scholarly journals Serogroup W meningococcal disease: global spread and current affect on the Southern Cone in Latin America

2014 ◽  
Vol 142 (12) ◽  
pp. 2461-2470 ◽  
Author(s):  
R. ABAD ◽  
E. L. LÓPEZ ◽  
R. DEBBAG ◽  
J. A. VÁZQUEZ
Keyword(s):  
Latin America ◽  
Conjugate Vaccine ◽  
Clonal Complex ◽  
Incidence Rates ◽  
Response Strategy ◽  
Target Groups ◽  
Immunization Programme ◽  
Global Spread ◽  
Current Century ◽  
Immunization Programmes

SUMMARYMeningococcal serogroup W strains have been emerging throughout the current century with most of the isolates belonging to the sequence type (ST11)/electrophoretic type (ET37) clonal complex (ST11/E37 CC), particularly since the international outbreak following Hajj 2000. That outbreak appears to have triggered off that trend, contributing to the spread of W ST11/ET37 CC strains globally; however, local strains could be also responsible for increases in the percentage and/or incidence rates of this serogroup in some countries. More recently, unexpected increases in the percentage and incidence rate of W has been noticed in different countries located in the South Cone in Latin America, and W ST11/ET37 CC strains now appear as endemic in the region and an extensive immunization programme with tetravalent conjugate vaccine (covering serogroups A, C, Y and W) has been recently implemented in Chile. It is difficult to ascertain whether we are observing the emergence of W ST11 CC strains in different geographical areas or whether the Hajj 2000 strain is still spreading globally. Several aspects of the evolution of that situation are analysed in this paper, reviewing also the implications in immunization programmes. Closely related with the analysis of this potential evolution, it will be very interesting to monitor the evolution of serogroup W in the African meningitis belt after implementation of the extensive immunization programme with serogroup A conjugate vaccine that is currently underway. More data about carriers, transmission, clonal lineages, etc. are needed for taking decisions (target groups, outbreak control, defining the extent, etc.) to adapt the response strategy with potential interventions with broad coverage vaccines against the emergent serogroup W.

scholarly journals Evaluation of Typhoid Conjugate Vaccine Effectiveness in Ghana (TyVEGHA) Using a Cluster-Randomized Controlled Phase IV Trial: Trial Design and Population Baseline Characteristics

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 281
Author(s):  
Andrea Haekyung Haselbeck ◽  
Birkneh Tilahun Tadesse ◽  
Juyeon Park ◽  
Malick M. Gibani ◽  
Ligia María Cruz Espinoza ◽  
...  
Keyword(s):  
Public Health ◽  
Blood Culture ◽  
Typhoid Fever ◽  
Conjugate Vaccine ◽  
Incidence Rates ◽  
Health Programs ◽  
Public Health Programs ◽  
High Burden ◽  
Pan African ◽  
Cluster Randomized

Typhoid fever remains a significant health problem in sub-Saharan Africa, with incidence rates of >100 cases per 100,000 person-years of observation. Despite the prequalification of safe and effective typhoid conjugate vaccines (TCV), some uncertainties remain around future demand. Real-life effectiveness data, which inform public health programs on the impact of TCVs in reducing typhoid-related mortality and morbidity, from an African setting may help encourage the introduction of TCVs in high-burden settings. Here, we describe a cluster-randomized trial to investigate population-level protection of TYPBAR-TCV®, a Vi-polysaccharide conjugated to a tetanus-toxoid protein carrier (Vi-TT) against blood-culture-confirmed typhoid fever, and the synthesis of health economic evidence to inform policy decisions. A total of 80 geographically distinct clusters are delineated within the Agogo district of the Asante Akim region in Ghana. Clusters are randomized to the intervention arm receiving Vi-TT or a control arm receiving the meningococcal A conjugate vaccine. The primary study endpoint is the total protection of Vi-TT against blood-culture-confirmed typhoid fever. Total, direct, and indirect protection are measured as secondary outcomes. Blood-culture-based enhanced surveillance enables the estimation of incidence rates in the intervention and control clusters. Evaluation of the real-world impact of TCVs and evidence synthesis improve the uptake of prequalified/licensed safe and effective typhoid vaccines in public health programs of high burden settings. This trial is registered at the Pan African Clinical Trial Registry, accessible at Pan African Clinical Trials Registry (ID: PACTR202011804563392).

