Giuseppe
Emeritus
[Source: PLoS ONE, full text: (LINK). Abstract, edited.]
-------
Research Article
Compliance to Oseltamivir among Two Populations in Oxfordshire, United Kingdom Affected by Influenza A(H1N1)pdm09, November 2009 ? A Waste Water Epidemiology Study
Andrew C. Singer, Josef D. J?rhult, Roman Grabic, Ghazanfar A. Khan, Ganna Fedorova, Jerker Fick, Richard H. Lindberg, Michael J. Bowes, Bj?rn Olsen, Hanna S?derstr?m
Abstract
Antiviral provision remains the focus of many pandemic preparedness plans, however, there is considerable uncertainty regarding antiviral compliance rates. Here we employ a waste water epidemiology approach to estimate oseltamivir (Tamiflu?) compliance. Oseltamivir carboxylate (oseltamivir's active metabolite) was recovered from two waste water treatment plant (WWTP) catchments within the United Kingdom at the peak of the autumnal wave of the 2009 Influenza A (H1N1)pdm09 pandemic. Predictions of oseltamivir consumption from detected levels were compared with two sources of national government statistics to derive compliance rates. Scenario and sensitivity analysis indicated between 3?4 and 120?154 people were using oseltamivir during the study period in the two WWTP catchments and a compliance rate between 45?60%. With approximately half the collected antivirals going unused, there is a clear need to alter public health messages to improve compliance. We argue that a near real-time understanding of drug compliance at the scale of the waste water treatment plant (hundreds to millions of people) can potentially help public health messages become more timely, targeted, and demographically sensitive, while potentially leading to less mis- and un-used antiviral, less wastage and ultimately a more robust and efficacious pandemic preparedness plan.
Citation: Singer AC, J?rhult JD, Grabic R, Khan GA, Fedorova G, et al. (2013) Compliance to Oseltamivir among Two Populations in Oxfordshire, United Kingdom Affected by Influenza A(H1N1)pdm09, November 2009 ? A Waste Water Epidemiology Study. PLoS ONE 8(4): e60221. doi:10.1371/journal.pone.0060221
Editor: Richard Joseph Sugrue, Nanyang Technical University, United States of America
Received: November 15, 2012; Accepted: February 18, 2013; Published: April 15, 2013
Copyright: ? 2013 Singer et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The authors received funding for the collection and analysis from the Swedish Research Council Formas, the Natural Environment Research Council?Knowledge Transfer (PREPARE) Initiative contract NE/F009216/1, the Ministry of Education, Youth and Sports of the Czech Republic CENAKVA No. CZ.1.05/2.1.00/01.0024 and the Grant Agency of the University of South Bohemia No. 047/2010/Z. The authors received in-kind support from G.F.F. Hoffman ? La Roche Ltd. through donated deuterated OC. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors received funding from a commercial source (La Roche Ltd.). There are no further patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.
-Compliance to Oseltamivir among Two Populations in Oxfordshire, United Kingdom Affected by Influenza A(H1N1)pdm09, November 2009 ? A Waste Water Epidemiology Study
Andrew C. Singer, Josef D. J?rhult, Roman Grabic, Ghazanfar A. Khan, Ganna Fedorova, Jerker Fick, Richard H. Lindberg, Michael J. Bowes, Bj?rn Olsen, Hanna S?derstr?m
Abstract
Antiviral provision remains the focus of many pandemic preparedness plans, however, there is considerable uncertainty regarding antiviral compliance rates. Here we employ a waste water epidemiology approach to estimate oseltamivir (Tamiflu?) compliance. Oseltamivir carboxylate (oseltamivir's active metabolite) was recovered from two waste water treatment plant (WWTP) catchments within the United Kingdom at the peak of the autumnal wave of the 2009 Influenza A (H1N1)pdm09 pandemic. Predictions of oseltamivir consumption from detected levels were compared with two sources of national government statistics to derive compliance rates. Scenario and sensitivity analysis indicated between 3?4 and 120?154 people were using oseltamivir during the study period in the two WWTP catchments and a compliance rate between 45?60%. With approximately half the collected antivirals going unused, there is a clear need to alter public health messages to improve compliance. We argue that a near real-time understanding of drug compliance at the scale of the waste water treatment plant (hundreds to millions of people) can potentially help public health messages become more timely, targeted, and demographically sensitive, while potentially leading to less mis- and un-used antiviral, less wastage and ultimately a more robust and efficacious pandemic preparedness plan.
Citation: Singer AC, J?rhult JD, Grabic R, Khan GA, Fedorova G, et al. (2013) Compliance to Oseltamivir among Two Populations in Oxfordshire, United Kingdom Affected by Influenza A(H1N1)pdm09, November 2009 ? A Waste Water Epidemiology Study. PLoS ONE 8(4): e60221. doi:10.1371/journal.pone.0060221
Editor: Richard Joseph Sugrue, Nanyang Technical University, United States of America
Received: November 15, 2012; Accepted: February 18, 2013; Published: April 15, 2013
Copyright: ? 2013 Singer et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The authors received funding for the collection and analysis from the Swedish Research Council Formas, the Natural Environment Research Council?Knowledge Transfer (PREPARE) Initiative contract NE/F009216/1, the Ministry of Education, Youth and Sports of the Czech Republic CENAKVA No. CZ.1.05/2.1.00/01.0024 and the Grant Agency of the University of South Bohemia No. 047/2010/Z. The authors received in-kind support from G.F.F. Hoffman ? La Roche Ltd. through donated deuterated OC. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors received funding from a commercial source (La Roche Ltd.). There are no further patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.
-------