Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. ...Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. This study was conducted to identify key factors that need to be considered when deciding to introduce a new vaccine and current challenges faced by low and middle income countries using Malawi as an example. Methodology: The study employed a desk review approach, examining published literature from various sources such as PubMed, Medline, and Google Scholar. Policy documents from organizations like the World Health Organization, GAVI the Alliance, and the Ministry of Health for Malawi were also included. A total of 99 articles and documents on new vaccine introduction, challenges of immunization, policy documents in immunization and health systems strengthening were included. The review focused on addressing five key areas critical to new vaccine introduction namely: the need for a vaccine, availability of the vaccine, safety and effectiveness of the vaccine, demand for the vaccine, and the prudent use of public or private funds. Results: Malawi considered the burden of cervical cancer and the significance of malaria in the country when introducing the HPV and malaria vaccines. The country opted for vaccines that can be handled by the cold chain capacity and available human resources. Despite that malaria vaccine and Typhoid Conjugate Vaccine trials were done in country, there are limited vaccine safety and efficacy trials conducted in Malawi, leading to a reliance on WHO-prequalified vaccines. Demand for newly introduced vaccines varied, with high demand for Oral Cholera Vaccine during a cholera outbreak, while demand for COVID-19 vaccines decreased over time. Although cost-effectiveness studies were limited in the country, 2 studies indicated that Typhoid Conjugate Vaccine and malaria vaccine would be cost effective. All these have been implemented despite having challenges like lack of accurate surveillance data, inadequate cold chain capacity, limited safety and efficacy vaccine clinical trials, political influence, and limited funding. Conclusion: Despite several challenges Malawi set a good example of the careful considerations required before introducing a new vaccine. The process involves data review, priority setting, precise planning, and consultation with stakeholders. Low-income countries should invest in vaccine safety, efficacy, and cost-effectiveness trials.展开更多
Objective:To explore the changes in the epidemiological characteristics of varicella before and after implementing the two-dose varicella vaccine(VarV)immunization program in the Banan District of Chongqing and to pro...Objective:To explore the changes in the epidemiological characteristics of varicella before and after implementing the two-dose varicella vaccine(VarV)immunization program in the Banan District of Chongqing and to provide a reference for future epidemic prevention and control.Methods:The data of reported varicella cases in Banan District from 2014 to 2023 were collected and analyzed using the China Disease Prevention and Control Information System.Descriptive epidemiological methods were employed to assess the changes in the reported incidence of varicella before(2014-2018)and after(2019-2023)the implementation of the two-dose VarV immunization program.Results:The average annual reported incidence rate of varicella in Banan District from 2014 to 2023 was 81.53 per 100,000.From 2014 to 2018,the reported incidence rate showed an upward trend year by year(trend x2=223.96,P<0.05).However,the reported incidence rate decreased from 2019 to 2023(trend x?=189.51,P<0.05).Before and after the adjustment of the immunization program,the reported incidence rate for the 5-9 years old group was 774.62 per 100,000 and 476.98 per 100,000,respectively,with a statistically significant difference(x2=161.26,P<0.05).The onset of varicella showed a bimodal distribution,with peak incidence periods in May-June and October-December.From 2014 to 2023,a total of 155,181 doses of VarV were administered in Banan District.The estimated annual vaccination rate for the first varicella vaccine(VarV1)from 2019 to 2023 was 86.28%,and for the second dose(VarV2)was 59.18%.The primary vaccination targets were the 5-9-year-old group,accounting for 64.21%.Conclusion:After implementing the two-dose VarV immunization program in Banan District,the vaccination rate increased yearly,and the reported incidence of varicella showed a downward trend.The incidence rate of varicella in children aged 5-9 years reduced significantly,but the overall downward trend for the entire population was not as pronounced.Therefore,it is necessary to increase the vaccination rate of VarV2.展开更多
