scholarly journals Reduction in severity of all-cause gastroenteritis requiring hospitalisation in children vaccinated against rotavirus in Malawi

2021 ◽  
Author(s):  
Jonathan J Mandolo ◽  
Marc Henrion ◽  
Chimwemwe Mhango ◽  
End Chinyama ◽  
Richard Wachepa ◽  
...  
Keyword(s):  
Low Income ◽  
Severity Score ◽  
Age Groups ◽  
Rotavirus Vaccine ◽  
Low Income Country ◽  
Arm Circumference ◽  
Severity Scores ◽  
Severe Gastroenteritis ◽  
One Year ◽  
Mid Upper Arm Circumference

Background: Rotavirus is the major cause of severe gastroenteritis in children aged <5 years. Introduction of Rotarix rotavirus vaccine (RV1) in Malawi in 2012 has reduced rotavirus-associated hospitalisations and diarrhoeal mortality. However, RV1 impact on gastroenteritis severity remains unknown. We conducted a hospital-based surveillance study to assess RV1 impact on gastroenteritis severity in children aged <5 years, in Malawi. Methods: Stool samples were collected from children hospitalised with acute gastroenteritis from December 2011 to October 2019. Gastroenteritis severity was determined using Ruuska and Vesikari scores. Rotavirus was detected in stool using Enzyme Immunoassay. Rotavirus genotypes were determined using nested RT-PCR. Associations between RV1 vaccination and gastroenteritis severity were investigated using adjusted linear regression. Results: In total, 3,159 children were recruited. After adjusting for Mid-Upper Arm Circumference, age, weight, gender and receipt of other vaccines, all-cause gastroenteritis severity scores were 2.21 units lower (95% CI 1.85, 2.56; p<0.001) among RV1-vaccinated (n=2,224) compared to RV1-unvaccinated children (n=935); the decrease was comparable between rotavirus-positive and rotavirus-negative cases in all age groups. The reduction in severity score was observed against every rotavirus genotype, although the magnitude was smaller among those infected with G12P[6] compared to the remaining genotypes (p=0.011). Other than RV1 vaccination, age was the only variable associated with gastroenteritis severity. Each one-year increment in age was associated with a decrease of 0.43 severity score (95% CI 0.26, 0.60; p<0.001). Conclusion: Our findings provide additional evidence of RV1 impact in a high disease burden, low-income country, lending further support to rotavirus vaccine programme in Malawi.

scholarly journals Reduction in Severity of All-Cause Gastroenteritis Requiring Hospitalisation in Children Vaccinated against Rotavirus in Malawi

Viruses ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2491
Author(s):  
Jonathan J. Mandolo ◽  
Marc Y. R. Henrion ◽  
Chimwemwe Mhango ◽  
End Chinyama ◽  
Richard Wachepa ◽  
...  
Keyword(s):  
Severity Score ◽  
Rotavirus Vaccine ◽  
Rt Pcr ◽  
Arm Circumference ◽  
Severity Scores ◽  
Severe Gastroenteritis ◽  
Stool Samples ◽  
One Year ◽  
Mid Upper Arm Circumference ◽  
The Impact

Rotavirus is the major cause of severe gastroenteritis in children aged <5 years. Introduction of the G1P[8] Rotarix® rotavirus vaccine in Malawi in 2012 has reduced rotavirus-associated hospitalisations and diarrhoeal mortality. However, the impact of rotavirus vaccine on the severity of gastroenteritis presented in children requiring hospitalisation remains unknown. We conducted a hospital-based surveillance study to assess the impact of Rotarix® vaccination on the severity of gastroenteritis presented by Malawian children. Stool samples were collected from children aged <5 years who required hospitalisation with acute gastroenteritis from December 2011 to October 2019. Gastroenteritis severity was determined using Ruuska and Vesikari scores. Rotavirus was detected using enzyme immunoassay. Rotavirus genotypes were determined using nested RT-PCR. Associations between Rotarix® vaccination and gastroenteritis severity were investigated using adjusted linear regression. In total, 3159 children were enrolled. After adjusting for mid-upper arm circumference (MUAC), age, gender and receipt of other vaccines, all-cause gastroenteritis severity scores were 2.21 units lower (p < 0.001) among Rotarix®-vaccinated (n = 2224) compared to Rotarix®-unvaccinated children (n = 935). The reduction in severity score was observed against every rotavirus genotype, although the magnitude was smaller among those infected with G12P[6] compared to the remaining genotypes (p = 0.011). Each one-year increment in age was associated with a decrease of 0.43 severity score (p < 0.001). Our findings provide additional evidence on the impact of Rotarix® in Malawi, lending further support to Malawi’s Rotarix® programme.

