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Antoni S, Nakamura T, Cohen AL, Mwenda JM, Weldegebriel G, Biey JNM, Shaba K, Rey-Benito G, de Oliveira LH, Oliveira MTDC, Ortiz C, Ghoniem A, Fahmy K, Ashmony HA, Videbaek D, Daniels D, Pastore R, Singh S, Tondo E, Liyanage JBL, Sharifuzzaman M, Grabovac V, Batmunkh N, Logronio J, Armah G, Dennis FE, Seheri M, Magagula N, Mphahlele J, Leite JPG, Araujo IT, Fumian TM, EL Mohammady H, Semeiko G, Samoilovich E, Giri S, Kang G, Thomas S, Bines J, Kirkwood CD, Liu N, Lee DY, Iturriza-Gomara M, Page NA, Esona MD, Ward ML, Wright CN, Mijatovic-Rustempasic S, Tate JE, Parashar UD, Gentsch J, Bowen MD, Serhan F. Rotavirus genotypes in children under five years hospitalized with diarrhea in low and middle-income countries: Results from the WHO-coordinated Global Rotavirus Surveillance Network. PLOS Glob Public Health 2023; 3:e0001358. [PMID: 38015834 PMCID: PMC10683987 DOI: 10.1371/journal.pgph.0001358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 10/06/2023] [Indexed: 11/30/2023]
Abstract
Rotavirus is the most common pathogen causing pediatric diarrhea and an important cause of morbidity and mortality in low- and middle-income countries. Previous evidence suggests that the introduction of rotavirus vaccines in national immunization schedules resulted in dramatic declines in disease burden but may also be changing the rotavirus genetic landscape and driving the emergence of new genotypes. We report genotype data of more than 16,000 rotavirus isolates from 40 countries participating in the Global Rotavirus Surveillance Network. Data from a convenience sample of children under five years of age hospitalized with acute watery diarrhea who tested positive for rotavirus were included. Country results were weighted by their estimated rotavirus disease burden to estimate regional genotype distributions. Globally, the most frequent genotypes identified after weighting were G1P[8] (31%), G1P[6] (8%) and G3P[8] (8%). Genotypes varied across WHO Regions and between countries that had and had not introduced rotavirus vaccine. G1P[8] was less frequent among African (36 vs 20%) and European (33 vs 8%) countries that had introduced rotavirus vaccines as compared to countries that had not introduced. Our results describe differences in the distribution of the most common rotavirus genotypes in children with diarrhea in low- and middle-income countries. G1P[8] was less frequent in countries that had introduced the rotavirus vaccine while different strains are emerging or re-emerging in different regions.
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Affiliation(s)
- Sebastien Antoni
- Department of Immunization, Vaccines and Biologicals, World Health Organization Headquarters, Geneva, Switzerland
| | - Tomoka Nakamura
- Department of Immunization, Vaccines and Biologicals, World Health Organization Headquarters, Geneva, Switzerland
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Adam L. Cohen
- Department of Immunization, Vaccines and Biologicals, World Health Organization Headquarters, Geneva, Switzerland
| | - Jason M. Mwenda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | | | - Joseph N. M. Biey
- World Health Organization, Inter Country Support Team, Ouagadougou, Burkina Faso
| | - Keith Shaba
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Gloria Rey-Benito
- Pan American Health Organization, World Health Organization, Washington District of Columbia, Washington, DC, United States of America
| | - Lucia Helena de Oliveira
- Pan American Health Organization, World Health Organization, Washington District of Columbia, Washington, DC, United States of America
| | - Maria Tereza da Costa Oliveira
- Pan American Health Organization, World Health Organization, Washington District of Columbia, Washington, DC, United States of America
| | - Claudia Ortiz
- Pan American Health Organization, World Health Organization, Washington District of Columbia, Washington, DC, United States of America
| | - Amany Ghoniem
- World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Kamal Fahmy
- World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Hossam A. Ashmony
- World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Dovile Videbaek
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Danni Daniels
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Roberta Pastore
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Simarjit Singh
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Emmanuel Tondo
- World Health Organization, Regional Office for South East Asia, Delhi, India
| | | | | | - Varja Grabovac
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Nyambat Batmunkh
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Josephine Logronio
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - George Armah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Francis E. Dennis
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Mapaseka Seheri
- World Health Organization Regional Reference Laboratory for Rotavirus, Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Nonkululeko Magagula
- World Health Organization Regional Reference Laboratory for Rotavirus, Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Jeffrey Mphahlele
- World Health Organization Regional Reference Laboratory for Rotavirus, Diarrhoeal Pathogens Research Unit, Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Jose Paulo G. Leite
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Irene T. Araujo
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Tulio M. Fumian
- Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Hanan EL Mohammady
- Bacterial and Parasitic Diseases Research Program, U.S. Naval Medical Research Unit-3, Cairo, Egypt
| | - Galina Semeiko
- Republican Research and Practical Center for Epidemiology and Microbiology, Minsk, Belarus
| | - Elena Samoilovich
- Republican Research and Practical Center for Epidemiology and Microbiology, Minsk, Belarus
| | - Sidhartha Giri
- Division of Gastrointestinal Sciences, The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, The Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India
| | - Sarah Thomas
- Enteric Diseases Group Murdoch Children’s Research Institute, Department of Paediatrics University of Melbourne, Parkville, Victoria, Australia
| | - Julie Bines
- Enteric Diseases Group Murdoch Children’s Research Institute, Department of Paediatrics University of Melbourne, Parkville, Victoria, Australia
| | - Carl D. Kirkwood
- Enteric Diseases Group Murdoch Children’s Research Institute, Department of Paediatrics University of Melbourne, Parkville, Victoria, Australia
| | - Na Liu
- National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Deog-Yong Lee
- Division of Viral Diseases, Bureau of Infectious Diseases Diagnosis Control, Korea Diseases Control and Prevention Agency, Osong, Korea
| | | | - Nicola Anne Page
- National Institute for Communicable Diseases, Centre for Enteric Disease, Johannesburg, South Africa
- Faculty of Health Sciences, Department of Medical Virology, University of Pretoria, Arcadia, Pretoria, South Africa
| | - Mathew D. Esona
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - M. Leanne Ward
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | | | - Jon Gentsch
- Retired Researcher, West Newton, Pennsylvania, United States of America
| | | | - Fatima Serhan
- Department of Immunization, Vaccines and Biologicals, World Health Organization Headquarters, Geneva, Switzerland
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Miliya T, Soputhy C, Leab P, Tan P, Sao S, Heffelfinger JD, Batmunkh N, Ork V, Hossain MS, Day NP, Turner C, Turner P. Pneumococcal colonization and severity of pneumonia in hospitalized Cambodian children following introduction of the 13-valent pneumococcal conjugate vaccine. IJID Reg 2023; 8:9-15. [PMID: 37583480 PMCID: PMC10423667 DOI: 10.1016/j.ijregi.2023.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 08/17/2023]
Abstract
Objectives This study sought to characterize pneumococcal colonization and clinical/radiological features in Cambodian children admitted to hospital with an illness compatible with pneumonia following national introduction of the 13-valent pneumococcal conjugate vaccine (PCV13). Methods Children aged 0-59 months admitted to Angkor Hospital for Children who met the World Health Organization (WHO) case definition for clinical pneumonia were enrolled over a 3-year period. Clinical, radiological and vaccination data were collected at enrolment. A nasopharyngeal swab was collected for detection of pneumococcal colonization using the WHO standard culture method. Results Between 1 September 2015 and 31August 2018, 2209 analysable illness episodes were enrolled. Pneumococci were detected in 943/2209 (42.7%) children. PCV13 serotypes were detected less frequently in children who had been vaccinated appropriately for their age compared with undervaccinated children: 309/567 (53.6%) vs 216/342 (63.2%) (P=0.006). Age-appropriate PCV13 vaccination was negatively associated with hypoxic presentation [adjusted odds ratio (aOR) 0.72, 95% confidence interval (CI) 0.60-0.87; P=0.0006] and primary endpoint pneumonia on chest x ray (aOR 0.69, 95% CI 0.54-0.90; P=0.006). Conclusions The introduction of PCV13 in Cambodia was associated with a decline in vaccine serotype nasopharyngeal colonization, and clinical and radiological severity in children hospitalized with clinical pneumonia.
