Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item Is equity meaningfully incorporated into pandemic preparedness and response? A scoping review and critical analysis of Ebola andCOVID-19 outbreak responses in Uganda 2019-2023(Taylor and Francis Group, 2025-12-31) Redondo G; Murray L; Bromhead C; Makumbi ISocietal inequities produce vulnerabilities that infectious disease can exploit. Current approaches to pandemic prevention, detection and response are led by the International Health Regulations IHR and the Global Health Security Agenda. However, to contain the spread of infectious diseases, localised action to address systemic inequities must be considered. The purpose of this scoping review and equity analysis is to 1) Synthesise the available information on Uganda’s Ebola Virus Disease (EVD) and COVID-19 preparedness and outbreak responses between 2019 and 2023, and 2) Critique if and how Uganda’s Ministry of Health incorporated concepts of health equity in its EVD and COVID-19 interventions, while building national capacity to identify and prevent public health emergencies. This scoping review and critical analysis was conducted following the five-stage process defined by Levac et al. After identification and screening, the scoping review was based on six preparedness and response plans, three after-action reviews, and 20 grey literature and peer-reviewed articles. The findings revealed that the EVD and COVID-19 preparedness and response plans in Uganda show the country’s commitment and readiness for early detection and response to infectious disease outbreaks. However, further examination of the plans reveals missed opportunities to address systemic inequities. The ongoing mpox outbreak, declared a PHEIC by WHO on July 23, 2022, with significant impacts in African countries including Uganda, further underscores the need for a paradigm shift in managing infectious disease outbreaks. Such a shift may be similar to that experienced by the field of disaster risk reduction, which underwent a significant transformation at the Sendai Conference in 2015 towards a more holistic and proactive approach that addresses underlying systemic issues and focuses on building resilience. The exclusive focus on biomedical strategies to manage infectious diseases fails to address the social aspects of transmission, the local perceptions of illness, and community vulnerabilities often associated with social and historical perspectives. The social determinants of health disparities should be incorporated into pandemic planning and response. This will contribute to fostering equitable health outcomes and resilience in the face of the multifaceted challenges posed by future pandemics and environmental changes.Item Temporal reconstruction of a Salmonella Enteritidis ST11 outbreak in New Zealand(Microbiology Society, 2025-10-30) Strydom H; Wright J; Bromhead C; Welch D; Williams E; Mulqueen K; de Ligt J; Biggs PJ; Paine S; Jefferies S; French NOutbreaks caused by Salmonella Enteritidis are commonly linked to eggs and poultry meat internationally, but this serovar had never been detected in Aotearoa New Zealand (NZ) poultry prior to 2021. Locally designated genomic cluster Salmonella Enteritidis_2019_C_01, was implicated in a 2019 outbreak associated with a restaurant in Auckland. Four Enteritidis_2019_C_01 sub-clusters have since been identified, two retrospectively, in the Auckland region. Authorities initiated a formal outbreak investigation after genomically indistinguishable S. Enteritidis was isolated from the NZ poultry production environment. This study analysed 231 S. Enteritidis genomes obtained from the outbreak using Bayesian phylodynamic tools to gain insight into the outbreak's dynamics and origin. We used Bayesian integrated coalescent epoch plots to estimate the change of the Enteritidis ST11 population size over time and marginal structured coalescent approximation to estimate transmission between poultry producers. We investigated human and poultry isolates to elucidate the time and location of the most recent common ancestor of the outbreak and transmission pathways. The median most recent common ancestor was estimated to be February 2019. We found evidence of amplification and spread of strain Enteritidis_2019_C_01 within the poultry industry, as well as transmission events throughout the production chain. The intervention by the public health and food safety authorities coincided with a drop in the effective population size of the S. Enteritidis ST11 as well as notified human cases. This information is crucial for understanding and preventing the transmission of S. Enteritidis in NZ poultry to ensure poultry meat and eggs are safe for consumption.Item Prevalence of human T-cell lymphotropic virus type 1 or 2 among blood donors screened at the New Zealand Blood Service: An observational study, 2001–2024(Elsevier B.V., 2025-10) Aye PS; Gray L; Charlewood R; Bennett W; Bromhead C; Balm M; Crengle S; Bartholomew KObjective To investigate prevalence of Human T-cell Lymphotropic Virus type 1 or 2 (HTLV-1/2) using the New Zealand Blood Service (NZBS) data, to inform whether further HTLV-1/2 prevalence study may be required, in the context of drivers