Prevalence and patterns of adverse events following immunisation among children less than 24 months attending immunisation clinics in Kano, Nigeria

Adverse Events Following Immunisation (AEFI) contribute to child morbidity and mortality as they often lead to low uptake of vaccines with consequent persistence of vaccine-preventable diseases. It is essential to assess the prevalence of AEFIs in northern Nigeria, where misconceptions about immunisation exist. This study assessed the prevalence and pattern of AEFI among children less than 24 months after attending immunisation clinics in Kano, Nigeria. Using a mixed-methods design, adapted intervieweradministered questionnaires were assigned to a cross-section of 384 mother-baby pairs who presented to the immunisation clinics of selected primary healthcare centres (PHCs) within metropolitan Kano. This was followed by six sessions of focus group discussion with a sub-sample of the mothers. Logistic regression and the framework approach were used to analyse the data. The prevalence of AEFI was (43.5%, n=164), and most cases (72.4%, n=273) were mild. Fever was the most common type of AEFI reported (66.5%, n=109) and was higher among infants less than three months (44.5%, n=73). Age of the index child was the only significant predictor of AEFI (OR:0.18, 95% CI: 0.10-0.35). Our study shows that AEFI was common among children less than 24 months old in Kano. We recommend sensitisation and health education of caregivers using valuable communication strategies and sufficient training of immunisation service providers on professional ways to deliver these vaccines safely.

Global Seroprevalence of West Nile Virus in Horses of Morocco

West Nile Fever (WNF) is a viral emerging mosquito-borne disease causing mortality and morbidity with varying severity (from mild fever to severe neuroinvasive disease) among human and animal populations in many parts of the world. The current study aimed to confirm the virus circulation and assess the disease seroprevalence in horses of Morocco. A sample of 1171 healthy non-vaccinated (against-WNF) horses, taken from 11 (out of 12) regions of the country during July-December 2016, was primarily tested using competitive ELISA assay (cELISA). All cELISA-reactive positive and doubtful sera (n= 269) were further tested by virus neutralization test (VNT). The results of cELISA test revealed an overall WNF seroprevalence in 21.8% (255/1171) of sampled horses. This rate decreased to 18.8% (220/1171) after the confirmation of VNT. The WNF seroprevalence in the current study varied significantly by age, gender, and breed of the tested horses. Indeed, the higher seropositivity rates were found in the oldest (27.7%), female (22.0%), and saddle (32.1%) horses. However, the origin of animals did not show any significant effect on the West Nile virus infection. The obtained results of the present study, therefore, provided serological and epidemiological evidence of the endemicity of the WNV in horse populations of Morocco.

Predictors of prolonged hospitalisation and mortality among children admitted with blackwater fever in eastern Uganda

Our study aimed at determining clinical factors associated with prolonged hospitalisation and death among children admitted with blackwater fever (BWF). We analysed 920 eligible records for the period January – December 2018 from Mbale and Soroti Regional Referral Hospitals in Eastern Uganda. The median hospitalisation was 3 (IQR: 2–5 days) days. Prolonged hospitalisation was in 251/920 (27.3%). Clinical features independently associated with prolonged hospitalisation included abdominal tenderness, body pain and mild fever. 29/920 (3.2%) died, of these 20 (69.0%) within 48 h of admission. Features of severity associated with mortality were noisy or interrupted breathing, tachypnoea, chest pain, convulsions, delayed capillary refill time (≥3 s), severe pallor, high fever (>38.5°C), altered level of consciousness, prostration and acidotic breathing.

Kikuchi Fujimoto Disease: A Case Report with Literature Review

Kikuchi-Fujimoto disease (KFD), also referred to as histiocytic necrotizing lymphadenitis, is an uncommon entity, usually benign, self-limiting disease characterised by fever and regional lymphadenopathy of unexplained aetiology. There is an increase in reported cases of KFD, particularly in Asia. It is important to recognize this condition because it may be confused for systemic lupus erythematosus (SLE), tuberculosis or lymphoma. The knowledge of this condition among clinicians and pathologists can help to avoid misdiagnosis and inappropriate treatment. It must be considered among the differential diagnoses of cervical lymphadenopathy. Here, we present a case of 20-year-old male who came to the hospital with complaints of mild fever, chills, fatigue and cervical lymphadenopathy. After radiological investigations an excisional biopsy of the cervical lymph node was done and the diagnosis of KFD was confirmed. Due to the paucity of cases in literature, reporting this case may help shed light on this rare disease.

A Study to assess side effects of first dose of Covid-19 Vaccination among GNM students studying at JSS School of Nursing Chamarajanagar

Background: The world is in the midst of a COVID-19 Pandemic. While countries, including India, have taken strong measures to control the spread of COVID-19 through better diagnostics and treatment. Vaccines will provide a lasting solution by enhancing Immunity and containing the disease spread. COVID-19 vaccine has been rolled out recently in several parts of the world. Although the protective efficiency is frequently discussed, little is known about the real-world post-vaccination experience outside of clinical trial conditions. Knowledge about what to expect after vaccination will help educate the public, dispel misinformation and reduce vaccine hesitancy. Objectives: To assess the immediate response to the first dose of Covid- 19 vaccine and to study the side effects of Covid- 19 vaccination. Results: Results of the study revealed that 143(95.3%) participants are not developed any side effects, only 7 (4.66%) participants reported mild side effects within 30 minutes after vaccination, 104 (69.33%) participants are developed mild side effects like fever, body pain after 30 minutes to 24 hours, 14 (9.33%) participants are developed side effects in mild form after 24 hours, only 2(1.33%) participants are developed side effects like mild fever and fatigue after 1 week of vaccination, majority of the participants 149 (99.33%) didn't required any hospitalization and only 1 participant (0.66% ) admitted to hospital due to fever for one day, majority of participants 63 (42%) are recovered from side effects within 24 hours, 28 (18.66%) participants are recovered within 2 to 8 hours, 14 (9.3%) participants are recovered within 2 hours, 4 (2.66%)participants are recovered within 8 to 24hours and 41 (27.3%) participants are recovered after 24 hours. All the participants are willing to take 2nd dose and recommend for their family members and friends to get vaccination.

