Enteropathogen Changes After Rotavirus Vaccine Scale-up

PEDIATRICS ◽  
2021 ◽  
Author(s):  
Sarah-Blythe Ballard ◽  
David Requena ◽  
Holger Mayta ◽  
Gerardo J. Sanchez ◽  
Maria G. Oyola-Lozada ◽  
...  
Keyword(s):  
Scale Up ◽  
Age Groups ◽  
Enterotoxigenic Escherichia Coli ◽  
Rotavirus Vaccine ◽  
Rotavirus Vaccination ◽  
Heat Stable ◽  
Shigella Spp ◽  
Norovirus Gii ◽  
Age Range ◽  
And Control

OBJECTIVES: To inform next steps in pediatric diarrhea burden reduction by understanding the shifting enteropathogen landscape after rotavirus vaccine implementation. METHODS: We conducted a case-control study of 1788 medically attended children younger than 5 years, with and without gastroenteritis, after universal rotavirus vaccine implementation in Peru. We tested case and control stools for 5 viruses, 19 bacteria, and parasites; calculated coinfection-adjusted attributable fractions (AFs) to determine pathogen-specific burdens; and evaluated pathogen-specific gastroenteritis severity using Clark and Vesikari scales. RESULTS: Six pathogens were independently positively associated with gastroenteritis: norovirus genogroup II (GII) (AF 29.1, 95% confidence interval [CI]: 28.0–32.3), rotavirus (AF 8.9, 95% CI: 6.8–9.7), sapovirus (AF 6.3, 95% CI: 4.3–7.4), astrovirus (AF 2.8, 95% CI: 0.0–4.0); enterotoxigenic Escherichia coli heat stable and/or heat labile and heat stable (AF 2.4, 95% CI: 0.6–3.1), and Shigella spp. (AF 2.0, 95% CI: 0.4–2.2). Among typeable rotavirus cases, we most frequently identified partially heterotypic strain G12P[8] (54 of 81, 67%). Mean severity was significantly higher for norovirus GII–positive cases relative to norovirus GII–negative cases (Vesikari [12.7 vs 11.8; P < .001] and Clark [11.7 vs 11.4; P = .016]), and cases in the 6- to 12-month age range relative to cases in other age groups (Vesikari [12.7 vs 12.0; P = .0002] and Clark [12.0 vs 11.4; P = .0016]). CONCLUSIONS: Norovirus is well recognized as the leading cause of pediatric gastroenteritis in settings with universal rotavirus vaccination. However, sapovirus is often overlooked. Both norovirus and sapovirus contribute significantly to the severe pediatric disease burden in this setting. Decision-makers should consider multivalent vaccine acquisition strategies to target multiple caliciviruses in similar countries after successful rotavirus vaccine implementation.

scholarly journals Global Impact of Rotavirus Vaccination on Diarrhea Hospitalizations and Deaths Among Children <5 Years Old: 2006–2019

2020 ◽  
Vol 222 (10) ◽  
pp. 1731-1739 ◽  
Author(s):  
Eleanor Burnett ◽  
Umesh D Parashar ◽  
Jacqueline E Tate
Keyword(s):  
Age Groups ◽  
Published Data ◽  
Rotavirus Vaccine ◽  
Immunization Programs ◽  
Median Percentage ◽  
Global Impact ◽  
Vaccine Introduction ◽  
Rotavirus Vaccination ◽  
Younger Age ◽  
Before And After

Abstract Background Since 2006, more than 100 countries have introduced rotavirus vaccine into their immunization programs. We reviewed published data on relative reductions of rotavirus hospitalizations, acute gastroenteritis (AGE) hospitalizations, and AGE deaths among children &lt;5 years old. Methods Articles published from January 1, 2006 to December 31, 2019 with at least 12 months of data before and after rotavirus vaccine introduction were included. Relative reductions were abstracted into a standardized form. Descriptive statistics are presented as medians and interquartile ranges (IQRs). Results We reviewed 1827 total records and included 105 articles from 49 countries. Among children &lt;5 years old, there was a median reduction of 59% (IQR, 46–74) in rotavirus hospitalizations, 36% (IQR, 23–47) in AGE hospitalizations, and 36% (IQR, 28–46) AGE mortality. Reductions were larger in countries with low child mortality, among younger age groups, and in countries with higher coverage. The median percentage of specimens that tested positive for rotavirus among children &lt;5 years old hospitalized for diarrhea was 40% (IQR, 28–45) before rotavirus vaccine introduction and 20% (IQR, 20–20) 4 years after introduction. Conclusions Overall, we found sustained impact on rotavirus and AGE hospitalizations and deaths. These results should encourage countries still considering rotavirus vaccine implementation.

