scholarly journals Assessing the efficiency of catch-up campaigns for introduction of pneumococcal conjugate vaccine; a modelling study based on data from Kilifi, Kenya

2017 ◽  
Author(s):  
Stefan Flasche ◽  
John Ojal ◽  
Olivier Le Polain de Waroux ◽  
Mark Otiende ◽  
Katherine L. O’Brien ◽  
...  
Keyword(s):  
Pneumococcal Disease ◽  
Vaccine Coverage ◽  
Age Groups ◽  
World Health Organisation ◽  
World Health ◽  
Local Data ◽  
Herd Protection ◽  
Low Middle Income Countries ◽  
Dose Efficiency ◽  
Catch Up

AbstractBackgroundThe World Health Organisation recommends the use of catch-up campaigns as part of the introduction of pneumococcal conjugate vaccines (PCVs) to accelerate herd protection and hence PCV impact. The value of a catch-up campaign is a trade-off between the costs of vaccinating additional age groups and the benefit of additional direct and indirect protection. There is a paucity of observational data, particularly from low-middle income countries to quantify the optimal breadth of such catch-up campaigns.MethodsIn Kilifi, Kenya PCV10 was introduced in 2011 using the 3-dose EPI infant schedule and a catch-up campaign in children <5 years old. We fitted a transmission dynamic model to detailed local data including nasopharyngeal carriage and invasive pneumococcal disease (IPD) to infer the marginal impact of the PCV catch-up campaign over hypothetical routine cohort vaccination in that setting, and to estimate the likely impact of alternative campaigns and their dose-efficiency.ResultsWe estimated that, within 10 years of introduction, the catch-up campaign among <5y olds prevents an additional 65 (48 to 84) IPD cases, compared to PCV cohort introduction alone. Vaccination without any catch-up campaign prevented 155 (121 to 193) IPD cases and used 1321 (1058 to 1698) PCV doses per IPD case prevented. In the years after implementation, the PCV programme gradually accrues herd protection and hence its dose-efficiency increases: 10 years after the start of cohort vaccination alone the programme used 910 (732 to 1184) doses per IPD case averted. We estimated that a two-dose catch-up among <1y olds uses an additional 910 (732 to 1184) doses per additional IPD case averted. Furthermore, by extending a single dose catch-up campaign to children 1 to <2y old and subsequently to 2 to <5y olds the campaign uses an additional 412 (296 to 606) and 543 (403 to 763) doses per additional IPD case averted. These results were not sensitive to vaccine coverage, serotype competition, the duration of vaccine protection or the relative protection of infants.ConclusionsWe find that catch-up campaigns are a highly dose-efficient way to accelerate population protection against pneumococcal disease.

scholarly journals Meningococcal disease epidemiology in Australia 10 years after implementation of a national conjugate meningococcal C immunization programme

2016 ◽  
Vol 144 (11) ◽  
pp. 2382-2391 ◽  
Author(s):  
G. L. LAWRENCE ◽  
H. WANG ◽  
M. LAHRA ◽  
R. BOOY ◽  
P. B. McINTYRE
Keyword(s):  
Disease Surveillance ◽  
Vaccine Coverage ◽  
Disease Incidence ◽  
Age Groups ◽  
Disease Epidemiology ◽  
Immunization Programme ◽  
Published Evidence ◽  
Incidence And Mortality ◽  
Catch Up ◽  
Vaccine Failures