COVID-19: Immune Perspective and Current Treatment Strategies

Coronavirus disease 2019 (COVID-19) is now a well-established and globally lethal respiratory pandemic, affecting millions with about 10% fatality rate. Infected patients show mild to severe symptoms that may manifest as mild fever, cough, headache and nausea or they may even remain asymptomatic. World Health Organization has reported over 245,373,039 confirmed cases worldwide with 4,979,421 deaths (October 2021). There are myriads of promising approaches to pharmacologically treat the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the newly reported seventh human coronavirus, which is responsible for this pandemic. Various types of potential drugs; monoclonal antibodies, interferon therapies, peptides, small molecule drugs, oligonucleotides and vaccines are under consideration and target various structural components of the virus. A strong host immune system is a key player in combating COVID-19 along with the effective vaccines that are a game-changing tool. The focus of the review is some worth mentioning drug candidates; remdesivir, lopinavir, emetine, aloxistatin, viracept, homoharringtonine, ivermectin, favipiravir, tocilizumab, chloroquine and leronlimab against COVID-19 infections, targeting the membrane nucleocapsid, spike or envelope proteins, either currently in clinical trials or under consideration. Many drugs directly inhibit the viral infection while others trigger the immune system to fight against the virus. Furthermore, we also discussed the current covid vaccines; Pfizer, Moderna, etc. from different technical lines for immunization. Therefore, here we review how the immune system tries to manage the infection as well as vaccines and some of the potential therapeutic agents. Copyright(c) The Authors

Intraoperative Post Partum Hemorrhage in a Patient with Dengue Fever

A 33 year old obstetric patient with mild fever of undiagnosed etiology underwent emergency caesarean section under general anesthesia. She had platelet count of 98,000 per microliter and increased APTT of 37.8 s at the time of surgery. After uneventful anesthetic induction and delivery of fetus, slow and oozing type of bleeding led to massive hemorrhage. Patient remained vitally stable throughout perioperative phase and was extubated. Next day, patient’s dengue IgM antibody was reported positive. Neonate was well and his dengue test was negative. Pregnant women are at high risk of developing severe complications of dengue fever with unclear mechanisms related to impaired coagulation. Regional anesthesia may not have safe outcome due to dengue infection. doi: https://doi.org/10.12669/pjms.38.1.4519 How to cite this:Ahmed U, Aman A. Intraoperative Post Partum Hemorrhage in a Patient with Dengue Fever. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4519 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Croup as a manifestation of COVID-19 in infancy: a case series

The second wave of the COVID-19 pandemic in India brought with it an emerging clinical spectrum of the infection in children. Amongst these is the rarely reported presentation of croup, which otherwise remains a common clinical condition in infants caused by a variety of viruses and seen by pediatricians regularly. Airway manifestations of COVID-19 require reporting and unless their evaluation brings up any specific peculiarities, it is imperative to screen all such children presenting to the emergency department for SARS-CoV-2 infection. We hereby reported a series of three infants who were brought to us with typical features of croup including a mild fever, runny nose and indicators of subglottic inflammation including a hoarse voice, brassy cough and an inspiratory stridor. Each of them responded to conventional therapies for croup. However, the added conundrum of possible SARS-CoV-2 infection increases the relevance of rapid screening, assessment for complications and counselling in children presenting with croup.

Hepatic cyst infection complicated by a hepatobronchial fistula diagnosed with unique features

ABSTRACT A hepatobronchial fistula (HBF) is a rare condition, defined as an abnormal connection of the respiratory system with the liver parenchyma. Although imaging may be helpful for diagnosis, fistulae are often difficult to identify. An 81-year-old woman presented with mild fever and right upper quadrant abdominal pain. Computed tomography (CT) showed bilateral pneumonia and hepatic cyst infection with air-fluid levels. After mechanical ventilation, abdominal CT showed increased air in the hepatic cyst. The drainage bag for the hepatic cyst infection was also inflated by positive pressure ventilation, suggesting a possible HBF. The ventilator was adjusted to minimize pressure on the fistula and prevent retrograde infection. The fistula eventually closed spontaneously. Appropriate antibiotic treatment and continuous drainage resulted in improvement of the hepatic cyst infection; however, the patient died due to respiratory complications. HBF should be suspected when positive pressure ventilation results in increased air at the hepatic infection site.

Plasmodium falciparum Malaria Vaccines and Vaccine Adjuvants

Malaria—a parasite vector-borne disease—is a global health problem, and Plasmodium falciparum has proven to be the deadliest among Plasmodium spp., which causes malaria in humans. Symptoms of the disease range from mild fever and shivering to hemolytic anemia and neurological dysfunctions. The spread of drug resistance and the absence of effective vaccines has made malaria disease an ever-emerging problem. Although progress has been made in understanding the host response to the parasite, various aspects of its biology in its mammalian host are still unclear. In this context, there is a pressing demand for the development of effective preventive and therapeutic strategies, including new drugs and novel adjuvanted vaccines that elicit protective immunity. The present article provides an overview of the current knowledge of anti-malarial immunity against P. falciparum and different options of vaccine candidates in development. A special emphasis has been made on the mechanism of action of clinically used vaccine adjuvants.