scholarly journals Impact of Duration of Cessation of Mass BCG Vaccination Programs on Covid -19 Mortality

2020 ◽  
Author(s):  
Tareef Fadhil Raham
Keyword(s):  
Statistical Correlation ◽  
P Value ◽  
Confounding Factors ◽  
Vaccination Programs ◽  
Bcg Vaccination ◽  
Screening Behavior ◽  
Compound Model ◽  
Back Ground ◽  
Data Screening ◽  
Stem Leaf

Back ground: BCG have heterogeneous immunity to certain pathogens other than Mycobacterium tuberculosis effect. At early times during COVID-19 pandemic heterogeneous immunity towards (SARS-CoV-2), was hypothesized and statistical correlation between of BCG vaccination practices and COVID-19 mortality variances among countries was statistically proved . These studies was criticized because of low evidence of such studies and possible confounding factors. For that reason this study was designed to look for impact of duration of cessation of BCG programs on Covid-19 mortality looking for the hypotheses by different design and looking forward to support previous studies. Methods: Total number of studied group is 14 countries which has stopped BCG vaccination programs. Through applying stem-leaf plot for exploring data screening behavior concerning Covid-19 Mortality for obsolescence duration of cessation of mass BCG vaccination programs, as well as (nonlinear regression of compound model) for predicted shape behavior for that group. Results: Slope value shows highly significant effectiveness of obsolescence of cessation of mass BCG vaccination programs on Covid -19 mortality at P-value<0.000. Obsolescence of duration of cessation of mass BCG vaccination programs has strongly negatively associated with Covid-19 mortality in countries which stopped BCG vaccination programs. Conclusion: The longer the cessation duration of BCG programs, the higher the Covid-19 mortality is, and vice versa.

scholarly journals COVID-19 Vaccination Perception and Attitude among Healthcare Workers in Egypt

2021 ◽  
Vol 12 ◽  
pp. 215013272110133
Author(s):  
Samar Fares ◽  
Merihan M. Elmnyer ◽  
Shimaa Sabry Mohamed ◽  
Radwa Elsayed
Keyword(s):  
Healthcare Workers ◽  
Study Groups ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Accurate Information ◽  
P Value ◽  
Major Barrier ◽  
Vaccination Programs ◽  
The World ◽  
Health Organization

Introduction COVID-19 pandemic has affected the whole world, especially the frontline worriers. To get shielded through this war, the world is racing to reach and manufacture COVID-19 vaccines. Vaccination hesitancy is one of the significant obstacles to global health. Objectives This study aimed to assess the perception and attitude of healthcare workers in Egypt toward COVID-19 vaccines, acknowledge the determinants of their attitude, and the factors that could increase the acceptance of the vaccine. Methods an observational web-based anonymous survey was conducted on 385 Egyptian healthcare workers in different governorates. The questionnaire-based on Vaccine Hesitancy Survey Questions of the World Health Organization was available in Arabic and English languages and was tested for reliability. Results Regarding vaccination decision, 51% of the participants were undecided, 28% refused, and 21% accepted vaccination. Reasons for vaccine acceptance mainly were risks of COVID-19 (93%), safety (57.5%), and effectiveness (56.25%) of the vaccine. Simultaneously, the reasons for vaccine hesitancy were the absence of enough clinical trials (92.4%) and fear of side effects of the vaccine (91.4%). The leading factor that could increase vaccination acceptance among the participants was to get sufficient and accurate information about the available vaccines. The participants revealed a high mean level of concern for COVID-19 vaccines’ safety (3.8 of 5) that differs significantly among the different study groups ( P-value .002). Conclusion Despite the COVID-19 pandemic, only approximately 21% of Egyptian healthcare workers in our study accepted the COVID-19 vaccination. Vaccine hesitancy represents a major barrier to implementing vaccination programs.