scholarly journals The relationships between height and arm span, mid-upper arm and waist circumferences and sum of four skinfolds in Ellisras rural children aged 8–18 years

2015 ◽  
Vol 19 (7) ◽  
pp. 1195-1199 ◽  
Author(s):  
Kotsedi Daniel Monyeki ◽  
Michael Matome Sekhotha
Keyword(s):  
Waist Circumference ◽  
Pearson Correlation ◽  
Age Groups ◽  
Limpopo Province ◽  
Rural Children ◽  
Linear Regression Models ◽  
Upper Arm ◽  
Arm Span ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

AbstractObjectiveHeight is required for the assessment of growth and nutritional status, as well as for predictions and standardization of physiological parameters. To determine whether arm span, mid-upper arm and waist circumferences and sum of four skinfolds can be used to predict height, the relationships between these anthropometric variables were assessed among Ellisras rural children aged 8–18 years.DesignThe following parameters were measured according to the International Society for the Advancement of Kinathropometry: height, arm span, mid-upper arm circumference, waist circumference and four skinfolds (suprailiac, subscapular, triceps and biceps). Associations between the variables were assessed using Pearson correlation coefficients and linear regression models.SettingEllisras Longitudinal Study (ELS), Limpopo Province, South Africa.SubjectsBoys (n911) and girls (n858) aged 8–18 years.ResultsMean height was higher than arm span, with differences ranging from 4 cm to 11·5 cm between boys and girls. The correlation between height and arm span was high (ranging from 0·74 to 0·91) withP<0·001. The correlation between height and mid-upper arm circumference, waist circumference and sum of four skinfolds was low (ranging from 0·15 to 0·47) withP<0·00 among girls in the 15–18 years age group.ConclusionsArm span was found to be a good predictor of height. The sum of four skinfolds was significantly associated with height in the older age groups for girls, while waist circumference showed a negative significant association in the same groups.

scholarly journals Precision of Measurements Performed by a Cadre of Anthropometrists Trained for a Large Household Nutrition Survey in Ethiopia

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Cami Moss ◽  
Desalegn Kuche ◽  
Tesfaye Hailu Bekele ◽  
Mihretab Salasibew ◽  
Girmay Ayana ◽  
...  
Keyword(s):  
Low Income ◽  
Nutrition Interventions ◽  
Limits Of Agreement ◽  
Nutrition Survey ◽  
Low Income Country ◽  
Large Numbers ◽  
Arm Circumference ◽  
Satisfactory Precision ◽  
Large Household ◽  
Error Of Measurement

