Background: The most recent estimate for the number of Australians living with chronic hepatitis B virus (HBV) infection is 150,000, with over one million ever having been infected. One in four people with chronic infection will die as a result. Worldwide, the burden of chronic HBV infection is great. As many as 400 million people are chronically infected, and the World Health Organisation estimates that as a result HBV infection is the tenth leading cause of death. / Aim: The aim of the research presented in this thesis is to improve the accuracy and relevance of our understanding of the epidemiology and control of HBV infection in Australia, through the development of new methodological approaches to the collection and analysis of relevant epidemiological data. / Methods: Three novel approaches were adopted. First, a serosurvey of a randomised, age-structured convenience sample of over 3200 specimens was performed spanning the period from 1995 to 2005 to estimate the prevalence of markers of infection with, and immunity to HBV. Secondly, a comparative analysis of the serosurvey results with national surveillance notifications since 1971 and migration records since 1945 was undertaken. Finally, a complex deterministic mathematical model of HBV infection in Australia was constructed simulating the entire population between 1951 and 2050. / Results: The serosurvey indicates that chronic infection with HBV is more common in the Victorian population than existing national serosurvey estimates suggest, and the coverage of immunisation programs (particularly of adolescents) is far from universal. Significant geographic, age, and gender disparities in the prevalence of chronic HBV infection were identified in the serosurvey, which appear in part to relate to historical migration patterns and which could be used to develop a targeted and effective public health response. The comparative analysis of the serosurvey results with notifications and migration data demonstrates coherence of these disparate sources of information, and suggest that knowledge of migration patterns can lead to robust predictions of future notifications. The novel regression model developed implies that at least 50,000 people with chronic HBV infection are undiagnosed. The mathematical model of HBV infection in the Australian population is unique in many respects, and has been validated against external data to provide reassurance regarding the accuracy of the simulated outcomes. Some of these outcomes include an estimated 160,000 Australians living with chronic HBV infection in 2009, increasing by several thousand people every year, and that less than 5 per cent of chronic infections entering the population are able to be addressed by domestic vaccination or other prevention programs. / Conclusion: The new insights into the epidemiology of HBV infection in Australia provided by the approaches described all suggest a large and increasing burden of chronic HBV infection. New approaches are needed to provide essential policy outcomes to assist and empower Australians living with chronic HBV infection. If this does not occur, the economic and human costs to our community are likely to become great.

Arbovirus infections are widespread, and their disease burden has increased in the past decade. In Africa, arbovirus infections and fever with unknown etiology are common. Due to the lack of well-established epidemiologic surveillance systems and accurate differential diagnosis in most African countries, little is known about the prevalence of human arbovirus infections in Africa. The aim of this review is to summarize the available epidemiological data and diagnostic laboratory tools of infections with dengue, yellow fever, Zika, and chikungunya viruses, all transmitted by Aedes mosquitoes. Studies indicate that these arboviral infections are endemic in most of Africa. Surveillance of the incidence and prevalence of the infections would enable medical doctors to improve the diagnostic accuracy in patients with typical symptoms. If possible, arboviral diagnostic tests should be added to the routine healthcare systems. Healthcare providers should be informed about the prevalent arboviral diseases to identify possible cases.

