Christian Bottomley
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View article: Leptospirosis Prevalence and Risk Factors Among Patients Presenting With Fever to 4 Healthcare Sites in Sub-Saharan Africa and South East Asia: An International Multisite Observational and Nested Case–Control Study
Leptospirosis Prevalence and Risk Factors Among Patients Presenting With Fever to 4 Healthcare Sites in Sub-Saharan Africa and South East Asia: An International Multisite Observational and Nested Case–Control Study Open
Background We investigated the prevalence, diversity, and risk factors for acute leptospirosis in the Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE) study. Methods Febrile patients aged ≥2 months in Laos, Malawi, Moza…
View article: Incidence, risk factors and outcomes for neonatal sepsis in The Gambia: Descriptive cohort analysis embedded in a randomised clinical trial
Incidence, risk factors and outcomes for neonatal sepsis in The Gambia: Descriptive cohort analysis embedded in a randomised clinical trial Open
Background Neonatal sepsis is a major contributor to adverse neonatal outcomes in West Africa. High quality data on risk factors for sepsis in this region is limited, yet important for surveillance, prevention and management of newborns at…
View article: Uptake and 24-month Outcomes of Dolutegravir- Versus Lopinavir-based Second-line Antiretroviral Therapy for People With HIV in South Africa: A Retrospective Cohort Study and Emulated Target Trial
Uptake and 24-month Outcomes of Dolutegravir- Versus Lopinavir-based Second-line Antiretroviral Therapy for People With HIV in South Africa: A Retrospective Cohort Study and Emulated Target Trial Open
Background Aligning with the World Health Organization, South Africa has replaced ritonavir-boosted lopinavir (LPV/r) with dolutegravir (DTG) in second-line antiretroviral therapy (ART) after treatment failure with tenofovir disoproxil fum…
View article: The impact of 10-valent pneumococcal conjugate vaccine on the incidence of admissions to hospital with hypoxaemic and non-hypoxaemic pneumonia in Kenyan children
The impact of 10-valent pneumococcal conjugate vaccine on the incidence of admissions to hospital with hypoxaemic and non-hypoxaemic pneumonia in Kenyan children Open
Observational evidence suggests that pneumococcal conjugate vaccines (PCVs) are more effective at reducing the incidence of hypoxaemic pneumonia compared to non-hypoxaemic pneumonia. We examined the impact of 10-valent PCV (PCV10, Synflori…
View article: HIV Testing Uptake in a Sexual and Reproductive Health Service for Youth and Impact on Population-Level Prevalence of Undiagnosed HIV in Zimbabwe
HIV Testing Uptake in a Sexual and Reproductive Health Service for Youth and Impact on Population-Level Prevalence of Undiagnosed HIV in Zimbabwe Open
Although community-based integrated HIV/SRH achieved high HIV testing uptake, there was no impact on population-level prevalence of undiagnosed HIV. Concerted efforts are needed to identify and reach those at highest risk, and to address s…
View article: Capturing the complete clinical spectrum and incidence of severe acute Group A Streptococcus (GAS) disease: a population-based study in Auckland, New Zealand
Capturing the complete clinical spectrum and incidence of severe acute Group A Streptococcus (GAS) disease: a population-based study in Auckland, New Zealand Open
Ministry of Health New Zealand, Health Research Council of New Zealand (HRC-NZ), Royal College of Pathologists of Australasia (RCPA) Foundation.