Immune checkpoint inhibitors are increasingly drawing much attention in the therapeutic development for cancer treatment. However, many cancer patients do not respond to treatments with immune checkpoint inhibitors, p...Immune checkpoint inhibitors are increasingly drawing much attention in the therapeutic development for cancer treatment. However, many cancer patients do not respond to treatments with immune checkpoint inhibitors, partly because of the lack of tumor-infiltrating effector T cells. Cancer vaccines may prime patients for treatments with immune checkpoint inhibitors by inducing effector T-ceU infiltration into the tumors and immune checkpoint signals. The combination of cancer vaccine and an immune checkpoint inhibitor may function synergistically to induce more effective antitumor immune responses, and clinical trials to test the combination are currently ongoing.展开更多
Objectives: To assess the received suspected adverse events occurring upon treatment with drugs and vaccines, at National Centre for Pharmacovigilance, in Togo, from 2009 to 2016. Methods: A crossover study was conduc...Objectives: To assess the received suspected adverse events occurring upon treatment with drugs and vaccines, at National Centre for Pharmacovigilance, in Togo, from 2009 to 2016. Methods: A crossover study was conducted in order to collect data about patients, drugs, suspected adverse events and notifiers. Suspected adverse events were classified using Med DRA 19.1. Notification’s circumstances were classified into Public Health Programs’ campaigns and routine practice. Data were collated into Excel spreadsheet and processed with SPSS software. Key Findings: Regional distribution is irregular. Of the 322 collected report forms, paramedics have notified 60.8% of the cases. Adult patients were the most represented (70.2%). Public Health Programs campaigns provided 72.6% versus 27.4% for routine practice including Neglected Tropical Diseases (41.4%), immunization (27.7%), tuberculosis (25.9%) and 4.5% for HIV. Skin disorders were the most prevalent suspected adverse events (147 sheets;45.7%) followed by general disorders and administration site disorders (29.8%) and gastro-intestinal disorders (12.7%). General anti-infective drugs for systemic use, antiparasites, and insecticides were the most reported class of medications (161 sheets;44.7%). Conclusions: A thorough follow-up of pharmacovigilance launched activities is needed to build a sustainable adverse effect’s surveillance system and routine practice has to be strengthened.展开更多
In order to increase the convenience of application and minimize logistical problems in the recent years, the use of combined vaccines has become a growing trend. The use of combined vaccines offers benefits such as, ...In order to increase the convenience of application and minimize logistical problems in the recent years, the use of combined vaccines has become a growing trend. The use of combined vaccines offers benefits such as, a reduction in the number of patient visits, less complications which are associated with multiple intramuscular drilling and other risks. In 1997 the Department of Epidemiology （DE） of Institute of Public Health initiated and carried out conspicuous quantitative and qualitative modifications of up-to-them statutory notification system thus compiling the new Major Disease-Based Epidemiological Surveillance System. Mandatory reporting system on Measles/Rubella Case-Based Surveillance represents in itself an addendum of the statutory reporting system of infectious diseases. These diseases are enlisted in the Group B of the 14/Sh Form. Diphtheria is enlisted in the Group A containing the infectious diseases of the highest public health importance. They are subject of a mandatory urgent notification from the basic level. The aim of this study is to examine and check up the effectiveness of combined vaccines in our country, through the evaluation of the data from national epidemiologic surveillance verifying the distributions in time and space of these diseases in relation to the history of vaccination policies in Albania.展开更多