FREQUENCY RATE OF BCG VACCINATION AND SELECTED INDICATORS OF CLINICAL CHARACTERISTICS OF TUBERCULOSIS IN SCHOOL-AGE CHILDREN

2021 ◽  
Vol 100 (5) ◽  
pp. 124-130
Author(s):  
V.A. Aksenova ◽  
◽  
A.V. Gordina ◽  
S.A. Sterlikov ◽  
D.A. Kucheryawaya ◽  
...  
Keyword(s):  
Repeated Administration ◽  
Bcg Vaccine ◽  
School Age Children ◽  
Confounding Factors ◽  
Bcg Vaccination ◽  
Data Registration ◽  
Comparison Groups ◽  
The Russian Federation ◽  
Group 2 ◽  
Group 1

Objective of the study: to assess the effect of the frequency of administration of the BCG vaccine on the nature and structure of clinical forms of tuberculosis (TB) in children. Materials and methods of research: a cohort observational retrospective continuous comparative multicenter crosssectional study was carried out. The data (registration form № 089/u-tube) of 3253 children of 7–14 years old with newly revealed changes in the lungs of a specific genesis, registered in 2019–2020 in the institutions of the anti-tuberculosis service of the Russian Federation were analyzed. Two comparison groups were identified: group 1 (observation group) – children who received a double injection of BCG vaccine (vaccination and revaccination) (n=184), group 2 (comparison group) – children who received a single BCG vaccination (n=3358). To achieve this goal, 5 null hypotheses were identified for testing which groups are formed from the received data array with the necessary parameters. The data were analyzed using univariate and multivariate analyzes (including confounding factors). Results: it was found that BCG revaccination does not reduce the risk of TB compared with residual changes after, it does not reduce the proportion of generalized forms of TB compared with localized forms (OR=2,4, p=0,08). The frequency of vaccination has not a statistically significant effect on the frequency of bacterial excretion (aOR=1,6, p=0,15) and destruction of lung tissue (OR=1,1, p=1). Revaccination has a statistically significant effect on the ratio of primary and secondary forms of TB, reducing the likelihood of its primary forms (aOR=0,4, p<0,001). In the course of multivariate analysis, it was found that the formation of primary or secondary TB, as well as the frequency of bacterial excretion in the comparison groups, was significantly influenced by confounding factors. Conclusion: this work has demonstrated the absence of a pronounced protective effect of repeated administration of the BCG vaccine on the clinical course of a specific process.

scholarly journals Association Between BCG Policy is Significantly Confounded by Age and is Unlikely to Alter Infection or Mortality Rates

2020 ◽  
Author(s):  
Stefan Kirov
Keyword(s):  
Mortality Rates ◽  
Causal Link ◽  
Confounding Factors ◽  
Income Levels ◽  
Bcg Vaccination ◽  
Start Date ◽  
The Press ◽  
Number Of Publications ◽  
Public Policy Decisions ◽  
Mandatory Vaccination

AbstractRecently a number of publications looked at the association between COVID-19 morbidity and mortality on one hand and countries’ policies with respect to BCG vaccination on the other. This connection arises from differences in the rates of infection in countries where BCG vaccination is mandatory compared to countries where mandatory vaccination no longer exists or was never implemented in the first place. In at least 2 preprint publications the authors expressed the view that the “known immunological benefits” of BCG vaccination may be behind the biological mechanism of such observation.One study accounted for different income levels in different groups. Another study did not attempted to do so, instead exploring the differences between countries where a booster shot is given vs others where no such practice exists (finding no connection).Both of these studies did not explore other potential confounding factors. Meanwhile the press has focused on these headlines and pushed the narrative that BCG vaccination is causally linked to infection and mortality rates. This poses a serious challenge, demonstrated by the recently initiated clinical trials on BCG vaccination within the COVID19 context.This study shows that population age is a very significant confounding factor that explains the rates of infections much better and has a solid biology mechanism which explains this correlation. It suggests that BCG vaccination may have little or no causal link to infection rates and advises that any follow up studies should control for several confounding factors, such as population age, ethnicity, rates of certain chronic diseases, time from community spread start date, major public policy decisions and income levels.

scholarly journals Recruitment and Retention of Participant and Study Partner Dyads in Two Multinational Alzheimer’s Disease Registration Trials

2020 ◽  
Author(s):  
Olivia M Bernstein ◽  
Joshua D. Grill ◽  
Daniel L. Gillen
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Random Forest ◽  
Random Forest Model ◽  
P Value ◽  
Confounding Factors ◽  
Forest Model ◽  
Partner Type ◽  
Study Partner ◽  
The Relationship

