Impact of Rotavirus Vaccine Introduction in Children Less Than 2 Years of Age Presenting for Medical Care With Diarrhea in Rural Matlab, Bangladesh

Abstract Background Following the conclusion of a human rotavirus vaccine (HRV) cluster-randomized, controlled trial (CRT) in Matlab, Bangladesh, HRV was included in Matlab’s routine immunization program. We describe the population-level impact of programmatic rotavirus vaccination in Bangladesh in children <2 years of age. Methods Interrupted time series were used to estimate the impact of HRV introduction. We used diarrheal surveillance collected between 2000 and 2014 within the 2 service delivery areas (International Centre for Diarrhoeal Disease Research, Bangladesh [icddr,b] service area [ISA] and government service area [GSA]) of the Matlab Health and Demographic Surveillance System, administered by icddr,b. Age group–specific incidence rates were calculated for both rotavirus-positive (RV+) and rotavirus-negative (RV–) diarrhea diagnoses of any severity presenting to the hospital. We used 2 models to assess the impact within each service area: Model 1 used the pre-vaccine time period in all villages (HRV– and control-only) and Model 2 combined the pre-vaccine time period and the CRT time period, using outcomes from control-only villages. Results Both models demonstrated a downward trend in RV+ diarrheal incidences in the ISA villages during 3.5 years of routine HRV use, though only Model 2 was statistically significant. Significant impacts of HRV on RV+ diarrhea incidences in GSA villages were not observed in either model. Differences in population-level impacts between the 2 delivery areas may be due to the varied rotavirus vaccine coverage and presentation rates to the hospital. Conclusions This study provides initial evidence of the population-level impact of rotavirus vaccines in children <2 years of age in Matlab, Bangladesh. Further studies are needed of the rotavirus vaccine impact after the nationwide introduction in Bangladesh.

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Possible Impact of Wide-scale Vaccination Against Serogroup B Neisseria Meningitidis on Gonorrhea Incidence Rates in One Region of Quebec, Canada

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx180.002 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S734-S735 ◽

Cited By ~ 7

Author(s):

Jean Longtin ◽

Rejean Dion ◽

Marc Simard ◽

Jean-Francois Betala Belinga ◽

Yves Longtin ◽

...

Keyword(s):

Neisseria Meningitidis ◽

Vaccine Coverage ◽

Vaccination Campaign ◽

Age Groups ◽

Incidence Rates ◽

Study Objective ◽

Grant Recipient ◽

Invasive Infections ◽

Wide Scale ◽

The Impact

Abstract Background Owing to a persistent increase of serogroup B Neisseria meningitidis (Nm) invasive infections in the Saguenay-Lac-Saint-Jean (SLSJ) region of the province of Quebec (Canada) since 2006, a wide-scale vaccination campaign of individuals aged 6 months to 20 years was conducted between May and December 2014 using the 4-component protein-based meningococcus serogroup B vaccine (4CMenB). Components of this vaccine have shown to potentially cross-react with Neisseria gonorrhoeae (Ng). The study objective was to assess the impact of the vaccination campaign on Ng incidence rate (IR). Methods Ng cases notified to public health authorities during prevaccination period (January 2006 to June 2014) and postvaccination period (July 2014 to June 2017) were analyzed. The impact of this mass campaign was estimated by a Poisson regression model, including the year (11 July–June categories), age (14–20 vs. 21 years and older), and the intervention (0 by default and 1 in those 14–20 years in the period of July 2014 to June 2017). Results Overall vaccine coverage was 82% in the target group. A total of 231 Ng cases were reported among persons 14 years and older (IR: 8.4/100,000 person-years) of the SLSJ region from January 2006 to June 2017. A decrease in the Ng number of cases and IR among individuals 14–20 years was observed during the post-vaccination period whereas it increased in those 21 years and older (figure). Estimate of vaccination impact was an Ng risk reduction of 59% (95% CI: −22% to 84%; P = 0.1). During the same period, Chlamydia trachomatis (Ct) infections increased among persons of both age groups in the SLSJ region. Conclusion Although the estimate of the impact of the campaign was not statistically significant, possibly due to limited size of the study population and the low incidence of the disease, it is congruent with results of a case–control study in New Zealand showing an OMV-MeNZB vaccine effectiveness of 31%. A higher effectiveness of 4CMenB is a plausible hypothesis as three additional proteins also found in Ng are included in the vaccine used in the SLSJ region. The results of this ecologic study suggest cross-protection of 4CMenB vaccine against Ng infections. Further studies on this topic are warranted. Disclosures P. De Wals, GlaxoSmithKline: Grant Investigator and Scientific Advisor, Grant recipient and travel expenses. Pfizer: Grant Investigator and Scientific Advisor, Grant recipient and travel expenses. Sanofi-Pasteur: Grant Investigator and Scientific Advisor, Grant recipient and travel expenses. Novartis: Grant Investigator and Scientific Advisor, Grant recipient and travel expenses.