Chronic hepatitis B virus(CHB) is currently treated with either interferon-based or nucleot(s)idebased antiviral therapies.However,treatment with pegylated interferon alpha results in a durable antiviral response in o...Chronic hepatitis B virus(CHB) is currently treated with either interferon-based or nucleot(s)idebased antiviral therapies.However,treatment with pegylated interferon alpha results in a durable antiviral response in only about 30%patients and is associated with side effects.Most patients receiving nucleot(s)ide analogue treatment do not establish long-term,durable control of Infection and have rebounding viremia after cessation of therapy.Thus,novel therapy strategies are necessary to achieve the induction of potent and durable antiviral immune responses of the patients which can maintain long-term control of viral replication.Therapeutic vaccination of HBV carriers is a promising strategy for the control of hepatitis B.Here the authors review new therapeutic vaccination strategies to treat chronic hepatitis B which may be introduced for patient treatment in the future.展开更多
Objective:To assess levels of HBs Ab amongst infants who received hepatitis B vaccine in the Expanded Program on Immunization in Vietnam.Methods:A cross-sectional study was carried out at 16 community health centers f...Objective:To assess levels of HBs Ab amongst infants who received hepatitis B vaccine in the Expanded Program on Immunization in Vietnam.Methods:A cross-sectional study was carried out at 16 community health centers from February 2016 to July 2017.Eligible infants were tested for HBs Ab and HBs Ag.Structured questionnaires were used to collect relevant information about the demographics of the parents/caregivers and their infants after physical examination.Results:A total of 199 eligible infants were selected with a mean age of(17.3±4.5)months.Protective antibody levels with HBs Ab≥10 m IU/m L were detected in 68.3%of infants.Of these,antibody levels from 10 to 99 m IU/m L were 48.5%of those tested and antibody levels≥100 ml U/m L were recorded as 51.5%.No cases were recorded of being infected with hepatitis B virus.The rate of positive HBs Ab level in those who were not wasting and≥18 months old was less than that among those who were<18 months old(OR 0.49,95%CI:0.26-0.92,P<0.05)while the infants with wasting and<18 months were less likely to be positive HBs Ab than those who were not wasting and of the same age group(OR 0.15,95%CI:0.04-0.55,P<0.05).Conclusions:Seroprotection against hepatitis B virus was low in the infants tested(at 68.3%),which suggests that the hepatitis B vaccine should be administered with one additional dose for infants between 12 and 24 months of age,particularly those with wasting.展开更多
Objective:To explore and understand the attitude towards dengue vaccination and its modifiable determinants among inhabitants of Aceh(northern Sumatra Island,Indonesia),the region that was most severely affected by th...Objective:To explore and understand the attitude towards dengue vaccination and its modifiable determinants among inhabitants of Aceh(northern Sumatra Island,Indonesia),the region that was most severely affected by the earthquake and tsunami of 26 December 2004.Methods:A communitybased,cross-sectional study was conducted among 535 healthy inhabitants in nine regencies(Kabupaten or Kotamadya)of Aceh that were selected randomly from November 2014 to March 2015.A set of validated,pre-tested,structured questionnaires was used to guide the interviews.The questionnaires covered a range of explanatory variables and one outcome variable(attitude to dengue vaccination).Multi-step logistic regression analysis and Spearman's rank correlation were used to test the role of explanatory variables for the outcome