Background: Non-validated, rapid intelligence surveillance data is becoming more important in detecting and responding to public health emergencies in the absence of readily available, validated surveillance data published by reputable sources such as WHO or the CDC. There is a lack of timely mumps surveillance data, which is particularly concerning as a resurgence of mumps outbreaks seem to be occurring worldwide in fully vaccinated young adults. Methods: Using open-source mumps data obtained between 2016-2019 from the rapid intelligence surveillance tool EpiWATCH, a descriptive analysis was conducted to identify information about the number of confirmed/probable/suspected mumps cases and also the date, country, and location of outbreaks. Results: Data entries logged into EpiWATCH detected 65 mumps outbreaks worldwide with a majority of outbreaks occurring in university settings, where a majority of students had been fully vaccinated against the disease. School and university settings were identified as high-risk environments susceptible to mumps outbreaks explained by the prolonged, close-contact nature in which students interact. EpiWATCH was able to detect reported cases of mumps within days of news outlets publishing this information; far quicker than the months it takes for case data to be published by validated sources. EpiWATCH was also able to capture mumps outbreak data not previously detected by WHO or the CDC. Conclusions: The resurgence of mumps in fully vaccinated young adults is likely due to secondary vaccine failure and possibly genetic drift of WT mumps strains. Global and readily available mumps surveillance data is lacking; however, EpiWATCH has been successful in somewhat filling these gaps of information and, more importantly, providing surveillance data in a timely fashion. Thus, data from EpiWATCH could be used in the field to improve the speed of detection and response to mumps outbreaks.
Background and aim Globally, nearly one in five people who inject drugs (PWID) are living with HIV, and the rate of new HIV infections in PWID is increasing in some settings. Early diagnosis is crucial for effective HIV control. We reviewed the evidence on the association between opioid agonist therapy (OAT) and HIV testing uptake among PWID.Methods We conducted a systematic review searching MEDLINE, Scopus, Web of Science, Cochrane Central Register of Controlled Trials and PsycINFO for studies published from January 2000 to March 2019. Reference lists and conference proceedings were hand-searched. Observational and intervention studies were eligible for inclusion. Risk of bias was assessed using the Risk of Bias in Non-Randomised Studies of Interventions (ROBINS-I) tool. Meta-analyses were conducted using random-effects models. Results Of 13 373 records identified, 11 studies from Australia, Europe, Malaysia and the United States were included. All studies had at least a serious risk of bias, largely due to confounding and selection bias, making it difficult to draw causal conclusions from the evidence. Ten studies provided data on the association between current OAT use and recent HIV testing. Six showed a positive association, while four provided little evidence of an association: pooled odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.28-2.27. Looking at having ever been on OAT and having ever been HIV tested, seven studies showed a positive association and three showed either weak or no evidence of an association: pooled OR = 3.82, 95% CI = 2.96-4.95. Conclusions Opioid agonist therapy may increase uptake of HIV testing among people who inject drugs, providing further evidence that opioid agonist therapy improves the HIV treatment care cascade.
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