View article: Malaria infection confounds inflammation-adjusted micronutrient biomarker concentrations in children and women in Malawi: a secondary analysis of the 2015/2016 Malawi micronutrient survey
Malaria infection confounds inflammation-adjusted micronutrient biomarker concentrations in children and women in Malawi: a secondary analysis of the 2015/2016 Malawi micronutrient survey Open
Inflammation and infections such as malaria affect concentrations of many micronutrient biomarkers and hence estimates of nutritional status. We aimed to assess the relationship between malaria infection and micronutrient biomarker concent…
View article: Infectious diseases burden and antibiotic prescribing patterns among primary care patients in Harare, Zimbabwe – a cross-sectional analysis
Infectious diseases burden and antibiotic prescribing patterns among primary care patients in Harare, Zimbabwe – a cross-sectional analysis Open
Low- and middle-income countries (LMIC) continue to experience a high burden of infectious diseases and disparities in access to and use of antimicrobials, yet data on antibiotic prescribing in outpatient settings, where the majority of gl…
View article: Impact of increasing CD4 count threshold eligibility for antiretroviral therapy initiation on advanced HIV disease and tuberculosis prevalence and incidence in South Africa: an interrupted time series analysis
Impact of increasing CD4 count threshold eligibility for antiretroviral therapy initiation on advanced HIV disease and tuberculosis prevalence and incidence in South Africa: an interrupted time series analysis Open
Introduction We investigated the impact of increasing CD4 count eligibility for antiretroviral therapy (ART) initiation on advanced HIV disease (AHD) and tuberculosis (TB) prevalence and incidence among people living with HIV (PLHIV) in So…
View article: Risk of major adverse cardiovascular events with dolutegravir versus efavirenz-based antiretroviral therapy: emulated target trials using routine, de-identified data from South Africa
Risk of major adverse cardiovascular events with dolutegravir versus efavirenz-based antiretroviral therapy: emulated target trials using routine, de-identified data from South Africa Open
SUMMARY Background Integrase inhibitors, including dolutegravir, may increase risk of major adverse cardiovascular events (MACEs). However, limited data exists from low- and middle-income countries, where tenofovir disoproxil fumarate, lam…
View article: Serotype-specific pneumococcal invasiveness: a global meta-analysis of paired estimates of disease incidence and carriage prevalence
Serotype-specific pneumococcal invasiveness: a global meta-analysis of paired estimates of disease incidence and carriage prevalence Open
Background Serotype-specific estimates of pneumococcal invasiveness used in pneumococcal carriage transmission models to predict changes in disease incidence post-vaccination are largely derived from high-income settings. We conducted a sy…
View article: Workload in antenatal care before and after implementation of an electronic decision support system: an observed time-motion study of healthcare providers in Nepal
Workload in antenatal care before and after implementation of an electronic decision support system: an observed time-motion study of healthcare providers in Nepal Open
Background Healthcare interventions are shaped by the resources needed to implement them, including staff time. This study, part of a process evaluation, aims to compare time spent on antenatal care (ANC) and related recordkeeping in two r…
View article: Misclassification of malaria as pneumonia in children in sub-Saharan Africa
Misclassification of malaria as pneumonia in children in sub-Saharan Africa Open
Background The World Health Organization (WHO) clinical case definitions for pneumonia were designed to prioritize sensitivity over specificity. In sub-Saharan Africa, the disease that is most likely to be misclassified as pneumonia is Pla…
View article: Epidemiology of human metapneumovirus among children with severe or very severe pneumonia in high pneumonia burden settings: the Pneumonia Etiology Research for Child Health (PERCH) study experience
Epidemiology of human metapneumovirus among children with severe or very severe pneumonia in high pneumonia burden settings: the Pneumonia Etiology Research for Child Health (PERCH) study experience Open
HMPV-associated severe paediatric pneumonia in high-burden settings was predominantly in young infants and clinically indistinguishable from RSV. HMPV-positives had low case fatality, similar to that in RSV-positives.
View article: Brazil towards malaria elimination: A time-series analysis of imported cases from 2007 to 2022
Brazil towards malaria elimination: A time-series analysis of imported cases from 2007 to 2022 Open
Malaria is a global health challenge, and international efforts are underway to alleviate its impact by 2035. Within the 249 million global cases, 0.6 million occur in the Americas, mainly in Venezuela, Brazil, and Colombia. Considering Br…
View article: Fractional Doses of Pneumococcal Conjugate Vaccine — A Noninferiority Trial
Fractional Doses of Pneumococcal Conjugate Vaccine — A Noninferiority Trial Open
In a three-dose schedule (two primary doses and a booster), 40% doses of PCV13 were noninferior to full doses for all included serotypes. Lower doses of PCV13 and PCV10 did not meet the criteria for noninferiority. (Funded by the Bill and …
View article: Changes in the medical admissions and mortality amongst children in four South African hospitals following the COVID-19 pandemic: A five-year review
Changes in the medical admissions and mortality amongst children in four South African hospitals following the COVID-19 pandemic: A five-year review Open
Vulnerable children from poor communities with high HIV and Tuberculosis(TB) burdens were impacted by COVID-19 lockdowns. Concern was raised about the extent of this impact and anticipated post-pandemic surges in mortality. Interrupted tim…