variable.Results:More than 70%of the participants had a poor attitude towards dengue vaccination.Modifiablc determinants associated with poor attitude to dengue vaccination were low education level,working as farmers and traditional market traders,low socioeconomic status and poor knowledge,attitude and practice regarding dengue fever(P<0.05).The KAP domain scores were correlated strongly with attitude to dengue vaccination,r_s=0.25,r_S=0.67 and r_s=0.20,respectively(P<0.001).Multivariate analysis found that independent predictors associated with attitude towards dengue vaccination among study participants were only sex and attitude towards dengue fever(P<0.001).Conclusions:This study reveals that low KAP regarding dengue fever,low education level and low socioeconomic status are associated with a poor attitude towards dengue vaccination.Therefore,inhabitants of suburbs who are working as larmers or traditional market traders with low socioeconomic status are the most appropriate target group for a dengue vaccine introduction program.展开更多
Introduction: Despite the enormous resources deployed and the success achieved in vaccination, reducing the number of children who remain unvaccinated remains a major operational challenge in certain countries. In 201...Introduction: Despite the enormous resources deployed and the success achieved in vaccination, reducing the number of children who remain unvaccinated remains a major operational challenge in certain countries. In 2014, the Kalemie Expanded Program of Immunization outpost in the Democratic Republic of the Congo was faced with a high number of unvaccinated children. They instituted a “token” catch-up system based on a collaborative approach with community health workers. This study aims to document the effects of this strategy on vaccination coverage. Methods: This study was a comparative quasi-experimental test/control study. The “test” health area was Undugu where the catch-up strategy was implemented and the “control” health area was Kanunka. A vaccination coverage survey was conducted according to the WHO method in both health areas, examining children aged 12 to 23 months. The proportions were compared using a Pearson chi-square test and the odds ratios were estimated. Results: Vaccine coverage was significantly higher in the “test” health area for all the antigens. Full vaccination coverage was 69.4% in the “test” health area versus 31% in the “control” health area, with a 4.7 times greater chance of being fully vaccinated in the “test” health area (OR: 4.7;CI 95% [3.1 - 7.2];p = 0.0001). Conclusion: This study demonstrates the value of a strategy that can increase access to vaccination and use of vaccination services, leading to a reduction in inequality in this area. However, this is linked to adapting the collaborative model on which it is based. This must be taken into consideration in plans to reproduce the findings.展开更多
Objectives: Despite the well-known advantages associated with immunization, it has proven difficult to achieve high levels of influenza vaccination among Health Care Professionals (HCPs). This report describes results...Objectives: Despite the well-known advantages associated with immunization, it has proven difficult to achieve high levels of influenza vaccination among Health Care Professionals (HCPs). This report describes results of an influenza vaccination program implemented within a comprehensive cancer center. Methods: Using records from calendar years 2005-2013, we completed a retrospective analysis of annual influenza vaccination rates at this center. A mandatory influenza vaccination policy was implemented in 2010, while prior to that vaccination was encouraged but not required. Vaccinations are free to employees and distributed at various locations. Annual influenza vaccination rates were examined by calendar year and by occupational group (medical, nursing, administrative, scientific, other support staff). Results: High levels of adherence with the mandatory influenza policy were observed for all employee groups. Prior to influenza vaccine mandates flu vaccination rates ranged from ~30% - 40% and increased to 85% - 89% with the mandate. Conclusions: Robust influenza vaccination rates have been sustained since implementation of a vaccination mandate supporting further expansion of policies requiring influenza vaccination for HCPs.展开更多