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Affiliation(s)
- Thyl Miliya
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
| | - Chansovannara Soputhy
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
| | - Phana Leab
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
| | - Pisey Tan
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
| | - Sena Sao
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
| | - James D. Heffelfinger
- Regional Office for the Western Pacific, World Health Organization, Manila, Philippines
| | - Nyambat Batmunkh
- Regional Office for the Western Pacific, World Health Organization, Manila, Philippines
| | - Vichit Ork
- National Immunization Programme, Ministry of Health, Phnom Penh, Cambodia
| | | | - Nicholas P.J. Day
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Claudia Turner
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Paul Turner
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Kraay ANM, Steele MK, Baker JM, Hall EW, Deshpande A, Saidzosa BF, Mukaratirwa A, Boula A, Mpabalwani EM, Kiulia NM, Tsolenyanu E, Enweronu-Laryea C, Abebe A, Beyene B, Tefera M, Willilo R, Batmunkh N, Pastore R, Mwenda JM, Antoni S, Cohen AL, Pitzer VE, Lopman BA. Predicting the long-term impact of rotavirus vaccination in 112 countries from 2006 to 2034: A transmission modeling analysis. Vaccine 2022; 40:6631-6639. [PMID: 36210251 DOI: 10.1016/j.vaccine.2022.09.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 01/27/2023]
Abstract
Rotavirus vaccination has been shown to reduce rotavirus burden in many countries, but the long-term magnitude of vaccine impacts is unclear, particularly in low-income countries. We use a transmission model to estimate the long-term impact of rotavirus vaccination on deaths and disability adjusted life years (DALYs) from 2006 to 2034 for 112 low- and middle-income countries. We also explore the predicted effectiveness of a one- vs two- dose series and the relative contribution of direct vs indirect effects to overall impacts. To validate the model, we compare predicted percent reductions in severe rotavirus cases with the percent reduction in rotavirus positivity among gastroenteritis hospital admissions for 10 countries with pre- and post-vaccine introduction data. We estimate that vaccination would reduce deaths from rotavirus by 49.1 % (95 % UI: 46.6-54.3 %) by 2034 under realistic coverage scenarios, compared to a scenario without vaccination. Most of this benefit is due to direct benefit to vaccinated individuals (explaining 69-97 % of the overall impact), but indirect protection also appears to enhance impacts. We find that a one-dose schedule would only be about 57 % as effective as a two-dose schedule 12 years after vaccine introduction. Our model closely reproduced observed reductions in rotavirus positivity in the first few years after vaccine introduction in select countries. Rotavirus vaccination is likely to have a substantial impact on rotavirus gastroenteritis and its mortality burden. To sustain this benefit, the complete series of doses is needed.
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Affiliation(s)
- A N M Kraay
- Department of Kinesiology and Community Health, University of Illinois, Champaign, IL, United States; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
| | - M K Steele
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - J M Baker
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - E W Hall
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - A Deshpande
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - B F Saidzosa
- State Institution "Republican Center of Immunoprophylaxis" of Ministry of Health and Social Protection of Population of the Republic of Tajikistan, Dushanbe, Tajikistan
| | | | - A Boula
- Mother & Child Hospital (MCH), Chantal Biya Foundation, Yaoundé, Cameroon
| | | | - N M Kiulia
- Enteric Pathogens and Water Research Laboratory, Institute of Primate Research, Karen, Nairobi, Kenya
| | - E Tsolenyanu
- Department of Paediatrics, Medical School of Lome, Togo; Ministry of Health, Togo
| | - C Enweronu-Laryea
- Department of Pediatrics, University of Ghana Medical School, Accra, Ghana
| | - A Abebe
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - B Beyene
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - M Tefera
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - R Willilo
- RTI International, Dar es Salaam, Tanzania
| | - N Batmunkh
- Expanded Programme on Immunisation, Regional Office for the Western Pacific, World Health Organization, Manila, Philippines
| | - R Pastore
- Division of Country Health Programmes, Vaccine-preventable Diseases and Immunization (VPI), World Health Organization Regional Office for the Europe, Copenhagen, Denmark
| | - J M Mwenda
- WHO Regional Office for Africa, Immunization and Vaccines Development, Brazzaville, Congo
| | - S Antoni
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - A L Cohen
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - V E Pitzer
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, United States
| | - B A Lopman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
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Donadel M, Scobie HM, Pastore R, Grabovac V, Batmunkh N, O’Connor S, Dahl BA, Murrill CS. Comprehensive Vaccine-Preventable Disease Surveillance in the Western Pacific Region: A Literature Review on Integration of Surveillance Functions, 2000-2021. Glob Health Sci Pract 2022; 10:GHSP-D-22-00017. [PMID: 36316133 PMCID: PMC9622275 DOI: 10.9745/ghsp-d-22-00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION A strategic framework for 2021-2030 developed by the World Health Organization (WHO) Regional Office for the Western Pacific emphasizes the need for high-quality and integrated vaccine-preventable disease (VPD) surveillance. We conducted a literature review to document the barriers, enabling factors, and innovations for integrating surveillance functions for VPDs and other communicable diseases in Western Pacific Region (WPR) countries. METHODS We searched published and gray literature on integrated VPD surveillance from 2000 to 2021. Articles in English, Spanish, or French were screened to identify those relating to VPD surveillance in a WPR country and not meeting defined exclusion criteria. We categorized articles using the 8 WHO surveillance support functions and abstracted data on the country; type of surveillance; and reported barriers, enabling factors, and best practices for integration. RESULTS Of the 3,137 references screened, 87 met the eligibility criteria. Of the 8 surveillance support functions, the proportion of references that reported integration related to the laboratory was 56%, followed by workforce capacity (54%), governance (51%), data management and use (47%), field logistics and communication (47%), coordination (15%), program management (13%), and supervision (9%). Several references noted fragmented systems and a lack of coordination between units as barriers to integration, highlighting the importance of engagement across public health units and between the public and private sectors. The literature also indicated a need for interoperable information systems and revealed the use of promising new technologies for data reporting and laboratory testing. In some WPR countries, workforce capacity was strengthened at all administrative levels by the implementation of integrated trainings on data monitoring and use and on laboratory techniques applicable to multiple VPDs. CONCLUSION This literature review supports integrating VPDs into broader communicable disease surveillance systems in WPR countries while ensuring that the minimal WHO-recommended standards for VPD surveillance are met.