scholarly journals Lack of effect of supplementation with essential fatty acids on bone mineral density in healthy pre- and postmenopausal women:two randomized controlled trials of Efacal® v. calcium alone

2000 ◽  
Vol 83 (6) ◽  
pp. 629-635 ◽  
Author(s):  
E. Joan Bassey ◽  
Julie J. Littlewood ◽  
M. Claire Rothwell ◽  
David W. Pye
Keyword(s):  
Bone Turnover ◽  
Age Groups ◽  
Group Differences ◽  
Mineral Density ◽  
Control Groups ◽  
Treatment Groups ◽  
Markers Of Bone Turnover ◽  
Total Body ◽  
Age Range ◽  
And Control

Randomized controlled trials of the effects of the dietary supplement Efacal® (Scotia Pharmaceuticals Plc, Guildford, Surrey, UK) v. Ca only on total body bone mineral density (BMD) and markers of bone turnover were conducted in healthy pre- and postmenopausal women separately. Total daily dose for 12 months for the Efacal® groups was: Ca 1·0 g, evening primrose oil 4·0 g and marine fish oil 440 mg; and for the control groups was: Ca 1·0 g. Reported compliance was better than 90 % in both age groups. For the forty-three premenopausal women (age range 25–40 years), initial mean total body BMD values were similar for Efacal® and control groups and both groups showed highly significant mean increases of about 1 %; however, there were no significant between-group differences for the changes in BMD or markers of bone turnover. For the forty-two postmenopausal women (age range 50–65 years), initial mean total body BMD values were again well-matched across treatment groups. Both Efacal® and control groups showed highly significant decreases in total body BMD of about 1 %, but again there were no significant between-group differences in total body BMD or markers of bone turnover. Possible confounding variables such as initial total body BMD were explored but had no effect on the outcome in either age group. Nail quality improved in both age groups and in both Efacal® and control groups. Again, there was no significant difference between treatment groups. No evidence was found to support a beneficial effect of Efacal® on BMD in these women.

scholarly journals Criterion validity of a Wechsler-III scale short form in a sample of Brazilian Elderly

2010 ◽  
Vol 4 (3) ◽  
pp. 207-213
Author(s):  
Eliane Ferreira Carvalho Banhato ◽  
Isabel Cristina Gonçalves Leite ◽  
Danielle Viveiros Guedes ◽  
Alfredo Chaoubah
Keyword(s):  
Short Form ◽  
Age Groups ◽  
The Elderly ◽  
Total Sample ◽  
Criterion Validity ◽  
Predictive Values ◽  
Clock Drawing Test ◽  
Sensitivity Specificity ◽  
Age Range ◽  
And Control

Abstract Although a normative process, changes in cognitive functioning vary among older adults. The differential diagnosis between normal and pathological aging must be made early using psychometrically adequate measures. Objectives: To assess the evidence of criterion validity of a Short Form (SF) of the Wechsler-III Scale containing eight subtests (SF8) by determining its sensitivity, specificity, positive and negative predictive values and cut-off points for Brazilian elderly from different age groups. Methods: 168 individuals, aged 60 years or above, living in the community or in an institution, were assigned to case and control groups, and investigated according to age range. Measures included a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), Verbal Fluency Test, Clock-Drawing Test and the SF8. Results: More than two thirds of the sample was women (73.8%), mean age was 74.5 years (SD=8.9), mean education was 6.2 years (SD=4.8) and 40.5% were widows/widowers. In the total sample, the best cut-off point for the SF8 was 142 while cut offs among individuals aged 60 to 69 years, 70 to 79 years, and more than 80 years were 160, 129 and 129, respectively. Conclusions: The results demonstrated the importance of different cut-off points for different age ranges. Sensitivity and specificity values of the SF8 were sufficiently high to warrant the use of the SF8 as an instrument to identify cognitive impairment in the elderly.