SUMMARYAustralia implemented conjugate meningococcal C immunization in 2003 with a single scheduled dose at age 12 months and catch-up for individuals aged 2–19 years. Several countries have recently added one or more booster doses to their programmes to maintain disease control. Australian disease surveillance and vaccine coverage data were used to assess longer term vaccine coverage and impact on invasive serogroup C disease incidence and mortality, and review vaccine failures. Coverage was 93% in 1-year-olds and 70% for catch-up cohorts. In 10 years, after adjusting for changes in diagnostic practices, population invasive serogroup C incidence declined 96% (95% confidence interval 94–98) to 0·4 and 0·6 cases/million in vaccinated and unvaccinated cohorts, respectively. Only three serogroup C deaths occurred in 2010–2012vs.68 in 2000–2002. Four (<1/million doses) confirmed vaccine failures were identified in 10 years with no increasing trend. Despite published evidence of waning antibody over time, an ongoing single dose of meningococcal C conjugate vaccine in the second year of life following widespread catch-up has resulted in near elimination of serogroup C disease in all age groups without evidence of vaccine failures in the first decade since introduction. Concurrently, serogroup B incidence declined independently by 55%.

scholarly journals Neonatal hypothermia and adherence to World Health Organisation thermal care guidelines among newborns at Moi Teaching and Referral Hospital, Kenya

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248838
Author(s):  
Winstone Mokaya Nyandiko ◽  
Paul Kiptoon ◽  
Florence Ajaya Lubuya
Keyword(s):  
World Health Organisation ◽  
Referral Hospital ◽  
World Health ◽  
Preterm Neonates ◽  
Local Data ◽  
Thermal Care ◽  
Increased Risk ◽  
Care Guidelines ◽  
Prospective Study Design ◽  
Neonatal Hypothermia

Neonatal hypothermia is a great concern with near epidemic levels globally. In Kenya, its prevalence is as high as 87% with limited local data on the associated factors such as adherence to warm chain guidelines as recommended by the World Health Organisation (WHO) is limited. This study aimed to determine the prevalence of hypothermia and level of adherence to the WHO thermal care guidelines among newborns admitted at Moi Teaching and Referral Hospital (MTRH). It adopted a prospective study design of following up neonates for the first 24 hours of admission to the MTRH newborn unit. Thermometry, interview of mothers and observation of thermal care practices was done. Descriptive and inferential statistical techniques were adopted. Specifically, Pearson’s chi-square test of associations between predictors of neonatal hypothermia and management outcomes was conducted with their corresponding risk estimates at 95% confidence interval. Among the 372 participants, 64.5% (n = 240) were born at MTRH, 47.6% (177) were preterm and 53.2% (198) had birth weights below 2500 grams. Admission hypothermia was noted among 73.7% (274) and 13% (49) died on the first day of admission. Only 7.8% (29) newborns accessed optimal thermal care. Prematurity, day one mortality and adherence to the warm chain were significantly (p<0.001) associated with admission hypothermia. Inappropriate thermal appliance, inadequate clothing and late breastfeeding significantly increased the risk of neonatal hypothermia. Absence of admission hypothermia increased the likelihood of neonatal survival more than twenty-fold (AOR = 20.91, 95% CI: 2.15–153.62). Three out four neonates enrolled had admission hypothermia which was significantly associated with prematurity, lack of adherence to warm chain and increased risk of neonatal mortality on the first day of life. There was low adherence to the WHO thermal care guidelines. This should be optimized among preterm neonates to improve likelihood of survival.

scholarly journals Preventing congenital rubella infection in the European Region of WHO: 2010 target

2004 ◽  
Vol 9 (4) ◽  
pp. 3-4 ◽  
Author(s):  
J. S. Spika ◽  
F X Hanon ◽  
S Wassilak ◽  
R G Pebody ◽  
N Emiroglu
Keyword(s):  
Vaccine Coverage ◽  
Policy Decision ◽  
World Health Organisation ◽  
Congenital Rubella Syndrome ◽  
World Health ◽  
Measles Vaccine ◽  
Mmr Vaccine ◽  
Regional Office ◽  
Rubella Infection ◽  
Congenital Rubella

The World Health Organisation (WHO) Regional Office for Europe has recently published a strategic plan and surveillance guidelines for measles and congenital rubella infection. The strategy prioritises measles control activities but encourages the introduction of rubella vaccine when measles vaccine coverage has reached &gt;90 %; although, many western European countries with suboptimal measles vaccine coverage are already using the combined measles, mumps and rubella (MMR) vaccine. Women in these countries may have an especially high risk of having an infant with congenital rubella syndrome. WHO is seeking to improve the surveillance for rubella and congenital rubella syndrome as a means to obtain better information on the burden of these diseases and engage policy decision makers in the need to support the WHO European Region's strategies for rubella.

