scholarly journals The vaccine coverage and vaccine immunity status and risk factors of non-protective levels of antibodies against vaccines in children with juvenile idiopathic arthritis: cross-sectional Russian tertiary Centre study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Mikhail M. Kostik ◽  
Natalia A. Lubimova ◽  
Irina V. Fridman ◽  
Olga V. Goleva ◽  
Susanna M. Kharit

Abstract Background Immunosuppressive drugs, incomplete vaccine coverage, immune system dysregulation might be factors of a low level of anti-vaccine antibodies in JIA patients. The study aimed to evaluate vaccine coverage, post-vaccine immunity, and risk factors of non-protective levels of antibodies against measles, mumps, rubella, hepatitis B, and diphtheria in JIA patients. Methods A cross-sectional study included 170 children diagnosed with JIA aged 2 to 17 years who received routine vaccinations against measles, rubella, mumps (MMR), diphtheria, and hepatitis B national vaccine schedule. In all patients, the levels of post-vaccination antibodies (IgG) for measles, rubella, mumps, hepatitis B, and diphtheria were measured with ELISA. Results Protective level of antibodies were 50% against hepatitis B, 52% - diphtheria, 58% - measles, 80% - mumps, 98% rubella. MMR’s best coverage had patients with enthesitis-related arthritis-85%, compared to oligoarthritis-70%, polyarthritis-69%, systemic arthritis-63%. Diphtheria coverage was 50, 51, 46, 63%, respectively. Incomplete MMR vaccination had 39% patients, treated with biologics, 22% with methotrexate and 14% with NSAID (p = 0.025), and 61, 46, 36% for diphtheria (p = 0.021). Incomplete vaccination was a risk factor of non-protective level of antibodies against measles (HR = 2.03 [95%CI: 1.02; 4.0], p = 0.042), mumps (HR = 6.25 [95%CI: 2.13; 17.9], p = 0.0008) and diphtheria (HR = 2.39 [95%CI: 1.18; 4.85], p = 0.016) vaccines, as well as JIA category, biologics, corticosteroids and long-term methotrexate treatment for distinct vaccines. One-third part of JIA patients continued vaccination against MMR and diphtheria without serious adverse events and JIA flare. There were no differences between patients who continued MMR vaccination or denied in the means of JIA category and treatment options. Patients, continued diphtheria vaccination rare received methotrexate (p = 0.02), biologics (p = 0.004), but had higher levels of anti-diphtheria antibodies (p = 0.024) compare who omitted vaccination. Methotrexate (OR = 9.5 [95%CI: 1.004; 90.3]) and biologics (OR = 4.4 [95%CI: 1.6; 12.1]) were predictors of omitted diphtheria revaccination. Conclusion Children with JIA may have lower anti-vaccine antibody levels and required routine checks, especially in children with incomplete vaccination, biologics, systemic arthritis, and long-term methotrexate treatment. Revaccination of JIA patients was safe and effective.

2021 ◽  
Author(s):  
Mikhail Kostik ◽  
Natalia A. Lubimova ◽  
Irina V. Fridman ◽  
Olga V. Goleva ◽  
Susanna M. Kharit

Abstract Background: Immunosuppressive drugs, decreased vaccine coverage, aberrant immunity might be factors of low anti-vaccine antibodies in JIA patients. The study aimed to evaluate vaccine coverage, post-vaccine immunity and risk factors of non-protective levels of antibodies against measles, mumps, rubella, hepatitis B and diphtheria in JIA patients. Methods: A prospective study included 170 children diagnosed with JIA aged 2 to 17 years, who received routine vaccinations against measles, rubella, mumps (MMR) diphtheria and hepatitis B. In all patients, the levels of post-vaccination antibodies (IgG) for measles, rubella, mumps, hepatitis B and diphtheria measured with ELISA.Results: Protective level of antibodies were 50% against hepatitis B, 52% - diphtheria, 58% - measles, 80% - mumps, 98% rubella. The best coverage for MMR had patients with enthesytis-related arthritis-85%, compare to oligoarthritis-70%, polyarthritis-69%, systemic arthritis-63%. Diphtheria coverage was 50%, 51%, 46%, 63%, respectively. Incomplete MMR vaccination had 39% patients, treated with biologics, 22% with methotrexate and 14% with NSAID (p=0.025), and 61%, 46%, 36% for diphtheria (p=0.021). Incomplete vaccination was a risk factor of non-protective level of antibodies against measles (HR=2.03 [95%CI: 1.02; 4.0], p=0.042), parotitis (HR=6.25 [95%CI: 2.13; 17.9], p=0.0008) and diphtheria (HR=2.39 [95%CI: 1.18; 4.85], p=0.016) vaccines, as well as JIA category, biologics, corticosteroids and long-term methotrexate treatment for distinct vaccines.Conclusion: Children with JIA may have lower anti-vaccine antibodies levels and required routine check, especially in children with incomplete vaccination, biologics, systemic arthritis and long-term methotrexate treatment.


Sexual Health ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 89 ◽  
Author(s):  
Jillian S. Y. Lau ◽  
Dilip Ratnam ◽  
Ian Woolley

Previously we found that local patients were often not tested for HIV prior to commencing nucleoside/nucleotide reverse transcription inhibitor (NRTI) therapy for hepatitis B virus. We performed a national cross-sectional cohort study of physician practices via an online survey. A small majority (23/44; 52%) of participants reported always testing their hepatitis B virus patients for HIV prior to NRTI therapy, and 8/44 (18%) reported testing for HIV the majority of the time. Thirteen (30%) respondents reported testing only if risk factors were present. One physician reported a patient seroconverting to HIV while on TDF monotherapy.