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Affiliation(s)
- Morgane Donadel
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.,Correspondence to Morgane Donadel ()
| | - Heather M. Scobie
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Roberta Pastore
- World Health Organization, Western Pacific Regional Office, Manila, the Philippines
| | - Varja Grabovac
- World Health Organization, Western Pacific Regional Office, Manila, the Philippines
| | - Nyambat Batmunkh
- World Health Organization, Western Pacific Regional Office, Manila, the Philippines
| | - Stephanie O’Connor
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Benjamin A. Dahl
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christopher S. Murrill
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
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Hartman RM, Cohen AL, Antoni S, Mwenda J, Weldegebriel G, Biey J, Shaba K, de Oliveira L, Rey G, Ortiz C, Tereza M, Fahmy K, Ghoniem A, Ashmony H, Videbaek D, Singh S, Tondo E, Sharifuzzaman M, Liyanage J, Batmunkh N, Grabovac V, Logronio J, Serhan F, Nakamura T. Risk Factors for Mortality Among Children Younger Than Age 5 Years With Severe Diarrhea in Low- and Middle-income Countries: Findings From the World Health Organization-coordinated Global Rotavirus and Pediatric Diarrhea Surveillance Networks. Clin Infect Dis 2022; 76:e1047-e1053. [PMID: 35797157 PMCID: PMC9907489 DOI: 10.1093/cid/ciac561] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/22/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Diarrhea is the second leading cause of death in children younger than 5 years of age globally. The burden of diarrheal mortality is concentrated in low-resource settings. Little is known about the risk factors for childhood death from diarrheal disease in low- and middle-income countries. METHODS Data from the World Health Organization (WHO)-coordinated Global Rotavirus and Pediatric Diarrhea Surveillance Networks, which are composed of active, sentinel, hospital-based surveillance sites, were analyzed to assess mortality in children <5 years of age who were hospitalized with diarrhea between 2008 and 2018. Case fatality risks were calculated, and multivariable logistic regression was performed to identify risk factors for mortality. RESULTS This analysis comprises 234 781 cases, including 1219 deaths, across 57 countries. The overall case fatality risk was found to be 0.5%. Risk factors for death in the multivariable analysis included younger age (for <6 months compared with older ages, odds ratio [OR] = 3.54; 95% confidence interval [CI], 2.81-4.50), female sex (OR = 1.18; 95% CI, 1.06-1.81), presenting with persistent diarrhea (OR = 1.91; 95% CI, 1.01-3.25), no vomiting (OR = 1.13; 95% CI, .98-1.30), severe dehydration (OR = 3.79; 95% CI, 3.01-4.83), and being negative for rotavirus on an enzyme-linked immunosorbent assay test (OR = 2.29; 95% CI, 1.92-2.74). Cases from the African Region had the highest odds of death compared with other WHO regions (OR = 130.62 comparing the African Region with the European Region; 95% CI, 55.72-422.73), whereas cases from the European Region had the lowest odds of death. CONCLUSIONS Our findings support known risk factors for childhood diarrheal mortality and highlight the need for interventions to address dehydration and rotavirus-negative diarrheal infections.
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Affiliation(s)
- Rachel M Hartman
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Adam L Cohen
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Sebastien Antoni
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Jason Mwenda
- Department of Vaccine Preventable Diseases Program, World Health Organization Regional Office for Africa, Brazzaville, Congo Republic
| | - Goitom Weldegebriel
- Department of Immunization, Vaccines and Biologicals, World Health Organization Regional Office for Africa, Inter-Support Team for East and South Africa, Harare, Zimbabwe
| | - Joseph Biey
- Department of Vaccine Preventable Diseases, World Health Organization Regional Office for Africa, Inter-Support Team for West Africa, Ouagadougou, Burkina Faso
| | - Keith Shaba
- Department of Vaccine Preventable Diseases Program, World Health Organization Regional Office for Africa, Brazzaville, Congo Republic
| | - Lucia de Oliveira
- Pan American Health Organization/Department of Family, Health Promotion, and Life Course, World Health Organization Regional Office for the Americas, Comprehensive Family Immunization Unit, Washington, DC, USA
| | - Gloria Rey
- Pan American Health Organization/Department of Family, Health Promotion, and Life Course, World Health Organization Regional Office for the Americas, Comprehensive Family Immunization Unit, Washington, DC, USA
| | - Claudia Ortiz
- Pan American Health Organization/Department of Family, Health Promotion, and Life Course, World Health Organization Regional Office for the Americas, Comprehensive Family Immunization Unit, Washington, DC, USA
| | - Maria Tereza
- Pan American Health Organization/Department of Family, Health Promotion, and Life Course, World Health Organization Regional Office for the Americas, Comprehensive Family Immunization Unit, Washington, DC, USA
| | - Kamal Fahmy
- Department of Communicable Diseases, Immunization, Vaccines and Biologicals Unit, World Health Organization Eastern Mediterranean Office, Cairo, Egypt
| | - Amany Ghoniem
- Department of Communicable Diseases, Immunization, Vaccines and Biologicals Unit, World Health Organization Eastern Mediterranean Office, Cairo, Egypt
| | - Hossam Ashmony
