scholarly journals Using Population-Based Structures to Actively Monitor AEFIs during a Mass Immunization Campaign—A Case of Measles–Rubella and Polio Vaccines

Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1293
Author(s):  
Dan Kajungu ◽  
Victoria Nambasa ◽  
Michael Muhoozi ◽  
Joan Tusabe ◽  
Beate Kampmann ◽  
...  

Active vaccine pharmacovigilance complements the standard passive or spontaneous surveillance system, which suffers from low reporting rates. This study aimed at utilizing population-based structures to report and profile adverse events following immunization (AEFI) with the measles and rubella vaccine (MR), or MR in combination with the bivalent oral polio vaccine (bOPV 1&3) (MR & bOPV), during mass vaccination in Uganda. Caretakers of children at home (less than 5 years) and schoolgoing children were followed up on and encouraged to report any AEFIs on day one, 2–3 days, 10 days, and 14 days after vaccination at school by their teachers and at-home, community-based village health teams. Out of 9798 children followed up on, 382 (3.9%) reported at least one AEFI, and in total, 517 AEFIs were reported. For MR, high temperature (21%), general feeling of weakness (19.3%), and headache (13%) were the most reported AEFIs, though there were variations on the days when they were reported. For the combination dose of MR & bOPV, high temperature (44%), rash (17%), general feeling of weakness (13%), and diarrhoea (8%) were the most common adverse events following immunization reported by caretakers. All 382 children cleared the AEFIs within 2 days, with 343 (90%) children reporting mild or moderate AEFIs and only 39 (10%) reporting severe AEFIs. The reported AEFIs are known and are mentioned in the vaccine leaflets with similar severity classification. Rates of AEFIs differed with the number of days after receiving the immunization. Conclusion: Active surveillance for AEFIs provides additional important information to national vaccine regulatory bodies. It reassures the public that vaccines are safe and that their safety is being taken seriously in Uganda, which would improve vaccine acceptability and confidence in the health system. Piggybacking on existing structures such as village health team members (for children at home) and teachers (for schoolgoing children) facilitates reaching vaccine recipients and increases reporting rates. Therefore, studies using active reporting of AEFIs should be conducted at regular intervals to report the overall incidence of AEs and to monitor trends and changes.

Author(s):  
Aditi Dey ◽  
Han Wang ◽  
Helen Quinn ◽  
Rona Hiam ◽  
Nicholas Wood ◽  
...  

This report summarises Australian passive surveillance data for adverse events following immunisation (AEFI) for 2017 reported to the Therapeutic Goods Administration and describes reporting trends over the 18-year period 1 January 2000 to 31 December 2017. There were 3,878 AEFI records for vaccines administered in 2017; an annual AEFI reporting rate of 15.8 per 100,000 population. There was a 12% increase in the overall AEFI reporting rate in 2017 compared with 2016. This increase in reported adverse events in 2017 compared to the previous year was likely due to the introduction of the zoster vaccine (Zostavax®) provided free for people aged 70–79 years under the National Immunisation Program (NIP) and also the state- and territory-based meningococcal ACWY conjugate vaccination programs. AEFI reporting rates for most other individual vaccines in 2017 were similar to 2016. The most commonly reported reactions were injection site reaction (34%), pyrexia (17%), rash (15%), vomiting (8%) and pain (7%). The majority of AEFI reports (88%) described non-serious events. Two deaths were reported that were determined to have a causal relationship with vaccination; they occurred in immunocompromised people contraindicated to receive the vaccines.


2020 ◽  
Vol 310 ◽  
pp. 147-154 ◽  
Author(s):  
Malik Elharram ◽  
Cristiano S. Moura ◽  
Michal Abrahamowicz ◽  
Sasha Bernatsky ◽  
Hassan Behlouli ◽  
...  

2017 ◽  
Vol 3 (12) ◽  
pp. 1425-1433 ◽  
Author(s):  
Michelle Samuel ◽  
Mohammad Almohammadi ◽  
Meytal Avgil Tsadok ◽  
Jacqueline Joza ◽  
Cynthia A. Jackevicius ◽  
...  

2018 ◽  
Vol 34 (4) ◽  
pp. 224-231 ◽  
Author(s):  
Roger W. Hunt ◽  
Katina D’Onise ◽  
Anh-Minh Thi Nguyen ◽  
Kamalesh Venugopal

Aims:To describe changes in the place of death of patients with cancer from 1990 to 2012, and to identify issues for their end-of-life care.Materials and Methods:Population-based descriptive study, with analyses of place of death patterns, using the South Australian Cancer Registry records of 86 257 patients with cancer who died from 1990 to 2012.Results:From 1990 to 2012, the proportion of cancer deaths in hospital decreased from 63.4% to 50.9%, and in nursing homes increased from 8.2% to 22.5%. After the year 2000, the proportions in hospices and at home were both below 15%. Multivariate analyses showed that young patients with cancer were more likely to die in a hospice or at home, compared to elderly patients with cancer who were more likely to die in a nursing home; the likelihood of dying in a hospice increased with socioeconomic status; patients with a short survival time or a hematological malignancy were more likely to die in a metropolitan hospital.Conclusions:Compared to most other countries, the proportion of cancer deaths at home was low, and many patients would not have died at their preferred place. The trend for more cancer deaths to occur in nursing homes is likely to continue, but nursing homes generally lack the resources and skilled staff to provide quality palliative care. Models of palliative care delivery should take account of patient preferences, the growth of terminal cancer care in nursing homes, and apparent inequities.


