scholarly journals Evaluation of the impact of childhood 13-valent pneumococcal conjugate vaccine introduction on adult pneumonia in Ulaanbaatar, Mongolia: study protocol for an observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Claire von Mollendorf ◽  
Mukhchuluun Ulziibayar ◽  
Bradford D. Gessner ◽  
Lien Anh Ha Do ◽  
Cattram D. Nguyen ◽  
...  
Keyword(s):  
Pneumococcal Vaccination ◽  
Health Impact ◽  
Population Based ◽  
Community Acquired Pneumonia ◽  
Primary Objective ◽  
Asia Pacific ◽  
Vaccine Type ◽  
Indirect Impact ◽  
Syncytial Virus ◽  
The Impact

Abstract Background Community-acquired pneumonia is an important cause of morbidity and mortality in adults. Approximately one-third of pneumonia cases can be attributed to the pneumococcus. Pneumococcal conjugate vaccines (PCVs) protect against colonisation with vaccine-type serotypes. The resulting decrease in transmission of vaccine serotypes leads to large indirect effects. There are limited data from developing countries demonstrating the impact of childhood PCV immunisation on adult pneumonia. There are also insufficient data available on the burden and severity of all-cause pneumonia and respiratory syncytial virus (RSV) in adults from low resource countries. There is currently no recommendation for adult pneumococcal vaccination with either pneumococcal polysaccharide vaccine or PCVs in Mongolia. We describe the protocol developed to evaluate the association between childhood 13-valent PCV (PCV13) vaccination and trends in adult pneumonia. Methods PCV13 was introduced into the routine childhood immunisation schedule in Mongolia in a phased manner from 2016. In March 2019 we initiated active hospital-based surveillance for adult pneumonia, with the primary objective of evaluating trends in severe hospitalised clinical pneumonia incidence in adults 18 years and older in four districts of Ulaanbaatar. Secondary objectives include measuring the association between PCV13 introduction and trends in all clinically-defined pneumonia, radiologically-confirmed pneumonia, nasopharyngeal carriage of S. pneumoniae and pneumonia associated with RSV or influenza. Clinical questionnaires, nasopharyngeal swabs, urine samples and chest radiographs were collected from enrolled patients. Retrospective administrative and clinical data were collected for all respiratory disease-related admissions from January 2015 to February 2019. Discussion Establishing a robust adult surveillance system may be an important component of monitoring the indirect impact of PCVs within a country. Monitoring indirect impact of childhood PCV13 vaccination on adult pneumonia provides additional data on the full public health impact of the vaccine, which has implications for vaccine efficiency and cost-effectiveness. Adult surveillance in Mongolia will contribute to the limited evidence available on the burden of pneumococcal pneumonia among adults in low- and middle-income countries, particularly in the Asia-Pacific region. In addition, it is one of the few examples of implementing prospective, population-based pneumonia surveillance to evaluate the indirect impact of PCVs in a resource-limited setting.

scholarly journals Age-stratified burden of pneumococcal community acquired pneumonia in hospitalised Canadian adults from 2010 to 2015

2020 ◽  
Vol 7 (1) ◽  
pp. e000550 ◽  
Author(s):  
Jason LeBlanc ◽  
May ElSherif ◽  
Lingyun Ye ◽  
Donna MacKinnon-Cameron ◽  
Ardith Ambrose ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Burden Of Illness ◽  
Pneumococcal Vaccination ◽  
Community Acquired Pneumonia ◽  
Age Cohorts ◽  
Vaccine Recommendations ◽  
Vaccine Type ◽  
Age Cohort ◽  
Testing Patient ◽  
The Impact