- Department of Communicable Diseases, Immunization, Vaccines and Biologicals Unit, World Health Organization Eastern Mediterranean Office, Cairo, Egypt
| | - Dovile Videbaek
- Division of Country Health Programmes, Vaccine-Preventable Diseases and Immunization Unit, World Health Organization European Regional Office, Copenhagen, Denmark
| | - Simarjit Singh
- Division of Country Health Programmes, Vaccine-Preventable Diseases and Immunization Unit, World Health Organization European Regional Office, Copenhagen, Denmark
| | - Emmanuel Tondo
- Department of Immunization and Vaccine Development, World Health Organization South-East Asia Regional Office, New Delhi, India
| | - Mohammed Sharifuzzaman
- Department of Immunization and Vaccine Development, World Health Organization South-East Asia Regional Office, New Delhi, India
| | - Jayantha Liyanage
- Department of Immunization and Vaccine Development, World Health Organization South-East Asia Regional Office, New Delhi, India
| | - Nyambat Batmunkh
- Division of Programmes for Diseases Control, Vaccine Preventable Diseases and Immunization, World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Varja Grabovac
- Division of Programmes for Diseases Control, Vaccine Preventable Diseases and Immunization, World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Josephine Logronio
- Division of Programmes for Diseases Control, Vaccine Preventable Diseases and Immunization, World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Fatima Serhan
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Tomoka Nakamura
- Correspondence: T. Nakamura, Department of Immunization, Vaccines and Biologicals, World Health Organization, WHO Headquarters, Avenue Appia 20, 1211, Geneva, Switzerland ()
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6
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Nakamura T, Cohen AL, Schwartz S, Mwenda JM, Weldegebriel G, Biey JNM, Katsande R, Ghoniem A, Fahmy K, Rahman HA, Videbaek D, Daniels D, Singh S, Wasley A, Rey-Benito G, de Oliveira L, Ortiz C, Tondo E, Liyanage JBL, Sharifuzzaman M, Grabovac V, Batmunkh N, Logronio J, Heffelfinger J, Fox K, De Gouveia L, von Gottberg A, Du Plessis M, Kwambana-Adams B, Antonio M, El Gohary S, Azmy A, Gamal A, Voropaeva E, Egorova E, Urban Y, Duarte C, Veeraraghavan B, Saha S, Howden B, Sait M, Jung S, Bae S, Litt D, Seaton S, Slack M, Antoni S, Ouattara M, Van Beneden C, Serhan F. The Global Landscape of Pediatric Bacterial Meningitis Data Reported to the World Health Organization-Coordinated Invasive Bacterial Vaccine-Preventable Disease Surveillance Network, 2014-2019. J Infect Dis 2021; 224:S161-S173. [PMID: 34469555 PMCID: PMC8409679 DOI: 10.1093/infdis/jiab217] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) coordinates the Global Invasive Bacterial Vaccine-Preventable Diseases (IB-VPD) Surveillance Network to support vaccine introduction decisions and use. The network was established to strengthen surveillance and laboratory confirmation of meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis. METHODS Sentinel hospitals report cases of children <5 years of age hospitalized for suspected meningitis. Laboratories report confirmatory testing results and strain characterization tested by polymerase chain reaction. In 2019, the network included 123 laboratories that follow validated, standardized testing and reporting strategies. RESULTS From 2014 through 2019, >137 000 suspected meningitis cases were reported by 58 participating countries, with 44.6% (n = 61 386) reported from countries in the WHO African Region. More than half (56.6%, n = 77 873) were among children <1 year of age, and 4.0% (n = 4010) died among those with reported disease outcome. Among suspected meningitis cases, 8.6% (n = 11 798) were classified as probable bacterial meningitis. One of 3 bacterial pathogens was identified in 30.3% (n = 3576) of these cases, namely S. pneumoniae (n = 2177 [60.9%]), H. influenzae (n = 633 [17.7%]), and N. meningitidis (n = 766 [21.4%]). Among confirmed bacterial meningitis cases with outcome reported, 11.0% died; case fatality ratio varied by pathogen (S. pneumoniae, 12.2%; H. influenzae, 6.1%; N. meningitidis, 11.0%). Among the 277 children who died with confirmed bacterial meningitis, 189 (68.2%) had confirmed S. pneumoniae. The proportion of pneumococcal cases with pneumococcal conjugate vaccine (PCV) serotypes decreased as the number of countries implementing PCV increased, from 77.8% (n = 273) to 47.5% (n = 248). Of 397 H. influenzae specimens serotyped, 49.1% (n = 195) were type b. Predominant N. meningitidis serogroups varied by region. CONCLUSIONS This multitier, global surveillance network has supported countries in detecting and serotyping the 3 principal invasive bacterial pathogens that cause pediatric meningitis. Streptococcus pneumoniae was the most common bacterial pathogen detected globally despite the growing number of countries that have nationally introduced PCV. The large proportions of deaths due to S. pneumoniae reflect the high proportion of meningitis cases caused by this pathogen. This global network demonstrated a strong correlation between PCV introduction status and reduction in the proportion of pneumococcal meningitis infections caused by vaccine serotypes. Maintaining case-based, active surveillance with laboratory confirmation for prioritized vaccine-preventable diseases remains a critical component of the global agenda in public health.The World Health Organization (WHO)-coordinated Invasive Bacterial Vaccine-Preventable Disease (IB-VPD) Surveillance Network reported data from 2014 to 2019, contributing to the estimates of the disease burden and serotypes of pediatric meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis.