Thesis (MScMedSc (Pathology. Medical Virology))--University of Stellenbosch, 2005. / There are currently an estimated 5.3 million people infected with human immunodeficiency virus / acquired immunodeficiency syndrome (HIV/AIDS) in South Africa. HIV-1 group M Subtype C is currently responsible for the majority of HIV infections in sub-Saharan Africa (56% worldwide). The Khayelitsha informal settlement, located 30 km outside Cape Town, has one of the highest HIV prevalence rates in the Western Cape. The objective of this study was to investigate the molecular epidemiology of HIV-1 in Khayelitsha using serotyping and genotyping techniques. Patient samples were received from the Matthew Goniwe general health clinic located at site C in Khayelitsha. Serotyping was performed through a competitive enzymelinked immunosorbent assay (cPEIA). RNA was isolated from patient plasma and a two step RT-PCR amplification of the gag p24, env gp41 IDR, env gp120 V3 and pol genome regions performed. Sequences obtained were used for detailed sequence and phylogenetic analysis. Neighbour-joining and maximum likelihood phylogenetic trees were drawn to assess the relationship between the Khayelitsha sequences obtained and a set of reference sequences obtained from the Los Alamos National Library (LANL) HIV database (http://www.hiv.lanl.gov/). Through serotyping and genotyping the majority of HIV strains were characterised as HIV-1 group M subtype C. One sample (1154) was characterised as a possible C / D recombinant strain. In 9 other samples HIV-1 recombination cannot be excluded, as only one of the gene regions investigated could be amplified and characterised in these samples. The gag p24 genome region was found to be more conserved than the env gp41 IDR, with the env gp41 IDR more conserved than the env gp120 V3. The variability of the env gp120 V3 region indicates that patients might be dually infected with variant HIV-1 subtype C strains or quasispecies. Conserved regions identified in the Khayelitsha sequences can induce CD4+ T-cell responses and are important antibody recognition target sites. These conserved regions can play a key role in the development of an effective HIV-1 immunogen reactive against all HIV-1 subtypes. The majority of subtype C viruses were predicted to use CCR5 as their major chemokine co-receptor. The pol sequences analysed indicate that mutations associated with minor resistance to Protease Inhibitors (PIs) might be present in the Khayelitsha community. The identification of resistant mutations is vital for people receiving antiretroviral treatment (ART). It can influence the success of their treatment and delay the onset of AIDS. Serotyping is a quick characterisation method, but not always accurate. With genotyping detailed molecular analysis can be performed. However, with genotyping the success of amplification often depends on viral load. In Southern Africa a subtype C candidate vaccine appears to be the best option for future vaccine considerations. The sporadic detection of non-subtype C and recombinant subtype C viruses remains a concern and will thus have to be closely monitored. Phylogenetic analysis can help to classify and monitor the spread and evolution of these viruses.

Cette thèse évalue le risque d’émergence d’un pathogène via l’avifaune sauvage dans une région indemne en combinant deux approches :(1) L’étude de pathogènes partageant des caractéristiques éco-épidémiologiques communes avec le pathogène émergeant ;et (2) L’utilisation de données écologiques disponibles dans la région indemne.<p>\ / Doctorat en Sciences agronomiques et ingénierie biologique / info:eu-repo/semantics/nonPublished

Abstract :Bluetongue (BT) is a vector-borne infectious disease primarily transmitted to even- toed ungulates by the bite of several Culicoides species. The global distribution of BT can be attributed to the ubiquity of its vectors and its rapid spread, likely to the enhancement of human activities (intensification of animal production, trans- port, changing habitat). During the last decades, BT established in Southern Europe and more recently emerged in Northern Europe, causing the death of millions of domestic ruminants. On the same time, a Belgian research project has been set up to develop remote-sensing tools to study the EPidemiology and Space-TIme dynamicS of infectious diseases (EPISTIS). In that general framework, this thesis aimed to study the space-time distribution of the main Culicoides vectors occurring in Italy and Belgium, at two different scales. Firstly, we aimed to clarify the role of several eco-climatic factors on the regional-scale distribution of C. imicola in time, based on weekly samplings achieved throughout Italy from 2001 to 2006 and to develop an easy-to-use and reproducible tool, which could be widely validated on the basis of former vector sampling and freely accessible remote-sensing data. Secondly, we aimed to investigate how Culicoides species were distributed in the fine-scale habitat encountered throughout the agro-ecological landscapes of Belgium, while recent studies have suggested that the landscapes configuration could explain the spatial distribution of BT. In the first part, we showed that an autoregressive model where the observed monthly growth rate is predicted by monthly temperature, allowed predicting >70% of the seasonal variability in C. imicola trap catches. The model predicted the seasonality, the altitudinal gradient, and the low populations’ activity taking place during the winter. Incorporating eco-climatic indices such as the Normalized Difference Vegetation Index into the model did not enhance its predictive power. In the second part, we quantified how Culicoides populations are spatially structured in the neighbourhood of farms, and demonstrated the unexpectedly high level