We aimed to define the epidemiology of COVID-19 outbreaks in aged care facilities (ACFs) during the postvaccine period, including vaccine effectiveness (VE) for this high-risk group.

Systematic review and meta-analysis.

Ovid Medline, Ovid Embase, Scopus, Web of Science and Cochrane databases were searched through 1 September 2023.

Any original observational studies and trials reporting data on COVID-19 outbreaks among the partially/fully vaccinated residents from ACFs during or after the worldwide implementation of vaccine roll-out.

We estimated the attack rate, case fatality rate, mortality rate and VE during postvaccine period. Random effect model was adopted for meta-analysis. Quality assessment on all included studies was performed using the Meta Quality Appraisal Tool.

38 articles were included from 12 countries reporting 79 outbreaks with 1708 confirmed cases of COVID-19 from 78 ACFs. The pooled attack rate was 28% (95% CI 20% to 37%) among the fully vaccinated residents. Two-thirds (62.5%) of the index cases were unvaccinated healthcare professionals (eg, physicians, nurses) and caregivers. Unvaccinated residents had a significantly higher rates (12%) (95% CI 7% to 19%) of mortality compared with the vaccinated residents (2%) (95% CI% 1 to 4%) and the post-COVID-19 vaccine estimates for case fatality rate (13% vs 23%) and hospitalisation rate (17% vs 37%) were substantially lower. VE in preventing disease among residents in ACFs was 73% (95% CI 49% to 86). Overall, the included studies were heterogeneous in nature, however, the risk of bias was low to moderate.

Our study reaffirmed the impact of vaccination as a key public health measure to minimise the burden of COVID-19 in ACFs. Facilities with higher crowding indexes should be prioritised for vaccination and should advocate for higher vaccination targets among staff and residents as a critical intervention strategy to minimise disease burden in this vulnerable population.

Energy poverty contributes to the general well-being of households; however, there is representational paucity on its role in household nutrition across sub-Saharan Africa (SSA). This study examined the influence of different domains of energy poverty and a Multidimensional Energy Poverty Index (MEPI) on household burden of malnutrition in SSA.

Secondary data from the most recent Demographic and Health Survey conducted in 18 SSA countries were analysed.

A cross-sectional design was used to examine the relationship between household energy poverty and household burden of malnutrition.

Different dimensions of household energy poverty and an MEPI were computed from the sources of energy used for cooking, lighting, entertainment and accessing information by households. Household burden of malnutrition was coded as a binary categorical dependent variable using indicators of undernutrition, overnutrition and anaemia among women of reproductive age (15–49 years) and children under five years in the household.

More than nine in ten households were energy poor in terms of cooking fuel and about three in four were energy poor in terms of lighting. Considering the various domains of energy poverty, lack of electricity for lighting, using biofuels, not owning a refrigerator/freezer, not owning a television/radio and not owning a mobile phone were associated with increased odds of a household experiencing undernutrition. Similarly, deprivation in these domains was associated with a lower likelihood of households experiencing overnutrition, the only exception being using biofuels. Overall, households that were most energy poor on the MEPI were more likely to be undernourished and double and triple burden malnutrition households but less likely to suffer from overnutrition.

These results highlight the complex and multifaceted nature of the relationship between energy poverty and household burden of malnutrition and provides guidance for appropriate interventions to address energy poverty and malnutrition in SSA.

The Gastric Alimetry platform offers a multimodal assessment of gastric function through body surface gastric mapping (BSGM) and concurrent symptom-tracking via a validated App. We aim to perform a longitudinal cohort study to examine the impact of Gastric Alimetry, and changes in clinical management on patient symptoms, quality of life and psychological health.

This is a prospective multicentre longitudinal observational cohort study of participants with chronic gastroduodenal symptoms. Consecutive participants undergoing Gastric Alimetry will be invited to participate. Quality of life will be assessed via EuroQol-5D and the Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life score. Gastrointestinal symptoms will be assessed via the Patient Assessment of Upper Gastrointestinal Symptom Severity index, and the Gastroparesis Cardinal Symptom Index. Psychometrics will be assessed, including anxiety via the General Anxiety Disorder-7, perceived stress using the Perceived Stress Scale 4, and depression via the Patient Health Questionnaire 9. Clinical parameters including diagnoses, investigations and treatments (medication and procedures) will also be captured. Assessments will be made the week after the BSGM test, at 30 days, 90 days, 180 days and 360 days thereafter. The primary outcome is feasibility of longitudinal follow-up of a cohort that have undergone Gastric Alimetry testing; from which patients’ continuum of care can be characterised. Secondary outcomes include changes in patient-reported symptoms, quality of life and psychometrics (anxiety, stress and depression). Inferential causal analyses will be performed at the within patient level to explore causal associations between treatment changes and clinical outcomes. The impact of Gastric Alimetry on clinical management will also be captured.

The protocol has been approved in Aotearoa New Zealand by the Auckland Health Research Ethics Committee. Results will be submitted for conference presentation and peer-reviewed publication.