ABSTRACT Background Well-trained anthropometrists are essential for the delivery of high-quality anthropometric data used to evaluate public health nutrition interventions. Scant data are currently available on the precision of data collected by large teams of anthropometrists employed for nutrition surveys in low-income country settings. Objectives The purpose of this study was to assess the precision of child midupper arm circumference (MUAC) and length/height measurements taken by fieldworkers training for nutrition survey deployment. Methods Following 3 d of training, an anthropometry standardization exercise was conducted in small teams of trainees at 7 sites in the Amhara region of Ethiopia. In groups of 2–4, trainee anthropometrists (n = 79) each measured 16 children aged 6–47 mo (n = 336) twice for MUAC and length/height. Both intraobserver and interobserver precision were analyzed using technical error of measurement (TEM), relative TEM, coefficient of reliability (R), and repeatability metrics. Bland–Altman limits of agreement were calculated for intraobserver measurements. Results Intraobserver TEM was between 0.00 and 0.57 cm for MUAC (Bland–Altman 95% limits of agreement: −0.50 to 0.54 cm) and between 0.04 and 2.58 cm for length/height measurements (Bland–Altman 95% limits of agreement: –1.43 to 1.41 cm). Interobserver TEM was between 0.09 and 0.43 cm for MUAC and between 0.06 and 2.98 cm for length/height measurements. A high proportion of trainees achieved intraobserver R &gt;0.95 (MUAC: 95%; length/height: 97%). Most teams also achieved interobserver R &gt;0.95 (MUAC: 90%; length/height: 95%). Conclusions Large numbers of anthropometrists (&gt;75) in low-income settings can attain satisfactory precision in anthropometry following training and standardization. These protocols permit researchers to assess trainees, identify individuals who have not achieved the desired level of precision, and retrain or adjust roles prior to survey deployment.

scholarly journals A Nanoparticle-Based Trivalent Vaccine Targeting the Glycan Binding VP8* Domains of Rotaviruses

Viruses ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 72
Author(s):  
Ming Xia ◽  
Pengwei Huang ◽  
Xi Jiang ◽  
Ming Tan
Keyword(s):  
Low Income ◽  
Vaccine Candidate ◽  
Rotavirus Vaccine ◽  
Vaccine Production ◽  
Binding Function ◽  
Severe Gastroenteritis ◽  
New Type ◽  
Health Need ◽  
Trivalent Vaccine ◽  
Promising Vaccine Candidate

Rotavirus causes severe gastroenteritis in children. Although vaccines are implemented, rotavirus-related diarrhea still claims ~200,000 lives annually worldwide, mainly in low-income settings, pointing to a need for improved vaccine tactics. To meet such a public health need, a P24-VP8* nanoparticle displaying the glycan-binding VP8* domains, the major neutralizing antigens of rotavirus, was generated as a new type of rotavirus vaccine. We reported here our development of a P24-VP8* nanoparticle-based trivalent vaccine. First, we established a method to produce tag-free P24-VP8* nanoparticles presenting the VP8*s of P[8], P[4], and P[6] rotaviruses, respectively, which are the three predominantly circulating rotavirus P types globally. This approach consists of a chemical-based protein precipitation and an ion exchange purification, which may be scaled up for large vaccine production. All three P24-VP8* nanoparticle types self-assembled efficiently with authentic VP8*-glycan receptor binding function. After they were mixed as a trivalent vaccine, we showed that intramuscular immunization of the vaccine elicited high IgG titers specific to the three homologous VP8* types in mice. The resulted mouse sera strongly neutralized replication of all three rotavirus P types in cell culture. Thus, the trivalent P24-VP8* nanoparticles are a promising vaccine candidate for parenteral use against multiple P types of predominant rotaviruses.

scholarly journals ANTHROPOMETRY AND BLOOD HAEMOGLOBIN STATUS OF WOMEN IN MAKWANPUR DISTRICT, NEPAL

1970 ◽  
Vol 40 (140) ◽  
pp. 162-171
Author(s):  
B Manandhar ◽  
D Osrin ◽  
B P Shrestha ◽  
J R Shrestha ◽  
D S Manandhar ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Low Birthweight ◽  
Age Groups ◽  
Background Information ◽  
Upper Arm ◽  
Energy Deficiency ◽  
Chronic Energy Deficiency ◽  
Arm Circumference ◽  
Blood Haemoglobin ◽  
Mid Upper Arm Circumference

