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Influenza epidemiology and immunization during pregnancy: Final report of a World Health Organization working group.
Vaccine. 2017 Oct 13; 35(43):5738-5750.From 2014 to 2017, the World Health Organization convened a working group to evaluate influenza disease burden and vaccine efficacy to inform estimates of maternal influenza immunization program impact. The group evaluated existing systematic reviews and relevant primary studies, and conducted four new systematic reviews. There was strong evidence that maternal influenza immunization prevented influenza illness in pregnant women and their infants, although data on severe illness prevention were lacking. The limited number of studies reporting influenza incidence in pregnant women and infants under six months had highly variable estimates and underrepresented low- and middle-income countries. The evidence that maternal influenza immunization reduces the risk of adverse birth outcomes was conflicting, and many observational studies were subject to substantial bias. The lack of scientific clarity regarding disease burden or magnitude of vaccine efficacy against severe illness poses challenges for robust estimation of the potential impact of maternal influenza immunization programs. Copyright (c) 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Geneva, Switzerland, WHO, 2013.  p.The World Malaria Report 2013 summarizes information received from malaria-endemic countries and other sources, and updates the analyses presented in the 2012 report. It highlights the progress made towards global malaria targets set for 2015, and describes current challenges for global malaria control and elimination.
[Clinical, epidemiological and microbiological characteristics of a cohort of pulmonary tuberculosis patients in Cali, Colombia] Caracteristicas clinicas, epidemiologicas y microbiologicas de una cohorte de pacientes con tuberculosis pulmonar en Cali, Colombia.
Biomedica. 2010 Oct-Dec; 30(4):482-91.INTRODUCTION: The World Health Organization recommended strategy for global tuberculosis control is a short-course, clinically administered treatment, This approach has approximately 70% coverage in Colombia. OBJECTIVE: The clinical, epidemiological and microbiological characteristics along with drug therapy outcomes were described in newly diagnosed, pulmonary tuberculosis patients. MATERIALS AND METHODS: This was a descriptive study, conducted as part of a multicenter clinical trial of tuberculosis treatment. A cohort of 106 patients with pulmonary tuberculosis were recruited from several public health facilities in Cali between April 2005 and June 2006. Sputum smear microscopy, culture, drug susceptibility tests to first-line anti-tuberculosis drugs, chest X- ray and HIV-ELISA were performed. Clinical and epidemiological information was collected for each participant. Treatment was administered by the local tuberculosis health facility. Food and transportation incentives were provided during a 30 month follow-up period. RESULTS: The majority of patients were young males with a diagnostic delay longer than 9 weeks and a high sputum smear grade (2+ or 3+). The initial drug resistance was 7.5% for single drug treatment and 1.9% for multidrug treatments. The incidence of adverse events associated with treatment was 8.5%. HIV co-infection was present in 5.7% of the cases. Eighty-six percent of the patients completed the treatment and were considered cured. The radiographic presentation varied within a broad range and differed from the classic progression to cavity formation. CONCLUSION: Delay in tuberculosis diagnosis was identified as a risk factor for treatment compliance failure. The study population had similar baseline epidemiologic characteristics to those described in other cohort studies.
Measles outbreaks and progress towards meeting measles pre-elimination goals: WHO African Region, 2009-2010. Flambees de rougeole et progres accomplis en vue d'atteindre les objectifs de preelimination de la rougeole: Region africaine de l'OMS, 2009-2010.
Releve Epidemiologique Hebdomadaire. 2011 Apr 1; 86(14):129-36.This report summarizes the progress made during 2009-2010 towards meeting the pre-elimination goals after a historically low incidence of measles cases was reported in 2008. In addition, it provides information on measles outbreaks occurring during the same period which highlights the urgent need for renewed political will from governments and their partners to ensure that national multiyear vaccination plans, budgetary line-items and financial commitments exist for routine immunization services and measles-control activities. To assist countries in resonding to measles outbreaks, WHO guidelines were published in 2009.
Symposium proceedings. HPV Vaccines: New Tools in the Prevention of Cervical Cancer and Other HPV Disease in Asia and the Pacific, Bangkok, Thailand, 2 November 2006.