目的:分析2005—2023年钦州市甲型肝炎(甲肝)的流行病学特征和甲肝疫苗在2008年纳入扩大国家免疫规划项目(Expanded Program on Immunization,EPI)后的预防效果,为制定甲肝防控策略提供参考。方法:通过中国疾病预防控制信息管理系统收集...目的:分析2005—2023年钦州市甲型肝炎(甲肝)的流行病学特征和甲肝疫苗在2008年纳入扩大国家免疫规划项目(Expanded Program on Immunization,EPI)后的预防效果,为制定甲肝防控策略提供参考。方法:通过中国疾病预防控制信息管理系统收集2005—2023年钦州市甲肝发病情况,对甲肝疫苗纳入EPI前(2005—2007年)和之后(2008—2023年)的甲肝流行特征进行对比性的分析。结果:2005—2023年钦州市共报告甲肝病例1063例,年均发病率为1.75/10万,无死亡病例。甲肝年均发病率由纳入免疫规划前的3.52/10万下降至纳入免疫规划后的1.43/10万(χ^(2)=195.647,P<0.05)。发病无明显季节性。不同县区发病具有差异性。男性发病高于女性(χ^(2)=92.447,P<0.05),男女性别比为2.14∶1。发病年龄后移,15岁以下构成比由41.67%显著下降至11.77%。职业分布以农民为主,占55.03%。适龄儿童甲肝疫苗接种率为88.61%。结论:2005—2023年钦州市甲肝发病呈下降趋势。甲肝疫苗纳入EPI后,目标儿童甲肝发病率显著降低,但成人(尤其是农民)的防控形势仍然严峻,在巩固儿童甲肝疫苗接种的同时,还应加强重点地区、重点人群的甲肝疫苗预防接种及健康教育等综合防控工作。展开更多
目的了解铜陵市儿童家长对非免疫规划疫苗的接种犹豫现状并分析其影响因素,为改善非免疫规划疫苗接种犹豫提供参考。方法采用便利抽样法,选取铜陵地区某院就诊≤12岁儿童的家长开展调查,基于计划行为理论(theory of planned behavior,T...目的了解铜陵市儿童家长对非免疫规划疫苗的接种犹豫现状并分析其影响因素,为改善非免疫规划疫苗接种犹豫提供参考。方法采用便利抽样法,选取铜陵地区某院就诊≤12岁儿童的家长开展调查,基于计划行为理论(theory of planned behavior,TPB)设计问卷收集儿童家长对非免疫规划疫苗的接种犹豫情况,运用多因素logistic回归和结构方程模型(structural equation model,SEM)分析接种犹豫的影响因素。结果共纳入334例儿童家长,非免疫规划疫苗接种犹豫的比率为36.22%(121/334)。多因素logistic回归结果显示,具有医学背景的儿童家长对非免疫规划疫苗仍具有更低的接种犹豫发生率(OR=0.418,P=0.010),儿童近半年生病次数的减少也是非免疫规划疫苗接种犹豫的保护因素(OR=0.198,P<0.001)。TPB模型验证性因子分析检验结果显示,问卷的态度、主观规范、知觉行为控制、感知风险、行为意向等各维度Cronbach’sα系数为0.893~0.955,量表总Cronbach’sα系数为0.941,内部一致性较好。相关性分析表明,平均方差萃取值的平方根均大于潜变量相关系数的最大值,提示具有良好的区分效度。通过SEM分析态度、主观规范、知觉行为控制和感知风险四个因素与儿童家长在非免疫规划疫苗接种方面犹豫之间的关系,SEM总体方差解释率为76.90%,结果显示行为控制(β’=-0.702)、主观规范(β’=-0.651)、态度(β’=-0.511)和感知风险(β’=-0.488)均与儿童家长对非免疫规划疫苗的接种犹豫相关(P<0.05)。结论本研究揭示铜陵市儿童家长对非免疫规划疫苗接种犹豫的影响因素,强调医学背景和儿童健康状况的重要性,并指出通过TPB模型提升家长疫苗信心与认知,结合医务人员及社交媒体的宣传,可以有效提高接种意愿。展开更多
文摘Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. This study was conducted to identify key factors that need to be considered when deciding to introduce a new vaccine and current challenges faced by low and middle income countries using Malawi as an example. Methodology: The study employed a desk review approach, examining published literature from various sources such as PubMed, Medline, and Google Scholar. Policy documents from organizations like the World Health Organization, GAVI the Alliance, and the Ministry of Health for Malawi were also included. A total of 99 articles and documents on new vaccine introduction, challenges of immunization, policy documents in immunization and health systems strengthening were included. The review focused on addressing five key areas critical to new vaccine introduction namely: the need for a vaccine, availability of the vaccine, safety and effectiveness of the vaccine, demand for the vaccine, and the prudent use of public or private funds. Results: Malawi considered the burden of cervical cancer and the significance of malaria in the country when introducing the HPV and malaria vaccines. The country opted for vaccines that can be handled by the cold chain capacity and available human resources. Despite that malaria vaccine and Typhoid Conjugate Vaccine trials were done in country, there are limited vaccine safety and efficacy trials conducted in Malawi, leading to a reliance on WHO-prequalified vaccines. Demand for newly introduced vaccines varied, with high demand for Oral Cholera Vaccine during a cholera outbreak, while demand for COVID-19 vaccines decreased over time. Although cost-effectiveness studies were limited in the country, 2 studies indicated that Typhoid Conjugate Vaccine and malaria vaccine would be cost effective. All these have been implemented despite having challenges like lack of accurate surveillance data, inadequate cold chain capacity, limited safety and efficacy vaccine clinical trials, political influence, and limited funding. Conclusion: Despite several challenges Malawi set a good example of the careful considerations required before introducing a new vaccine. The process involves data review, priority setting, precise planning, and consultation with stakeholders. Low-income countries should invest in vaccine safety, efficacy, and cost-effectiveness trials.