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Impact of vaccination on the incidence of measles in Mozambique in the period 2000 to 2011

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2013000200013 ◽

2013 ◽

Vol 29 (2) ◽

pp. 257-269 ◽

Cited By ~ 2

Author(s):

Artur Manuel Muloliwa ◽

Luiz Antonio Bastos Camacho ◽

José Fernando Souza Verani ◽

Taynãna César Simões ◽

Martinho do Carmo Dgedge

Keyword(s):

Vaccine Coverage ◽

Incidence Rates ◽

Measles Elimination ◽

High Incidence ◽

Maputo City ◽

Measles Vaccination ◽

Coverage Rates ◽

Vaccination Campaigns ◽

Measles Incidence ◽

The Impact

The aim of this study was to contribute to the better planning of measles elimination actions in Mozambique, by considering the impact of vaccination actions over the period 2000 to 2011. Descriptive and ecological studies and case records made available by the Ministry of Health were used to analyze measles vaccination coverage. Statistical analysis was performed using time series and spatial analysis. Vaccine coverage rates ranged from 82% to 99%. Coverage rates in Maputo city were under 70% and in Niassa province they were over 100%. Coverage showed a clustered pattern in the districts. The measles incidence rate was 1.58 per 100,000 inhabitants (0.00-40.08 per 100,000 inhabitants); districts bordering neighboring countries presented high incidence rates. Although measles morbidity and mortality has decreased in Mozambique, vaccine coverage has been insufficient to interrupt measles transmission. Enhanced surveillance, including investigation of cases and outbreaks, and improvements in measles vaccination are recommended in order to achieve a homogenous coverage rate of ≥ 95% for both routine and mass vaccination campaigns.

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Diarrheal Diseases Hospitalization in Yemen before and after Rotavirus Vaccination

Scientifica ◽

10.1155/2016/8485417 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Mohammed Amood AL-Kamarany ◽

Lina Al-Areqi ◽

Abulatif Mujally ◽

Fawzya Alkarshy ◽

Arwa Nasser ◽

...

Keyword(s):