scholarly journals 1536Antimicrobial resistance in the emerging COVID-19 pandemic

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Abhishek Jaiswal ◽  
Ankita Jaiswal ◽  
Surabhi Puri ◽  
Adarsh Pal
Keyword(s):  
English Language ◽  
Age Groups ◽  
Resistance Management ◽  
World Health Organisation ◽  
World Health ◽  
Cochrane Library ◽  
Outcome Variable ◽  
Increased Risk ◽  
Bacterial Coinfection

Abstract Background Inappropriate usage of antibiotics among COVID-19 patients can raise disastrous effects on antimicrobial resistance management and antibiotic stewardship programs. A study from USA reported 71% of COVID-19 patients received antibiotics while only 4% had bacterial co-infection. Similar findings were reported from a review of data from COVID-19 cases in Asia, which reported more than 70% of the patient receiving antibiotics however less than 10% on average had bacterial coinfection. The World Health Organisation discourages the use of antibiotics for mild cases of COVID-19, however they recommend it for severe cases at increased risk of secondary bacterial infection and death. This review aims to discuss the usage of antibiotics in COVID-19 patients pointing the role of bacterial coinfections, types of antibiotics used, and antibiotic resistance. Methods We systematically searched Medline, Cochrane library, Google Scholar for eligible studies published from 1st January 2020 till 29th May 2021. We included English language articles. We included patients of all age groups, in all settings. Primary outcome variable was bacterial coinfection and antimicrobial usage among COVID-19 patients. Results Less than 10% of the hospitalised COVID-19 patients had bacterial Co-infection. Antibiotics used among COVID-19 positives were moxifloxacin, ceftriaxone, azithromycin, piperacillin-tazobactam, levofloxacin, meropenem, etc. Conclusions Low proportion of COVID-19 patients had bacterial co-infection. Routine usage of antibiotics among COVID-19 positives should be discouraged. Key messages Bacterial co-infection among COVID-19 patients is low and therefore misuse of antibiotics among them should be discouraged.

scholarly journals Impact of the meningococcal C conjugate vaccine in Spain: an epidemiological and microbiological decision

2004 ◽  
Vol 9 (7) ◽  
pp. 5-6 ◽  
Author(s):  
R Cano ◽  
A Larrauri ◽  
S Mateo ◽  
B Alcalá ◽  
C Salcedo ◽  
...  
Keyword(s):  
Conjugate Vaccine ◽  
Genetic Recombination ◽  
Vaccine Coverage ◽  
Age Groups ◽  
Immunisation Programme ◽  
Vaccination Schedule ◽  
The Past ◽  
Catch Up ◽  
Vaccine Failures ◽  
Programme Coverage

The new meningococcal C conjugate vaccine became available in Spain and was included in the infant vaccination schedule in 2000. A catch-up campaign was carried out in children under six years of age. As a consequence, the incidence of meningococcal disease caused by serogroup C has fallen sharply during the last three epidemiological years in Spain. The risk of contracting serogroup C disease in 2002/2003 fell by 58% when compared with the season before the conjugate vaccine was introduced. There was also an important decrease in mortality. Three deaths due to serogroup C occurred in the age groups targeted for vaccination in 2002/2003, compared with 30 deaths in the same age groups in the season before the launch of the vaccine campaign. In the catch-up campaign the vaccine coverage reached values above 92%. For the 2001, 2002 and 2003 routine childhood immunisation programme coverage values ranged from 90% to 95%. During the past three years a total of 111 cases of serogroup C disease have been reported in patients in the vaccine target group. Most of the vaccination failures occurred during the epidemiological year 2002/2003. Eight (53%) vaccine failures occurred in children who had been routinely immunised in infancy, and could be related to a lost of protection with time since vaccination. The isolation of several B:2a:P1.5 strains (ST-11 lineage) is noteworthy. These may have their origin in C:2a:P1.5 strains which, after undergoing genetic recombination at the capsular operon level, express serogroup B. These strains could have relevant epidemic potential.