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Affiliation(s)
- Tomoka Nakamura
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Adam L Cohen
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Stephanie Schwartz
- Division of Bacterial Diseases, US Centers for Disease Control and Prevention, Global Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, National Center for Immunization and Respiratory Disease, Atlanta, Georgia, USA
| | - Jason M Mwenda
- Department of Vaccine Preventable Diseases Program, World Health Organization Regional Office for Africa, Brazzaville, Congo Republic
| | - Goitom Weldegebriel
- Department of Immunization, Vaccines and Biologicals, World Health Organization Regional Office for Africa, Inter-Support Team for East and South Africa, Harare, Zimbabwe
| | - Joseph N M Biey
- Department of Vaccine Preventable Diseases, World Health Organization Regional Office for Africa, Inter-Support Team for West Africa, Ouagadougou, Burkina Faso
| | - Reggis Katsande
- Department of Vaccine Preventable Diseases Program, World Health Organization Regional Office for Africa, Brazzaville, Congo Republic
| | - Amany Ghoniem
- Department of Communicable Diseases, Immunization, Vaccines and Biologicals Unit, World Health Organization Eastern Mediterranean Office, Cairo, Egypt
| | - Kamal Fahmy
- Department of Communicable Diseases, Immunization, Vaccines and Biologicals Unit, World Health Organization Eastern Mediterranean Office, Cairo, Egypt
| | - Hossam Abdel Rahman
- Department of Communicable Diseases, Immunization, Vaccines and Biologicals Unit, World Health Organization Eastern Mediterranean Office, Cairo, Egypt
| | - Dovile Videbaek
- Division of Country Health Programmes, Vaccine-Preventable Diseases and Immunization Unit, World Health Organization European Regional Office, Copenhagen, Denmark
| | - Danni Daniels
- Division of Country Health Programmes, Vaccine-Preventable Diseases and Immunization Unit, World Health Organization European Regional Office, Copenhagen, Denmark
| | - Simarjit Singh
- Division of Country Health Programmes, Vaccine-Preventable Diseases and Immunization Unit, World Health Organization European Regional Office, Copenhagen, Denmark
| | - Annemarie Wasley
- Division of Country Health Programmes, Vaccine-Preventable Diseases and Immunization Unit, World Health Organization European Regional Office, Copenhagen, Denmark
| | - Gloria Rey-Benito
- Pan American Health Organization/Department of Family, Health Promotion, and Life Course, World Health Organization Regional Office for the Americas, Comprehensive Family Immunization Unit, Washington DC, USA
| | - Lucia de Oliveira
- Pan American Health Organization/Department of Family, Health Promotion, and Life Course, World Health Organization Regional Office for the Americas, Comprehensive Family Immunization Unit, Washington DC, USA
| | - Claudia Ortiz
- Pan American Health Organization/Department of Family, Health Promotion, and Life Course, World Health Organization Regional Office for the Americas, Comprehensive Family Immunization Unit, Washington DC, USA
| | - Emmanuel Tondo
- Department of Immunization and Vaccine Development, World Health Organization South-East Asia Regional Office, New Delhi, India
| | - Jayantha B L Liyanage
- Department of Immunization and Vaccine Development, World Health Organization South-East Asia Regional Office, New Delhi, India
| | - Mohammad Sharifuzzaman
- Department of Immunization and Vaccine Development, World Health Organization South-East Asia Regional Office, New Delhi, India
| | - Varja Grabovac
- Division of Programmes for Diseases Control, Vaccine Preventable Diseases and Immunization, World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Nyambat Batmunkh
- Division of Programmes for Diseases Control, Vaccine Preventable Diseases and Immunization, World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Josephine Logronio
- Division of Programmes for Diseases Control, Vaccine Preventable Diseases and Immunization, World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - James Heffelfinger
- Division of Programmes for Diseases Control, Vaccine Preventable Diseases and Immunization, World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Kimberly Fox
- Division of Programmes for Diseases Control, Vaccine Preventable Diseases and Immunization, World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Linda De Gouveia
- Division of the National Health Laboratory Service, National Institute for Communicable Diseases, African Regional Reference Laboratory For The WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Centre for Respiratory Diseases and Meningitis, Johannesburg, South Africa
| | - Anne von Gottberg
- Division of the National Health Laboratory Service, National Institute for Communicable Diseases, African Regional Reference Laboratory For The WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Centre for Respiratory Diseases and Meningitis, Johannesburg, South Africa
- University of the Witwatersrand, School of Pathology, Faculty of Health Sciences, Johannesburg, South Africa
| | - Mignon Du Plessis
- Division of the National Health Laboratory Service, National Institute for Communicable Diseases, African Regional Reference Laboratory For The WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Centre for Respiratory Diseases and Meningitis, Johannesburg, South Africa
- University of the Witwatersrand, School of Pathology, Faculty of Health Sciences, Johannesburg, South Africa
| | - Brenda Kwambana-Adams
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, WHO Collaborating Centre for New Vaccines Surveillance and African Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Fajara, Banjul, The Gambia
| | - Martin Antonio
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, WHO Collaborating Centre for New Vaccines Surveillance and African Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Fajara, Banjul, The Gambia
| | - Samaa El Gohary
- Department of Clinical Bacteriology Development, Central Public Health Laboratories, Eastern Mediterranean Region Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Cairo, Egypt
| | - Aya Azmy
- Department of Clinical Bacteriology Development, Central Public Health Laboratories, Eastern Mediterranean Region Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Cairo, Egypt
| | - Asmaa Gamal
- Department of Clinical Bacteriology Development, Central Public Health Laboratories, Eastern Mediterranean Region Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Cairo, Egypt
| | - Elena Voropaeva
- G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology, Laboratory of Clinical Microbiology and Biotechnology, European Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Moscow, Russian Federation
| | - Ekaterina Egorova
- G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology, Laboratory of Clinical Microbiology and Biotechnology, European Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Moscow, Russian Federation
| | - Yulia Urban
- G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology, Laboratory of Clinical Microbiology and Biotechnology, European Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Moscow, Russian Federation
| | - Carolina Duarte
- Instituto Nacional de Salud, Dirección de Redes en Salud Pública, Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Bogotá, D.C., Colombia
| | - Balaji Veeraraghavan
- Department of Clinical Microbiology, Christian Medical College and Hospital, South-East Asia Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Vellore, Tamil Nadu, India
| | - Samir Saha
- Department of Microbiology, Bangladesh Institute of Child Health and Child Health Research Foundation, South-East Asia Region National Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Dhaka, Bangladesh
| | - Ben Howden
- The Peter Doherty Institute for Infection and Immunity, Microbiological Diagnostic Unit Public Health Laboratory, Western Pacific Region Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Melbourne, Australia
| | - Michelle Sait
- The Peter Doherty Institute for Infection and Immunity, Microbiological Diagnostic Unit Public Health Laboratory, Western Pacific Region Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Melbourne, Australia
| | - Sangoun Jung
- Division of Bacterial Disease, Korea Disease Control and Prevention Agency, Western Pacific Region Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Cheongju-Si, Chungcheongbuk-do, Republic of Korea
| | - Songmee Bae
- Division of Tuberculosis and Bacterial Respiratory Infections, Korea Disease Control and Prevention Agency, Western Pacific Region Regional Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, Cheongju-Si, Chungcheongbuk-do, Republic of Korea
| | - David Litt
- Public Health England, Respiratory and Vaccine Preventable Bacteria Reference Unit, WHO Collaborating Center for Haemophilius and Streptococcus pneumoniae, London, United Kingdom
| | - Shila Seaton
- Public Health England, United Kingdom National External Quality Assessment Services, London, United Kingdom
| | - Mary Slack
- Public Health England, Respiratory and Vaccine Preventable Bacteria Reference Unit, WHO Collaborating Center for Haemophilius and Streptococcus pneumoniae, London, United Kingdom
| | - Sebastien Antoni
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Mahamoudou Ouattara
- Division of Bacterial Diseases, US Centers for Disease Control and Prevention, Global Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, National Center for Immunization and Respiratory Disease, Atlanta, Georgia, USA
| | - Chris Van Beneden
- Division of Bacterial Diseases, US Centers for Disease Control and Prevention, Global Reference Laboratory for the WHO-coordinated Invasive Bacterial Vaccine Preventable Disease Surveillance Network, National Center for Immunization and Respiratory Disease, Atlanta, Georgia, USA
| | - Fatima Serhan
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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Steffen CA, Henaff L, Durupt A, Omeiri NE, Ndiaye S, Batmunkh N, Liyanage JBL, Hasan Q, Mosina L, Jones I, O'Brien K, Hombach J. Evidence-informed vaccination decision-making in countries: Progress, challenges and opportunities. Vaccine 2021; 39:2146-2152. [PMID: 33712350 DOI: 10.1016/j.vaccine.2021.02.055] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 11/29/2022]
Abstract
Countries face an increasingly complex vaccination landscape. As well as ever-changing infectious disease epidemiology, the number and diversity of vaccine-preventable diseases, vaccine products, and vaccine technologies continue to increase. To ensure that vaccination decision-making is transparent, country-owned and informed by sound scientific evidence, many countries have established national immunization technical advisory groups (NITAGs) to provide independent expert advice. The past decade has seen substantial growth in NITAG numbers and functionality, and there is now a need to consolidate this progress, by further capacity building, to ensure that NITAGs are responsive to the changing face of immunization over the next decade.