文摘Objective:To explore the changes in the epidemiological characteristics of varicella before and after implementing the two-dose varicella vaccine(VarV)immunization program in the Banan District of Chongqing and to provide a reference for future epidemic prevention and control.Methods:The data of reported varicella cases in Banan District from 2014 to 2023 were collected and analyzed using the China Disease Prevention and Control Information System.Descriptive epidemiological methods were employed to assess the changes in the reported incidence of varicella before(2014-2018)and after(2019-2023)the implementation of the two-dose VarV immunization program.Results:The average annual reported incidence rate of varicella in Banan District from 2014 to 2023 was 81.53 per 100,000.From 2014 to 2018,the reported incidence rate showed an upward trend year by year(trend x2=223.96,P<0.05).However,the reported incidence rate decreased from 2019 to 2023(trend x?=189.51,P<0.05).Before and after the adjustment of the immunization program,the reported incidence rate for the 5-9 years old group was 774.62 per 100,000 and 476.98 per 100,000,respectively,with a statistically significant difference(x2=161.26,P<0.05).The onset of varicella showed a bimodal distribution,with peak incidence periods in May-June and October-December.From 2014 to 2023,a total of 155,181 doses of VarV were administered in Banan District.The estimated annual vaccination rate for the first varicella vaccine(VarV1)from 2019 to 2023 was 86.28%,and for the second dose(VarV2)was 59.18%.The primary vaccination targets were the 5-9-year-old group,accounting for 64.21%.Conclusion:After implementing the two-dose VarV immunization program in Banan District,the vaccination rate increased yearly,and the reported incidence of varicella showed a downward trend.The incidence rate of varicella in children aged 5-9 years reduced significantly,but the overall downward trend for the entire population was not as pronounced.Therefore,it is necessary to increase the vaccination rate of VarV2.
基金supported by the Viragh Foundation(L.Z.)National Institutes of Health(NIH)(Grant No.K23 CA148964,L.Z.)the NCI SPORE in Gastrointestinal Cancers(Grant No.P50 CA062924,L.Z.)
文摘Immune checkpoint inhibitors are increasingly drawing much attention in the therapeutic development for cancer treatment. However, many cancer patients do not respond to treatments with immune checkpoint inhibitors, partly because of the lack of tumor-infiltrating effector T cells. Cancer vaccines may prime patients for treatments with immune checkpoint inhibitors by inducing effector T-ceU infiltration into the tumors and immune checkpoint signals. The combination of cancer vaccine and an immune checkpoint inhibitor may function synergistically to induce more effective antitumor immune responses, and clinical trials to test the combination are currently ongoing.
文摘Objectives: To assess the received suspected adverse events occurring upon treatment with drugs and vaccines, at National Centre for Pharmacovigilance, in Togo, from 2009 to 2016. Methods: A crossover study was conducted in order to collect data about patients, drugs, suspected adverse events and notifiers. Suspected adverse events were classified using Med DRA 19.1. Notification’s circumstances were classified into Public Health Programs’ campaigns and routine practice. Data were collated into Excel spreadsheet and processed with SPSS software. Key Findings: Regional distribution is irregular. Of the 322 collected report forms, paramedics have notified 60.8% of the cases. Adult patients were the most represented (70.2%). Public Health Programs campaigns provided 72.6% versus 27.4% for routine practice including Neglected Tropical Diseases (41.4%), immunization (27.7%), tuberculosis (25.9%) and 4.5% for HIV. Skin disorders were the most prevalent suspected adverse events (147 sheets;45.7%) followed by general disorders and administration site disorders (29.8%) and gastro-intestinal disorders (12.7%). General anti-infective drugs for systemic use, antiparasites, and insecticides were the most reported class of medications (161 sheets;44.7%). Conclusions: A thorough follow-up of pharmacovigilance launched activities is needed to build a sustainable adverse effect’s surveillance system and routine practice has to be strengthened.
文摘In order to increase the convenience of application and minimize logistical problems in the recent years, the use of combined vaccines has become a growing trend. The use of combined vaccines offers benefits such as, a reduction in the number of patient visits, less complications which are associated with multiple intramuscular drilling and other risks. In 1997 the Department of Epidemiology （DE） of Institute of Public Health initiated and carried out conspicuous quantitative and qualitative modifications of up-to-them statutory notification system thus compiling the new Major Disease-Based Epidemiological Surveillance System. Mandatory reporting system on Measles/Rubella Case-Based Surveillance represents in itself an addendum of the statutory reporting system of infectious diseases. These diseases are enlisted in the Group B of the 14/Sh Form. Diphtheria is enlisted in the Group A containing the infectious diseases of the highest public health importance. They are subject of a mandatory urgent notification from the basic level. The aim of this study is to examine and check up the effectiveness of combined vaccines in our country, through the evaluation of the data from national epidemiologic surveillance verifying the distributions in time and space of these diseases in relation to the history of vaccination policies in Albania.