Bangkok, Thailand, Family Health International [FHI], Asia / Pacific Regional Office, 2007. 55 p.Cervical cancer -- the most preventable and treatable of all cancers -- is the most common cancer among women in developing countries. This report presents the proceedings of a November 2006 symposium organized by FHI in Bangkok, Thailand, that brought together leading specialists in immunization, cancer prevention, and other disciplines to start building consensus on a comprehensive approach to programming for the prevention and early detection of cervical cancers in the Asia region. Presentations covered such topics as improved screening methods for cervical cancer, the latest research on human papillomavirus (HPV) vaccines, and country and social perspectives related to HPV vaccination. Participants concluded that there is a need to 1) further educate health professionals, especially so they can influence policymakers and service planners, and 2) devise communication strategies that will shape debates on HPV vaccines.
Epidemiology and clinical features of pneumonia according to radiographic findings in Gambian children.
Tropical Medicine and International Health. 2007 Nov; 12(11):1377-1385.The objective was to assess the effect of vaccines against pneumonia in Gambian children. Data from a randomized, controlled trial of a 9-valent pneumococcal conjugate vaccine (PCV) were used. Radiographic findings, interpreted using WHO definitions, were classified as primary end point pneumonia, 'other infiltrates / abnormalities' pneumonia and pneumonia with no abnormality. We calculated the incidence of the different types of radiological pneumonia, and compared clinical and laboratory features between these groups. Among children who did not receive PCV, the incidence of pneumonia with no radiographic abnormality was about twice that of 'other infiltrates' pneumonia and three times that of primary endpoint pneumonia. Most respiratory symptoms, reduced feeding and vomiting occurred most frequently in children with primary endpoint pneumonia. These children were more likely to be malnourished, to have bronchial breath sounds or invasive bacterial diseases, and to die within 28 days of consultation than children in the other groups. Conversely, a history of convulsion, diarrhoea or fast breathing, malaria parasitaemia and isolation of salmonellae were commoner in children with pneumonia with no radiographic abnormality. Lower chest wall indrawing and rhonchi on auscultation were seen most frequently in children with 'other infiltrates / abnormalities' pneumonia. Primary endpoint pneumonia is strongly associated with bacterial aetiology and severe pneumonia. Since this category of pneumonia is significantly reduced after vaccination with Hib and pneumococcal vaccines, the risk-benefit of antimicrobial prescription for clinical pneumonia for children with increased respiratory rate may warrant re-examination once these vaccines are in widespread use. (author's)
Beijing, China, National Center for AIDS / STD Prevention and Control, 2006 Jan 24.  p.Over the past two years, the response to HIV/AIDS across China has intensified, and the Chinese government has strengthened leadership on HIV/AIDS. Effective measures have been launched in each key area of HIV/AIDS prevention, treatment and care work, and the environment for comprehensive work in these areas has improved considerably. This report was jointly prepared by the Ministry of Health of the People's Republic of China, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) to describe the current status of China's HIV/AIDS epidemic, progress made over the past year in China's HIV/AIDS response, and key challenges that need to be addressed to stop the spread of AIDS. (excerpt)
American Journal of Tropical Medicine and Hygiene. 2006 Feb; 74(2):187-188.Accurate measurement of malaria incidence is of great importance to malaria control, but it is very hard to achieve in most circumstances. Robert Snow and colleagues recently reported the results of a method to determine the case incidences of Plasmodium falciparum malaria around the world. For non-African P. falciparum malaria, they estimated three times more cases than in recent WHO figures. They suggested that the WHO estimates were lower due to the use of passively reported national malaria records. We, who prepared the WHO estimates of non-African malaria cases and published the method used to derive them, discuss here the suggestion by Snow and colleagues that, because of the data and methods used, the WHO estimates must be an under-representation of the true incidence of malaria cases. (excerpt)
Generic protocol to estimate the burden of Shigella diarrhoea and dysenteric mortality. Field test version, May 1999.