Abstract Background: Early study exit is detrimental to statistical power and increases the risk for bias in Alzheimer’s disease clinical trials. Previous analyses in early phase academic trials demonstrated associations between rates of trial incompletion and participants’ study partner type, with participants enrolling with non-spouse study partners being at greater risk.Methods: We conducted secondary analyses of two multinational phase III trials of semagacestat, an oral gamma secretase inhibitor, for mild-to-moderate AD dementia. Cox’s proportional hazards regression model was used to estimate the relationship between study partner type and the risk of early exit from the trial after adjustment for a priori identified potential confounding factors. Additionally, we used a random forest model to identify top predictors of dropout.Results: Among participants with spousal, adult child, and other study partners, respectively, 35%, 38%, and 36% dropped out or died prior to protocol-defined study completion, respectively. In unadjusted models, the risk of trial incompletion differed by study partner type (unadjusted p-value=0.027 for test of differences by partner type), but in models adjusting for potential confounding factors the differences were not statistically significant (p-value=0.928). In exploratory modeling, participant age was identified as the primary characteristic to explain the relationship between study partner type and the risk of failing to complete the trial. Participant age was also the strongest predictor of trial incompletion in the random forest model.Conclusions: After adjustment for age, no qualitative differences in the risk of incompletion were observed when comparing participants with different study partner types in these trials. Differences between our findings and the findings of previous studies may be explained by differences in trial phase, size, geographic regions, or the composition of academic and non-academic sites.

scholarly journals Neonatal and Maternal Outcomes in Spontaneously-Conceived Twin Pregnancies According to Mode of Delivery

Folia Medica ◽  
2020 ◽  
Vol 62 (3) ◽  
pp. 468-476
Author(s):  
Samantha Mc Kenzie Stancu ◽  
Manuela Cristina Russu
Keyword(s):  
Neonatal Intensive Care ◽  
Statistical Significance ◽  
Mode Of Delivery ◽  
Statistical Correlation ◽  
P Value ◽  
Maternal Outcomes ◽  
Chi Square ◽  
Chi Square Test ◽  
Nicu Admission ◽  
Twin Pregnancies

Introduction: Appropriate intrapartum conduct in a twin delivery remains a challenging aspect of obstetric practice. The objective of this study was to compare neonatal and maternal outcomes in twin pregnancies according to mode of delivery.&nbsp; Materials and methods: This is a single centre retrospective cohort study of all consecutive spontaneously-conceived twin deliver-ies (&ge; 24 weeks, estimated fetal weight &ge; 500 grams) over a nine-year period between 01/01/2007 - 31/12/2016 at a tertiary-level centre. Neonatal outcomes included survival, APGAR score, prematurity-associated pathology (PAP), admission to the neonatal intensive care unit (NICU) and length of stay (LOS). Maternal outcomes included postpartum complications and LOS. Statistical analysis comprised Chi-square test with subsequent p-value and odds-ratio with 95% confidence interval. Statistical significance was set at p<0.05. Results: A total of 173 consecutive women with spontaneously-conceived twin deliveries were enrolled in this study, 129 (74.6%) women delivered by caesarean section (CS). The success rate of vaginal delivery (VD) was 93.6% (44/47). A strong statistical correlation was identified between CS and NICU admission; 53.2% vs. 1.5% (p=0.0001). Neonatal LOS in the NICU was significantly longer in the CS group. Prematurity-associated pathology (PAP) was noted in 75 pairs of twins (75/173); 61 pairs were delivered by CS, bearing strong statistical significance (p<0.0001). Postpartum complications occurred in 14.7% of CS compared to 13.6% of VDs.&nbsp; Conclusion: Neonates delivered by CS had a higher rate of PAP, NICU admission, lower birth weight and longer LOS. This study showed that VD is safe, especially when the first twin is in cephalic presentation

scholarly journals Maternal dietary diversity and Nutritional adequacy in relation with anthropometric measurements of newborns at birth: a cohort study in Tehran city