基金the Deutsche Forschungsgemeinschaft(TRR60 and GK 1045/2)National Major Science and Technology Project for Infectious Diseases of China(2008ZX10002-011,2012ZX10004503)+1 种基金the National Natural Science Foundation of China(No.30271170,30571646,81101248)the International Science&Technology CooperationProgram of China(2011DFA31030)for supporting some of the work in the review
文摘Chronic hepatitis B virus(CHB) is currently treated with either interferon-based or nucleot(s)idebased antiviral therapies.However,treatment with pegylated interferon alpha results in a durable antiviral response in only about 30%patients and is associated with side effects.Most patients receiving nucleot(s)ide analogue treatment do not establish long-term,durable control of Infection and have rebounding viremia after cessation of therapy.Thus,novel therapy strategies are necessary to achieve the induction of potent and durable antiviral immune responses of the patients which can maintain long-term control of viral replication.Therapeutic vaccination of HBV carriers is a promising strategy for the control of hepatitis B.Here the authors review new therapeutic vaccination strategies to treat chronic hepatitis B which may be introduced for patient treatment in the future.
文摘Objective:To assess levels of HBs Ab amongst infants who received hepatitis B vaccine in the Expanded Program on Immunization in Vietnam.Methods:A cross-sectional study was carried out at 16 community health centers from February 2016 to July 2017.Eligible infants were tested for HBs Ab and HBs Ag.Structured questionnaires were used to collect relevant information about the demographics of the parents/caregivers and their infants after physical examination.Results:A total of 199 eligible infants were selected with a mean age of(17.3±4.5)months.Protective antibody levels with HBs Ab≥10 m IU/m L were detected in 68.3%of infants.Of these,antibody levels from 10 to 99 m IU/m L were 48.5%of those tested and antibody levels≥100 ml U/m L were recorded as 51.5%.No cases were recorded of being infected with hepatitis B virus.The rate of positive HBs Ab level in those who were not wasting and≥18 months old was less than that among those who were<18 months old(OR 0.49,95%CI:0.26-0.92,P<0.05)while the infants with wasting and<18 months were less likely to be positive HBs Ab than those who were not wasting and of the same age group(OR 0.15,95%CI:0.04-0.55,P<0.05).Conclusions:Seroprotection against hepatitis B virus was low in the infants tested(at 68.3%),which suggests that the hepatitis B vaccine should be administered with one additional dose for infants between 12 and 24 months of age,particularly those with wasting.
文摘Objective:To explore and understand the attitude towards dengue vaccination and its modifiable determinants among inhabitants of Aceh(northern Sumatra Island,Indonesia),the region that was most severely affected by the earthquake and tsunami of 26 December 2004.Methods:A communitybased,cross-sectional study was conducted among 535 healthy inhabitants in nine regencies(Kabupaten or Kotamadya)of Aceh that were selected randomly from November 2014 to March 2015.A set of validated,pre-tested,structured questionnaires was used to guide the interviews.The questionnaires covered a range of explanatory variables and one outcome variable(attitude to dengue vaccination).Multi-step logistic regression analysis and Spearman's rank correlation were used to test the role of explanatory variables for the outcome variable.Results:More than 70%of the participants had a poor attitude towards dengue vaccination.Modifiablc determinants associated with poor attitude to dengue vaccination were low education level,working as farmers and traditional market traders,low socioeconomic status and poor knowledge,attitude and practice regarding dengue fever(P<0.05).The KAP domain scores were correlated strongly with attitude to dengue vaccination,r_s=0.25,r_S=0.67 and r_s=0.20,respectively(P<0.001).Multivariate analysis found that independent predictors associated with attitude towards dengue vaccination among study participants were only sex and attitude towards dengue fever(P<0.001).Conclusions:This study reveals that low KAP regarding dengue fever,low education level and low socioeconomic status are associated with a poor attitude towards dengue vaccination.Therefore,inhabitants of suburbs who are working as larmers or traditional market traders with low socioeconomic status are the most appropriate target group for a dengue vaccine introduction program.
