scholarly journals Baseline incidence of meningitis, malaria, mortality and other health outcomes in infants and young sub-Saharan African children prior to the introduction of the RTS,S/AS01E malaria vaccine

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Keyword(s):  
Health Outcomes ◽  
Prospective Cohort ◽  
Disease Surveillance ◽  
Malaria Vaccine ◽  
Incidence Rates ◽  
Age Group ◽  
Malaria Mortality ◽  
Vaccine Introduction ◽  
Baseline Incidence ◽  
Sub Saharan

Abstract Background The lack of background disease incidence rates in sub-Saharan countries where the RTS,S/AS01E malaria vaccine is being implemented may hamper the assessment of vaccine safety and effectiveness. This study aimed to document baseline incidence rates of meningitis, malaria, mortality, and other health outcomes prior to vaccine introduction through the Malaria Vaccine Implementation Programme. Methods An ongoing disease surveillance study is combining prospective cohort event monitoring and hospital-based disease surveillance in three study sites in Ghana and Kenya. An interim analysis was performed on the prospective cohort in which children were enrolled in two age-groups (the 5 to 17 months or 6 to 12 weeks age-group), capturing data in the framework of routine medical practice before the introduction of the malaria vaccine. Incidence and mortality rates were computed with 95% confidential intervals (CI) using an exact method for a Poisson variable. Results This analysis includes 14,329 children; 7248 (50.6%) in the 6 to 12 weeks age-group and 7081 (49.4%) in the 5 to 17 months age-group. In the 5 to 17 months age-group (where the malaria vaccine was planned to be subsequently rolled out) the meningitis, malaria, severe malaria and cerebral malaria incidences were 92 (95% CI 25–236), 47,824 (95% CI 45,411–50,333), 1919 (95% CI 1461–2476) and 33 (95% CI 1–181) per 100,000 person-years, respectively. The all-cause mortality was 969 (95% CI 699–1310) per 100,000 person-years. Conclusion Incidence estimates of multiple health outcomes are being generated to allow before-after vaccine introduction comparisons that will further characterize the benefit-risk profile of the RTS,S/AS01E vaccine. Trial registration: clinicaltrials.gov NCT02374450.

scholarly journals A high incidence of intussusception in Japan as studied in a sentinel hospital over a 25-year period (1978–2002)

2005 ◽  
Vol 134 (1) ◽  
pp. 57-61 ◽  
Author(s):  
T. NAKAGOMI ◽  
Y. TAKAHASHI ◽  
K. ARISAWA ◽  
O. NAKAGOMI
Keyword(s):  
Local Community ◽  
Secular Trend ◽  
Incidence Rates ◽  
Geographic Variability ◽  
Vaccine Introduction ◽  
Rotavirus Vaccines ◽  
High Incidence ◽  
Baseline Incidence ◽  
Clinical Records

SUMMARYThe development of second-generation rotavirus vaccines requires knowledge of baseline incidence rates for intussusception in infants prior to vaccine introduction. To obtain such estimates we reviewed clinical records in a hospital that served as the major provider of paediatric beds in a local community in the northern part of Japan. During the 25-year period (1978–2002), there were 91 hospitalizations due to radiologically confirmed intussusception in children <5 years of age, of which 45% were <1 year of age. Assuming that all children with intussusception in the area had been admitted to this hospital, there were an average of 185 and 78 hospitalizations per 100 000 person-years for children <1 year old and 5 years old respectively. There was period-to-period variability with no long-term secular trend in the incidence of intussusception. The incidence rate in Japan was among the highest thus far reported, providing further evidence of geographic variability.

scholarly journals Estimated impact of RTS,S/AS01 malaria vaccine allocation strategies in sub-Saharan Africa: A modelling study

PLoS Medicine ◽  
2020 ◽  
Vol 17 (11) ◽  
pp. e1003377
Author(s):  
Alexandra B. Hogan ◽  
Peter Winskill ◽  
Azra C. Ghani
Keyword(s):  
Public Health ◽  
Malaria Vaccine ◽  
Vaccine Coverage ◽  
Health Impact ◽  
Sub Saharan Africa ◽  
Phase Iii ◽  
Public Health Impact ◽  
Vaccine Introduction ◽  
Dose Constraint ◽  
Sub Saharan