of the inequities in lung cancer for Māori (the Indigenous population). Methods This observational cross-sectional study used the NZBS data of all blood donors nationwide (01/01/2001–30/06/2024). Prevalence overall and by ethnicity was calculated as the number of confirmed HTLV-1/2 positive cases per 10,000 donors. Results Of 679,946 new donors over the 23.5 years, 25 HTLV-1/2 positive cases were identified. The overall prevalence of HTLV-1/2 in New Zealand was 0.4 cases per 10,000 donors, highest among Middle Eastern, Latin American and African ethnicity (six cases per 10,000 donors), with no positive cases in Māori and Pacific donors. Among the positive cases, the highest proportions were seen separately for those aged 25–34, females, of New Zealand European ethnicity, resident in Auckland, and born in India, compared to their counterparts. Conclusions Prevalence of HTLV-1/2 infection among blood donors in New Zealand was very low, with no evidence of infection among Māori and Pacific donors, suggesting that a wider HTLV-1/2 seroprevalence study was unlikely to be necessary.Item Correction: Development of a non-infectious control for viral hemorrhagic fever PCR assays(PLOS, 2025-07-09) Knox MA; Bromhead C; Hayman DTSThe Funding statement for this article is incorrect. The correct Funding statement is as follows: EBO-SURSY project funded by the European Union via the World Organisation for Animal Health (Grant 3000034275; OIE Laboratory (or Collaborating Centre) Twinning Project: Enhancing capacity for early detection of viral haemorrhagic fevers in Liberia through epidemiological and laboratory training).Item VEGF-A cis-located SNPs on human chromosome 6 associated with VEGF-A plasma levels and survival in a coronary disease cohort(BioMed Central Ltd, 2025-12) Meza-Alvarado JC; Pilbrow AP; Frampton CM; Cameron VA; Richards AM; Troughton RW; Doughty RN; Page RA; Mallard B; Bromhead C; Palmer BRBackground: Cardiovascular disease (CVD) is the leading cause of death worldwide. Risk stratification of CVD patients may be improved by predictive biomarkers, including genetic markers. Elevated circulating vascular endothelial growth factor A (VEGF-A) levels have been linked to CVD development. We explored whether single nucleotide polymorphisms (SNPs) at the VEGFA locus on human chromosome 6 were associated with VEGF-A levels and clinical outcomes in established CVD. VEGF-A levels were compared between coronary heart disease patients and heart healthy controls. Methods: Imputed genotypes of 30 SNPs from the VEGFA region for 1935 patients from the Coronary Disease Cohort Study (CDCS) and 1183 individuals from the Canterbury Healthy Volunteers Study (HVOL) were analysed for associations with cardiometabolic parameters. Association with clinical endpoints was assessed using Kaplan-Meier analysis and multivariate regression models. To validate the findings from imputed data, DNA samples of 2027 CDCS patients and 227 HVOL participants were manually genotyped for variants rs6921438 and rs7767396. Baseline plasma VEGF-A assayed by ELISA in 227 HVOL participants was compared with levels in 549 CDCS patients. Results: Manual genotyping showed rs6921438 AA and rs7767396 GG genotype groups had lower VEGF-A levels at baseline (CDCS: rs6921438 AA (27.7 pg/mL), AG (43.3 pg/mL), GG (63.2 pg/mL), p = 4.49 × 10− 22; rs7767396: GG (27.4 pg/mL), AG (42.8 pg/mL), AA (61.5 pg/mL) p = 3.47 × 10− 21; HVOL rs6921438 AA (12.8 pg/mL), GA (19.9 pg/mL), GG (26.4 pg/mL) p = 0.021; rs7767396 GG (12.6 pg/mL), AG (19.6 pg/mL), AA (25.9 pg/mL) p = 0.029). In the CDCS cohort rs6921438 AA was associated with increased risk of all-cause death (p = 0.03); non ST-elevated myocardial infarction (NSTEMI, p = 0.0003), heart failure (HF, p = 0.035) and major adverse cardiovascular events (p = 0.032); rs7767396 GG was associated with increased NSTEMI (p = 0.001) and HF (p = 0.023) risk; rs6921438 AA (Hazard Ratio (HR) = 6.55 p = 0.017), rs7767396 GG (HR = 0.149, p = 0.017) and VEGF-A (HR = 2.55, p = 0.018) were independent HF admission risk predictors. Conclusions: Variants rs6921438 and rs7767396 are associated with plasma VEGF-A levels. Both SNPs and VEGF-A may be useful in prognosis for HF after acute coronary events.Item Antibiotic and Heavy Metal Resistance in Bacteria from Contaminated Agricultural Soil: Insights from a New Zealand Airstrip(MDPI (Basel, Switzerland), 2025-02) Heydari A; Kim ND; Biggs PJ; Horswell J; Gielen GJHP; Siggins A; Bromhead C; Meza-Alvarado JC; Palmer BR; Abia ALKBACKGROUND/OBJECTIVES: Agricultural soils accumulate inorganic contaminants from the application of phosphate fertilisers. An airstrip located at Belmont Regional Park (BRP), near Wellington, New Zealand, has been found to have a gradient of cadmium contamination due to spillage of superphosphate fertiliser. METHODS: Soil samples from the BRP airstrip with a gradient of cadmium contamination, were used as a novel source to explore bacterial communities' resistance to heavy metals (HMs) and any co-selected antibiotic (Ab) resistance. RESULTS: Differences between BRP soil samples with higher levels of HMs compared to those with lower HM concentrations showed significantly more bacterial isolates resistant to