scholarly journals Gender differences in suicide in Serbia within the period 2011-2015

2018 ◽  
Vol 75 (12) ◽  
pp. 1165-1171
Author(s):  
Gordana Dedic ◽  
Srdjan Dedic
Keyword(s):  
Mental Health ◽  
Gender Differences ◽  
Suicide Prevention ◽  
Age Groups ◽  
World Health Organisation ◽  
World Health ◽  
Suicide Method ◽  
Elderly Male ◽  
Male Population ◽  
Female Suicide

Background/Aim. The World Health Organisation (WHO) estrimates that approximately 1,000,000 people die by suicide every year. The aim of this study was to examine the gender differences in cases of committed suicides, including suicide rates, socio-demographic factors and methods of suicide in Serbia within the period 2011?2015. This investigation is continuing the previous investigation from the period 2006?2010. Methods. Data were obtained from the Statistical Office of the Republic of Serbia. Their classification related to the suicide method was carried out on the basis of International Classification of Diseases-Tenth Revions- Clinical Modification (ICD-X-CM) (WHO 1992). Statistical analysis was done by using the crude number of committed suicide. Results. Within the period 2011?2015, the total number of suicides in Serbia was 5,897, of which 74.56% were males and 25.44% females (male to female suicide ratio was 2.93). Annual suicide rate (per 100,000) showed constantly decreased from 2011 to 2015, and in 2015 it was 15. Male/female suicide ratio was the highest among adolescents and decreased with age. The suicide was the most often committed by married males (47.6%) and widowed females (38.86%) with completed high school, retired, Serbs. About a quarter (23.38%) suicide committers were older than 75 years, and 39.39% were older than 65 years. The most common suicide method males (64.63%) and females (59.00%) used was hanging, strangulation and suffocation. The second most common method males used was by firearm (18.96%) and females by poisoning (16.73%). Conclusions. Suicide Prevention Programme in Serbia should be primarily oriented towards two age groups at highest risk to commit suicide, towards the adolescents whose suicide was on the rise and towards the elderly male population, less ready to refer to the doctors for help because of problems related to their mental health. With the aim to suicide prevention, doctors should become familiar with community, state and national resources that are concerned with youth and elderly populations, including mental health institutions, family and crisis intervention centers.

The Global Burn Registry: A Work in Progress

2020 ◽  
Vol 41 (5) ◽  
pp. 929-934
Author(s):  
Cameron Gibson ◽  
Palmer Q Bessey ◽  
James J Gallagher
Keyword(s):  
Low Income ◽  
Burn Injury ◽  
Age Groups ◽  
Case Fatality ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Burn Care ◽  
High Resource ◽  
Low Middle Income Countries