PLoS ONE ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. e0210359
Author(s):  
Kaat Goorts ◽  
Sofie Vandenbroeck ◽  
Tinne Vander Elst ◽  
Dorina Rusu ◽  
Marc Du Bois ◽  
...  

1970 ◽  
Vol 42 (3) ◽  
pp. 199-203
Author(s):  
ND Uleanya ◽  
EO Obidike

Background: Hepatitis B Virus (HBV) infection has reached pandemic proportions all over the world with areas of highest prevalence being the sub- Saharan Africa and Southeast Asia. Most deaths related to HBV are due to complications from chronic infection. Acquisition of infection at a younger age is the most important predictor of chronicity. Eradication of HBV is an important but difficult tasks facing public health. HB immunization is the single most important factor in hepatitis B control and was commenced in 2004 in Nigeria.Objectives: To determine the prevalence of Hepatitis B surface antigen (HBsAg) among children in the era of HB immunization, the risk factors of transmission and knowledge of mothers about their HB status.Methods: A cross sectional study carried out on one hundred and forty children aged 18 months to 15 years at the children outpatient clinic (CHOP) of the University of Nigeria Teaching Hospital, Ituku. Hepatitis B surface antigen (HBsAg) was determined using Determine Test Kits and a structured interviewer administered questionnaire administered.Results: Six were positive for HBsAg, giving a prevalence rate of 4.3%. HBsAg was least prevalent among children 1-5 years (2%). None of the children ≤ 5 years who received HB vaccination was positive for HBsAg though one child > 5 years who received the vaccine was positive. Sharing of toothbrushes among siblings was found to be a significantly associated risk factor. Only 6.4% of mothers knew their hepatitis B status.Conclusion: There is a gradual fall in the prevalence of HBsAg in our environment due to HB immunization. Sharing of toothbrushes may be a potent means of transmission of HBV infection.Keywords: HBV, Prevalence, Children, Transmission, HB immunization


2021 ◽  
Vol 14 (11) ◽  
Author(s):  
Mariana Dias de Borba ◽  
Carlos Eduardo da Cunha Nascimento ◽  
Gabriel Mael Sussuarana Silva Lobo ◽  
Lucca Gonçalo de Castro Lima ◽  
Camila Lays Winter ◽  
...  

Brazil has the National Immunization Program for disease prevention that offers nineteen vaccines, yet it is known that vaccination coverage according to age is not always reached. Thus, this study aimed to evaluate the vaccination coverage in the municipality of Sinop, in the Mato Grosso state and in the Brazil for meningococcal C conjugate vaccines and Hepatitis B in the period from 2015 to 2019. Method: This is a descriptive, retrospective and cross-sectional study, with data available in the Information System of the National Immunization Program. Results: Vaccination coverage for mingococcal C in children under one year in Sinop was above the target in 2015 and 2018, Mato Grosso was above only in 2015, for the booster dose only Sinop was above the target in 2016. Coverage for hepatitis B in children under 30 days of life demonstrated that Sinop had coverage above the state of Mato Grosso, which in turn was above Brazil. For children under 1 year old, only in 2016 and 2019 the state presented greater vaccination coverage at the expense of Sinop and Brazil. Conclusion: The results demonstrate that there is hesitation on the part of the population regarding vaccination, being greater in vaccines such as meningococcal C. Strengthening childcare is the key to improving the panorama of vaccine coverage.


Author(s):  
Aung-Hein Aung ◽  
Kala Kanagasabai ◽  
Jocelyn Koh ◽  
Pei-Yun Hon ◽  
Brenda Ang ◽  
...  

BACKGROUND Movement of patients in a healthcare network poses challenges for the control of carbapenemase-producing Enterobacteriaceae (CPE). We aimed to identify intra- and inter-facility transmission events and facility type-specific risk factors of CPE in an acute care hospital (ACH) and its intermediate-term and long-term care facilities (ILTCFs). METHODS Serial cross-sectional studies were conducted in June-July of 2014-2016 to screen for CPE. Whole genome sequencing was done to identify strain relatedness and CPE genes (blaIMI; blaIMP-1; blaKPC-2; blaNDM-1; blaOXA-48). Multivariable logistic regression models, stratified by facility type were used to determine independent risk factors. RESULTS Of 5357 patients, half (55%) were from the ACH. CPE prevalence was 1.3% in the ACH and 0.7% in ILTCFs (p=0.029). After adjusting for socio-demographics, screening year, and facility type, the odds of CPE colonization increased significantly with hospital stay ≥ 3 weeks (aOR 2.67, 95%CI 1.17-6.05), penicillins use (aOR 3.00, 95%CI 1.05–8.56), proton pump inhibitors use (aOR 3.20, 95%CI 1.05–9.80), dementia (aOR 3.42, 95%CI 1.38–8.49), connective tissue disease (aOR 5.10, 95%CI 1.19-21.81), and prior carbapenem-resistant Enterobacteriaceae (CRE) carriage (aOR 109.02, 95%CI 28.47–417.44) in the ACH. For ILTCFs, presence of wound (aOR 5.30, 95%CI 1.01–27.72), respiratory procedures (aOR 4.97, 95%CI 1.09-22.71), vancomycin-resistant Enterococci carriage (aOR 16.42, 95%CI 1.52–177.48), and CRE carriage (aOR 758.30, 95%CI 33.86-16982.52) showed significant association. Genomic analysis revealed only possible intra-ACH transmission, and no evidence for ACH-to-ILTCFs transmission. CONCLUSIONS Although CPE colonization was predominantly in the ACH, risk factors varied between facilities. Targeted screening and precautionary measures are warranted.


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