Visiting Fellow Report: Patricia Graves

From July 28 to August 17 2016, Dr Patricia Graves visited the Cochrane Infectious Diseases Group (CIDG) editorial base as a Visiting Fellow. Dr Graves is an Adjunct Professor at the College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Cairns, Australia. She is a specialist in the epidemiology of malaria, filariasis, and other vector-borne diseases, and has extensive experience in applied research and consulting in the Pacific, Africa, and Asia.

In this report, she provides an insight into her involvement with the CIDG and her time at the CIDG editorial base in Liverpool.


How did you first become involved with the CIDG?

Paul Garner, who is a long standing friend and colleague from the 1980s, roped me in in about 1996 to work on the malaria vaccines review. It was at the time of the trials of the first malaria vaccine Spf66 and there was a lot of confusion about whether it had sufficient efficacy or not.

What were the objectives of this visit to the CIDG editorial base? 

There were three main tasks:

Who have you met with at the CIDG/outside the CIDG to help attain your objectives during your visit?

Prior to visiting, I communicated several times with Phil Hinds and Vittoria Lutje about the searches that were prepared in advance. During the visit I worked extensively with Paul Garner, Anne-Marie Stephani, and Vittoria Lutje on the tasks above. I had discussions with other editors and authors: David SinclairDeirdre Walshe, and Rachael Milligan. I also benefited greatly from the support of Phil Hinds, Christianne Esparza, and Paula Waugh at the CIDG. Regarding vector reviews, Paul and I had in-person discussions with Hilary Ranson, Dave Malone (IVCC), and others at LSTM about priorities and how to move some reviews along. For malaria reviews, we had conference calls with CIDG Editors Uthman Olalekan and Hellen Gelband. 

Outside the CIDG at LSTM, I took the opportunity of meeting with David Molyneux, Louise Kelly-Hope, Joe Turner, Stephen Cross, Julio Furlong-Silva, and Suzy Campbell to discuss NTDs, mainly lymphatic filariasis (LF) in Myanmar and Nepal but also soil-transmitted helminths (STHs) as well. I also met with Ian Hastings to talk about malaria infectiousness models.

How has visiting the CIDG editorial base helped development of your protocol/review? 

Being able to discuss in person with CIDG members, to clarify in person who is doing which review and what stage they are at, and to focus on the tasks at hand meant that there was a lot of progress on all the tasks, and a clearer way forward with prioritization. It was important to clarify the overlap between certain reviews, understand why some had not progressed, and avoid repetition. 

I really appreciate the opportunity and all the support that was provided. 

What were the main results/outputs of your visit?

The ‘Primaquine or other 8-aminoquinoline for reducing P. falciparum transmission’ update has advanced significantly. The new search was done and screened by two authors. We identified several new trials for inclusion, from which data has been extracted. The review is being updated with the new information. 

The update of the indoor residual spraying (IRS) review is more complicated because the questions have changed. The updated search, which used the strategy in the original review, returned an extremely large number of publications. The strategy was refined and tested, and appears more specific. However, the questions and objectives have changed, and therefore the protocol has to be revised. Suggested revisions to the protocol were provided, and a search for a new lead author was initiated.  

The ‘Primaquine for Plasmodium vivax relapses’ review also needed significant update with revised objectives, and had progressed towards a new protocol led by Rachael Milligan. We clarified what should be covered in this review rather than the tafenoquine for relapses, the primaquine/tafenoquine for prophylaxis, and the artermisinin-based combination therapy (ACT) for P. vivax reviews. 

The ‘Space spraying for reducing malaria transmission’ review now has a registered title. 

Input, opinion, or review of searches was given on the following other topics:

  1. vector control for Aedes-transmitted diseases (dengue and zika);
  2. dengue vaccines;
  3. piperonyl butoxide (PBO) nets;
  4. spatial repellents;
  5. mass drug administration (MDA) for LF (albendazole etc). 

What further work will need to be undertaken?

Patricia Graves and Hellen Gelband need to finish updating the primaquine for P. falciparum review with Paul Garner’s help. Target: resubmission before end of 2016.

The IRS review needs a new lead author to do the update using the improved search strategy and revised protocol. Target: 2017.

Uthman Olalekan will revise the primaquine safety review following feedback and updated search.

Continued editorial or general input on other reviews mentioned above.

What do you like about the city of Liverpool?

Lovely architecture, preserved Victorian buildings, easy to get around, art friendly, near the sea, and the home of the LSTM and the CIDG editorial base.