Journal Articles

Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915

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    Ethnic equity in Aotearoa New Zealand's COVID-19 response: A descriptive epidemiological study
    (Elsevier Limited, United Kingdom, on behalf of The Royal Society for Public Health, 2025-07) Jefferies S; Gilkison C; Duff P; Grey C; French N; Carr H; Priest P; Crengle S
    Objectives: Aotearoa New Zealand employed one of the most stringent public health pandemic responses internationally. We investigated whether ethnic health equity was achieved in the response and outcomes, from COVID-19 elimination in June 2020 through to Omicron-response easing, including international border reopening, in 2022. Study design: Descriptive epidemiology study. Methods: All COVID-19 cases, patients tested for SARS-CoV-2 and people vaccinated against COVID-19 between 9 June 2020 and 13 April 2022 were examined over three response periods: by demographic features and COVID-19 outcomes, transmission and vaccination patterns, time-to-vaccination and testing rates. Results: There were 15,693 cases per 100,000, 138·7 hospitalisations per 100,000, and 9·8 deaths per 100,000 people. Pacific peoples and Indigenous Māori had, respectively, 9·3 to 35-fold and 1·5 to 8·3-fold higher risk of COVID-19, 5·1-fold and 2·6-fold higher age-standardised risk of hospitalisation and 9-fold and 4-fold higher age-standardised risk of death, than European or Other. Māori and Pacific peoples had lower vaccination coverage at critical points in the response, and slower access to vaccination (Adjusted Time Ratios for two doses 1·32 (95% CI 1·31–1·32) and 1·14 (1·14–1·14), respectively), than European or Other. Testing rates remained high, especially among Māori and Pacific peoples. Conclusions: Despite achieving a low overall burden of disease by international comparisons, the multi-faceted New Zealand response did not prevent stark ethnic inequities in access to vaccination and COVID-19 outcomes. Policies which address disparities in upstream determinants, early vaccine programme planning and implementation with high-risk communities, and prioritisation that addresses systematic ethnic disadvantage and promotes health equity in response decisions is recommended.
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    Unravelling the reservoirs for colonisation of infants with Campylobacter spp. in rural Ethiopia: protocol for a longitudinal study during a global pandemic and political tensions.
    (BMJ Publishing Group Ltd, 2022-10-05) Havelaar AH; Brhane M; Ahmed IA; Kedir J; Chen D; Deblais L; French N; Gebreyes WA; Hassen JY; Li X; Manary MJ; Mekuria Z; Ibrahim AM; Mummed B; Ojeda A; Rajashekara G; Roba KT; Saleem C; Singh N; Usmane IA; Yang Y; Yimer G; McKune S
    INTRODUCTION: Undernutrition is an underlying cause of mortality in children under five (CU5) years of age. Animal-source foods have been shown to decrease malnutrition in CU5. Livestock are important reservoirs for Campylobacter bacteria, which are recognised as risk factors for child malnutrition. Increasing livestock production may be beneficial for improving nutrition of children but these benefits may be negated by increased exposure to Campylobacter and research is needed to evaluate the complex pathways of Campylobacter exposure and infection applicable to low-income and middle-income countries. We aim to identify reservoirs of infection with Campylobacter spp. of infants in rural Eastern Ethiopia and evaluate interactions with child health (environmental enteric dysfunction and stunting) in the context of their sociodemographic environment. METHODS AND ANALYSIS: This longitudinal study involves 115 infants who are followed from birth to 12 months of age and are selected randomly from 10 kebeles of Haramaya woreda, East Hararghe zone, Oromia region, Ethiopia. Questionnaire-based information is obtained on demographics, livelihoods, wealth, health, nutrition and women empowerment; animal ownership/management and diseases; and water, sanitation and hygiene. Faecal samples are collected from infants, mothers, siblings and livestock, drinking water and soil. These samples are analysed by a range of phenotypic and genotypic microbiological methods to characterise the genetic structure of the Campylobacter population in each of these reservoirs, which will support inference about the main sources of exposure for infants. ETHICS AND DISSEMINATION: Ethical approval was obtained from the University of Florida Internal Review Board (IRB201903141), the Haramaya University Institutional Health Research Ethics Committee (COHMS/1010/3796/20) and the Ethiopia National Research Ethics Review Committee (SM/14.1/1059/20). Written informed consent is obtained from all participating households. Research findings will be disseminated to stakeholders through conferences and peer-reviewed journals and through the Feed the Future Innovation Lab for Livestock Systems.