Intussusception Rates Before and After the Introduction of Rotavirus Vaccine

2018 ◽  
pp. 61-67
Author(s):  
Jacqueline E. Tate ◽  
Catherine Yen ◽  
Claudia A. Steiner ◽  
Margaret M. Cortese ◽  
Umesh D. Parashar
Keyword(s):  
Age Groups ◽  
Population Level ◽  
Hospitalization Rate ◽  
Rotavirus Vaccine ◽  
Vaccine Introduction ◽  
Rotavirus Vaccination ◽  
Before And After ◽  
Increase Risk ◽  
Consistent Change ◽  
Rate Ratios

BACKGROUND Recent US studies have identified a small increased risk of intussusception after rotavirus vaccination, mainly after the first dose. We examined trends in intussusception hospitalizations before (2000–2005) and after (2007–2013) rotavirus vaccine introduction to assess whether this observed temporal risk translates into more hospitalized cases at the population level. METHODS Intussusception hospitalizations in children &lt;12 months of age were abstracted from the State Inpatient Database maintained by the Healthcare Cost and Utilization Project for 26 states that provided data from 2000 to 2013. Rates were calculated using bridged-race postcensal population estimates. Trends were analyzed by age groups (6–14 weeks, 15–24 weeks, and 25–34 weeks) based on the recommended ages for vaccine administration as well as 8–11 weeks when the majority of first doses are given. Rate ratios were calculated by using Poisson regression. RESULTS No consistent change in intussusception hospitalization rates was observed among all children &lt;12 months of age and among children 15 to 24 weeks and 25 to 34 weeks of age. The intussusception hospitalization rate for children aged 8 to 11 weeks was significantly elevated by 46% to 101% (range: 16.7–22.9 per 100 000) in all postvaccine years except 2011 and 2013 compared with the prevaccine baseline (11.7 per 100 000). CONCLUSIONS The increase in the intussusception hospitalization rate in children 8 to 11 weeks when the majority of first doses of vaccine are given is consistent with recent US postlicensure studies. Given the magnitude of declines in rotavirus disease compared with this small increase in intussusception, the benefits of rotavirus vaccination outweigh the increase risk of intussusception.

Reaction Times and Movement Times: Benefits of Practice to Younger and Older Adults

1996 ◽  
Vol 4 (1) ◽  
pp. 27-41 ◽  
Author(s):  
Kathye E. Light ◽  
Marie A. Reilly ◽  
Andrea L. Behrman ◽  
Waneen W. Spirduso
Keyword(s):  
Older Adults ◽  
Movement Time ◽  
Age Groups ◽  
Memory Task ◽  
Reaction Times ◽  
Control Groups ◽  
Arm Reaching ◽  
Age Range ◽  
And Control ◽  
Response Consistency

The purpose of this study was to examine the effect of practice on simple reaction time (RT), movement time (MT), and response consistency for two arm-reaching tasks of graded complexity in younger and older adults. Forty subjects, 20 younger adults (age range = 20–29 years) and 20 older adults (age range = 60–82 years), were randomly subdivided into practice and control groups. All subjects were pretested on each arm-reaching movement on Day 1. The practice groups practiced each task for 160 trials over 2 consecutive days while the control groups practiced a memory task and answered a health survey. All subjects were posttested on Day 3. The major finding was that practice reduced the simple RTs of older persons to the level of younger persons. MTs for both practice age groups were reduced, but the age differences in MT performance were maintained.

Clinical, epidemiological and climatic factors related to the occurrence of cutaneous leishmaniasis in an endemic area in northeastern Brazil

2020 ◽  
Author(s):  
R. S. Oliveira ◽  
K. B. A. Pimentel ◽  
M. L. Moura ◽  
C. F. Aragão ◽  
A. S. Guimarães-e-Silva ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Climatic Factors ◽  
Wide Distribution ◽  
Northeastern Brazil ◽  
Public Health Issue ◽  
Air Humidity ◽  
Disease Occurrence ◽  
Relative Air Humidity ◽  
Age Range ◽  
And Control

Abstract Cutaneous leishmaniasis (CL) is a neglected tropical disease with a wide distribution in the Americas. Brazil is an endemic country and present cases in all states. This study aimed to describe the occurrence, the underlying clinical and epidemiological factors, and the correlation of climatic variables with the frequency of reported CL cases in the municipality of Caxias, state of Maranhão, Brazil. This is a retrospective and descriptive epidemiological study based on data extracted from the Brazilian Information System of Diseases Notification, from 2007 to 2017. Maximum and minimum temperature, precipitation, and relative air humidity data were provided by the Brazilian National Institute of Meteorology. A total of 201 reported autochthonous CL cases were analyzed. The predominance of cases was observed in males (70.1%). The age range between 31 and 60 years old was the most affected, with 96 cases (47.9%). Of the total number of registered cases, 38.8% of the affected individuals were engaged in agriculture-related activities. The georeferenced distribution revealed the heterogeneity of disease occurrence, with cases concentrated in the Western and Southern regions of the municipality. An association was detected between relative air humidity (monthly mean) and the number of CL cases per month (p = 0.04). CL continues to be a concerning public health issue in Caxias. In this context, there is a pressing need to strengthen measures of prevention and control of the disease through the network of health services of the municipality, considering local and regional particularities.

