Infectious disease control
Infectious diseases remain an important global public health problem, especially in developing countries. HIV/AIDS, malaria and tuberculosis still challenge healthcare resources. The so-called neglected tropical diseases are far from eliminated, and newly emerging infections surprise the world continuously.
Our main research activities cover neglected tropical diseases (NTDs), including various species of parasitic worm infections, leishmaniasis and leprosy, as well as tuberculosis, HIV/AIDS and other sexually transmitted infections. We also study infectious diseases common in migrant populations in Rotterdam, as well as hand hygiene in healthcare settings and antimicrobial resistance. Our research methodologies include mathematical modelling, epidemiological data analysis, and behavioral studies. Most NTD research is part of or linked to the NTD Modelling Consortium, a collaboration of various international modelling teams, funded by the Bill & Melinda Gates Foundation. Findings and insights have been published in special issues of the high-impact scientific journals Clinical Infectious Diseases, PLoS Neglected Tropical Diseases and Journal of Infectious Diseases, and have also been summarized in two well-received booklets for non-specialist readers.
Our ambition is to do research that has tangible influence on policy and practice. A good example is that the World Health Organization (WHO) invited the NTD Modelling Consortium to reflect on their proposed new 2030 targets and guidelines. The outcomes of this exercise have been documented in a series of publications in Gates Open Research and are summarized on the WHO website. Another example is that our modelling work on the impact of HPV vaccination strategies was part of the reason why the Dutch government has recently decided to also include boys in routine HPV vaccination. Furthermore, our study on the impact of combination HIV prevention in Zimbabwe was directly used in the next national strategic plan for HIV control.
In 2018, WHO (for the first time) issued official guidelines for the prevention, diagnosis and treatment of leprosy. These guidelines recommend the use of chemoprophylaxis with single-dose rifampicin (SDR) to prevent leprosy in contacts of leprosy patients. This recommendation was based primarily on studies by our Infectious Disease Control group, together with field partners in Bangladesh. These studies have been ongoing since the year 2000, and included the influential COLEP study on preventing leprosy in contacts. After completion of a large randomized controlled trial on the efficacy of chemoprophylaxis with SDR, we were involved in an implementation and feasibility study of SDR in seven endemic countries: India, Nepal, Indonesia, Myanmar, Sri Lanka, Tanzania and Brazil. In this so-called LPEP program we provided SDR to over 100,000 contacts. Our group partnered with the Swiss Tropical and Public Health Institute for scientific support of this mammoth project. LPEP was completed at the end of 2018 and the final data analyzed and reported in 2019. So far, our group has produced 6 PhD theses on leprosy control and currently another 10 researchers from different countries are working on their PhD thesis on this topic with our group.
The Neglected Tropical Diseases (NTD) Modelling Consortium, funded by the Bill & Melinda Gates Foundation (BMGF); with a responsibility for four of the seven diseases, we are the largest contributing group, and new research activities for a fifth NTD are also linked to the consortium. Improving access to HIV services for sex workers in Zimbabwe: field study and mathematical modelling (Dutch AIDS Foundation); this is one of the very few studies world-wide that focusses on female, male and transgender sex workers in countries with a generalized HIV epidemic. Combating MRSA: increasing our understanding of transmission success will lead to better control of MRSA (JP-EC-AMR/ZonMw); within the MACOTRA consortium we pioneer with developing an individual-based model of the spread of MRSA (a drug resistant bacterium relatively common in hospitals and nursing homes) in the general population.
Richardus R, Alam K, Kundu K, Chandra Roy J, Zafar T, Chowdhury AS, Nieboer D, Faber R, Butlin CR, Geluk A, Richardus JH. Effectiveness of single-dose rifampicin after BCG vaccination to prevent leprosy in close contacts of patients with newly diagnosed leprosy: A cluster randomized controlled trial. Int J Infect Dis. 2019;88:65-72. doi:10.1016/j.ijid.2019.08.035
Giardina F, Coffeng LE, Farrell SH, Vegvari C, Werkman M, Truscott JE, Anderson RM, de Vlas SJ. Sampling strategies for monitoring and evaluation of morbidity targets for soil-transmitted helminths. PLoS Negl Trop Dis. 2019;13(6):e0007514. Published 2019 Jun 26. doi:10.1371/journal.pntd.0007514
Coffeng LE, Stolk WA, Golden A, de Los Santos T, Domingo GJ, de Vlas SJ. Predictive Value of Ov16 Antibody Prevalence in Different Subpopulations for Elimination of African Onchocerciasis. Am J Epidemiol. 2019;188(9):1723-1732. doi:10.1093/aje/kwz109
Matthijsse SM, Naber SK, Hontelez JAC, Bakker R, van Ballegooijen M, Lansdorp-Vogelaar, I, de Kok I, de Koning HJ, van Rosmalen J, de Vlas SJ. The health impact of human papillomavirus vaccination in the situation of primary human papillomavirus screening: A mathematical modeling study. PLoS One. 2018;13(9):e0202924. Published 2018 Sep 4. doi:10.1371/journal.pone.0202924
Stolk WA, Prada JM, Smith ME, Kontoroupis P, de Vos AS, Touloupou P, Irvine MA, Brown P, Subramanian S, Kloek,M, Michael E, Hollingsworth TD, de Vlas SJ. Are Alternative Strategies Required to Accelerate the Global Elimination of Lymphatic Filariasis? Insights From Mathematical Models. Clin Infect Dis. 2018;66(suppl_4): S260-S266. doi:10.1093/cid/ciy003
Le Rutte EA, Chapman LAC, Coffeng LE, et al. Policy Recommendations From Transmission Modeling for the Elimination of Visceral Leishmaniasis in the Indian Subcontinent. Clin Infect Dis. 2018;66(suppl_4):S301-S308. doi:10.1093/cid/ciy007