View article: Impact of increasing CD4 count threshold eligibility for antiretroviral therapy initiation on advanced HIV disease and tuberculosis prevalence and incidence in South Africa: an interrupted time series analysis
Impact of increasing CD4 count threshold eligibility for antiretroviral therapy initiation on advanced HIV disease and tuberculosis prevalence and incidence in South Africa: an interrupted time series analysis Open
Introduction We investigated the impact of increasing CD4 count eligibility for antiretroviral-therapy (ART) initiation on advanced HIV and tuberculosis (TB) prevalence and incidence among people living with HIV (PLHIV) in South Africa. Me…
View article: Impact of Intrapartum Azithromycin on the Carriage and Antibiotic Resistance of <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> in Mothers and Their Newborns: A Substudy of a Randomized, Double-Blind Trial Conducted in The Gambia and Burkina Faso
Impact of Intrapartum Azithromycin on the Carriage and Antibiotic Resistance of <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> in Mothers and Their Newborns: A Substudy of a Randomized, Double-Blind Trial Conducted in The Gambia and Burkina Faso Open
Background Limited data exist on the effects of intrapartum azithromycin on the prevalence of carriage and antibiotic resistance of Enterobacterales. Methods We conducted a randomized trial in The Gambia and Burkina Faso where women receiv…
View article: Sustained impact of 10-valent pneumococcal conjugate vaccine on invasive pneumococcal disease in Kenya, 2011-2022
Sustained impact of 10-valent pneumococcal conjugate vaccine on invasive pneumococcal disease in Kenya, 2011-2022 Open
Background There are only a few long-term PCV impact assessments in sub-Saharan Africa, and these have been confined to settings using a 13-valent PCV. A 10-valent PCV was introduced in Kenya in 2011 with catchup vaccination among children…
View article: Impact of pneumococcal conjugate vaccination on pneumococcal nasopharyngeal carriage in the Gambia: Population-based cross-sectional surveys
Impact of pneumococcal conjugate vaccination on pneumococcal nasopharyngeal carriage in the Gambia: Population-based cross-sectional surveys Open
Introduction of PCV was associated with reduced VT pneumococcal carriage in young, and older children, although with substantial residual prevalence. Persisting VT, and non-VT, carriage indicate significant, persistent transmission of pneu…
View article: Immunogenicity and vaccine-serotype carriage prevalence after full or fractional doses of Pneumococcal Conjugate Vaccines in Kenyan infants: an individually randomised, controlled, non-inferiority trial
Immunogenicity and vaccine-serotype carriage prevalence after full or fractional doses of Pneumococcal Conjugate Vaccines in Kenyan infants: an individually randomised, controlled, non-inferiority trial Open
Background Pneumococcal conjugate vaccines (PCVs) are the most expensive component of the routine immunisation schedule in Gavi-supported countries. As countries transition out of Gavi support, PCV programmes are at risk. We assessed wheth…
View article: Impact of active case-finding for tuberculosis on case-notifications in Blantyre, Malawi: A community-based cluster-randomised trial (SCALE)
Impact of active case-finding for tuberculosis on case-notifications in Blantyre, Malawi: A community-based cluster-randomised trial (SCALE) Open
Active case-finding (ACF) for tuberculosis can help find the “missing millions” with undiagnosed tuberculosis. In a cluster-randomised trial, we investigated impact of ACF on case-notifications in Blantyre, Malawi, where ACF has been inten…
View article: Effect and cost-effectiveness of human-centred design-based approaches to increase adolescent uptake of modern contraceptives in Nigeria, Ethiopia and Tanzania: Population-based, quasi-experimental studies
Effect and cost-effectiveness of human-centred design-based approaches to increase adolescent uptake of modern contraceptives in Nigeria, Ethiopia and Tanzania: Population-based, quasi-experimental studies Open
Around half of adolescent pregnancies in low- and middle-income countries are unintended, contributing to millions of unsafe abortions per year. Adolescents 360 (A360), a girl-centred initiative, aimed to increase voluntary uptake of moder…
View article: Assessing the impact of the “malaria supporters project” intervention to malaria control in the Brazilian Amazon: an interrupted time-series analysis
Assessing the impact of the “malaria supporters project” intervention to malaria control in the Brazilian Amazon: an interrupted time-series analysis Open
Background In 2021, Brazil was responsible for more than 25% of malaria cases in the Americas. Although the country has shown a reduction of cases in the last decades, in 2021 it reported over 139,000 malaria cases. One major malaria contr…
View article: Symptom prevalence and secondary attack rate of SARS‐CoV‐2 in rural Kenyan households: A prospective cohort study
Symptom prevalence and secondary attack rate of SARS‐CoV‐2 in rural Kenyan households: A prospective cohort study Open
Background We estimated the secondary attack rate of SARS‐CoV‐2 among household contacts of PCR‐confirmed cases of COVID‐19 in rural Kenya and analysed risk factors for transmission. Methods We enrolled incident PCR‐confirmed cases and the…
View article: SARS‐CoV‐2 seroprevalence and implications for population immunity: Evidence from two Health and Demographic Surveillance System sites in Kenya, February–December 2022
SARS‐CoV‐2 seroprevalence and implications for population immunity: Evidence from two Health and Demographic Surveillance System sites in Kenya, February–December 2022 Open
Background We sought to estimate SARS‐CoV‐2 antibody seroprevalence within representative samples of the Kenyan population during the third year of the COVID‐19 pandemic and the second year of COVID‐19 vaccine use. Methods We conducted cro…