scholarly journals Leptospirosis in Latin America: exploring the first set of regional data

2017 ◽  
Vol 41 ◽  
pp. 1 ◽  
Author(s):  
Maria Cristina Schneider ◽  
Deise Galan Leonel ◽  
Patricia Najera Hamrick ◽  
Eduardo Pacheco de Caldas ◽  
Reina Teresa Velásquez ◽  
...  
Keyword(s):  
Latin America ◽  
Cumulative Incidence ◽  
Health Indicators ◽  
Incidence Rates ◽  
First Year ◽  
Surveillance Systems ◽  
New Information ◽  
Open Access Database ◽  
Surveillance Programs ◽  
Health Organization

Objectives.To demonstrate the importance of country surveillance systems for leptospirosis and their use for preliminary epidemiological analysis, as well as to generate research questions for future, morecomprehensive studies on the disease.Methods.In 2015, for the first time, the Pan American Health Organization (PAHO) included human cases of leptospirosis in its Regional Core Health Data Initiative, an open-access database that collects annual health indicators from the countries and territories of the Americas. This new information was used to analyze leptospirosis cases by country and sex and to calculate cumulative incidence rates. Maps were used to help present the results. To supplement that general review of leptospirosis in the Americas, more detailed descriptions of the epidemiological situation and the surveillance programs of four selected countries (Brazil, Colombia, Cuba, and Honduras) were provided.Results.In this first year of PAHO requesting leptospirosis data, of the 49 countries and territories in the Americas, 38 of them (77.6%) reported information. Among those 38, 28 of them (73.7%) reported the presence of human cases; the majority of instances of zero cases were in Caribbean territories. From those 28, a total of 10 702 human cases were recorded. The largest numbers of cases in Latin America were in Brazil (40.2%), Peru (23.6%), Colombia (8.8%), and Ecuador (7.2%). The cumulative incidence rate for Latin America was estimated to be 2.0 per 100 000 population. On average, 65.1% of cases were males.Conclusions.This study demonstrates that many countries in Latin America are making efforts to establish strong surveillance systems and programs for leptospirosis. The study also shows the importance of having leptospirosis surveillance systems as well as how the information generated can be used for evidence-based decision-making on leptospirosis.

scholarly journals Retrospective Analysis of Chilean and Mexican GI Stromal Tumor Registries: A Tale of Two Latin American Realities

2020 ◽  
pp. 647-657
Author(s):  
Germán Calderillo ◽  
Matías Muñoz-Medel ◽  
Edelmira Carbajal ◽  
Miguel Córdova-Delgado ◽  
Doris Durán ◽  
...  
Keyword(s):  
Latin America ◽  
Retrospective Analysis ◽  
Latin American ◽  
Clinical Characteristics ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Tumor Location ◽  
Incidence Rates ◽  
Stage At Diagnosis ◽  
Risk Of Recurrence

