", "Diggory Hardy", "Richard Steketee", "Thomas A. Smith"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0032587.t003", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Deaths_averted_with_RTS_S_by_transmission_setting_and_delivery_strategy_/342197", "title"=>"Deaths averted with RTS,S by transmission setting and delivery strategy.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-03-06 00:36:37"}

PMC Usage Stats | Further Information

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Relative Metric

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F1000Prime