Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item Practitioner perspectives on informing decisions in One Health sectors with predictive models(Springer Nature Limited, 2025-12-01) Pepin KM; Carlisle K; Chipman RB; Cole D; Anderson DP; Baker MG; Benschop J; Bunce M; Binny RN; French N; Greenhalgh S; O’Neale DRJ; McDougall S; Morgan FJ; Muellner P; Murphy E; Plank MJ; Tompkins DM; Hayman DTSThe continued emergence of challenges in human, animal, and environmental health (One Health sectors) requires public servants to make management and policy decisions about system-level ecological and sociological processes that are complex, poorly understood, and change over time. Relying on intuition, evidence, and experience for robust decision-making is challenging without a formal assimilation of these elements (a model), especially when the decision needs to consider potential impacts if an action is or is not taken. Models can provide assistance to this challenge, but effective development and use of model-based evidence in decision-making (‘model-to-decision workflow’) can be challenging. To address this gap, we examined conditions that maximize the value of model-based evidence in decision-making in One Health sectors by conducting 41 semi-structured interviews of researchers, science advisors, operational managers, and policy decision-makers with direct experience in model-to-decision workflows (‘Practitioners’) in One Health sectors. Broadly, our interview guide was structured to understand practitioner perspectives about the utility of models in health policy or management decision-making, challenges and risks with using models in this capacity, experience with using models, factors that affect trust in model-based evidence, and perspectives about conditions that lead to the most effective model-to-decision workflow. We used inductive qualitative analysis of the interview data with iterative coding to identify key themes for maximizing the value of model-based evidence in One Health applications. Our analysis describes practitioner perspectives for improved collaboration among modelers and decision-makers in public service, and priorities for increasing accessibility and value of model-based evidence in One Health decision-making. Two emergent priorities include establishing different standards for development of model-based evidence before or after decisions are made, or in real-time versus preparedness phases of emergency response, and investment in knowledge brokers with modeling expertise working in teams with decision-makers.Item Case-control study of leptospirosis in Aotearoa New Zealand reveals behavioural, occupational, and environmental risk factors(Cambridge University Press, 2025-06-02) Nisa S; Ortolani E; Vallée E; Marshall J; Collins-Emerson J; Yeung P; Prinsen G; Wright J; Quin T; Fayaz A; Littlejohn S; Baker MG; Douwes J; Benschop J; Hahné SLeptospirosis in NZ has historically been associated with male workers in livestock industries; however, the disease epidemiology is changing. This study identified risk factors amid these shifts. Participants (95 cases:300 controls) were recruited nationwide between 22 July 2019 and 31 January 2022, and controls were frequency-matched by sex (90% male) and rurality (65% rural). Multivariable logistic regression models, adjusted for sex, rurality, age, and season - with one model additionally including occupational sector - identified risk factors including contact with dairy cattle (aOR 2.5; CI: 1.0-6.0), activities with beef cattle (aOR 3.0; 95% CI: 1.1-8.2), cleaning urine/faeces from yard surfaces (aOR 3.9; 95% CI: 1.5-10.3), uncovered cuts/scratches (aOR 4.6; 95% CI: 1.9-11.7), evidence of rodents (aOR 2.2; 95% CI: 1.0-5.0), and work water supply from multiple sources - especially creeks/streams (aOR 7.8; 95% CI: 1.5-45.1) or roof-collected rainwater (aOR 6.6; 95% CI: 1.4-33.7). When adjusted for occupational sector, risk factors remained significant except for contact with dairy cattle, and slaughter without gloves emerged as a risk (aOR 3.3; 95% CI: 0.9-12.9). This study highlights novel behavioural factors, such as uncovered cuts and inconsistent glove use, alongside environmental risks from rodents and natural water sources.Item Preparing for the next pandemic: insights from Aotearoa New Zealand's Covid-19 response(Elsevier Ltd, 2025-03-18) French NP; Maxwell H; Baker MG; Callaghan F; Dyet K; Geoghegan JL; Hayman DTS; Huang QS; Kvalsvig A; Russell E; Scott