BackgroundIn Canada, 13-valent pneumococcal conjugate vaccine (PCV13) is recommended in childhood, in individuals at high risk of invasive pneumococcal disease (IPD) and in healthy adults aged ≥65 years for protection against vaccine-type IPD and pneumococcal community-acquired pneumonia (pCAP). Since vaccine recommendations in Canada include both age-based and risk-based guidance, this study aimed to describe the burden of vaccine-preventable pCAP in hospitalised adults by age.MethodsSurveillance for community-acquired pneumonia (CAP) in hospitalised adults was performed prospectively from 2010 to 2015. CAP was radiologically confirmed, and pCAP was identified using blood and sputum culture and urine antigen testing. Patient demographics and outcomes were stratified by age (16–49, 50–64, ≥65 and ≥50 years).ResultsOf 6666/8802 CAP cases tested, 830 (12.5%) had pCAP, and 418 (6.3%) were attributed to a PCV13 serotype. Of PCV13 pCAP, 41% and 74% were in adults aged ≥65 and ≥50 years, respectively. Compared with non-pCAP controls, pCAP cases aged ≥50 years were more likely to be admitted to intensive care units (ICUs) and to require mechanical ventilation. Older adults with pCAP were less likely to be admitted to ICU or required mechanical ventilation, given their higher mortality and goals of care. Of pCAP deaths, 67% and 90% were in the ≥65 and ≥50 age cohorts, respectively.ConclusionsAdults hospitalised with pCAP in the age cohort of 50–64 years contribute significantly to the burden of illness, suggesting that an age-based recommendation for adults aged ≥50 years should be considered in order to optimise the impact of pneumococcal vaccination programmes in Canada.

Youth Mentor Dietary Outcomes and Waist Circumference Improvement: Camp NERF Study Findings

2019 ◽  
Vol 21 (6) ◽  
pp. 962-971
Author(s):  
Laura C. Hopkins ◽  
Alison Webster ◽  
Julie A. Kennel ◽  
Kelly M. Purtell ◽  
Carolyn Gunther
Keyword(s):  
Mental Health ◽  
Waist Circumference ◽  
Child Nutrition ◽  
Intervention Strategy ◽  
Health Impact ◽  
Primary Objective ◽  
Positive Role ◽  
Sugar Sweetened Beverage ◽  
The Impact ◽  
Depth Interviews

Background. The health impact of youth mentors serving in the delivery of child nutrition and physical activity (PA) interventions on youth mentors themselves has been understudied. Objective. The primary objective of the current study was to examine the impact of engaging youth mentors in the delivery of a summertime childhood obesity prevention intervention on youth mentors’ behavioral health. Method. Data were collected at baseline and postintervention. A survey of validated nutrition, mental health, PA, and psychosocial questionnaires was administered. Diet was assessed via 24-hour recall. Height, weight, and waist circumference (WC) were measured. In-depth interviews were conducted with youth mentors. Results. Eleven youth mentors enrolled: 60% were female, mean age was 16.1 ± 0.38 years, and 100% were Black. Mean kilocalories ( p = .05), sugar-sweetened beverage intake ( p = .08), and waist circumference ( p = .04) decreased. In-depth interviews were conducted with 11 youth mentors, and three themes emerged: perceived improvement in nutrition, PA, and mental health-related behaviors; formation of a positive role modeling relationship with the child campers; and strengthening of higher education goals and future career aspirations. Conclusions. Youth mentor staffing may be an important intervention strategy for changing health behaviors among youth mentors. Results from this study can be used to inform utilization of youth mentors in the delivery of this and similar health behavior interventions in the future.

scholarly journals Use of Multiple Imputation to Estimate the Proportion of Respiratory Virus Detections Among Patients Hospitalized With Community-Acquired Pneumonia

2018 ◽  
Vol 5 (4) ◽  
Author(s):  
Catherine H Bozio ◽  
W Dana Flanders ◽  
Lyn Finelli ◽  
Anna M Bramley ◽  
Carrie Reed ◽  
...  
Keyword(s):  
Multiple Imputation ◽  
Population Based ◽  
Community Acquired Pneumonia ◽  
Influenza Viruses ◽  
Absolute Difference ◽  
Respiratory Illnesses ◽  
Active Population ◽  
Syncytial Virus ◽  
Using Data ◽  
Relative Differences