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Affiliation(s)
- Christoph A Steffen
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland.
| | - Louise Henaff
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Antoine Durupt
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Nathalie El Omeiri
- Pan-American Health Organization/Regional Office for the Americas, World Health Organization, Washington, DC, USA
| | - Sidy Ndiaye
- Regional Office for Africa, World Health Organization, Brazzaville, Congo
| | - Nyambat Batmunkh
- Regional Office for the Western Pacific, World Health Organization, Manila, Philippines
| | | | - Quamrul Hasan
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt
| | - Liudmila Mosina
- Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Ian Jones
- WHO Consultant, Jinja Publishing Ltd., Bishop's Stortford, UK
| | - Katherine O'Brien
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Joachim Hombach
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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8
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Raguindin PF, Morales-Dizon M, Aldaba J, Mangulabnan LP, Reyes RP, Batmunkh N, Ducusin MJ, Lopez AL. Timeliness of childhood vaccinations in the Philippines. J Public Health Policy 2021; 42:53-70. [PMID: 33398056 PMCID: PMC7979588 DOI: 10.1057/s41271-020-00255-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2020] [Indexed: 12/02/2022]
Abstract
Timeliness of vaccinations is rarely part of monitoring in a routine immunization program. We reviewed infant immunization and conducted caregiver interviews in three regions in the Philippines from January to October 2016. We randomly selected thirty public health centers, one for each region. We defined timeliness of the receipt of antigen as within 4 weeks after the recommended age at vaccination. We assessed a total of 986 infants for timeliness of vaccination. The median age of receipt of vaccine was at 2.7 weeks (BCG), 10.1 weeks (Penta 1), and 21.7 weeks (Penta 3) compared to the recommended 0, 6, and 14 weeks of age, respectively. We found timely receipt only in 74.4% for BCG, 70.3% for Penta 1, and 39.1% for Penta 3 recipients. Thus, alongside declining immunization coverage, the infants in the Philippines had substantial delays in vaccine receipt.
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Affiliation(s)
- Peter Francis Raguindin
- Institute of Child Health and Human Development, National Institutes of Health – University of the Philippines Manila, Manila, Philippines
- Present Address: Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
| | - Merrylle Morales-Dizon
- Institute of Child Health and Human Development, National Institutes of Health – University of the Philippines Manila, Manila, Philippines
| | - Josephine Aldaba
- Institute of Child Health and Human Development, National Institutes of Health – University of the Philippines Manila, Manila, Philippines
| | - Lailani P. Mangulabnan
- Department of Health, Center for Health Development Region 3, San Fernando City, Pampanga Philippines
| | - Renelyn P. Reyes
- Department of Health, Center for Health Development Region 6, Iloilo City, Iloilo Philippines
| | - Nyambat Batmunkh
- Vaccine Preventable Diseases and Immunization, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Maria Joyce Ducusin
- Department of Health, Disease Prevention and Control Bureau, Manila, Philippines
| | - Anna Lena Lopez
- Institute of Child Health and Human Development, National Institutes of Health – University of the Philippines Manila, Manila, Philippines
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9
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Turner P, Leab P, Ly S, Sao S, Miliya T, Heffelfinger JD, Batmunkh N, Lessa FC, Walldorf JA, Hyde TB, Ork V, Hossain MS, Gould KA, Hinds J, Cooper BS, Ngoun C, Turner C, Day NPJ. Impact of 13-Valent Pneumococcal Conjugate Vaccine on Colonization and Invasive Disease in Cambodian Children. Clin Infect Dis 2020; 70:1580-1588. [PMID: 31175819 PMCID: PMC7145996 DOI: 10.1093/cid/ciz481] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/05/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Cambodia introduced the 13-valent pneumococcal conjugate vaccine (PCV13) in January 2015 using a 3 + 0 dosing schedule and no catch-up campaign. We investigated the effects of this introduction on pneumococcal colonization and invasive disease in children aged <5 years. METHODS There were 6 colonization surveys done between January 2014 and January 2018 in children attending the outpatient department of a nongovernmental pediatric hospital in Siem Reap. Nasopharyngeal swabs were analyzed by phenotypic and genotypic methods to detect pneumococcal serotypes and antimicrobial resistance. Invasive pneumococcal disease (IPD) data for January 2012-December 2018 were retrieved from hospital databases. Pre-PCV IPD data and pre-/post-PCV colonization data were modelled to estimate vaccine effectiveness (VE). RESULTS Comparing 2014 with 2016-2018, and using adjusted prevalence ratios, VE estimates for colonization were 16.6% (95% confidence interval [CI] 10.6-21.8) for all pneumococci and 39.2% (95% CI 26.7-46.1) for vaccine serotype (VT) pneumococci. There was a 26.0% (95% CI 17.7-33.0) decrease in multidrug-resistant pneumococcal colonization. The IPD incidence was estimated to have declined by 26.4% (95% CI 14.4-35.8) by 2018, with a decrease of 36.3% (95% CI 23.8-46.9) for VT IPD and an increase of 101.4% (95% CI 62.0-145.4) for non-VT IPD. CONCLUSIONS Following PCV13 introduction into the Cambodian immunization schedule, there have been declines in VT pneumococcal colonization and disease in children aged <5 years. Modelling of dominant serotype colonization data produced plausible VE estimates.