P; Thompson TP; Plank MJIn 2020 Aotearoa New Zealand, like many other countries, faced the coronavirus pandemic armed with an influenza-based pandemic plan. The country adapted rapidly to mount a highly strategic and effective elimination response to the SARS-CoV-2 pandemic. However, implementation was hampered by gaps in pandemic preparedness. These gaps undermined effectiveness of the response and exacerbated inequitable impacts of both Covid-19 disease and control measures. Our review examines the Covid-19 response, reflecting on strengths, limitations and implications for pandemic planning. We identify three key areas for improvement: 1) development of a systematised procedure for risk assessment of a new pandemic pathogen; 2) investment in essential capabilities during inter-pandemic periods; and 3) building equity into all stages of the response. We present a typology of potential pathogens and scenarios and describe the evidence assessment process and core capabilities required for countries to respond fluidly, equitably, and effectively to a rapidly emerging pandemic threat.Item Investigating animals and environments in contact with leptospirosis patients in Aotearoa New Zealand reveals complex exposure pathways.(Taylor and Francis Group, 2025-02-12) Benschop J; Collins-Emerson JM; Vallee E; Prinsen G; Yeung P; Wright J; Littlejohn S; Douwes J; Fayaz A; Marshall JC; Baker MG; Quin T; Nisa SCASE HISTORY: Three human leptospirosis cases from a case-control study were recruited for in-contact animal and environment sampling and Leptospira testing between October 2020 and December 2021. These cases were selected because of regular exposure to livestock, pets, and/or wildlife, and sampling was carried out on their farms or lifestyle blocks (sites A-C), with veterinarians overseeing the process for livestock, and cases collecting environmental and wildlife samples. LABORATORY FINDINGS: Across the three sites, a total of 137 cattle, > 40 sheep, 28 possums, six dogs, six rats, three pigs and three rabbits were tested. Herd serology results on Site A, a dairy farm, showed infection with Tarassovi and Pomona; urinary shedding showed Leptospira borgpetersenii str. Pacifica. Animals were vaccinated against Hardjo, Pomona and Copenhageni. The farmer was diagnosed with Ballum. On Site B, a beef and sheep farm, serology showed infection with Pomona; animals were not vaccinated, and the farmer was diagnosed with Hardjo. On Site C, cattle were shedding L. borgpetersenii; animals were not vaccinated, and the case's serovar was indeterminate. Six wild animals associated with Sites A and C and one environmental sample from Site A were positive for pathogenic Leptospira by PCR. CONCLUSION: These findings highlight the complexity of potential exposures and the difficulty in identifying infection sources for human cases. This reinforces the need for multiple preventive measures such as animal vaccination, the use of personal protective equipment, pest control, and general awareness of leptospirosis to reduce infection risk in agricultural settings. CLINICAL RELEVANCE: Farms with unvaccinated livestock had Leptospira infections, highlighting the importance of animal vaccination. Infections amongst stock that were vaccinated emphasise the importance of best practice vaccination recommendations and pest control. Abbreviations: MAT: Microscopic agglutination test; PIC: Person in charge; PPE: Personalprotective equipmentItem An evaluation of the population uptake and contact tracer utilisation of the Covid-19 Bluetooth Exposure Notification Framework in New Zealand(Elsevier B.V. on behalf of Public Health Association of Australia, 2024-11-05) Chambers T; Anglemyer A; Chen A; Atkinson J; Elers P; Baker MGObjective: Our primary research objective was to assess the population uptake and contact tracer utilisation of the Bluetooth function of the New Zealand Covid Tracer App (NZCTA) throughout the pandemic. Methods: We adopted a retrospective cohort study design using all diagnosed COVID-19 community cases from December 12, 2020 to February 16, 2022. Results: At its height, more than 60 % of the eligible population had the Bluetooth function of NZCTA activated. However, only an estimated 2.2 % of the population was able to fully participate. Cases managed by the national case investigation service were 17 times (aRR 17.54, 95%CI: 13.02-23.90) and 9 times (aRR 9.27, 95%CI: 6.91, 12.76) more likely to generate a Bluetooth token than cases managed by local