Abstract In 2018, the World Health Organization (WHO) launched the Global Burn Registry (GBR). Its purpose is to help improve the understanding of burn injury worldwide. The purpose of this study was to identify early findings from this database. The GBR was accessed on January 5, 2020. Cases from centers in low income (LIC) and low-middle-income countries (LMIC) were combined into a low resource (LR) group, and cases in high income (HIC) and upper-middle-income countries (UMIC) were combined into a high resource (HR) group. Statistical analysis was performed with SAS 9.4. Data are expressed as mean ± SEM. Logistic regression was used to identify risk factors for death. Revised Baux Score (RBS) was calculated. Odds ratios are expressed as mean (95% confidence interval). The LA50 was calculated from the regression of death and total burn size (TBSA) for different age groups. At the time of analysis, there were 4307 cases in the GBR treated at 28 facilities in 17 countries (5 HIC, 5 UMIC, 4 LMIC, and 3 LIC). There were 2945 cases (68%) from HR countries and 1362 (32%) from LR countries. The mean age of patients in both LR and HR was similar (24.5 ± 0.5 vs 24.2 ± 0.4 years, P = .58), but LR had larger TBSA burns (30.5 ± 0.7% vs 19.8 ± 0.4% TBSA, P &lt; .0001). There were fewer scald burns and more flame injuries in the LR countries (28.4 ± 1.3% vs 43.3 ± 1.0% and 55.2 ± 1.4% vs 39.0 ± 0.9%, P &lt; .0001). Case fatality and RBS were greater in LR (31.9 ± 1.3% vs 9.4 ± 0.5% and 59.4 ± 1.1% vs 45.3 ± 0.6%, P &lt; .0001). In regression analysis, LR was an independent risk factor for death with an odds ratio of 4.2 (3.2–5.4). The LA50 for HR countries was similar to that calculated from cases in the National Burn Repository of the American Burn Association (ABA NBR). For LR countries, the LA50 was lower for all ages except those 65 and older, ranging from 30% to 43% TBSA. Only a few facilities have contributed data to the GBR so far, with LR countries less represented than HR ones. The proportion of cases in the pediatric age group is much less represented in LR countries than in HR, possibly because many burned children in LR countries do not get burn care at specialized centers. Survival in HR countries is similar to that in North America. The GBR provides early insights into global burn care. Opportunities for improvement are greatest in LR countries. New Innovations may be necessary to increase participation from burn centers in LR countries. This report provides an early look at burn care across the globe based on cases in the GBR. It may inform further efforts to characterize and improve burn care in LR countries.

scholarly journals The Impact of Pneumococcal Conjugate Vaccine (PCV) Coverage Heterogeneities on the Changing Epidemiology of Invasive Pneumococcal Disease in Switzerland, 2005–2019

2021 ◽  
Vol 9 (5) ◽  
pp. 1078
Author(s):  
Oluwaseun Rume-Abiola Oyewole ◽  
Phung Lang ◽  
Werner C. Albrich ◽  
Kerstin Wissel ◽  
Stephen L. Leib ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Vaccine Coverage ◽  
Age Groups ◽  
Nationwide Survey ◽  
Vaccine Uptake ◽  
Dependent Manner ◽  
Beneficial Effects ◽  
Vaccine Type ◽  
The Impact

Pneumococcal conjugate vaccines (PCVs) have lowered the incidence of invasive pneumococcal disease (IPD) worldwide. However, the influence of regional vaccine uptake differences on the changing epidemiology of IPD remains unclear. We aimed to examine the overall impact of both seven- and 13-valent PCVs (PCV7 and PCV13) on IPD in Switzerland. Three-year periods from 2005–2010 and 2011–2019 were considered, respectively, as (early and late) PCV7 eras and (early, mid and late) PCV13 eras. Vaccine coverage was estimated from a nationwide survey according to east (German-speaking) and west (French/Italian-speaking) regions for each period. Reported incidence rate ratios (IRRs) were compared between successive periods and regions using nationwide IPD surveillance data. Overall IPD incidence across all ages was only 16% lower in the late PCV13 era compared to the early PCV7 era (IRR 0.83, 95% CI 0.79–0.88), due to increasing incidence of non-PCV-type IPD (2.59, 2.37–2.83) in all age groups, except children <5 years. PCV uptake rates in swiss children were slightly higher in the west than the east (p < 0.001), and were accompanied by lower IPD incidences across all age groups in the former region. Post-PCV13, non-PCV serotypes 8, 22F and 9N were the major cause of IPD in adults ≥65 years. Increased PCV coverage in both areas of Switzerland resulted in a decrease in vaccine-type and overall IPD incidence across all age groups, in a regionally dependent manner. However, the rising incidence of non-vaccine-type IPD, exclusive to older adults, may undermine indirect beneficial effects.

scholarly journals Neonatal hypothermia and adherence to World Health Organisation thermal care guidelines among newborns at Moi Teaching and Referral Hospital, Kenya