Abstract Background Real-time polymerase chain reaction (PCR) on respiratory specimens and serology on paired blood specimens are used to determine the etiology of respiratory illnesses for research studies. However, convalescent serology is often not collected. We used multiple imputation to assign values for missing serology results to estimate virus-specific prevalence among pediatric and adult community-acquired pneumonia hospitalizations using data from an active population-based surveillance study. Methods Presence of adenoviruses, human metapneumovirus, influenza viruses, parainfluenza virus types 1–3, and respiratory syncytial virus was defined by positive PCR on nasopharyngeal/oropharyngeal specimens or a 4-fold rise in paired serology. We performed multiple imputation by developing a multivariable regression model for each virus using data from patients with available serology results. We calculated absolute and relative differences in the proportion of each virus detected comparing the imputed to observed (nonimputed) results. Results Among 2222 children and 2259 adults, 98.8% and 99.5% had nasopharyngeal/oropharyngeal specimens and 43.2% and 37.5% had paired serum specimens, respectively. Imputed results increased viral etiology assignments by an absolute difference of 1.6%–4.4% and 0.8%–2.8% in children and adults, respectively; relative differences were 1.1–3.0 times higher. Conclusions Multiple imputation can be used when serology results are missing, to refine virus-specific prevalence estimates, and these will likely increase estimates.

scholarly journals 1238Estimating the non-specific effects of seasonal influenza vaccine on RSV-hospitalisations in children

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Huong Le ◽  
Christopher Blyth ◽  
Heather Gidding ◽  
Tom Snelling ◽  
Parveen Fathima ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Seasonal Influenza ◽  
Vaccine Coverage ◽  
Population Based ◽  
Vaccine Uptake ◽  
Respiratory Pathogens ◽  
Seasonal Influenza Vaccine ◽  
Specific Effects ◽  
Syncytial Virus ◽  
The Impact

Abstract Background Seasonal influenza vaccine is effective against influenza hospitalisations, but little is known about non-specific effects on other respiratory pathogens with similar seasonal patterns. We aimed to assess the causal impact of seasonal influenza vaccine on laboratory-confirmed hospitalisations for respiratory syncytial virus (RSV) in children using an instrumental variable (IV) strategy. Methods We used population-based probabilistically linked data on births, childhood immunisations, deaths, hospitalisations, perinatal and statewide microbiology data (2000-2013) in Western Australia (WA). Our analysis cohort included children up to age 7 years. We exploited WA’s unique preschool influenza vaccination policy commencing in 2008 and used this as an instrument for vaccination status. We estimated a system of two simultaneous probit equations: determinants of influenza vaccine uptake, and determinants of RSV-confirmed hospitalisation. Results Influenza vaccine coverage was low prior to 2008 but increased to 33.7% in children aged 6-23 months in 2009. RSV-hospitalisations ranged from 3.5/1000 children (12-23 months) to 6.4/1000 (6-12 months). Receipt of seasonal influenza vaccine reduced RSV-hospitalisations in the population cohort of children aged <2 years by an average of 0.21% in the same year (p < 0.001). Conclusions To our knowledge, this is the first analysis utilising an IV estimation strategy to assess the impact of influenza vaccine on RSV-hospitalisations. We estimated a small, but highly statistically significant impact that warrants further investigation using contemporary data. Key messages RSV is a leading cause of childhood morbidity. The role of influenza vaccine offering cross protection to RSV could be further explored prior to RSV vaccines being commercially available.

scholarly journals Trauma and orthopaedic team members’ mental health during the COVID-19 pandemic