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Affiliation(s)
- Paul Turner
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Phana Leab
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap
| | - Sokeng Ly
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap
| | - Sena Sao
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap
| | - Thyl Miliya
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap
| | - James D Heffelfinger
- Regional Office for the Western Pacific, World Health Organization, Manila, Philippines
| | - Nyambat Batmunkh
- Regional Office for the Western Pacific, World Health Organization, Manila, Philippines
| | | | | | - Terri B Hyde
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Vichit Ork
- National Immunisation Program, Ministry of Health, Cambodia
| | | | - Katherine A Gould
- Institute for Infection and Immunity, St George’s, University of London, United Kingdom
- Bacterial Microarray Group at St George’s Bioscience, London Bioscience Innovation Centre, United Kingdom
| | - Jason Hinds
- Institute for Infection and Immunity, St George’s, University of London, United Kingdom
- Bacterial Microarray Group at St George’s Bioscience, London Bioscience Innovation Centre, United Kingdom
| | - Ben S Cooper
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chanpheaktra Ngoun
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap
| | - Claudia Turner
- Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Nicholas P J Day
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, United Kingdom
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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10
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Bonifacio J, Lupisan S, Roque V, Ducusin MJ, Grabovac V, Batmunkh N, Heffelfinger JD, Fox K, Toda K, de Quiroz Castro M, Kirkwood C, Tandoc A. Molecular characterization of rotavirus diarrhea among children aged under five years in the Philippines, 2013-2015. Vaccine 2018; 36:7888-7893. [PMID: 30467066 DOI: 10.1016/j.vaccine.2018.08.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 04/25/2018] [Accepted: 08/20/2018] [Indexed: 01/30/2023]
Abstract
With the availability of new and existing rotavirus vaccines, credible and reliable data on burden of rotavirus-associated disease are needed to enable evidence-based decision making regarding the introduction of rotavirus vaccines. The national rotavirus surveillance program in the Philippines, a sentinel-based surveillance, was established in 2012 to determine the proportion of laboratory-confirmed rotavirus cases among children under five years with acute gastroenteritis and to describe the geographic distribution and molecular epidemiology of rotavirus in the country. During 2013 to 2015, rotavirus infection was the cause of acute gastroenteritis among children under five years admitted to hospitals or evaluated in emergency rooms, constituting more than one-third of gastroenteritis hospitalizations at the sentinel site hospitals. The predominant genotype observed was G1P[8]. Although a rotavirus surveillance network has been established, findings suggest the need to strengthen the network in the country and to continue monitoring prevalent rotavirus strains to help identify the possible emergence of new strains.
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Affiliation(s)
- Joseph Bonifacio
- Research Institute for Tropical Medicine, Muntinlupa City, Philippines.
| | - Socorro Lupisan
- Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Vito Roque
- Department of Health, Manila, Philippines
| | | | - Varja Grabovac
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Nyambat Batmunkh
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - James D Heffelfinger
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Kimberley Fox
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Kohei Toda
- Office of the World Health Organization Representative in the Philippines, Manila, Philippines
| | | | - Carl Kirkwood
- Enteric Viruses Group, Murdoch Childrens Research Institute, VIC, Australia
| | - Amado Tandoc
- Research Institute for Tropical Medicine, Muntinlupa City, Philippines
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11
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Huyen DTT, Hong DT, Trung NT, Hoa TTN, Oanh NK, Thang HV, Thao NTT, Hung DM, Iijima M, Fox K, Grabovac V, Heffelfinger J, Batmunkh N, Anh DD. Epidemiology of acute diarrhea caused by rotavirus in sentinel surveillance sites of Vietnam, 2012-2015. Vaccine 2018; 36:7894-7900. [PMID: 29784467 DOI: 10.1016/j.vaccine.2018.05.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 04/10/2018] [Accepted: 05/01/2018] [Indexed: 11/26/2022]
Abstract
A prospective, multicentre study was conducted in four sentinel surveillance hospitals to assess the trend and epidemiology of acute diarrhea caused by Rotavirus in Vietnam. During the period 2012-2015, a total 8,889 children under 5 years of age were enrolled in the surveillance, and 8689 stool samples were collected. Of these cases, Rotavirus was most common pathogen 46.7% (4054 cases); in which 26.6% (1117) rotavirus-positive stool samples were evaluated to identify genotypes. The proportion of rotavirus positive specimens decreased annually from 54.7% in 2012 to 36.6% in 2015. Rotavirus was detected year-round, but most rotavirus gastroenteritis cases (77.1%) occurred between December and May, corresponding to the rotavirus seasonality. It is found that the peaks varied by regions. Rotavirus positivities varied between the youngest and oldest age, but children 6-11 months old (38.8%) and 12-23 months old (38.4%) counted for most cases. A significant higher number of diarrhea within 24 hours (8.3 times, 95%CI: 8.1-8.4 times) and higher proportion of severe dehydration (12.9%) in Rotavirus positive group than that in Rotavirus negative group (7.7 times, 95%CI: 7.6-7.9 times; and 9.7%, respectively). A downtrend of prevalence of G1P[8] was observed from 82% in 2013 to 15% in 2015. However, G2P[4] was found in 5% of samples in 2012, 9% in 2013, 36% in 2014, and 28% in 2015. Rotavirus infection is the most important cause of acute diarrhea among hospitalized children in Vietnam, and a rotavirus vaccination program for children may significantly reduce this disease.
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Affiliation(s)
| | - Duong Thi Hong
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | | | | | | | | | | | | | - Kimberley Fox
- Global Immunization Division, Centers for Diesease Control and Prevention, USA.
| | - Varja Grabovac
- Expanded Programme on Immunization, Division of Communicable Diseases, Western Pacific Regional Office, Manila, Philippines.
| | - James Heffelfinger
- Expanded Programme on Immunization, Division of Communicable Diseases, Western Pacific Regional Office, Manila, Philippines.
| | - Nyambat Batmunkh
- Expanded Programme on Immunization, Division of Communicable Diseases, Western Pacific Regional Office, Manila, Philippines.
| | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
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Lopez AL, Raguindin PF, Esparagoza J, Fox K, Batmunkh N, Bonifacio J, Parashar UD, Tate JE, Ducusin MJ. Impact of rotavirus vaccine on diarrheal hospitalization and outpatient consultations in the Philippines: First evidence from a middle-income Asian country. Vaccine 2018; 36:3308-3314. [PMID: 29729994 PMCID: PMC5980826 DOI: 10.1016/j.vaccine.2018.04.058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/21/2018] [Accepted: 04/19/2018] [Indexed: 12/30/2022]
Abstract
Starting in 2012, RVV was introduced in public health clinics of Agusan del Sur province. Declines in diarrheal hospitalizations and consults were seen following RVV introduction. No declines in diarrheal admissions were observed in a province where RVV was not introduced. This is the first evidence of the public health impact of RVV in a middle income country Asia.