2020 ◽  
Author(s):  
Tahereh Karimi ◽  
Hassan Eini Zinab ◽  
Zeinab Moslemi ◽  
arezoo rezazadeh
Keyword(s):  
Cohort Study ◽  
Dietary Intake ◽  
Dietary Diversity ◽  
Anthropometric Measurements ◽  
P Value ◽  
Confounding Factors ◽  
Third Trimester ◽  
Nutritional Adequacy ◽  
Anthropometric Indices ◽  
The Third

Abstract Background Maternal dietary intake during pregnancy plays an important role in fetal development and birth outcomes. The aim of the present study was to determine maternal dietary diversity and Nutritional adequacy in relation with anthropometric measurements of newborn at birth as a cohort study in Tehran city. methods This prospective cohort study, was conducted by participation of 585 pregnant women referred to public health centers and hospitals covered by Shahid Beheshti, Tehran and Iran Universities in Tehran City. Using face-to-face interviews, general characteristics were obtained by questionnaire. Pre-pregnancy dietary intake was measured by a 168-item semi-quantitative food frequency questionnaire at the first visit, and dietary intake during pregnancy was measured by 2 non-consecutive 24-hour food recall (one holiday and one regular day) at 31–34 weeks. Maternal height and weight were measured using standard tools and protocol at the first visit, and maternal weight at the end of pregnancy and data related to neonatal anthropometric indices were collected from mothers and neonates health records in the Sib electrical system. By applying SPSS software (version 23) the association was analyzed by linear regression with adjusting for confounding factors. P-value < 0.05 was considered as significant. Results Mean ± standard deviation of body mass index (BMI) of pre-pregnancy, pregnancy weight gain, BMI for age z-score (BAZ) at birth of infants were 24.52 ± 4.12, 12.16 ± 6.85 kg and − 0.61 ± 1.48, respectively. Mean ± SD of the Dietary Diversity Score (DDS) and Mean Adequacy Ratio (MAR) before and during pregnancy were 5.31 ± 1.11, vs.5.23 ± 1.42 and 289.85 ± 113.12 vs. 371.07 ± 197.28, respectively. After adjusting for confounding factors DDS in the third trimester of pregnancy was inversely correlated with WAZ (B=-0.16, 95% CI=- 0.23_0.30) and BAZ (B = -0.24, 95% CI=- 0.06_0. 42) at birth, MAR of pre-pregnancy (B = -0.001, 95% CI=- 0.002_0.00) and in the third trimester of pregnancy (B = -0.18, 95% CI=- 0.35_0.004) were negatively associated with WAZ at birth. Conclusion The findings showed that maternal nutritional status (dietary diversity and nutritional adequacy) before and during pregnancy were correlated with neonatal anthropometric indices at birth.

Scar Formation and Tuberculin Conversion Following BCG

2021 ◽  
Vol 15 (11) ◽  
pp. 3056-3057
Author(s):  
Muhammad Sarfraz ◽  
Zahid Jamil ◽  
Muhammad Naim Ashraf ◽  
Saima Arshad ◽  
Zirwa Sarfraz ◽  
...  
Keyword(s):  
Skin Testing ◽  
Case Series ◽  
Operational Definition ◽  
Scar Formation ◽  
Bcg Vaccine ◽  
Base Line ◽  
Positive Skin ◽  
Post Vaccination ◽  
Vaccination Programs ◽  
Bcg Vaccination

Objective: To determine frequency of scar formation and positive tuberculin conversion test following BCG vaccine administered within 0-28 days of life in children in 6 months to 6 years of age presenting at outpatient department of Fauji Foundation Hospital Lahore. Study Design: Descriptive case series. Place and Duration of Study: Outdoor Department of Pediatrics, Fauji Foundation Hospital, Lahore from 1st July 2020 to 30th December 2020. Methodology: Ninety seven children were included. Base line demographic information of patients (age, gender, weight on weight machine) was recorded. 0.5 ml BCG was administered in right arm. Tuberculin skin test was assessed as per operational definition. After 48 to 72 hours, scar formation was assessed after 1 month. Data regarding scar formation and positive tuberculin conversion test was recorded. Results: The mean age was 3.20±1.46 years, 39 (40.21%) were male whereas 58 (59.79%) were females. The scar formation following BCG vaccine administered within 0-28 days of life in children in 6 months to 6 years of age was 59 (60.82%) and positive tuberculin conversion test following BCG vaccine administered within 0-28 days of life in children in 6 months to 6 years was recorded in 47 (48.45%). Conclusion: Most babies have developed a post-vaccination scar. The combination of the BCG scar and the positive skin testing tuberculin was very important. The development of BCG scars had no effect on age or sex. Greater trials are advised in order to detect the true extent of the problem and to evaluate regularly the BCG vaccination programs. Keywords: Infants, Tuberculosis, BCG vaccination, Scar formation, Positive tuberculin conversion test