PURPOSE Like other malignancies, GI stromal tumors (GIST) are highly heterogeneous. This not only applies to histologic features and malignant potential, but also to geographic incidence rates. Several studies have reported GIST incidence and prevalence in Europe and North America. In contrast, GIST incidence rates in South America are largely unknown, and only a few studies have reported GIST prevalence in Latin America. PATIENTS AND METHODS Our study was part of a collaborative effort between Chile and Mexico, called Salud con Datos. We sought to determine GIST prevalence and patients’ clinical characteristics, including survival rates, through retrospective analysis. RESULTS Overall, 624 patients were included in our study. Our results found significant differences between Mexican and Chilean registries, such as stage at diagnosis, primary tumor location, CD117-positive immunohistochemistry status, mitotic index, and tumor size. Overall survival (OS) times for Chilean and Mexican patients with GIST were 134 and 156 months, respectively. No statistically significant differences in OS were detected by sex, age, stage at diagnosis, or recurrence status in both cohorts. As expected, patients categorized as being at high risk of recurrence displayed a trend toward poorer progression-free survival in both registries. CONCLUSION To the best of our knowledge, this is the largest report from Latin America assessing the prevalence, clinical characteristics, postsurgery risk of recurrence, and outcomes of patients with GIST. Our data confirm surgery as the standard treatment of localized disease and confirm a poorer prognosis in patients with regional or distant disease. Finally, observed differences between registries could be a result of registration bias.

scholarly journals Economic Impact of Pneumococcal Protein-D Conjugate Vaccine (PHiD-CV) on the Malaysian National Immunization Programme

2014 ◽  
Vol 3 ◽  
pp. 146-155 ◽  
Author(s):  
Syed Aljunid ◽  
Namaitijiang Maimaiti ◽  
Zafar Ahmed ◽  
Amrizal Muhammad Nur ◽  
Zaleha Md Isa ◽  
...  
Keyword(s):  
Economic Impact ◽  
Conjugate Vaccine ◽  
Immunization Programme ◽  
National Immunization ◽  
National Immunization Programme

scholarly journals Evaluation of the indirect impact of the 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine in a cluster-randomised trial

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261750
Author(s):  
Hanna Rinta-Kokko ◽  
Arto A. Palmu ◽  
Esa Ruokokoski ◽  
Heta Nieminen ◽  
Marta Moreira ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Conjugate Vaccine ◽  
Invasive Pneumococcal Disease ◽  
Vaccination Coverage ◽  
Indirect Effects ◽  
Pneumococcal Disease ◽  
Incidence Rates ◽  
Cluster Randomised ◽  
Indirect Impact ◽  
Catch Up

Background In the nation-wide double-blind cluster-randomised Finnish Invasive Pneumococcal disease trial (FinIP, ClinicalTrials.gov NCT00861380, NCT00839254), we assessed the indirect impact of the 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) against five pneumococcal disease syndromes. Methods Children 6 weeks to 18 months received PHiD-CV10 in 48 clusters or hepatitis B/A-vaccine as control in 24 clusters according to infant 3+1/2+1 or catch-up schedules in years 2009―2011. Outcome data were collected from national health registers and included laboratory-confirmed and clinically suspected invasive pneumococcal disease (IPD), hospital-diagnosed pneumonia, tympanostomy tube placements (TTP) and outpatient antimicrobial prescriptions. Incidence rates in the unvaccinated population in years 2010―2015 were compared between PHiD-CV10 and control clusters in age groups <5 and ≥5 years (5―7 years for TTP and outpatient antimicrobial prescriptions), and in infants <3 months. PHiD-CV10 was introduced into the Finnish National Vaccination Programme (PCV-NVP) for 3-month-old infants without catch-up in 9/2010. Results From 2/2009 to 10/2010, 45398 children were enrolled. Vaccination coverage varied from 29 to 61% in PHiD-CV10 clusters. We detected no clear differences in the incidence rates between the unvaccinated cohorts of the treatment arms, except in single years. For example, the rates of vaccine-type IPD, non-laboratory-confirmed IPD and empyema were lower in PHiD-CV10 clusters compared to control clusters in 2012, 2015 and 2011, respectively, in the age-group ≥5 years. Conclusions This is the first report from a clinical trial evaluating the indirect impact of a PCV against clinical outcomes in an unvaccinated population. We did not observe consistent indirect effects in the PHiD-CV10 clusters compared to the control clusters. We consider that the sub-optimal trial vaccination coverage did not allow the development of detectable indirect effects and that the supervening PCV-NVP significantly diminished the differences in PHiD-CV10 vaccination coverage between the treatment arms.