Geneva, Switzerland, World Health Organization [WHO], Department of Vaccines and Biologicals, 1999. 37 p. (WHO/V&B/99.26)The WHO Department of Vaccines and Biologicals (V&B) has an increasing interest in vaccines against Shigella, and several candidate vaccines are being tested in clinical trials. The promise of having a new generation of vaccines available in the relatively near future emphasizes the need to understand the disease burden and the epidemiology of Shigella infection in developing countries. The V&B Steering Committee on Epidemiology and Field Research and the V&B Steering Committee on Diarrhoeal Disease Vaccines jointly identified the need for a practical method for immunization programme managers and clinical epidemiologists to assess the local disease burden due to Shigella. At the request of these Steering Committees, this generic protocol was prepared by staff at the U.S National Institute of Child Health and Human Development, the University of Maryland, and the U.S. Centers for Disease Control and Prevention. This protocol provides a general outline for a study and describes the main procedures involved. However, it will need to be adapted to the local setting, and details of field work and operational procedures should be added by local investigators with experience in conducting field studies of diarrhoeal diseases. WHO provides this protocol free-of-charge. In return, WHO would appreciate being informed about studies conducted using this protocol. This WHO document should be referenced in any publication resulting from its use. Comments or suggestions for improving this generic protocol are welcome and should be sent to the Department of Vaccines and Biologicals, WHO, 1211 Geneva 27, Switzerland. (excerpt)
American Journal of Clinical Nutrition. 2003 Aug; 78(2):291-295.Background: Opinions and recommendations about the optimal duration of exclusive breastfeeding have been strongly divided, but few published studies have provided direct evidence on the relative risks and benefits of different breastfeeding durations in recipient infants. Objective: We examined the effects on infant growth and health of 3 compared with 6 mo of exclusive breastfeeding. Design: We conducted an observational cohort study nested within a large randomized trial in Belarus by comparing 2862 infants exclusively breastfed for 3 mo (with continued mixed breastfeeding through = 6 mo) with 621 infants who were exclusively breastfed for = 6 mo. Regression to the mean, within-cluster correlation, and cluster- and individual-level confounding variables were accounted for by using multilevel regression analyses. Results: From 3 to 6 mo, weight gain was slightly greater in the 3-mo group [difference: 29 g/mo (95% CI: 13, 45 g/mo)], as was length gain [difference: 1.1 mm (0.5, 1.6 mm)], but the 6-mo group had a faster length gain from 9 to 12 mo [difference: 0.9 mm/mo (0.3, 1.5 mm/mo)] and a larger head circumference at 12 mo [difference: 0.19 cm (0.07, 0.31 cm)]. A significant reduction in the incidence density of gastrointestinal infection was observed during the period from 3 to 6 mo in the 6-mo group [adjusted incidence density ratio: 0.35 (0.13, 0.96)], but no significant differences in risk of respiratory infectious outcomes or atopic eczema were apparent. Conclusions: Exclusive breastfeeding for 6 mo is associated with a lower risk of gastrointestinal infection and no demonstrable adverse health effects in the first year of life. (author's)
Journal of Viral Hepatitis. 2003 Mar; 10(2):141-149.Hepatitis B (HB) is thought to be an expanding health problem in Russia. The incidence of infection was estimated from mandatorily reported HB cases in St Petersburg. The two-sided t-test for independent samples and the LOESS (locally-weighted regression) smoother were used to compare the age at infection for symptomatic, asymptomatic and chronic infections, by gender. The force of infection was estimated from seroprevalence data (907 sera taken in 1999) using a newly developed nonparametric method based on local polynomials, as well as an earlier method based on isotonic regression and kernel smoothers. With the local polynomial method, pointwise confidence intervals (95%) were constructed by bootstrapping. On average, men contracted HB infection at a significantly younger age than women (in 1999, 21.8 vs 22.7 years, respectively). The overall male to female ratio was 1.92. In 1999 the overall incidence almost doubled compared with the preceding years and tripled among the age groups with highest incidence (15–29-year olds: 85% of cases in 1999). The incidence increase was associated with a lower average age at infection (24.1 years in 1994 vs 22.1 years in 1999). The age and gender-specific force of infection estimates generally confirmed the incidence estimates and emphasized the usefulness of local polynomials to do this. Hence HB transmission in St Petersburg occurs mainly in young adults. The dramatic increase of infections in 1999 was probably due to injecting drug use. Without intervention, HB virus is expected to continue to spread rapidly with a greater proportion of female infections caused by sexual transmission. These trends may also provide an indication for HIV transmission. (author's)
WORLD HEALTH. 1995 Jan-Feb; 48(1):10-1.The World Health Organization has established a network of more than 60 national virology laboratories to perform the surveillance necessary to insure the eradication of poliovirus. These laboratories work with epidemiologists to determine the cause of cases of acute flaccid paralysis. Their work is supported by 15 regional reference laboratories and 5 specialized global laboratories. As the number of polio-free countries increases, researchers at the US Centers for Disease Control are engaging in "molecular epidemiology" to determine if the indigenous strains of wild polio have really disappeared. These studies examine the mutations which occur at a rate of approximately 2% of a selected portion of the genome each year to determine the relationship between viruses of the same type. Differences of more than 10% indicate different families of viruses. Analysis of many strains has allowed the mapping of the "homelands," or geographical areas, of various genotypes. Such molecular epidemiology will allow coordinated eradication activities to be directed at eliminating genotypes from homelands which extend beyond national borders. Until global eradication is achieved, all countries remain at risk.