Michael Marks

Github pages? I think pretty good for easy hosting of a website, code etc.

Thanks. I assumed so as the webpage reads as if it's focused on the transmission dynamics seen in the UK/Europe outbreaks as opposed to either the classic dynamics or indeed the current dynamics in most African outbreaks.

Nice project - look forward to seeing the outputs.

I looked briefly at this and need to look again because I think they present a range of different probabilities - but is a test that the day before diagnosis is only slightly better than a coin flip that useful?

This is with a UK focus I presume?

The STRAP study (modelled off SNAP) has a randomisation domain on IVIG for severe StrepA alongside domains on baseline antibiotics (penicillin vs ceftriaxone) and adjunctive antibiotics (nothing vs clindamycin vs linezolid) and should hopefully give proper data on this question.

I raised this concern when UK announced because I thought walking back the decision & taking people with you on that is going to be a very difficult thing to do.

Even thought vaccine is clearly safe there is a health economic cost in its deployment which could plausibly be better spent elsewhere.

🚀 Huge news for people living with #sleepingsickness!

Acoziborole, a one-day, single-dose oral treatment developed with Sanofi, has received a positive opinion from @ema.europa.eu for the treatment of the most common form of sleeping sickness.

👉 bit.ly/46ZFpEi

Dr Wilfried remembers treating sleeping sickness patients with the old medicine which was so toxic it killed 1 in 20 patients.

💊 Acoziborole is a revolution since those dark days: it cures the disease with one-day treatment course & is effective for both stages of the disease. #1Dose1Cure

ISS Webinar Series — International Syphilis Symposium A quarterly webinar series bringing together clinicians, academics, and public health organisations focused on global syphilis control.

Now with a (hopefully!) functioning website: The International Syphilis Symposium Webinar Series.

Thanks to Kelly Hawley @uconn.bsky.social @nicolelieberman.bsky.social & Lisa Frigati @suhealthsci.bsky.social for helping pull this together.

First webinar 26th March - sign up via website.

That said there are many issues.

For example I think average clinical journal club (regular event in hospital departments) is sorely lacking in methodological rigour - with many clinicians feeling able to judge papers where they don't understand methods.

I have never understood this phenomenon.

Also many clinical academics don't do population data science but immunology, genomics, health systems research etc.

Unrealistic to expect medical school to teach these skills to a level suitable for research. Thats why we have dedicated training pathways for people who do want to pursue this.

But in UK if you want a clinical academic career (i.e a proper 'I get grants' clinical-academic role) then expectation is dedicated academic training i.e via NIHR ACF & CL schemes and a PhD on top of clinical training to develop these skills.

That is why clinical academic training takes forever.

Some of my most fruitful (& enjoyable) work has been methodology collabs.

For example w @typemat12.bsky.social on using genomics to understand public health responses to STIs or w @rozeggo.bsky.social combining clinical epi with modelling on COVID.

These are studies neither side can do alone.

I don't really think either side is to blame - the issue is the general funding structure. We have far too many grants which say "I AM LEADING".

I think the general ecosystem would be better if most health grants required at least two lead applicants - a knowledge expert and a methodology expert.

It's an endless meme in the stats community how bad clinicians are as scientists. Of course it's true most are not scientists at all but talk as if they understand the science.

My experience is most of what I consider UK true clinical academics (i.e primary appointment at HEI) are good scientists.

“It left me burnt”: Traditional treatment and stigma experiences of cutaneous leishmaniasis in Kalu district, Ethiopia Author summary Ethiopia is significantly affected by all forms of leishmaniasis. Cutaneous leishmaniasis (CL) is a significant public health problem with an estimated incidence of 50 000 annually. The...

And from the same collaboration our qualitative study of peoples lived experience of cutaneous leishmaniasis at the community level in Ethiopia is also now out - demonstrating the considerable burden of stigma and mental health impact of the diagnosis.

Yes second of these studies. Historically the dose was set roughly like this:
1) Establish MIC in the rabbit
2) WHO group said well for humans lets go 6-10* higher than that for safety
3) And for late syphilis lets go three times dosing too

Ripe for a proper trial.

Amazing platform. Sadly the usage fee is now £25,000 for a year which means it is now a substantial cost to build into a multi-year grant. Obviously fair there is a cost but I suspect this may preclude it being used in many areas.

Clinical and patient-reported outcomes of cutaneous leishmaniasis treatment in Ethiopia: A prospective, observational cohort study in two referral hospitals We ran a prospective cohort of patients with cutaneous leishmaniasis patients in Ethiopia. Regardless of treatment choice we observed poor cure rates at 90

Our Cutaneous Leishmaniasis cohort study in Ethiopia now out.

Most patients received Sodium Stibogluconate but we show this has an extremely low cure rates at end of treatment.

This data underpins our @globalhealthedctp3.bsky.social Multi-Arms-Multi-Stage trial to improve CL treatment.

Next up hearing about the creation of an incredible (and I suspect unique) birth cohort of Palestinian refugees pubmed.ncbi.nlm.nih.gov/38414543/ Allows linkage of health & education data in this cohort & to explore (sadly) a wide range of exposures including the impact of conflict on outcomes. 4/n

ECHILD: Education and Child Health Insights from Linked Data

In UK we don't have direct linkage of Maternal and Infant records but it has still been possible to achieve record linkage.

This underpins www.echild.ac.uk/ which links education & health data.

Overall linkage ~80% (due predominantly to data-opt outs) although varies across different groups.
3/n

Cohort Profile: The 100 Million Brazilian Cohort An official website of the United States government

Moving on to establishment of 100 Million Brazilians cohort pmc.ncbi.nlm.nih.gov/articles/PMC... & role of Centre for Data and Knowledge Integration in Health pubmed.ncbi.nlm.nih.gov/34095542/

An incredible platform which has provided amazing insights into infectious diseases epidemiology

2/n

At @lshtm.bsky.social workshop on administrative data for early life exposures.

Wonderful opening Bethania Almedia CIDACS with a paper from 1946 on 'Record Linkage' to generate the Book of Life which still feels highly relevant today. pmc.ncbi.nlm.nih.gov/articles/PMC...

1/n

International Syphilis Symposium Webinar Series

Announcing launch of the International Syphilis Symposium Webinar Series.

The series brings together clinicians, academics, public health agencies & community organisations to highlight research & public health interventions focused on syphilis.

First meeting 26th March this year: Register below.

Good list. Number 2 is a bit unclear I think seeing as multiple other trials have found no effect.

Agree this is a big step forward. Great work by Linda!

I think in this trial they used open appendectomy in nearly all patients which makes the data harder to judge when SOC in most high income settings is laproscopic surgery.

There's a fair bit of data already. It should be the standard of care. I think WHO plan to recommend for RhD prophylaxis.

There are designs that could be done ethically but they would be hugely different to the current protocol & certainly couldn't be done for $1.6 million. And whether the evidence is any way compelling enough to do any design, even if ethical, I think remains highly questionable and I doubt it.

I wrote a proposal to do something a bit like this during MPOX.
Appointments were random for vaccine - some people got within a day or a week or two weeks. But could have been randomised - net result would have been same but the ability to generate high quality data would have been much better.