scholarly journals Impact of 10-valent pneumococcal conjugate vaccine on pneumococcal meningitis in children up to two years of age in Brazil

2015 ◽  
Vol 31 (2) ◽  
pp. 276-284 ◽  
Author(s):  
Indianara Maria Grando ◽  
Camile de Moraes ◽  
Brendan Flannery ◽  
Walter Massa Ramalho ◽  
Marco Aurélio P. Horta ◽  
...  
Keyword(s):  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Pneumococcal Meningitis ◽  
Incidence Rates ◽  
Morbidity And Mortality ◽  
Ecological Analysis ◽  
Post Vaccination ◽  
Meningitis In Children ◽  
Using Data ◽  
The Impact

The objective of this study was to analyze the impact of vaccination against Streptococcus pneumoniae on the morbidity and mortality from pneumococcal meningitis in children ≤ 2 years in Brazil, from 2007 to 2012. This is a descriptive study and ecological analysis using data from the Information System on Notifiable Diseases. Pre-vaccination (2007-2009) and post-vaccination (2011-2012) periods were defined to compare incidence rates and mortality. A total of 1,311 cases and 430 deaths were reported during the study period. Incidence decreased from 3.70/100,000 in 2007 to 1.84/100,000 in 2012, and mortality decreased from 1.30/100,000 to 0.40/100,000, or 50% and 69% respectively, with the greatest impact in the 6-11 month age group. This decrease in Pneumococcal meningitis morbidity and mortality rates two years after introduction of the 10-valent pneumococcal conjugate vaccine suggests its effectiveness.

scholarly journals Noninvasive Pneumococcal Clones Associated with Antimicrobial Nonsusceptibility Isolated from Children in the Era of Conjugate Vaccines

2015 ◽  
Vol 59 (9) ◽  
pp. 5761-5767 ◽  
Author(s):  
Martha McElligott ◽  
Imelda Vickers ◽  
Mary Meehan ◽  
Mary Cafferkey ◽  
Robert Cunney ◽  
...  
Keyword(s):  
Conjugate Vaccine ◽  
Clonal Complex ◽  
Treatment Strategies ◽  
Significant Decline ◽  
High Rate ◽  
Immunization Schedule ◽  
Childhood Immunization ◽  
Conjugate Vaccines ◽  
Vaccine Introduction ◽  
Single Locus Variant

ABSTRACTCarriage and noninvasive pneumococcal isolates frequently have a higher prevalence of antimicrobial nonsusceptibility than invasive isolates. From 2009 to 2014, we determined the associated clones in 169 pediatric noninvasive nonsusceptible pneumococci from a total of 506 isolates collected after 7- and 13-valent conjugate vaccine introduction (PCV7/13) to the Irish childhood immunization schedule in 2008 and 2010, respectively. We compared our results to those from 25 noninvasive pediatric pneumococcal isolates collected in 2007, the year before introduction of conjugate vaccines. In 2007, England14-9 and Spain9V-3 accounted for 12% and 32% of nonsusceptible clones, respectively, but in 2009 to 2014, their prevalence fell to 0% and 2.4%. Furthermore, there was a significant decline in Spain6B-2 and its variants from 2009 to 2014 (P= 0.0024). Fluctuations occurred in clonal complex 320 associated with serotype 19A. The prevalence of Sweden15A-25 and its variants and ST558 (a single-locus variant of Utah35B-24) associated with nonvaccine serotypes (NVT) 15A and 35B increased from 0% and 8% in 2007 to 19% and 16% in 2013 to 2014, respectively. Pilus locus 1 (PI-1) is associated with the spread of some nonsusceptible pneumococcal clones. PI-1 was more frequently associated with PCV7/13 serotypes than NVT (P= 0.0020). Our data highlight the value of surveillance of noninvasive pneumococci following conjugate vaccine introduction. Importantly, emerging clones associated with NVT may limit the effectiveness of PCV7/13 in reducing the high rate of nonsusceptibility among pediatric noninvasive pneumococci, with implications for empirical treatment strategies.