2020 ◽  
Vol 1 (6) ◽  
pp. 316-325 ◽  
Author(s):  
Amit Thakrar ◽  
Ali Raheem ◽  
Karen Chui ◽  
Edward Karam ◽  
Lilanthi Wickramarachchi ◽  
...  
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Health Impact ◽  
Primary Objective ◽  
Cross Sectional ◽  
Team Members ◽  
Black African ◽  
Black British ◽  
African Caribbean ◽  
The Impact

Aims Healthcare systems have been rapidly restructured to meet COVID-19 demand. Clinicians are working to novel clinical guidelines, treating new patient cohorts and working in unfamiliar environments. Trauma and orthopaedics (T&O) has experienced cancellation of routine clinics and operating, with redistribution of the workload and human resources. To date, no studies have evaluated the mental health impact of these changes on the T&O workforce. We report the results of a novel survey on the impact of the pandemic on the mental health of our orthopaedic workforce and the contributory factors. Methods A 20-question survey-based cross-sectional study of orthopaedic team members was conducted during the COVID-19 pandemic. The primary objective was to identify the impact of the pandemic on mental health in the form of major depressive disorder (MDD) and general anxiety disorder (GAD). The survey incorporated the patient health questionnaire (PHQ-2), which is validated for screening of MDD, and the generalized anxiety disorder questionnaire (GAD-2), which is validated for screening of GAD. Results There were 62 respondents (18 females and 44 males). As compared to the general population, we noted a greater estimated prevalence of GAD (17.7% vs 5.9%, p = 0.0009297) and MDD (19.4% vs 3.3%, p = 0.0000007731). The prevalence of MDD symptoms was greatest among senior house officers (SHOs) (p = 0.02216). Female respondents scored higher for symptoms of MDD (p = 0.03583) and GAD (p = 0.0001086). Those identifying as ‘Black, African, Caribbean or Black British’ displayed a higher prevalence of GAD symptoms (p = 0.001575) and felt least supported at work (p = 0.001341). Conclusion Our study, in the first of its kind, shows a significant prevalence of GAD and MDD in the workforce. We found that SHOs, females and those of Black, African, Caribbean, or Black British origin were disproportionately affected. Action should be taken to help prevent adverse mental health outcomes for our colleagues during the pandemic. Cite this article: Bone Joint Open 2020;1-6:316–325.

scholarly journals Community-Acquired Pneumonia Requiring Hospitalization among French Guianese Children

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Alexandre Cannesson ◽  
Narcisse Elenga
Keyword(s):  
Haemophilus Influenzae ◽  
French Guiana ◽  
Whooping Cough ◽  
Signs And Symptoms ◽  
Community Acquired Pneumonia ◽  
Vaccine Preventable Diseases ◽  
Syncytial Virus ◽  
Respiratory Signs And Symptoms ◽  
Epidemiological Characteristics ◽  
The Impact

Community-acquired pneumonia remains a leading cause of hospitalizations among children worldwide. The diagnosis is based on the history, the physical examination results in children with fever plus respiratory signs and symptoms, and chest radiography. The microbiological etiology is confirmed by viral testing and hemocultures. The most likely etiology depends on the age of the child. The features of childhood pneumonia vary between countries and territories. The purpose of this study was to describe the epidemiological characteristics and current microbial ecology of community-acquired pneumonia in children in French Guiana. We performed a retrospective, descriptive, and monocentric study between January 1, 2015, and December 31, 2017, in the pediatric ward of the Cayenne Hospital in French Guiana. The studied population was aged from 0 to 15 years and 3 months and hospitalized for acute community-acquired pneumonia. A total of 415 patients (mean age 3.62 years) were included. A pathogen was identifiable in 22.4% of cases, including bacteria in 61.3%, viruses in 43%, and coinfections in 14%. The main pathogens were respiratory syncytial virus (31.2%), Streptococcus pneumoniae (20.4%), Haemophilus influenzae (11.8%), and Mycoplasma pneumoniae (10.8%). The burden of hospitalization for children with community-acquired pneumonia was highest among less than 2 years, in whom respiratory viruses were the most commonly detected causes of pneumonia. The share of vaccine-preventable diseases (S. pneumoniae, H. influenzae, and influenza) remains high. With the vaccination requirement imposed since 1 January 2018 against pneumococcus, Haemophilus influenzae, and whooping cough and the possibility of practicing multiplex PCR in our hospital, it will be interesting to study the impact of this law enforcement on new child generations and compare these new data to our study.