public health units during the Delta and Omicron periods, respectively. Conclusions: The Bluetooth functionality of the NZCTA likely had a low impact on the pandemic response in NZ despite its exceptionally high levels of public uptake. The primary reason for the lack of impact was the low utilisation by contact tracers. Implications for public health: The results highlight the need for greater consultation and collaboration with the public health sector during the development and implementation of digital contact tracing tools.Item He Kāinga Oranga: reflections on 25 years of measuring the improved health, wellbeing and sustainability of healthier housing(Taylor and Francis, on behalf of Te Aparangi, The Royal Society of New Zealand, 2023-02-06) Howden-Chapman P; Crane J; Keall M; Pierse N; Baker MG; Cunningham C; Amore K; Aspinall C; Bennett J; Bierre S; Boulic M; Chapman R; Chisholm E; Davies C; Fougere G; Fraser B; Fyfe C; Grant L; Grimes A; Halley C; Logan-Riley A; Nathan K; Olin C; Ombler J; O’Sullivan K; Pehi T; Penny G; Phipps R; Plagman M; Randal E; Riggs L; Robson B; Ruru J; Shaw C; Schrader B; Teariki MA; Telfar Barnard L; Tiatia R; Toy-Cronin B; Tupara H; Viggers H; Wall T; Wilkie M; Woodward A; Zhang WThis paper reflects on the influences and outcomes of He Kāinga Oranga/Housing and Health Research Programme over 25 years, and their impact on housing and health policy in Aotearoa and internationally. Working in partnership particularly with Māori and Pasifika communities, we have conducted randomised control trials which have shown the health and broad co-benefits of retrofitted insulation, heating and remediation of home hazards, which have underpinned government policy in the Warm Up NZ-Heat Smart programme and the Healthy Homes Standards for rental housing. These trials have been included as evidence in the WHO Housing and Health Guidelines and led to our designation as a WHO Collaborating Centre on Housing and Wellbeing. We are increasingly explicitly weaving Māori frameworks, values and processes with traditional Western science.Item Severe weather events and cryptosporidiosis in Aotearoa New Zealand: A case series of space-time clusters.(Cambridge University Press, 2024-04-15) Grout L; Hales S; Baker MG; French N; Wilson NOccurrence of cryptosporidiosis has been associated with weather conditions in many settings internationally. We explored statistical clusters of human cryptosporidiosis and their relationship with severe weather events in New Zealand (NZ). Notified cases of cryptosporidiosis from 1997 to 2015 were obtained from the national surveillance system. Retrospective space-time permutation was used to identify statistical clusters. Cluster data were compared to severe weather events in a national database. SaTScan analysis detected 38 statistically significant cryptosporidiosis clusters. Around a third (34.2%, 13/38) of these clusters showed temporal and spatial alignment with severe weather events. Of these, nearly half (46.2%, 6/13) occurred in the spring. Only five (38%, 5/13) of these clusters corresponded to a previously reported cryptosporidiosis outbreak. This study provides additional evidence that severe weather events may contribute to the development of some cryptosporidiosis clusters. Further research on this association is needed as rainfall intensity is projected to rise in NZ due to climate change. The findings also provide further arguments for upgrading the quality of drinking water sources to minimize contamination with pathogens from runoff from livestock agriculture.Item Diagnosis of protozoa diarrhoea in Campylobacter patients increases markedly with molecular techniques.(Public Library of Science (PLoS), 2023-05-30) Hayman DTS; Garcia-Ramirez JC; Pita A; Velathanthiri N; Knox MA; Ogbuigwe P; Baker MG; Rostami K; Deroles-Main J; Gilpin BJ; Standley CCryptosporidium and Giardia are major causes of diarrhoea globally, and two of the most notified infectious diseases in New Zealand. Diagnosis requires laboratory confirmation carried out mostly via antigen or microscopy-based techniques. However, these methods are increasingly being superseded by molecular techniques. Here we investigate the level of protozoa detection by molecular methods in campylobacteriosis cases missed through antigen-based assays and investigate different molecular testing protocols. We report findings from two observational studies; the first among 111 people during a Campylobacter outbreak and the second