Background The RTS,S/AS01 vaccine against Plasmodium falciparum malaria infection completed phase III trials in 2014 and demonstrated efficacy against clinical malaria of approximately 36% over 4 years for a 4-dose schedule in children aged 5–17 months. Pilot vaccine implementation has recently begun in 3 African countries. If the pilots demonstrate both a positive health impact and resolve remaining safety concerns, wider roll-out could be recommended from 2021 onwards. Vaccine demand may, however, outstrip initial supply. We sought to identify where vaccine introduction should be prioritised to maximise public health impact under a range of supply constraints using mathematical modelling. Methods and findings Using a mathematical model of P. falciparum malaria transmission and RTS,S vaccine impact, we estimated the clinical cases and deaths averted in children aged 0–5 years in sub-Saharan Africa under 2 scenarios for vaccine coverage (100% and realistic) and 2 scenarios for other interventions (current coverage and World Health Organization [WHO] Global Technical Strategy targets). We used a prioritisation algorithm to identify potential allocative efficiency gains from prioritising vaccine allocation among countries or administrative units to maximise cases or deaths averted. If malaria burden at introduction is similar to current levels—assuming realistic vaccine coverage and country-level prioritisation in areas with parasite prevalence >10%—we estimate that 4.3 million malaria cases (95% credible interval [CrI] 2.8–6.8 million) and 22,000 deaths (95% CrI 11,000–35,000) in children younger than 5 years could be averted annually at a dose constraint of 30 million. This decreases to 3.0 million cases (95% CrI 2.0–4.7 million) and 14,000 deaths (95% CrI 7,000–23,000) at a dose constraint of 20 million, and increases to 6.6 million cases (95% CrI 4.2–10.8 million) and 38,000 deaths (95% CrI 18,000–61,000) at a dose constraint of 60 million. At 100% vaccine coverage, these impact estimates increase to 5.2 million cases (95% CrI 3.5–8.2 million) and 27,000 deaths (95% CrI 14,000–43,000), 3.9 million cases (95% CrI 2.7–6.0 million) and 19,000 deaths (95% CrI 10,000–30,000), and 10.0 million cases (95% CrI 6.7–15.7 million) and 51,000 deaths (95% CrI 25,000–82,000), respectively. Under realistic vaccine coverage, if the vaccine is prioritised sub-nationally, 5.3 million cases (95% CrI 3.5–8.2 million) and 24,000 deaths (95% CrI 12,000–38,000) could be averted at a dose constraint of 30 million. Furthermore, sub-national prioritisation would allow introduction in almost double the number of countries compared to national prioritisation (21 versus 11). If vaccine introduction is prioritised in the 3 pilot countries (Ghana, Kenya, and Malawi), health impact would be reduced, but this effect becomes less substantial (change of <5%) if 50 million or more doses are available. We did not account for within-country variation in vaccine coverage, and the optimisation was based on a single outcome measure, therefore this study should be used to understand overall trends rather than guide country-specific allocation. Conclusions These results suggest that the impact of constraints in vaccine supply on the public health impact of the RTS,S malaria vaccine could be reduced by introducing the vaccine at the sub-national level and prioritising countries with the highest malaria incidence.

scholarly journals Incidence of HIV in Sub-Saharan Africa, 2000–2015: The Interplay Between Social Determinants and Behavioral Risk Factors

2021 ◽  
Author(s):  
Deepa Jahagirdar ◽  
Magdalene Walters ◽  
Avina Vongpradith ◽  
Xiaochen Dai ◽  
Amanda Novotney ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Incidence Rates ◽  
Sub Saharan Africa ◽  
Behavioral Risk ◽  
Hiv Incidence ◽  
Hiv Knowledge ◽  
African Countries ◽  
Final Model ◽  
Sub Saharan ◽  
Disease Study

AbstractHIV incidence in sub-Saharan Africa declined substantially between 2000 and 2015. In this analysis, we consider the relative associations of nine structural and individual determinants with this decline. A linear mixed effects model of logged HIV incidence rates versus determinants was used. The data were from mathematical modelling as part of the 2019 Global Burden of Disease Study in 43 sub-Saharan African countries. We used forwards selection to determine a single final model of HIV incidence rate. The association of economic variables and HIV knowledge with incidence was found to be driven by education, while ART coverage had the largest impact on other determinants’ coefficients. In the final model, education years per capita contributed the most to explaining variation in HIV incidence rates; a 1-year increase in mean education years was associated with a 0.39 (− 0.56; − 0.2, t = − 4.48 p < 0.01) % decline in incidence rate while a unit increase in ART coverage was associated with a 0.81 (− 1.34; − 0.28, t = − 3.01, p < 0.01) % decline in incidence rate.

