Malaria: epidemiology, pregnancy, and pediatric infections

RTS,S/AS01 is the most advanced vaccine to prevent malaria. It is safe and moderately effective. A large pivotal phase III trial in over 15 000 young children in sub-Saharan Africa completed in 2014 showed that the vaccine could protect around one-third of children (aged 5–17 months) and one-fourth of infants (aged 6–12 weeks) from uncomplicated falciparum malaria. The European Medicines Agency approved licensing and programmatic roll-out of the RTSS vaccine in malaria endemic countries in sub-Saharan Africa. WHO is planning further studies in a large Malaria Vaccine Implementation Programme, in more than 400 000 young African children. With the changing malaria epidemiology in Africa resulting in older children at risk, alternative modes of employment are under evaluation, for example the use of RTS,S/AS01 in older children as part of seasonal malaria prophylaxis. Another strategy is combining mass drug administrations with mass vaccine campaigns for all age groups in regional malaria elimination campaigns. A phase II trial is ongoing to evaluate the safety and immunogenicity of the RTSS in combination with antimalarial drugs in Thailand. Such novel approaches aim to extract the maximum benefit from the well-documented, short-lasting protective efficacy of RTS,S/AS01.

Download Full-text

Antibiotic Options for Treatment of Pediatric Infections with Enterobacteriaceae Producing Broad Spectrum Beta-Lactamases

Anti-Infective Agents ◽

10.2174/2211362611208020130 ◽

2012 ◽

Vol 10 (2) ◽

pp. 130-135

Author(s):

Xuan Qin ◽

Emmanouil Galanakis ◽

Danielle M. Zerr ◽

Scott J. Weissman

Keyword(s):

Broad Spectrum ◽

Beta Lactamases ◽

Pediatric Infections

Download Full-text

IFN-λ4 is associated with increased risk and earlier occurrence of several common infections in African children

Genes and Immunity ◽

10.1038/s41435-021-00127-7 ◽

2021 ◽

Author(s):

Ludmila Prokunina-Olsson ◽

Robert D. Morrison ◽

Adeola Obajemu ◽

Almahamoudou Mahamar ◽

Sungduk Kim ◽

...

Keyword(s):

Respiratory Infections ◽

Genomic Region ◽

First Episode ◽

Genetic Associations ◽

Gastrointestinal Infections ◽

Type Iii ◽

Functional Variants ◽

Younger Age ◽

Increased Risk ◽

Pediatric Infections

AbstractGenetic polymorphisms within the IFNL3/IFNL4 genomic region, which encodes type III interferons, have been strongly associated with clearance of hepatitis C virus. We hypothesized that type III interferons might be important for the immune response to other pathogens as well. In a cohort of 914 Malian children, we genotyped functional variants IFNL4-rs368234815, IFNL4-rs117648444, and IFNL3-rs4803217 and analyzed episodes of malaria, gastrointestinal, and respiratory infections recorded at 30,626 clinic visits from birth up to 5 years of age. Compared to children with the rs368234815-TT/TT genotype (IFN-λ4-Null), rs368234815-dG allele was most strongly associated with an earlier time-to-first episode of gastrointestinal infections (p = 0.003). The risk of experiencing an infection episode during the follow-up was also significantly increased with rs368234815-dG allele, with OR = 1.53, 95%CI (1.13–2.07), p = 0.005 for gastrointestinal infections and OR = 1.30, 95%CI (1.02–1.65), p = 0.033 for malaria. All the associations for the moderately linked rs4803217 (r2 = 0.78 in this set) were weaker and lost significance after adjusting for rs368234815. We also analyzed all outcomes in relation to IFN-λ4-P70S groups. Our results implicate IFN-λ4 and not IFN-λ3 as the primary functional cause of genetic associations with increased overall risk and younger age at first clinical episodes but not with recurrence or intensity of several common pediatric infections.

Download Full-text

Antibiotic Resistance in Pediatric Infections: Global Emerging Threats, Predicting the Near Future

Antibiotics ◽

10.3390/antibiotics10040393 ◽

2021 ◽

Vol 10 (4) ◽

pp. 393

Author(s):

Alessandra Romandini ◽

Arianna Pani ◽

Paolo Andrea Schenardi ◽

Giulia Angela Carla Pattarino ◽

Costantino De Giacomo ◽

...

Keyword(s):

Antibiotic Resistance ◽

Pediatric Population ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Pediatric Age ◽

Carbapenem Resistant ◽

Pediatric Infections ◽

Surgical Treatments ◽

Developing System ◽

Near Future

Antibiotic resistance is a public health threat of the utmost importance, especially when it comes to children: according to WHO data, infections caused by multidrug resistant bacteria produce 700,000 deaths across all ages, of which around 200,000 are newborns. This surging issue has multipronged roots that are specific to the pediatric age. For instance, the problematic overuse and misuse of antibiotics (for wrong diagnoses and indications, or at wrong dosage) is also fueled by the lack of pediatric-specific data and trials. The ever-evolving nature of this age group also poses another issue: the partly age-dependent changes of a developing system of cytochromes determine a rather diverse population in terms of biochemical characteristics and pharmacokinetics profiles, hard to easily codify in an age- or weight-dependent dosage. The pediatric population is also penalized by the contraindications of tetracyclines and fluoroquinolones, and by congenital malformations which often require repeated hospitalizations and pharmacological and surgical treatments from a very young age. Emerging threats for the pediatric age are MRSA, VRSA, ESBL-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae and the alarming colistin resistance. Urgent actions need to be taken in order to step back from a now likely post-antibiotic era, where simple infections might cause infant death once again.

Download Full-text