Vaccine Coverage ◽

Rotavirus Vaccine ◽

Diarrheal Diseases ◽

Predominant Genotype ◽

Fecal Samples ◽

Vaccine Introduction ◽

Rotavirus Vaccination ◽

Before And After ◽

Rotavirus Diarrhea ◽

The Impact

The study aims to assess the impact of rotavirus vaccine introduction on diarrheal diseases hospitalization and to identify the rotavirus genotypes most prevalent before and after vaccine introduction among children ≤ 5 years of age. Rotarix™® rotavirus vaccine is currently licensed for infants in Yemen and was introduced in 2012. The vaccination course consists of two doses. The first dose is administrated at 6 weeks of age and the second dose is completed by 10 weeks. Based on a longitudinal observational study, we assessed the impact of vaccination on rotavirus hospitalization before and after vaccination among children ≤ 5 years of age at the Yemeni-Swedish Hospital (YSH) in Taiz, Yemen. Prevaccination covered January 2009–July 2012 during which 2335 fecal samples were collected from children ≤ 5 years old. Postvaccination covered January 2013–December 2014 during which 1114 fecal samples were collected. Rotavirus was detected by Enzyme Linkage Immunosorbent Assay (ELISA). The incidence ofrotavirushospitalization decreased from 43.79% in 2009 to 10.54% in 2014. Hospitalization due to rotavirus diarrhea was reduced by 75.93%. Vaccine coverage increased from 23% in 2012 to 72% in 2014. Also, the results showed that the most predominant genotypes in prevaccination period were G2P[4] (55.0%), followed by G1P[8] (15.0%), while in postvaccination period G1P[8] (31%) was the predominant genotype, followed by G9P[8] (27.5%). In conclusion, rotavirus vaccination in Yemen resulted in sharp reduction in diarrheal hospitalization. A successful rotavirus vaccination program in Yemen will rely upon efficient vaccine delivery systems and sustained vaccine efficacy against diverse and evolving rotavirus strains.

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Impact of azithromycin mass drug administration on the antibiotic-resistant gut microbiome: a randomized, controlled trial

10.1101/2021.03.02.20215632 ◽

2021 ◽

Author(s):

Harry Pickering ◽

John D. Hart ◽

Sarah Burr ◽

Richard Stabler ◽

Ken Maleta ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Drug Administration ◽

Mass Drug Administration ◽

Gut Microbiome ◽

Controlled Trial ◽

Diarrhoeal Disease ◽

Childhood Mortality ◽

Resistant Bacteria ◽

Clinical Benefits ◽

The Impact

AbstractBackgroundMass drug administration (MDA) with azithromycin is the primary strategy for global trachoma control efforts. Numerous studies have reported secondary effects of MDA with azithromycin, including reductions in childhood mortality, diarrhoeal disease and malaria. Most recently, the MORDOR clinical trial demonstrated that MDA led to an overall reduction in all-cause childhood mortality in targeted communities. There is however concern about the potential of increased antimicrobial resistance in treated communities.MethodsThis study evaluated the impact of azithromycin MDA on the prevalence of gastrointestinal carriage of macrolide-resistant bacteria in communities within the MORDOR Malawi study, additionally profiling changes in the gut microbiome after treatment. For faecal metagenomics, 60 children were sampled prior to treatment and 122 children after four rounds of MDA, half receiving azithromycin and half placebo.FindingsThe proportion of bacteria carrying macrolide resistance increased after azithromycin treatment; the effect was enhanced in children treated within six months of sampling. Diversity and global community structure of the gut was minimally impacted by treatment, however abundance of several species was altered by treatment. Notably, the putative human enteropathogen Escherichia albertii was more abundant after treatment.InterpretationThe impacts of MDA with azithromycin, including increased carriage of macrolide-resistant bacteria, were enhanced in children treated more recently, suggesting effects may be transient. Increased abundance of enteropathogenic Escherichia species after treatment requires further, higher resolution investigation. Future studies should focus on the number of treatments and administration schedule to ensure clinical benefits continue to outweigh costs in antimicrobial resistance carriage.FundingBill and Melinda Gates Foundation

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Long time frames to detect the impact of changing COVID-19 measures, Canada, March to July 2020

Eurosurveillance ◽

10.2807/1560-7917.es.2021.26.40.2001204 ◽

2021 ◽

Vol 26 (40) ◽

Author(s):

Jessica E Stockdale ◽

Renny Doig ◽

Joosung Min ◽

Nicola Mulberry ◽

Liangliang Wang ◽

...