during normal surveillance activities among 158 people presenting with diarrhoea and a positive Campylobacter test, but negative Cryptosporidium and Giardia antigen-based test results. The molecular methods used for comparison were in-house end-point PCR tests targeting the gp60 gene for Cryptosporidium and gdh gene for Giardia. DNA extraction was performed with and without bead-beating and comparisons with commercial real-time quantitative (qPCR) were made using clinical Cryptosporidium positive sample dilutions down to 10-5. The Cryptosporidium prevalence was 9% (95% CI: 3-15; 10/111) and Giardia prevalence 21% (95% CI: 12-29; 23/111) in the 111 Campylobacter outbreak patients. The Cryptosporidium prevalence was 40% (95% CI: 32-48; 62/158) and Giardia prevalence 1.3% (95% CI: 0.2-4.5; 2/158) in the 158 routine surveillance samples. Sequencing identified Cryptosporidium hominis, C. parvum, and Giardia intestinalis assemblages A and B. We found no statistical difference in positive test results between samples using end-point PCR with or without bead-beating prior to DNA extraction, or between the in-house end-point PCR and qPCR. The qPCR Ct value was 36 (95% CI: 35-37) for 1 oocyst, suggesting a high limit of detection. In conclusion in surveillance and outbreak situations we found diagnostic serology testing underdiagnoses Cryptosporidium and Giardia coinfections in Campylobacter patients, suggesting the impact of protozoa infections may be underestimated through underdiagnosis using antigen-based assays.Item Steps towards operationalizing One Health approaches.(Elsevier B.V., 2024-04-27) Pepin KM; Carlisle K; Anderson D; Baker MG; Chipman RB; Benschop J; French NP; Greenhalgh S; McDougall S; Muellner P; Murphy E; O'Neale DRJ; Plank MJ; Hayman DTSOne Health recognizes the health of humans, agriculture, wildlife, and the environment are interrelated. The concept has been embraced by international health and environmental authorities such as WHO, WOAH, FAO, and UNEP, but One Health approaches have been more practiced by researchers than national or international authorities. To identify priorities for operationalizing One Health beyond research contexts, we conducted 41 semi-structured interviews with professionals across One Health sectors (public health, environment, agriculture, wildlife) and institutional contexts, who focus on national-scale and international applications. We identify important challenges, solutions, and priorities for delivering the One Health agenda through government action. Participants said One Health has made progress with motivating stakeholders to attempt One Health approaches, but achieving implementation needs more guidance (action plans for how to leverage or change current government infrastructure to accommodate cross-sector policy and strategic mission planning) and facilitation (behavioral change, dedicated personnel, new training model).Item Factors Associated with Uptake of No-Cost Safety Modifications to Home Access Steps: Implications for Equity and Policy(MDPI (Basel, Switzerland), 2024-01-04) Keall MD; Pierse N; Cunningham CW; Baker MG; Bierre S; Howden-Chapman P; Grzebieta R(1) Background: Fall injuries in the home present a major health burden internationally for all age groups. One effective intervention to prevent falls is home modification, but safety is only increased if opportunities to install safety modifications are taken up. This study sought to identify factors that may lead to a higher uptake of no-cost home modifications when these are offered to people living in the community. (2) Methods: We studied 1283 houses in the New Zealand cities of New Plymouth and Wellington. Using logistic regression, we modelled the odds of uptake according to the number of access steps, the provider who was undertaking the modifications, occupant ethnicity, prior fall injury history, and age group. (3) Results: Homes with older residents (age 65+) had higher uptake rates (35% vs. 27% for other homes). Larger numbers of access steps were associated with higher uptake rates. There was indicative evidence that homes with Indigenous Māori occupants had a higher uptake of the modifications for one of the two providers, but not the other. (4) Conclusions: No-cost home safety modifications offered via cold calling are likely to have relatively low uptake rates but the households that do consent to the modifications may be those who are more likely to benefit from the concomitant increased safety.