Background Monovalent rotavirus (RV) vaccine was introduced in the Philippines in a phased manner beginning in 2012. To assess the impact of RV vaccine, we conducted a retrospective review of diarrheal admissions in two hospitals. Methods Records of physician-diagnosed diarrheal admissions were reviewed in D.O. Plaza Hospital (DOPH) from 2009 to 2016 in Agusan del Sur where RV vaccine was introduced in the immunization program; and in Cotabato Regional Medical Center (CRMC) from 2011 to 2016 in a region where the vaccine was not introduced. Reports from consultations in public health clinics in Agusan Del Sur and RV vaccine coverage were obtained. Results All-cause diarrheal admissions among children <5 years old in DOPH declined from 2013 to 2016 following RV vaccine introduction in 2012. Using the 2009–2011 mean number of hospitalizations as baseline (X‾ = 1,141), the reductions were 28% (n = 821), 56% (n = 507), 63% (n = 417) and 59% (n = 466) in 2013, 2014, 2015 and 2016, respectively. In comparison, no substantial declines in diarrheal hospitalizations were seen in CRMC from 2011 to 2016. A declining trend was also seen in outpatient consultations in Agusan del Sur following RV vaccine introduction with declines of 27% (n = 2,333), 33% (n = 2,143), 45% (n = 1,764) and 67% (n = 1,059) in 2013, 2014, 2015 and 2016. From September 2012 to December 2016, the 1 and 2-dose RV vaccine coverage gradually increased from 5% and 4% in 2012 to 92% and 88% in 2015, but decreased in 2016 to 53% and 52%, respectively. Discussion RV vaccine introduction was associated with a substantial decline in diarrheal hospitalizations and outpatient consultations for diarrhea in Agusan del Sur, Philippines.
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Affiliation(s)
- Anna Lena Lopez
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, Manila, Philippines.
| | - Peter Francis Raguindin
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Joel Esparagoza
- Democrito O. Plaza Memorial Hospital, Prosperidad, Philippines
| | - Kimberley Fox
- Expanded Programme on Immunization, World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Nyambat Batmunkh
- Expanded Programme on Immunization, World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Joseph Bonifacio
- Department of Virology, Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Umesh D Parashar
- Division of Viral Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, USA
| | - Jacqueline E Tate
- Division of Viral Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, USA
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Heffelfinger JD, Li X, Batmunkh N, Grabovac V, Diorditsa S, Liyanage JB, Pattamadilok S, Bahl S, Vannice KS, Hyde TB, Chu SY, Fox KK, Hills SL, Marfin AA. Japanese Encephalitis Surveillance and Immunization - Asia and Western Pacific Regions, 2016. MMWR Morb Mortal Wkly Rep 2017; 66:579-583. [PMID: 28594790 PMCID: PMC5720240 DOI: 10.15585/mmwr.mm6622a3] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Adjagba A, Senouci K, Biellik R, Batmunkh N, Faye PC, Durupt A, Gessner BD, da Silva A. Supporting countries in establishing and strengthening NITAGs: Lessons learned from 5 years of the SIVAC initiative. Vaccine 2015; 33:588-95. [DOI: 10.1016/j.vaccine.2014.12.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 12/13/2014] [Accepted: 12/15/2014] [Indexed: 10/24/2022]
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Senouci K, Dosso M, Tran Hien N, Batmunkh N, Faye PC, Blau J, Douglas D, Da Silva A, Gessner B. Enhancing the use of evidence-based decision-making processes to establish immunization policies and programmes at national level: what should be the roe of Pasteur Institutes? BMC Proc 2011. [DOI: 10.1186/1753-6561-5-s1-p105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Senouci K, Dosso M, Tran Hien N, Batmunkh N, Faye PC, Blau J, Douglas D, Da Silva A, Gessner B. Enhancing the use of evidence-based decision-making processes to establish immunization policies and programmes at national level: what should be the roe of Pasteur Institutes? BMC Proc 2011. [PMCID: PMC3019420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kamel Senouci
- Agence de Medecine Preventive, s/c Institut Pasteur, 75015 Paris, France
| | - Mireille Dosso
- Institut Pasteur de Côte d’Ivoire, 01 BP 490, Abidjan 01, Ivory Coast
| | | | - Nyambat Batmunkh
- International Vaccine Institute, Gwanak-gu, Seoul, Korea 151-919
| | - Papa Coumba Faye
- Agence de Medecine Preventive, s/c Institut Pasteur, 75015 Paris, France
| | - Julia Blau
- Agence de Medecine Preventive, s/c Institut Pasteur, 75015 Paris, France
| | - Don Douglas
- International Vaccine Institute, Gwanak-gu, Seoul, Korea 151-919
| | - Alfred Da Silva
- Agence de Medecine Preventive, s/c Institut Pasteur, 75015 Paris, France
| | - Bradford Gessner
- Agence de Medecine Preventive, s/c Institut Pasteur, 75015 Paris, France
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Kaljee LM, Anh DD, Minh TT, Huu Tho L, Batmunkh N, Kilgore PE. Rural and urban Vietnamese mothers utilization of healthcare resources for children under 6 years with pneumonia and associated symptoms. J Behav Med 2010; 34:254-67. [PMID: 21127959 DOI: 10.1007/s10865-010-9305-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Accepted: 11/16/2010] [Indexed: 10/18/2022]
Abstract
Worldwide, pneumonia causes 14% of deaths among children and infants (ages 4 weeks to 5 years). UNICEF and WHO have established treatment guidelines to reduce risk of death from pneumonia including caregiver symptom recognition, appropriate care, and use of antibiotics. In June 2008, cross-sectional survey data were collected in Khanh Hoa Province Viet Nam with 329 mothers of children under 6 years. In relation to pneumonia and associated symptoms (fever >38 °C, strong cough, "fast or difficult" breathing), data were collected on perceptions of symptom severity and child vulnerability, reported healthcare utilization including use of antibiotics, sources of health information, and barriers to care. Pearson's chi square, independent t tests, and multinomial analysis were conducted to assess different patterns of reported healthcare utilization in relation to residency (rural/urban), mother's education, and household income. Outcomes include rural and urban residency-based patterns related to perceptions of child's vulnerability and symptom severity, health facility utilization and barriers to care, and reported use of antibiotics during previous episodes of pneumonia. Implications include the need to target different healthcare facilities in urban and rural Viet Nam in relation to education about symptoms of childhood pneumonia and associated treatments.
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Affiliation(s)
- Linda M Kaljee
- Pediatric Prevention Research Center, The Carman and Ann Adams Department of Pediatrics, Wayne State University, Hutzel Building, Suite W534, 4707 St. Antoine, Detroit, MI 48201, USA.
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Lim K, Kim Y, Batmunkh N, Kilgore P. Disease Morbidity and Cost Analysis Associated with Laboratory-Confirmed Influenza Among Children <15 Years in South Korea, 2004–2007. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Anh DD, Minh TT, Tho LH, Slack MPE, Jodar L, Batmunkh N, Kilgore PE, Talarico CA. Hospital-Based Surveillance for Invasive Pneumococcal Disease in Khanh Hoa Province, Vietnam: Epidemiologic Characteristics and Justification for a Pneumococcal Vaccine. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s203-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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