BackgroundThe nutritional situation of women in Nepal remains precarious. Low energy, protein andmicronutrient intakes contribute to high levels of stunting and anaemia throughout thelife cycle. This suboptimal nutritional status contributes to high prevalences of low birthweight and death in early infancy. As background information for an ongoing study ofperinatal health interventions in 24 Village Development Committees (VDCs) of MakwanpurDistrict, a descriptive study of nutritional status and anaemia in a sample of women wascarried out.ObjectivesTo measure weight, height, mid-upper arm circumference (MUAC) and blood haemoglobinin non-pregnant married women of reproductive age.MethodsParticipants aged between 15 and 49 years were recruited at 12 sites in five VDCs. Personaldetails were collected in each case, after which height, weight, mid-upper arm circumference(MUAC) and blood haemoglobin level were measured.ResultsResults are available for 500 women. Mean height was 149.9 cm (95% confidence intervalfor mean 149.5 – 150.4 cm); mean weight was 45.5 kg (95% CI 44.9 - 46.1 kg); mean BodyMass Index (BMI) was 20.2 kg/m2(95% CI 20.0 – 20.4 kg/m2); mean MUAC was 23.47 cm(95% CI 23.2 – 23.7 cm). Overall, 27.8% (95% CI 24.1 – 32.2%) of women showed evidenceof Chronic Energy Deficiency (CED) on the basis of BMI, and 51.5% (95% CI 47.0 –56.0%) on the basis of MUAC. There were no significant differences in BMI or MUACbetween either ethnic or age groups. 35.3% of women were anaemic (95% CI 31.1 – 39.7%),one percent severely so. There were no significant differences in prevalence between ethnicgroups, but there was some evidence of an increase in anaemia prevalence with age.ConclusionsCED and anaemia appear common in Makwanpur District. As part of a package to improvenewborn infant outcome, access to and uptake of haematinics during pregnancy should bebeneficial. Community level intervention needs to attempt to address the issue of foodintake in young girls and women before improvements in nutritional status are possibleKey Words: Anaemia, anthropometry, nutritional status, Nepal.

scholarly journals Nutritional Status of the Underfive Children at The Pediatric Ward of Dr. Pirngadi Hospital, Medan

2019 ◽  
Vol 32 (5-6) ◽  
pp. 135-43
Author(s):  
Kaswadharma K. C. ◽  
Arizal Arizal ◽  
Endang D. Hamid ◽  
Iskandar Z. Lubis ◽  
Sjarika T. Tarigan
Keyword(s):  
Observational Study ◽  
Nutritional Status ◽  
Severe Malnutrition ◽  
Upper Arm ◽  
Supplementary Food ◽  
Pediatric Ward ◽  
Arm Circumference ◽  
Duration Of Hospitalization ◽  
One Year ◽  
Mid Upper Arm Circumference

An observational study on the assesment of nutritional status of the underfive children at the pediatric ward of Dr. Pirngadi hospital, Medan was conducted during February to March 1990. Nutritional status was determined usi11.g the parameters of Weight/Age (WIA), Weight/Height (WIH) and Mid upper Arm Circumference (MUAC) in accordance with the Seminar on Nutritional Anthropometry 1975. One-hundred and eighty patients were included in this study, consisting of 115 (67, 6%) children less than one year and 65 (32, 4%) children 1 - 5 years. According to the Weight/Age parameter there were 46.7% wellnourished children 42.8% with moderate and 10.5% with severe malnutrition on admission, while on discharge they were 48.3%, 42.8% and 8.9% (p > 0.05) respectively. Weight/Height and Mid upper Arm Circumference parameters also failed to reveal significant differences. The duration of hospitalization ranged from 1 to 3 0 days (mean 5 days). The most predominant disease was gastroenteritis with dehydration (68.9%). In 54.4% of patients, breast-feeding had been given until 6 month of age, while supplementary food starting before the age of 2 months was found in 52.2% . The incidence of undernutrition in underfive children was high.

scholarly journals The initial experience of InterSurgeon: an online platform to facilitate global neurosurgical partnerships

2020 ◽  
Vol 48 (3) ◽  
pp. E15 ◽  
Author(s):  
Jacob R. Lepard ◽  
S. Hassan A. Akbari ◽  
Faizal Haji ◽  
Matthew C. Davis ◽  
William Harkness ◽  
...  
Keyword(s):  
Low Income ◽  
Income Country ◽  
First Year ◽  
Initial Contact ◽  
Initial Experience ◽  
Middle Income ◽  
International Partnerships ◽  
Low Income Country ◽  
Social Network Dynamics ◽  
One Year