2002 ◽  
Vol 26 (9) ◽  
pp. 339-341 ◽  
Author(s):  
Aileen O'Brien ◽  
Mike Firn

Aims and MethodThe study aims to describe the experience of an assertive community treatment team when commencing clozapine at home rather than in hospital, following a locally-devised policy. Any failed attempts and problems experienced are described.ResultsThere have been no serious adverse events with 13 patients who have been started on clozapine at home.Clinical ImplicationsFor an assertive community treatment team, home-initiation of clozapine is a practical option, particularly when patients refuse to come in to hospital.


2021 ◽  
Author(s):  
Marketa Gross

Patient safety in health care remains a serious concern in Canada. Adverse events can lead to physiological and psychological complications and pose a significant economic burden on the health care system. The purpose of this descriptive qualitative study was to explore the team processes, roles and factors that underpin effective communication between team members during an OR-PACU handover. Content analysis revealed four major categories: Ownership, Distractions and Interruptions, Transfer of Information and Workflow. The results of this study, informed by the Theory of Collective Competence enhance our understanding of the OR-PACU handover and support the need for the development of a structured OR-PACU team handover process.


2018 ◽  
Vol 25 (4) ◽  
pp. 290-294 ◽  
Author(s):  
Jackson Fein ◽  
David Bogumil ◽  
Jeffrey S Upperman ◽  
Rita V Burke

BackgroundPrevious studies have identified risk factors for dog bites in children, but use data from individual trauma centers, with limited generalizability. This study identifies a population risk profile for pediatric dog bites using the National Trauma Data Bank. We hypothesized that the population at risk was younger boys, that such bites occur at home, are moderately severe, and are on the face or neck.MethodsFor this retrospective cross-sectional study, a sample of 7912 children 17 years old and younger with International Classification of Diseases (ICD)-9 event code E906.0, for dog bites, were identified. Datasets from 2007 to 2014 were used. Data included patient’s gender, age, ICD-9 primary and location E-codes, AIS body region and AIS severity.ResultsMost children were 6–12 years old and female, but a similar number fell into the narrower range of 0–2 years old. Injuries in the younger group frequently occurred at home, on the face and head, and with minor severity. Age of the child predicts the location of incident (P<0.001), the severity of injury (P<0.001) and the body region of the injury (P<0.001). Body region of the injury predicted its severity (P<0.001).DiscussionYounger children are more likely to receive dog bites, and bites incurred are likely of greater severity. Children this young cannot yet be taught how to properly interact with a dog.ConclusionsDog bites are a significant source of morbidity for children. Based on the population risk factors profile generated, this study recommends targeting live dog education towards the parents of young children.


2019 ◽  
Vol 119 (11) ◽  
pp. 1773-1784 ◽  
Author(s):  
Giuseppe Patti ◽  
Giuseppe Di Martino ◽  
Fabrizio Ricci ◽  
Giulia Renda ◽  
Sabina Gallina ◽  
...  

AbstractStudies evaluating the relationship between platelet indices and cardiovascular (CV) outcomes yielded conflicting results. We assessed the incidence of adverse events according to baseline quintiles of platelet indices in the prospective cohort of the Malmö Diet and Cancer Study. A total of 30,314 individuals (age 57 ± 8 years) were followed for a median of 16 years (468,490 person-years). Outcome measures included all-cause death, CV death, myocardial infarction (MI), and ischemic stroke. The fifth quintile of platelet count (> 274.6 × 109/L) was associated with higher incidence of all-cause death (hazard ratio [HR] 1.20, 95% confidence interval [CI] 1.09–1.32, p < 0.001), CV death (HR 1.19, 95% CI 1.00–1.42; p = 0.044), MI (HR 1.32, 95% CI 1.12–1.54; p = 0.001), and ischemic stroke (HR 1.27, 95% CI 1.08–1.50, p = 0.004) compared with the first quintile (≤ 185 × 109/L), and also associated with a lower survival, regardless of previous history of MI (p for interaction = 0.58) or stroke (p for interaction = 0.42). In the highest quintile, history of stroke had a higher risk of CV death (HR 3.18, 95% CI 1.54–6.54) compared with no previous stroke (HR 1.12, 95% CI 0.96–1.31). The risk of MI and stroke was greatest in the fifth quintile, regardless of previous MI or previous stroke, respectively. The risk of all adverse events was similar across different quintiles of mean platelet volume. In conclusion, elevated platelet count is associated with higher mortality and risk of CV events, regardless of previous MI and stroke. Platelet count may thus be a useful marker for further stratification of CV risk, and especially of death.


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