of population found in forest. We also showed how four classes of land use could influence the relative abundances of Culicoides species in the agro-ecological landscapes of Belgium. Although in summer, BT vectors were abundant in each of the four classes investigated, their relative abundances varied strongly as a function of sex, species and environmental conditions, and we quantified these variations. Finally, we also presented a new method to quantify the interference between Onderstepoort light traps, and used it to measure their range of attraction for several of the most common BT vectors species in Northern Europe. The model developed on C. imicola in Italy provided enthusiastic perspectives regarding the regional-scale analyses of its distribution in time, although further improvements are nevertheless required in order to assess the broad scale ecology of BT vectors throughout Europe. Mapping the abundances of C. imicola in Sardinia high- lighted an important lack of reliability attributable to the many land use classes that are currently not sampled in the vector surveillance achieved across Europe. Together with the novelties presented in the second part and the recent findings establishing that BT could circulate among wild hosts in both epidemiological systems (i.e. in Southern and Northern Europe), we call for increasing epidemiological and entomo- logical studies at the interface between farms and the surrounding natural habitats. Last, depicting in time the landscape-scale findings for Northern Europe highlighted how dramatic could be the role played by intensive farming practices to maintain BT within the agro-ecological landscapes studied and to facilitate its circulation between them. Quantifying the amplitude of the risk of disease transmission linked to these practices would require a further complex modeling approach accounting simultaneously for the diel activity of hosts, mainly resulting from the farming activities, the diel activities of different vector species and the landscapes configuration found in contrasted agro-ecological systems.<p>Résumé :La fièvre catarrhale ovine (FCO), encore appelée maladie de la langue bleue, est une maladie infectieuse des ruminants transmise par la piqûre d’un vecteur de type moucheron appartenant au genre Culicoides (Diptera :Ceratopogonidae). L’ubiquité de ses vecteurs peut expliquer son succès d’installation à l’échelle globale. Par ailleurs, sa rapide expansion a été grandement facilitée par l’importante activité anthropique (élevage, transport, modification de l’habitat) et peut-être même par les changements climatiques globaux. La FCO a été récemment qualifiée de maladie infectieuse émergente en Europe du fait de (i) son récent établissement dans la région, bien au delà de son aire de répartition traditionnelle, (ii) de sa forte capacité de dispersion affectant chaque jour un nombre plus important d’hôtes et enfin (iii) de sa forte virulence. Après avoir détaillé les caractéristiques majeures des deux principaux foyers de FCO rencontrés en Europe depuis 1998, la présente thèse s’est plus particulièrement intéressée à l’étude de la distribution spatio-temporelle de ses principaux vecteurs dans le sud (partie 1) puis dans le nord (partie 2) de l’Europe, à différentes échelles. Dans la première partie, un modèle discret, spatialement et temporellement explicite, a été développé afin de mesurer l’influence de différents facteurs éco-climatiques sur la distribution de Culicoides imicola, principal vecteur de la FCO dans le Bassin Méditerranéen. Les profils mensuels de distribution rencontrés en Sardaigne durant 6 années consécutives ont ainsi pu être reconstitués, principalement sur base de la température. Une cartographie de l’abondance de C. imicola sur le territoire a permis de mettre à jour le manque d’information sur sa distribution en dehors des exploitations agricoles. Dans la deuxième partie du travail, nous nous sommes penchés sur la distribution spatiale des Culicoides tels qu’on peut les rencontrer au sein de différents paysages agro-écologiques de Belgique. Nous avons ainsi pu décrire la structure adoptée par les populations de Culicoides au voisinage des fermes ainsi que quantifier l’importante population présente dans les forêts avoisinantes. Nous avons par ailleurs montré l’influence de différentes catégories d’utilisation du sol sur l’abondance et la composition en espèces. Enfin, nous avons présenté une méthode permettant de quantifier l’interférence entre des pièges lumineux utilisés dans un même paysage pour échantillonner les populations, et l’avons utilisé afin de mesurer leur rayon d’attractivité sur les espèces vectrices les plus communément rencontrées dans le nord de l’Europe. En guise de conclusion générale et conjointement aux récentes découvertes de cas de FCO au sein de la faune sauvage européenne, nous appelons à réaliser un plus grand nombre d’études éco-épidémiologiques à l’interface entre exploitations agricoles et zones (semi-) naturelles avoisinantes. En outres, les résultats présentés dans la seconde partie ont été mis en relation avec le mode de fonctionnement journalier de nos exploitations agricoles. Nous avons ainsi pu déduire le rôle dramatique joué par les pratiques agricoles intensives dans le maintien du virus de la FCO au sein de nos paysages agro-écologiques, ainsi que dans sa circulation d’un paysage à l’autre. Un cadre de modélisation complexe permettant une analyse simultanée de l’activité nycthémérale des hôtes de la FCO et de ses vecteurs Culicoides en fonction de la configuration des paysages agro-écologiques est néanmoins requis afin de quantifier l’amplitude du risque de transmission de la FCO lié aux pratiques agricoles intensives. / Doctorat en Sciences agronomiques et ingénierie biologique / info:eu-repo/semantics/nonPublished