OBJECTIVEDespite general enthusiasm for international collaboration within the organized neurosurgical community, establishing international partnerships remains challenging. The current study analyzes the initial experience of the InterSurgeon website in partnering surgeons from across the world to increase surgical collaboration.METHODSOne year after the launch of the InterSurgeon website, data were collected to quantify the number of website visits, average session duration, total numbers of matches, and number of offers and requests added to the website each month. Additionally, a 15-question survey was designed and distributed to all registered members of the website.RESULTSThere are currently 321 surgeon and institutional members of InterSurgeon representing 69 different countries and all global regions. At the time of the survey there were 277 members, of whom 76 responded to the survey, yielding a response rate of 27.4% (76/277). Twenty-five participants (32.9%) confirmed having either received a match email (12/76, 15.8%) or initiated contact with another user via the website (13/76, 17.1%). As expected, the majority of the collaborations were either between a high-income country (HIC) and a low-income country (LIC) (5/18, 27.8%) or between an HIC and a middle-income country (MIC) (9/18, 50%). Interestingly, there were 2 MIC-to-MIC collaborations (2/18, 11.1%) as well as 1 MIC-to-LIC (1/18, 5.6%) and 1 LIC-to-LIC partnership. At the time of response, 6 (33.3%) of the matches had at least resulted in initial contact via email or telephone. One of the partnerships had involved face-to-face interaction via video conference. A total of 4 respondents had traveled internationally to visit their partner’s institution.CONCLUSIONSWithin its first year of launch, the InterSurgeon membership has grown significantly. The partnerships that have already been formed involve not only international visits between HICs and low- to middle-income countries (LMICs), but also telecollaboration and inter-LMIC connections that allow for greater exchange of knowledge and expertise. As membership and site features grow to include other surgical and anesthesia specialties, membership growth and utilization is expected to increase rapidly over time according to social network dynamics.

scholarly journals Very Early Anthropometric Changes After Antiretroviral Therapy Predict Subsequent Survival, in Karonga, Malawi

2012 ◽  
Vol 6 (1) ◽  
pp. 36-44 ◽  
Author(s):  
David Maman ◽  
Judith R Glynn ◽  
Amelia C Crampin ◽  
Katharina Kranzer ◽  
Jacqueline Saul ◽  
...  
Keyword(s):  
Large Scale ◽  
Cox Regression ◽  
Scale Up ◽  
First Year ◽  
Clinical Criteria ◽  
Arm Circumference ◽  
Stage 4 ◽  
Detailed Assessment ◽  
One Year ◽  
Mid Upper Arm Circumference

Background: Antiretroviral (ART) scale-up in Malawi has been achieved on a large scale based mainly on clinical criteria. Simple markers of prognosis are useful, and we investigated the value of very early anthropometric changes in predicting mortality. Methods: Principal findings: Adult patients who initiated ART in Karonga District, northern Malawi, between September 2005 and August 2006 were included in a prospective cohort study, and followed for up to one year. We used Cox regression to examine the association between anthropometric changes at 2 and 6 weeks and deaths within the first year. 573 patients were included, of whom 59% were women; the median age at initiation was 37 and 64% were in WHO stage 4. Both body mass index (BMI) and mid-upper arm circumference (MUAC) increased linearly with increased time on ART, and were closely correlated with each other. There were 118 deaths. After 2 weeks on ART, a BMI increase of <0.5 kg/m2 (HR 2.47, 95%CI 1.24-4.94, p=0.005) or a MUAC increase of <0.5cm (HR 2.79, 95%CI 1.19-6.55, p=0.008) were strong predictors of death, and these associations were stronger after adjusting for baseline charactertistics. Similar results were found after 6 weeks on ART. Conclusions: Very early anthropometric changes, after 2 and 6 weeks on ART, are strong predictors of survival, independent of baseline characteristics. This should help identify patients requiring more detailed assessment where facilities are limited. MUAC is particularly valuable, requiring the simplest equipment and being appropriate for patients who have problems standing.

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