Undernutrition and HIV Infection in Sub-Saharan Africa: Health Outcomes and Therapeutic Interventions

2021 ◽  
Vol 18 (2) ◽  
pp. 87-97
Author(s):  
Hubaida Fuseini ◽  
Ben A. Gyan ◽  
George B. Kyei ◽  
Douglas C. Heimburger ◽  
John R. Koethe
Keyword(s):  
Hiv Infection ◽  
Health Outcomes ◽  
Sub Saharan Africa ◽  
Therapeutic Interventions ◽  
Sub Saharan

scholarly journals Age and Sex Specific Trends in Incidence of Juvenile Idiopathic Arthritis in Danish Birth Cohorts from 1992 to 2002: A Nationwide Register Linkage Study

2021 ◽  
Vol 18 (16) ◽  
pp. 8331
Author(s):  
Isabel Cardoso ◽  
Peder Frederiksen ◽  
Ina Olmer Specht ◽  
Mina Nicole Händel ◽  
Fanney Thorsteinsdottir ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Regression Model ◽  
Incidence Rate ◽  
Poisson Regression ◽  
Linkage Study ◽  
Incidence Rates ◽  
Age Group ◽  
Poisson Regression Model ◽  
Birth Cohorts ◽  
Age And Sex

This study reports age- and sex-specific incidence rates of juvenile idiopathic arthritis (JIA) in complete Danish birth cohorts from 1992 through 2002. Data were obtained from the Danish registries. All persons born in Denmark, from 1992–2002, were followed from birth and until either the date of first diagnosis recording, death, emigration, 16th birthday or administrative censoring (17 May 2017), whichever came first. The number of incident JIA cases and its incidence rate (per 100,000 person-years) were calculated within sex and age group for each of the birth cohorts. A multiplicative Poisson regression model was used to analyze the variation in the incidence rates by age and year of birth for boys and girls separately. The overall incidence of JIA was 24.1 (23.6–24.5) per 100,000 person-years. The rate per 100,000 person-years was higher among girls (29.9 (29.2–30.7)) than among boys (18.5 (18.0–19.1)). There were no evident peaks for any age group at diagnosis for boys but for girls two small peaks appeared at ages 0–5 years and 12–15 years. This study showed that the incidence rates of JIA in Denmark were higher for girls than for boys and remained stable over the observed period for both sexes.

scholarly journals Breast cancer survival and survival gap apportionment in sub-Saharan Africa (ABC-DO): a prospective cohort study

2020 ◽  
Vol 8 (9) ◽  
pp. e1203-e1212 ◽  
Author(s):  
Valerie McCormack ◽  
Fiona McKenzie ◽  
Milena Foerster ◽  
Annelle Zietsman ◽  
Moses Galukande ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cancer Survival ◽  
Breast Cancer Survival ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals The Economic Impact of Inflammatory Bowel Disease in Canada

2004 ◽  
Vol 18 (4) ◽  
pp. 255-257
Author(s):  
Robert Hilsden
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Labour Force ◽  
Incidence Rates ◽  
Age Group ◽  
Group Level ◽  
The Past ◽  
Inflammatory Bowel ◽  
Using Data ◽  
Very High

Longobardi and colleagues examined the effect of inflammatory bowel disease (IBD) on employment, using data from 10,891 respondents aged 20 to 64 years from the 1998 cycle of the Canadian National Population Health Survey (NPHS) (1). This sample included 187 (1.7%) subjects who self-reported IBD or a similar bowel disorder. A significantly greater proportion of IBD than non-IBD respondents reported that they were not in the labour force (28.9% versus 18.5%). Even after adjusting for other factors (age group, level of pain, etc), subjects with IBD had a 2.9% higher nonparticipation rate (21.4%). For example, among people not hospitalized within the past year and with no limitation of activities due to pain, IBD subjects were 1.2 times more likely to be unemployed than those without IBD. Subjects who reported high levels of pain had a very high probability of being out of the labour force. Based on Canadian annual compensation data for all employed persons in Canada, and age- and sex-specific prevalence, and incidence rates for IBD, the authors estimated that there are 119,980 IBD patients between the ages of 20 and 64 years in Canada and that this group includes 3479 people who are not in the labour force. This translates into lost wages of $104.2 million, or $868 per IBD patient

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