scholarly journals Exploring Why Adult Mexican Males Do Not Get Vaccinated: Implications for COVID-19 Preventive Actions

2020 ◽  
Vol 42 (4) ◽  
pp. 515-527
Author(s):  
V. Nelly Salgado de Snyder ◽  
Deliana Garcia ◽  
Roxana Pineda ◽  
Jessica Calderon ◽  
Dania Diaz ◽  
...  
Keyword(s):  
Preventive Medicine ◽  
Age Groups ◽  
Adult Males ◽  
Cross Sectional ◽  
Administrative Services ◽  
Minority Males ◽  
Socially Disadvantaged ◽  
Preventive Actions ◽  
Socially Excluded ◽  
Age Range

Vaccination is the single most important preventive medicine action worldwide. However, there are inequalities in the procurement of vaccines particularly among US ethnic and racial minority males when compared to the rest of the US population. This study explored the reasons given by adult Mexican-origin males residing in Texas, for obtaining or not, immunizations. This was a cross-sectional, exploratory study with a sample of convenience of 401 adult males (age range 18–79) who were invited to participate in the study while waiting their turn to receive administrative services at the Mexican Consulate in Austin Texas. Data was collected in Spanish with a seven-item multiple choice questionnaire, using electronic tablets. The majority of respondents received their last vaccination longer than 5 years earlier. A higher percentage of individuals in the older age groups received a vaccine in the last year, as opposed to their younger counterparts who obtained their last immunization 3 to 5 years earlier. Among the reasons given for not getting vaccinated were lack of time or money, feared injections and side effects, insufficient information, interest or motivation. Others did not get vaccines because they perceived themselves to be healthy and did not feel sick. Findings from this study have important implications for future preventive medicine and vaccination practices that reach socially excluded groups in times of COVID-19. Recommendations are made to facilitate access to vaccines to the target group of this study and other socially disadvantaged populations in the global health context.

scholarly journals Ten-year trends of hypertension treatment and control rate in Korea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kwang-il Kim ◽  
Eunjeong Ji ◽  
Jung-yeon Choi ◽  
Sun-wook Kim ◽  
Soyeon Ahn ◽  
...  
Keyword(s):  
Age Groups ◽  
Favorable Effect ◽  
Age Group ◽  
Hypertension Treatment ◽  
Treatment Rate ◽  
Cross Sectional ◽  
The Past ◽  
Nationally Representative ◽  
Multistage Sampling ◽  
And Control

AbstractWe analyzed the Korean National Health and Nutrition Examination Survey (KNHANES) database to determine the trends of hypertension treatment and control rate in Korea over the past 10 years. In addition, we tried to investigate the effect of chronic medical conditions on hypertension management. We investigated the hypertension prevalence, awareness, treatment, and control rate from 2008 to 2017. KNHANES, which uses a stratified multistage sampling design, is a cross-sectional, nationally representative survey conducted by the Korean government. A total of 59,282 adults (≥ 20 years) were included, which was representative of the total population of around 40 million Koreans per year. The mean age was 50.7 ± 16.4 years and 42.6% were male. The prevalence of hypertension, hypercholesterolemia, diabetes mellitus, and obesity significantly increased over the 10 years. During this period, the hypertension treatment and control rate significantly improved. Hypertension treatment rate was significantly lower in the younger age group compared to the older age group, but the control rate among the treated patients was not significantly different between age groups. The treatment and control rates of hypertension were higher in patients with multimorbidity, which implies that it has a favorable effect on the treatment and control of hypertension. Hypertension treatment and control rate have improved over the past 10 years. The higher treatment and control rate in patients with multimorbidity suggest that the more aggressive surveillance might be associated with the improvement of hypertension treatment and control rate in Korea.

scholarly journals Prevalence, awareness, treatment, and control of dyslipidemia among diabetes mellitus patients and predictors of optimal dyslipidemia control: results from the Korea National Health and Nutrition Examination Survey

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Seung Jae Kim ◽  
Oh. Deog Kwon ◽  
Kyung-Soo Kim
Keyword(s):  
Diabetes Mellitus ◽  
Optimal Control ◽  
National Health ◽  
Age Groups ◽  
Density Lipoprotein ◽  
Nutrition Examination Survey ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Factors Influencing ◽  
And Control