scholarly journals Trauma and orthopaedic team members’ mental health during the COVID-19 pandemic

2020 ◽  
Vol 1 (6) ◽  
pp. 316-325 ◽  
Author(s):  
Amit Thakrar ◽  
Ali Raheem ◽  
Karen Chui ◽  
Edward Karam ◽  
Lilanthi Wickramarachchi ◽  
...  
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Health Impact ◽  
Primary Objective ◽  
Cross Sectional ◽  
Team Members ◽  
Black African ◽  
Black British ◽  
African Caribbean ◽  
The Impact

Aims Healthcare systems have been rapidly restructured to meet COVID-19 demand. Clinicians are working to novel clinical guidelines, treating new patient cohorts and working in unfamiliar environments. Trauma and orthopaedics (T&O) has experienced cancellation of routine clinics and operating, with redistribution of the workload and human resources. To date, no studies have evaluated the mental health impact of these changes on the T&O workforce. We report the results of a novel survey on the impact of the pandemic on the mental health of our orthopaedic workforce and the contributory factors. Methods A 20-question survey-based cross-sectional study of orthopaedic team members was conducted during the COVID-19 pandemic. The primary objective was to identify the impact of the pandemic on mental health in the form of major depressive disorder (MDD) and general anxiety disorder (GAD). The survey incorporated the patient health questionnaire (PHQ-2), which is validated for screening of MDD, and the generalized anxiety disorder questionnaire (GAD-2), which is validated for screening of GAD. Results There were 62 respondents (18 females and 44 males). As compared to the general population, we noted a greater estimated prevalence of GAD (17.7% vs 5.9%, p = 0.0009297) and MDD (19.4% vs 3.3%, p = 0.0000007731). The prevalence of MDD symptoms was greatest among senior house officers (SHOs) (p = 0.02216). Female respondents scored higher for symptoms of MDD (p = 0.03583) and GAD (p = 0.0001086). Those identifying as ‘Black, African, Caribbean or Black British’ displayed a higher prevalence of GAD symptoms (p = 0.001575) and felt least supported at work (p = 0.001341). Conclusion Our study, in the first of its kind, shows a significant prevalence of GAD and MDD in the workforce. We found that SHOs, females and those of Black, African, Caribbean, or Black British origin were disproportionately affected. Action should be taken to help prevent adverse mental health outcomes for our colleagues during the pandemic. Cite this article: Bone Joint Open 2020;1-6:316–325.

The Impact of Different Validation Datasets on Air Quality Modeling Performance

2018 ◽  
Vol 2672 (25) ◽  
pp. 57-66 ◽  
Author(s):  
Haneen Khreis ◽  
Kees de Hoogh ◽  
Josias Zietsman ◽  
Mark J. Nieuwenhuijsen
Keyword(s):  
Air Quality ◽  
Spatial Resolution ◽  
Atmospheric Dispersion ◽  
Health Impact ◽  
Primary Objective ◽  
Validation Dataset ◽  
Health Impact Assessments ◽  
Secondary Objective ◽  
Pollution Modeling ◽  
The Impact