Discussion

2010 ◽  
pp. 346-351
Author(s):  
Patricia Cerrito ◽  
John Cerrito
Keyword(s):  
Clinical Trials ◽  
Linear Regression ◽  
Large Datasets ◽  
Cost Of Care ◽  
P Value ◽  
Confounding Factors ◽  
Chi Square ◽  
Sequential Treatments ◽  
The Cost ◽  
Improve Patient

Now that the data are more readily available for outcomes research and the techniques to analyze that data are available, we need to use the tools to investigate the total complexity of patient care. We should no longer rely upon basic tools while ignoring sequential treatments for patients with chronic diseases or the issue of patient compliance, and we can start investigating treatments from birth to death. It is no longer possible, with these large datasets, to rely on t-tests, chi-square statistics and simple linear regression. Without the luxury of clinical trials and randomizing patients into treatment versus control, there will always be confounding factors that should be considered in the data. In addition, large datasets almost guarantee that the p-value in a standard regression is statistically significant, so other methods of model adequacy must be used. If we do not start using outcomes data, we are missing crucial knowledge that can be used to improve patient outcomes while simultaneously reducing the cost of care. If we continue to use inferential statistical methods that were not designed to work with large datasets, we will not extract the information that is readily available in the outcomes datasets.

scholarly journals Increased Omega-3 Fatty Acid Intake is Inversely Associated with Sarcopenic Obesity in Women but not in Men, Based on the 2014–2018 Korean National Health and Nutrition Examination Survey

2020 ◽  
Vol 9 (12) ◽  
pp. 3856
Author(s):  
Woojung Yang ◽  
Jae-woo Lee ◽  
Yonghwan Kim ◽  
Jong Hun Lee ◽  
Hee-Taik Kang
Keyword(s):  
National Health ◽  
Sarcopenic Obesity ◽  
P Value ◽  
Confounding Factors ◽  
Nutrition Examination Survey ◽  
Fatty Acid Intake ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Omega 3 Fatty Acid ◽  
Health And Nutrition

(1) Background: Omega-3 fatty acids (ω3FAs) are known to improve protein anabolism, increase the sensitivity to anabolic stimuli, decrease lipogenesis, and stimulate lipid oxidation. We aim to investigate whether ω3FAs are associated with the prevalence of sarcopenic obesity (SO). (2) Methods: Data were obtained from the 2014–2018 Korean National Health and Nutrition Examination Survey. The ratio of daily ω3FA intake to energy intake (ω3FA ratio) was categorized into four quartile groups. (3) Results: The prevalence of SO from Q1 to Q4 was 8.9%, 11.3%, 11.0%, and 9.8% respectively, in men and 17.4%, 14.0%, 13.9%, and 10.1% respectively, in women. The ω3FA ratio in individuals with and without SO were 1.0% and 0.9% in men (p-value = 0.271) respectively, and 0.8% and 1.0% in women (p-value = 0.017), respectively. Compared with Q1, odds ratios (95% confidence intervals) of Q2, Q3, and Q4 of ω3FA ratios were 1.563 (0.802–3.047), 1.246 (0.611–2.542), and 0.924 (0.458–1.864) respectively, in men and 0.663 (0.379–1.160), 0.640 (0.372–1.102), and 0.246 (0.113–0.534) respectively, in women, after fully adjusting for confounding factors. (4) Conclusions: The ω3FA ratio was significantly higher in older females without SO than in older females with SO. The ω3FA ratio was associated with the prevalence of SO in elderly females.

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