scholarly journals The epidemiology of meningococcal disease in Latin America 1945–2010: an unpredictable and changing landscape

2012 ◽  
Vol 141 (3) ◽  
pp. 447-458 ◽  
Author(s):  
M. A. P. SÁFADI ◽  
S. GONZÁLEZ-AYALA ◽  
A. JÄKEL ◽  
H. WIEFFER ◽  
C. MORENO ◽  
...  
Keyword(s):  
Latin America ◽  
Meningococcal Disease ◽  
Epidemiological Data ◽  
Invasive Disease ◽  
Incidence Rates ◽  
Surveillance Systems ◽  
Reported Data ◽  
Over Time ◽  
Made In

SUMMARYMeningococcal disease is mostly endemic in Latin America, with periodic occurrences of outbreaks and epidemics over the last few decades. This literature review summarizes the available epidemiological data for this region between 1945 and 2010. Incidence rates and serogroup distribution differ from country to country and over time. Serogroups A, B, and C have all been major causes of meningococcal disease since the 1970s. In the last decade serogroups W135 and Y may now be emerging in certain countries, with serogroup A virtually disappearing. Although progress has been made in improving and coordinating the surveillance of invasive disease, the uniformity and quality of reported data reflect the fact that the current surveillance systems focus on passive rather than active reporting, hence the reliability of data may vary between countries. Consideration of vaccination policies to control meningococcal disease can only be made with a sufficient understanding of the changing epidemiology in the region.

scholarly journals International collaboration among medical societies is an effective way to boost Latin American production of articles on tuberculosis

2019 ◽  
Vol 45 (2) ◽  
Author(s):  
Giovanni Battista Migliori ◽  
Rosella Centis ◽  
Lia D’Ambrosio ◽  
Denise Rossato Silva ◽  
Adrian Rendon
Keyword(s):  
Latin America ◽  
Latin American ◽  
Incidence Rates ◽  
World Health ◽  
European Respiratory Society ◽  
Tuberculosis Incidence ◽  
Resistant Tuberculosis ◽  
Medical Societies ◽  
Mdr Tb ◽  
The Impact

ABSTRACT Objective: Most studies of tuberculosis originate from high-income countries with a low incidence of tuberculosis. A review of the scientific production on tuberculosis in Latin American countries, most of which are low- or middle-income countries (some with high or intermediate tuberculosis incidence rates), would improve the understanding of public health challenges, clinical needs, and research priorities. The aims of this systematic review were to determine what has been published recently in Latin America, to identify the leading authors involved, and to quantify the impact of international collaborations. Methods: We used PubMed to identify relevant manuscripts on pulmonary tuberculosis (PTB), drug-resistant tuberculosis (DR-TB), or multidrug-resistant tuberculosis (MDR-TB), published between 2013 and 2018. We selected only studies conducted in countries with an annual tuberculosis incidence of ≥ 10,000 reported cases and an annual MDR-TB incidence of ≥ 300 estimated cases, including Brazil, Peru, Mexico, Colombia, and Argentina. Articles were stratified by country, type, and topic. Results: We identified as eligible 395 studies on PTB and 188 studies on DR/MDR-TB-of which 96.4% and 96.8%, respectively, were original studies; 35.5% and 32.4%, respectively, had an epidemiological focus; and 52.7% and 36.2%, respectively, were conducted in Brazil. The recent Latin American Thoracic Association/European Respiratory Society/Brazilian Thoracic Association collaborative project boosted the production of high-quality articles on PTB and DR/MDR-TB in Latin America. Conclusions: Most of the recent Latin American studies on tuberculosis were conducted in Brazil, Mexico, or Peru. Collaboration among medical societies facilitates the production of scientific papers on tuberculosis. Such initiatives are in support of the World Health Organization call for intensified research and innovation in tuberculosis.

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