Keyword(s):

Population Level ◽

Time Frame ◽

Control Measures ◽

Type Model ◽

Time Period ◽

Long Time ◽

The Mean ◽

Reported Data ◽

Time Frames ◽

The Impact

Background Many countries have implemented population-wide interventions to control COVID-19, with varying extent and success. Many jurisdictions have moved to relax measures, while others have intensified efforts to reduce transmission. Aim We aimed to determine the time frame between a population-level change in COVID-19 measures and its impact on the number of cases. Methods We examined how long it takes for there to be a substantial difference between the number of cases that occur following a change in COVID-19 physical distancing measures and those that would have occurred at baseline. We then examined how long it takes to observe this difference, given delays and noise in reported cases. We used a susceptible-exposed-infectious-removed (SEIR)-type model and publicly available data from British Columbia, Canada, collected between March and July 2020. Results It takes 10 days or more before we expect a substantial difference in the number of cases following a change in COVID-19 control measures, but 20–26 days to detect the impact of the change in reported data. The time frames are longer for smaller changes in control measures and are impacted by testing and reporting processes, with delays reaching ≥ 30 days. Conclusion The time until a change in control measures has an observed impact is longer than the mean incubation period of COVID-19 and the commonly used 14-day time period. Policymakers and practitioners should consider this when assessing the impact of policy changes. Rapid, consistent and real-time COVID-19 surveillance is important to minimise these time frames.

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Measuring Social Movement Organization Populations: A Comprehensive Census of U.S. Environmental Movement Organizations

Mobilization An International Quarterly ◽

10.17813/maiq.12.3.j08421508773764m ◽

2007 ◽

Vol 12 (3) ◽

pp. 255-270 ◽

Cited By ~ 27

Author(s):

Robert Brulle ◽

Liesel Turner ◽

Jason Carmichael ◽

J. Jenkins

Keyword(s):

Population Level ◽

Environmental Movement ◽

Organizational Studies ◽

Population Parameters ◽

Multiple Sources ◽

Time Period ◽

Movement Organization ◽

Movement Organizations ◽

The Impact ◽

Different Sources

Population-level analyses of SMOs typically have relied on a single source for data, most commonly the Encyclopedia of Associations (EoA). However, the validity of this procedure has been drawn into question by recent organizational studies. To examine the impact of using different sources to estimate SMO populations, we compile a comprehensive population dataset of national and regional U.S. environmental movement organizations (or EMOs) over a 100-year time period using 155 different sources. We use this data to evaluate the accuracy and selection biases in five major compilations of U.S. EMOs. The analysis shows that all single sources are selective, tapping specific sections of the environmental movement. Multiple sources are needed to capture a comprehensive population of EMOs. Researchers should be aware of the limitations of specific sources before drawing conclusions about population parameters.

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Impact of Rotavirus Vaccine on Premature Infants

Clinical and Vaccine Immunology ◽

10.1128/cvi.00265-14 ◽

2014 ◽

Vol 21 (10) ◽

pp. 1404-1409 ◽

Cited By ~ 16

Author(s):

Jean-Michel Roué ◽

Emmanuel Nowak ◽

Grégoire Le Gal ◽

Thomas Lemaitre ◽

Emmanuel Oger ◽

...

Keyword(s):