both HMs (40.6% versus 63.1% resistant to 0.01 mM CdCl2, p < 0.05) and Abs (23.4% versus 37.8% resistant to 20 μg/mL tetracycline, p < 0.05) in soils with higher initial levels of HMs (1.14 versus 7.20 mg kg-1 Cd). Terminal restriction fragment length polymorphism (TRFLP) and 16S rDNA next-generation sequencing profiling investigated changes in HM-induced bacterial communities. Significant differences were observed among the bacterial community structures in the selected BRP soil samples. Conjugative transfer of cadmium resistance from 23-38% of cadmium-resistant isolates to a characterised recipient bacterial strain in vitro suggested many of these genes were carried by mobile genetic elements. Transconjugants were also resistant to zinc, mercury, and Abs. Higher levels of HMs in soil correlated with increased resistance to HMs, Abs, and elevated levels of HMs thus disturbed the bacterial community structure in BRP soil significantly. CONCLUSIONS: These findings suggest that HM contamination of agricultural soil can select for Ab resistance in soil bacteria with potential risks to human and animal health.Item Development of a non-infectious control for viral hemorrhagic fever PCR assays(2023-05-23) Knox MA; Bromhead C; Hayman DTSItem Hepatotoxicity of titanium dioxide nanoparticles.(John Wiley & Sons Ltd, 2024-05-13) Khan J; Kim ND; Bromhead C; Truman P; Kruger MC; Mallard BLThe food additive E171 (titanium dioxide, TiO2), is widely used in foods, pharmaceuticals and cosmetics. It is a fine white powder, with at least one third of its particles sized in the nanoparticulate (˂100 nm range, TiO2 NPs). The use of E171 is controversial as its relevant risk assessment has never been satisfactorily accomplished. In vitro and in vivo studies have shown dose-dependent toxicity in various organs including the liver. TiO2 NPs have been shown to induce inflammation, cell death and structural and functional changes within the liver. The toxicity of TiO2 NPs in experimental models varies between organs and according to their physiochemical characteristics and parameters such as dosage and route of administration. Among these factors, ingestion is the most significant exposure route, and the liver is a key target organ. The aim of this review is to highlight the reported adverse effects of orally administered TiO2 NPs on the liver and to discuss the controversial state of its toxicity.Item Development of a non-infectious control for viral hemorrhagic fever PCR assays.(PLOS, 2024-04-22) Knox MA; Bromhead C; Hayman DTS; Viennet EAssay validation is an essential component of disease surveillance testing, but can be problematic in settings where access to positive control material is limited and a safety risk for handlers. Here we describe a single non-infectious synthetic control that can help develop and validate the PCR based detection of the viral causes of Crimean-Congo hemorrhagic fever, Ebola virus disease, Lassa fever, Marburg virus disease and Rift Valley fever. We designed non-infectious synthetic DNA oligonucleotide sequences incorporating primer binding sites suitable for five assays, and a T7 promotor site which was used to transcribe the sequence. Transcribed RNA was used as template in a dilution series, extracted and amplified with RT-PCR and RT-qPCR to demonstrate successful recovery and determine limits of detection in a range of laboratory settings. Our results show this approach is adaptable to any diagnostic assay requiring validation of nucleic acid extraction and/or amplification, particularly where sourcing reliable, safe material for positive controls is infeasible.Item Co-selection of Heavy Metal and Antibiotic Resistance in Soil Bacteria from Agricultural Soils in New Zealand(MDPI (Basel, Switzerland), 2022-02-04) Heydari A; Kim ND; Horswell J; Gielen G; Siggins A; Taylor M; Bromhead C; Palmer BRAccumulation of trace elements (including heavy metals) in soil from usage of superphos-phate fertilisers induces resistance of soil bacteria to trace elements of environmental concern (TE-oEC) and may co‐select for resistance to antibiotics (Ab). This study aimed to investigate selection of co‐resistance of soil bacteria to Cd, Zn and Hg, and Ab in soils with varied management histories. Genetic diversity of these bacteria and horizontal transfer of Cd resistance genes (cadA and czcA) were also investigated. Soils with either pastoral and arable management histories and either high levels of Cd and Zn, or indigenous bush with background levels of these TEoEC from the Waikato region, New Zealand were sampled. Plate culturing with a range of TEoEC and Ab concentrations, Pollution Induced Community Tolerance (PICT) assay, antibiotic sensitivity, terminal restriction fragment length polymorphism (TRFLP) and horizontal gene transfer (HGT) analyses were em-ployed to investigate co‐selection of TEoEC and Ab resistance. Higher levels of bacterial resistance to TEoEC and Ab correlated with higher levels of TEoEC in soil. Bacterial community structures were altered in soils with high TEoEC levels. Cd resistance genes were transferred from donor bacterial isolates, to recipients and the transconjugants also had resistance to Zn and/or Hg and a range of Ab.