文摘Introduction: Despite the enormous resources deployed and the success achieved in vaccination, reducing the number of children who remain unvaccinated remains a major operational challenge in certain countries. In 2014, the Kalemie Expanded Program of Immunization outpost in the Democratic Republic of the Congo was faced with a high number of unvaccinated children. They instituted a “token” catch-up system based on a collaborative approach with community health workers. This study aims to document the effects of this strategy on vaccination coverage. Methods: This study was a comparative quasi-experimental test/control study. The “test” health area was Undugu where the catch-up strategy was implemented and the “control” health area was Kanunka. A vaccination coverage survey was conducted according to the WHO method in both health areas, examining children aged 12 to 23 months. The proportions were compared using a Pearson chi-square test and the odds ratios were estimated. Results: Vaccine coverage was significantly higher in the “test” health area for all the antigens. Full vaccination coverage was 69.4% in the “test” health area versus 31% in the “control” health area, with a 4.7 times greater chance of being fully vaccinated in the “test” health area (OR: 4.7;CI 95% [3.1 - 7.2];p = 0.0001). Conclusion: This study demonstrates the value of a strategy that can increase access to vaccination and use of vaccination services, leading to a reduction in inequality in this area. However, this is linked to adapting the collaborative model on which it is based. This must be taken into consideration in plans to reproduce the findings.
文摘Objectives: Despite the well-known advantages associated with immunization, it has proven difficult to achieve high levels of influenza vaccination among Health Care Professionals (HCPs). This report describes results of an influenza vaccination program implemented within a comprehensive cancer center. Methods: Using records from calendar years 2005-2013, we completed a retrospective analysis of annual influenza vaccination rates at this center. A mandatory influenza vaccination policy was implemented in 2010, while prior to that vaccination was encouraged but not required. Vaccinations are free to employees and distributed at various locations. Annual influenza vaccination rates were examined by calendar year and by occupational group (medical, nursing, administrative, scientific, other support staff). Results: High levels of adherence with the mandatory influenza policy were observed for all employee groups. Prior to influenza vaccine mandates flu vaccination rates ranged from ~30% - 40% and increased to 85% - 89% with the mandate. Conclusions: Robust influenza vaccination rates have been sustained since implementation of a vaccination mandate supporting further expansion of policies requiring influenza vaccination for HCPs.
文摘目的:分析2005—2023年钦州市甲型肝炎(甲肝)的流行病学特征和甲肝疫苗在2008年纳入扩大国家免疫规划项目(Expanded Program on Immunization,EPI)后的预防效果,为制定甲肝防控策略提供参考。方法:通过中国疾病预防控制信息管理系统收集2005—2023年钦州市甲肝发病情况,对甲肝疫苗纳入EPI前(2005—2007年)和之后(2008—2023年)的甲肝流行特征进行对比性的分析。结果:2005—2023年钦州市共报告甲肝病例1063例,年均发病率为1.75/10万,无死亡病例。甲肝年均发病率由纳入免疫规划前的3.52/10万下降至纳入免疫规划后的1.43/10万(χ^(2)=195.647,P<0.05)。发病无明显季节性。不同县区发病具有差异性。男性发病高于女性(χ^(2)=92.447,P<0.05),男女性别比为2.14∶1。发病年龄后移,15岁以下构成比由41.67%显著下降至11.77%。职业分布以农民为主,占55.03%。适龄儿童甲肝疫苗接种率为88.61%。结论:2005—2023年钦州市甲肝发病呈下降趋势。甲肝疫苗纳入EPI后,目标儿童甲肝发病率显著降低,但成人(尤其是农民)的防控形势仍然严峻,在巩固儿童甲肝疫苗接种的同时,还应加强重点地区、重点人群的甲肝疫苗预防接种及健康教育等综合防控工作。