Premature Infants ◽

Vaccine Coverage ◽

Vaccination Campaign ◽

University Hospital ◽

Vaccination Program ◽

National Study ◽

Rotavirus Vaccine ◽

Term Infants ◽

Rotavirus Diarrhea ◽

The Impact

ABSTRACTInfants born preterm are at a higher risk of complications and hospitalization in cases of rotavirus diarrhea than children born at term. We evaluated the impact of a rotavirus vaccination campaign (May 2007 to May 2010) on hospitalizations for rotavirus gastroenteritis in a population of children under 3 years old born prematurely (before 37 weeks of gestation) in the Brest University Hospital birth zone. Active surveillance from 2002 to 2006 and a prospective collection of hospitalizations for rotavirus diarrhea were initiated in the pediatric units of Brest University Hospital until May 2010. Numbers of hospitalizations for rotavirus diarrhea among the population of children born prematurely, before and after the start of the vaccination program, were compared using a Poisson regression model controlling for epidemic-to-epidemic variation. A total of 217 premature infants were vaccinated from 2007 to 2010. Vaccine coverage for a complete course of three doses was 41.9%. The vaccine safety in premature infants was similar to that in term infants. The vaccination program led to a division by a factor of 2.6 (95% confidence interval [CI], 1.3 to 5.2) in the number of hospitalizations for rotavirus diarrhea during the first two epidemic seasons following vaccine introduction and by a factor of 11 (95% CI, 3.5 to 34.8) during the third season. We observed significant effectiveness of the pentavalent rotavirus vaccine on the number of hospitalizations in a population of prematurely born infants younger than 3 years of age. A multicenter national study would provide better assessment of this impact. (This study [Impact of Systematic Infants Vaccination Against Rotavirus on Gastroenteritis Hospitalization: a Prospective Study in Brest District, France (IVANHOE)] has been registered at ClinicalTrials.gov under registration no. NCT00740935.)

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Impact of azithromycin mass drug administration on the antibiotic-resistant gut microbiome in children: a randomized, controlled trial

Gut Pathogens ◽

10.1186/s13099-021-00478-6 ◽

2022 ◽

Vol 14 (1) ◽

Author(s):

Harry Pickering ◽

John D. Hart ◽

Sarah Burr ◽

Richard Stabler ◽

Ken Maleta ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Drug Administration ◽

Mass Drug Administration ◽

Gut Microbiome ◽

Controlled Trial ◽

Diarrhoeal Disease ◽

Childhood Mortality ◽

Resistant Bacteria ◽

Clinical Benefits ◽

The Impact

Abstract Background Mass drug administration (MDA) with azithromycin is the primary strategy for global trachoma control efforts. Numerous studies have reported secondary effects of MDA with azithromycin, including reductions in childhood mortality, diarrhoeal disease and malaria. Most recently, the MORDOR clinical trial demonstrated that MDA led to an overall reduction in all-cause childhood mortality in targeted communities. There is however concern about the potential of increased antimicrobial resistance in treated communities. This study evaluated the impact of azithromycin MDA on the prevalence of gastrointestinal carriage of macrolide-resistant bacteria in communities within the MORDOR Malawi study, additionally profiling changes in the gut microbiome after treatment. For faecal metagenomics, 60 children were sampled prior to treatment and 122 children after four rounds of MDA, half receiving azithromycin and half placebo. Results The proportion of bacteria carrying macrolide resistance increased after azithromycin treatment. Diversity and global community structure of the gut was minimally impacted by treatment, however abundance of several species was altered by treatment. Notably, the putative human enteropathogen Escherichia albertii was more abundant after treatment. Conclusions MDA with azithromycin increased carriage of macrolide-resistant bacteria, but had limited impact on clinically relevant bacteria. However, increased abundance of enteropathogenic Escherichia species after treatment requires further, higher resolution investigation. Future studies should focus on the number of treatments and administration schedule to ensure clinical benefits continue to outweigh costs in antimicrobial resistance carriage. Trial registration ClinicalTrial.gov, NCT02047981. Registered January 29th 2014, https://clinicaltrials.gov/ct2/show/NCT02047981

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Long time frames to detect the impact of changing COVID-19 control measures

10.1101/2020.06.14.20131177 ◽

2020 ◽

Author(s):

Jessica E Stockdale ◽

Renny Doig ◽

Joosung Min ◽

Nicola Mulberry ◽

Liangliang Wang ◽

...