2020 ◽  
Author(s):  
Winstone Mokaya Nyandiko ◽  
Paul Kiptoon ◽  
Florence Ajaya Lubuya
Keyword(s):  
World Health Organisation ◽  
Referral Hospital ◽  
World Health ◽  
Categorical Variables ◽  
Systematic Sampling ◽  
Continuous Variables ◽  
Local Data ◽  
Thermal Care ◽  
Care Guidelines ◽  
Neonatal Hypothermia

ABSTRACTBackgroundNeonatal hypothermia is a great concern with near epidemic levels globally. The prevalence in Kenya is as high as 87%. Local data on the associated factors including adherence to warm chain guidelines as recommended by the World Health Organisation (WHO) is limited.ObjectiveTo determine the prevalence of hypothermia and level of adherence to the WHO thermal care guidelines among newborns admitted at Moi Teaching and Referral Hospital (MTRH).MethodsThis descriptive cross-sectional study was carried out among neonates admitted at the MTRH newborn unit. Systematic sampling was used to recruit 372 eligible participants. Axillary thermometry, interview of respective mothers and observation of thermal care practices was done. Means and medians described continuous variables while frequencies with corresponding percentages summarized categorical variables. Associations between various variables and neonatal hypothermia were computed using the Pearson chi-square test. Relative Risks and Odds Ratios were assessed between predictor and outcome variables. Independence among significant variables was determined through the logistic regression model at 5% prediction level.ResultsAmong the 372 participants, 64.5% (n=240) were born at MTRH, 47.6% (177) were preterm while 53.2% (198) had birth weights below 2500 grams. Admission hypothermia was noted among 73.7% (n= 274) while 13% (49) died on day one of admission. Only 7.8 % (29) newborns accessed optimal thermal care. Prematurity (RR=1.62, 95% CI: 1.43-1.84), day one mortality (RR=17.7, 95% CI: 2.40, 122.71) and adherence to the warm chain (p<0.001) was significantly associated with admission hypothermia. Inappropriate thermal resuscitation appliance (RR=1.50, 95% CI: 1.34-1.67) inappropriate clothing (RR = 1.78, 95% CI: 1.54 - 2.05) and late breastfeeding (RR = 2.01, 95% CI: 1.39-2.89) significantly increased the risk of hypothermia. Non hypothermic newborns had twenty-fold increased odds of survival (AOR=20.91, 95% CI: 2.15-153.62).ConclusionThree out four neonates at the MTRH newborn unit had hypothermia at admission. Hypothermia was significantly associated with prematurity, adherence to warm chain and day one mortality. There was notably low adherence to the warm chain.RecommendationStrategies to optimize adherence to the warm chain at MTRH with emphasis on 1thermal care of the preterm neonate should be instituted.

scholarly journals Research beyond biomedical confines: towards better mental health and well-being for all

2019 ◽  
Vol 2 (4) ◽  
pp. 1-4
Author(s):  
Jou Yin Teoh ◽  
Kee Hean Lim
Keyword(s):  
Mental Health ◽  
Suicide Risk ◽  
Age Groups ◽  
Interdisciplinary Approach ◽  
Well Being ◽  
World Health Organisation ◽  
World Health ◽  
Neuroscience Research ◽  
Working Together ◽  
Health And Well Being

‘Working Together to Prevent Suicide’ is the theme of World Mental Health Day 2019. According to the World Health Organisation, suicide is the second leading cause of death for people aged 15-19 years old. One person dies of suicide every 40 seconds, with this form of death affecting people of all age groups in all countries. Hence in line with this year’s theme calling for a trans-sectoral and interdisciplinary approach to address this epidemic, we would like to invite all contributors and readers of Neuroscience Research Notes (NeurosciRN) to take a moment to reflect on how they - as researchers can contribute towards the facilitation, discussion and promotion of positive mental health, which in turn has been found to reduce suicide risk.

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