Many studies rely on air pollution modeling such as land use regression (LUR) or atmospheric dispersion (AD) modeling in epidemiological and health impact assessments. Generally, these models are only validated using one validation dataset and their estimates at select receptor points are generalized to larger areas. The primary objective of this paper was to explore the effect of different validation datasets on the validation of air quality models. The secondary objective was to explore the effect of the model estimates’ spatial resolution on the models’ validity at different locations. Annual NOx and NO2 were generated using a LUR and an AD model. These estimates were validated against four measurement datasets, once when estimates were made at the exact locations of the validation points and once when estimates were made at the centroid of the 100m×100m grid in which the validation point fell. The validation results varied substantially based on the model and validation dataset used. The LUR models’ R2 ranged between 21% and 58%, based on the validation dataset. The AD models’ R2 ranged between 13% and 56% based on the validation dataset and the use of constant or varying background NOx. The validation results based on model estimates at the exact validation site locations were much better than those based on a 100m×100m grid. This paper demonstrated the value of validating modeled air quality against various datasets and suggested that the spatial resolution of the models’ estimates has a significant influence on the validity at the application point.

DOES CHILDHOOD NUTRITION PREDICT HEALTH OUTCOMES DURING ADULTHOOD? EVIDENCE FROM A POPULATION-BASED STUDY IN CHINA

2015 ◽  
Vol 47 (5) ◽  
pp. 650-666 ◽  
Author(s):  
YAQIANG QI ◽  
JIANLIN NIU
Keyword(s):  
Health Outcomes ◽  
Health Indicators ◽  
Health Impact ◽  
Subjective Health ◽  
Population Based ◽  
Late Childhood ◽  
Adult Health ◽  
Childhood Nutrition ◽  
Wide Range ◽  
The Impact

SummaryUsing data collected from the 2008 survey of Internal Migration and Health in China, this study examines the impact of late childhood nutrition intakes on a wide range of indicators of adult health. The results show that respondents who consume rich nutrients (meat, fish, milk, etc.) less frequently during late childhood have worse health outcomes when they grow up. They are more likely to rate their health as ‘fair/poor’, report a greater number of chronic diseases, have a higher incidence of acute illness, perceive greater numbers of physical pains/discomforts and to suffer more from insomnia and depression. With respect to objective biometrics, respondents who have less access to rich nutrients at age 14 tend to attain a shorter stature, gain more weight as an adult, and are more likely to become obese or have low lung capacity. Taken together, the evidence in support of a harmful impact of late childhood undernutrition on adult health is stronger and more consistent for subjective health indicators than for the objective biometrics examined in this study. Moreover, the results also indicate that the long-term health impact of late childhood nutrition deprivation is especially detrimental for females in China.

scholarly journals Risk factors for community-acquired pneumonia in German adults: the impact of children in the household

2007 ◽  
Vol 135 (8) ◽  
pp. 1389-1397 ◽  
Author(s):  
M. SCHNOOR ◽  
T. KLANTE ◽  
M. BECKMANN ◽  
B. P. ROBRA ◽  
T. WELTE ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adult Population ◽  
Population Based ◽  
Community Acquired Pneumonia ◽  
Number Of Children ◽  
Chronic Pulmonary Diseases ◽  
Independent Risk Factors ◽  
The Impact ◽  
Self Administered Questionnaire ◽  
Control Study

SUMMARYThe objective of this case-control study was to identify the main risk factors for community-acquired pneumonia (CAP) in a German adult population. A self-administered questionnaire was given to CAP cases provided by the German competence network CAPNETZ and population-based, randomly selected controls (sex- and age-matched). Multivariate analysis showed that in addition to known risk factors such as previous CAP [odds ratio (OR) 1·6, 95% confidence interval (CI) 1·3–2·1], more than one respiratory infection during the previous year (OR 3·6, 95% CI 2·9–4·5), chronic pulmonary diseases (OR 2·3, 95% CI 1·7–3·0), number of comorbidities (OR 1·6, 95% CI 1·4–1·9), and number of children in the household (2 children: OR 2·2, 95% CI 1·5–3·4; ⩾3 children: OR 3·2, 95% CI 1·5–7·0) were independent risk factors for CAP. This was pronounced in particular in people aged ⩽65 years. The most likely explanation for this finding is higher exposure to infectious agents.

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