Abstract Background This study aimed to investigate the prevalence, awareness, treatment, and control rates of dyslipidemia and identify the predictors of optimal control (low-density lipoprotein cholesterol < 100 mg/dL) among patients with diabetes mellitus (DM). Methods A cross-sectional study was conducted using the representative Korea National Health and Nutrition Examination Survey (2014–2018). Overall, 4311 patients with DM, aged ≥19 years, and without cardiovascular diseases were selected, and the prevalence, awareness, treatment, and control rates of dyslipidemia were calculated. Univariate and multivariate logistic regression analyses were conducted to evaluate the factors influencing the optimal control of dyslipidemia. Results Dyslipidemia was prevalent in 83.3% of patients with DM, but the awareness and treatment rates were 36.5 and 26.9%, respectively. The control rate among all patients with dyslipidemia was 18.8%, whereas it was 61.1% among those being treated. Prevalence and awareness rates were also significantly higher in women than in men. Dyslipidemia was most prevalent in those aged 19–39 years, but the rates of awareness, treatment, and control among all patients with dyslipidemia in this age group were significantly lower than those in other age groups. The predictors of optimal control were age ≥ 40 years [range 40–49 years: adjusted odds ratio (aOR) 3.73, 95% confidence interval (CI) 1.43–9.72; 50–59 years: aOR 6.25, 95% CI 2.50–15.65; 60–69 years: aOR 6.96, 95% CI 2.77–17.44; 70–79 years: aOR 9.21, 95% CI 3.58–23.74; and ≥ 80 years: aOR 4.43, 95% CI 1.60–12.27]; urban living (aOR 1.44, 95% CI 1.15–1.80); higher body mass index (aOR 1.27, 95% CI 1.13–1.42); lower glycated hemoglobin levels (aOR 0.71, 95% CI 0.67–0.76); hypertension (aOR 1.53, 95% CI 1.22–1.92); poorer self-rated health status (aOR 0.72, 95% CI 0.62–0.84); and receiving regular health check-ups (aOR 1.58, 95% CI 1.25–2.00). Conclusions Most patients with DM were diagnosed with dyslipidemia, but many were unaware of or untreated for their condition. Therefore, their control rate was suboptimal. Thus, by understanding factors influencing optimal control of dyslipidemia, physicians should make more effort to encourage patients to undergo treatment and thus, adequately control their dyslipidemia.

scholarly journals Characteristics of Osteoporosis & Osteoporotic Fractures in Korea Based on Health Insurance Review and Assessment (HIRA) Database: 2009–2017

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 324
Author(s):  
Ho-Seok Oh ◽  
Sung-Kyu Kim ◽  
Hyoung-Yeon Seo
Keyword(s):  
Health Insurance ◽  
Age Groups ◽  
Osteoporotic Fractures ◽  
Prescription Data ◽  
Diagnostic Codes ◽  
Number Of Patients ◽  
Upper And Lower Extremities ◽  
Fractures Of The Spine ◽  
And Gender ◽  
Age Range

To investigate the incidence and characteristics of osteoporosis and osteoporotic fractures in Korea, we used the Health Insurance Review and Assessment Service (HIRA) database. Patients over 50 years old, who were diagnosed or treated for osteoporosis and osteoporotic fractures in all hospitals and clinics, were analyzed between 1 January 2009 and 31 December 2017 by using the HIRA database that contains prescription data and diagnostic codes. These data were retrospectively analyzed by decade and age-specific and gender-specific incidents in each year. We also evaluated other characteristics of patients including medication state of osteoporosis, primary used medical institution, regional-specific incidence of osteoporosis, and incidence of site-specific osteoporotic fractures. The number of osteoporosis patients over 50 years old, as diagnosed by a doctor, steadily increased from 2009 to 2017. The number of osteoporosis patients was notably greatest in the 60′s and 70′s age groups in every study period. Patients undergoing treatment for osteoporosis increased significantly (96%) from 2009 to 2017. Among the patients diagnosed with osteoporosis, the proportion who experienced osteoporotic fracture increased gradually (60%) from 2009 to 2017. The number of patients with osteoporotic fractures of the spine and hip was highest in the 70 to 90 age range, and the number of patients with osteoporotic fractures in the upper and lower extremities was highest in the 50 to 70 age range. Understanding the trends of osteoporosis in Korea will contribute to manage the increased number of patients with osteoporosis and osteoporotic fractures.

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