Keyword(s):

Population Level ◽

Time Frame ◽

Control Measures ◽

Policy Makers ◽

Time Period ◽

Reporting Process ◽

Long Time ◽

The Mean ◽

Time Frames ◽

The Impact

AbstractBackgroundMany countries have implemented population-wide interventions such as physical distancing measures, in efforts to control COVID-19. The extent and success of such measures has varied. Many jurisdictions with declines in reported COVID-19 cases are moving to relax measures, while others are continuing to intensify efforts to reduce transmission.AimWe aim to determine the time frame between a change in COVID-19 measures at the population level and the observable impact of such a change on cases.MethodsWe examine how long it takes for there to be a substantial difference between the cases that occur following a change in control measures and those that would have occurred at baseline. We then examine how long it takes to detect a difference, given delays and noise in reported cases. We use changes in population-level (e.g., distancing) control measures informed by data and estimates from British Columbia, Canada.ResultsWe find that the time frames are long: it takes three weeks or more before we might expect a substantial difference in cases given a change in population-level COVID-19 control, and it takes slightly longer to detect the impacts of the change. The time frames are shorter (11-15 days) for dramatic changes in control, and they are impacted by noise and delays in the testing and reporting process, with delays reaching up to 25-40 days.ConclusionThe time until a change in broad control measures has an observed impact is longer than is typically understood, and is longer than the mean incubation period (time between exposure than onset) and the often used 14 day time period. Policy makers and public health planners should consider this when assessing the impact of policy change, and efforts should be made to develop rapid, consistent real-time COVID-19 surveillance.

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A pilot randomised controlled trial of a web-based implementation intervention to increase child intake of fruit and vegetables within childcare centres

Pilot and Feasibility Studies ◽

10.1186/s40814-020-00707-w ◽

2020 ◽

Vol 6 (1) ◽

Cited By ~ 1

Author(s):

Courtney Barnes ◽

Alice Grady ◽

Nicole Nathan ◽

Luke Wolfenden ◽

Nicole Pond ◽

...

Keyword(s):

Healthy Eating ◽

Controlled Trial ◽

Implementation Strategies ◽

Population Level ◽

Type Ii ◽

Implementation Intervention ◽

Web Based ◽

Randomised Controlled ◽

Eating Practices ◽

The Impact

Abstract Background As dietary behaviours developed during early childhood are known to track into adulthood, interventions that aim to improve child nutrition at a population level are recommended. Whilst early childhood education and care (ECEC) is a promising setting for interventions targeting children’s nutrition behaviours, previous interventions have largely used high intensity, face-to-face approaches, limiting their reach, implementation and potential impact at a population level. Web-based modalities represent a promising means of supporting the delivery of childcare-based interventions whilst overcoming challenges of previous approaches; however, the feasibility of using such modalities to support implementation is largely unknown. As such, this study sought to collect feasibility and pilot data to inform the design of a web-based intervention together with health promotion officer support within childcare centres. Child dietary intake will also be assessed to provide an estimate of the impact of the implementation intervention. Methods A superiority cluster randomised controlled trial with repeat cross-sectional data collection employing an effectiveness-implementation type-II hybrid design will be conducted with childcare centres within the Hunter New England region of New South Wales, Australia. Type-II hybrid designs provide the opportunity to assess intervention efficacy whilst piloting the feasibility of the implementation strategies. Centres allocated to the intervention group will receive access to a web-based program together with health promotion officer support to implement targeted healthy eating practices to improve child diet in care. A number of outcomes will be assessed to inform the feasibility to conduct a larger trial, including childcare centre and parent recruitment and consent rates for each component of data collection, uptake of the implementation strategies, acceptability of the intervention and implementation strategies, appropriateness of the implementation strategies and the contextual factors influencing implementation. Discussion This study will provide high-quality evidence regarding the potential feasibility of a web-based intervention and the impact of healthy eating practices on child diet in care. Web-based modalities provide a promising approach for population-wide implementation support to childcare centres given their potential reach and consistency with existing infrastructure. Trial registration Prospectively registered with Australian New Zealand Clinical Trial Registry (ACTRN12619001158156).

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