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This Week in PLOS Medicine: Unpublished Clinical Trials Data, Flu Vaccine for Children; & the Polio Endgame

This week PLOS Medicine publishes the following articles:

Image credit: AS Jegede, PLOS Medicine, e0040073
Image credit: AS Jegede, PLOS Medicine, e0040073

The current influenza (flu) vaccination policy in England and Wales should be expanded to target 5 to 16-year-olds in order to further reduce the number of deaths from flu, according to a study by UK researchers published in this week’s PLOS Medicine.  The results of the study by Marc Baguelin and colleagues from the London School of Hygiene & Tropical Medicine in the UK, Public Health England, and Athens University of Economics and Business, show that the current flu vaccination policy that targets people aged 65 years and over and also those in high risk groups has reduced the number of flu infections and associated deaths in these groups over the past 14 years.  The authors show that offering the flu vaccine to children will have beneficial effects especially as children are key “spreaders” of the flu virus.

Publicly available sources of information reporting findings from clinical trials provide much less information on patient-relevant outcomes than unpublished reports. The results of the study by Beate Wieseler and colleagues from the Institute for Quality and Efficiency in Health Care in Cologne, Germany, found that the publicly available information contained less information about both the benefits and potential harms of an intervention than the unpublished report. In this study, the researchers compared the information available in clinical study reports, which are detailed but usually unpublished accounts of clinical trials, to publicly available sources, including journal publications and registry reports.  They found that that unpublished reports included complete information for 86% of the patient-relevant outcomes, whereas the combined publicly available sources provided complete information for only 39% of the outcomes.

In a Policy Forum article, authors from Nigeria, Pakistan and Afghanistan led by Seye Abimbola from the National Primary Health Care Development Agency, Nigeria, argue that the global health community and governments involved in polio eradication efforts need to build trust and prioritise polio eradication as part of routine health services in order to address the problem of polio. Seye Abimbola and colleagues highlight that that increasing militancy, political unrest, lack of trust, and deteriorating security conditions are common denominators that threaten polio eradication efforts in all three countries, although these are embedded in country-specific contexts. However, the authors are concerned that current strategies being used to tackle polio may not be best suited to the situation within the three countries.

In an independently written Essay, Svea Closser and Rashid Jooma from Middlebury College, United States and Aga Khan University, Pakistan highlight the importance of Lady Health Workers in Pakistan who are crucial for the country’s polio eradication efforts. There are approximately 106,000 Lady Health Workers in Pakistan who in addition to working on polio campaigns, visit families monthly to promote family planning; advise on nutrition and hygiene; and create demand for antenatal care, childhood immunization, and use of skilled birth attendants. However, the authors describe how Pakistan’s Lady Health Workers are often in desperate financial straits, have little opportunity for career advancement and risk their lives as frontline health workers. The authors call for a shift away from the “leader-centric” model being employed by partners involved in the polio eradication effort and for increased support for Lady Health Workers in Pakistan.


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