Global Routine Vaccination Coverage — 2017 VanderEnde, Kristin; Gacic-Dobo, Marta; Diallo, Mamadou S. ...
MMWR. Morbidity and mortality weekly report,
11/2018, Letnik:
67, Številka:
45
Journal Article, Newsletter
Odprti dostop
Endorsed by the World Health Assembly in 2012, the Global Vaccine Action Plan 2011-2020 (GVAP) (1) calls on all countries to reach ≥90% national coverage with all vaccines in the country's national ...immunization schedule by 2020. This report updates previous reports (2,3) and presents global, regional, and national vaccination coverage estimates and trends as of 2017. It also describes the number of infants surviving to age 1 year (surviving infants) who did not receive the third dose of diphtheria and tetanus toxoids and pertussis-containing vaccine (DTP3), a key indicator of immunization program performance (4,5), with a focus on the countries with the highest number of children who did not receive DTP3 in 2017. Based on the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) estimates, global DTP3 coverage increased from 79% in 2007 to 84% in 2010, and has remained stable from 2010 to 2017 (84% to 85%). In 2017, among the 19.9 million children who did not receive DTP3 in the first year of life, 62% (12.4 million) lived in 10 countries. From 2007 to 2017, the number of children who had not received DTP3 decreased in five of these 10 countries and remained stable or increased in the other five. Similar to DTP3 coverage, global coverage with the first measles-containing vaccine dose (MCV1) increased from 80% in 2007 to 84% in 2010, and has remained stable from 2010 to 2017 (84% to 85%). Coverage with the third dose of polio vaccine (Pol3) has remained stable at 84%-85% since 2010. From 2007 to 2017, estimated global coverage with the second MCV dose (MCV2) increased from 33% to 67%, as did coverage with the completed series of rotavirus (2% to 28%), pneumococcal conjugate (PCV) (4% to 44%), rubella (26% to 52%), Haemophilus influenzae type b (Hib) (25% to 72%) and hepatitis B (HepB) (birth dose: 24% to 43%; 3-dose series: 63% to 84%) vaccines. Targeted, context-specific strategies are needed to reach and sustain high vaccination coverage, particularly in countries with the highest number of unvaccinated children.
Routine Vaccination Coverage — Worldwide, 2019 Chard, Anna N; Gacic-Dobo, Marta; Diallo, Mamadou S ...
MMWR. Morbidity and mortality weekly report,
11/2020, Letnik:
69, Številka:
45
Journal Article, Newsletter
Odprti dostop
What is already known about this topic? Global coverage with the third dose of diphtheria and tetanus toxoids and pertussis-containing vaccine (DTP), third dose of polio vaccine, and first dose of ...measles-containing vaccine has remained between 84% and 86% since 2010. What is added by this report? In 2019, 13.8 million children worldwide did not receive the first dose of DTP (zero-dose children). During 2010–2019, the number of zero-dose children increased in the African, Americas, and Western Pacific regions. What are the implications for public health practice? Increasing vaccination coverage beyond levels achieved in the past decade will require targeted, context-specific strategies to identify zero-dose and underimmunized children, introduce interventions to minimize missed vaccinations, monitor vaccination coverage, and respond to immunization program setbacks.
Visual and auditory cortices traditionally have been considered to be “modality-specific.” Thus, their activity has been thought to be unchanged by information in other sensory modalities. However, ...using functional magnetic resonance imaging (fMRI), the present experiments revealed that ongoing activity in the visual cortex could be modulated by auditory information and ongoing activity in the auditory cortex could be modulated by visual information. In both cases, this cross-modal modulation of activity took the form of deactivation. Yet, the deactivation response was not evident in either cortical area during the paired presentation of visual and auditory stimuli. These data suggest that cross-modal inhibitory processes operate within traditional modality-specific cortices and that these processes can be switched on or off in different circumstances.
Background: Understanding the drivers of coverage for vaccines offered in the second year of life (2YL) is a critical focus area for Ghana’s life course approach to vaccination. This study ...characterizes the predictors of vaccine receipt for 2YL vaccines—meningococcal serogroup A conjugate vaccine (MACV) and the second dose of measles-containing vaccine (MCV2)—in Ghana. Methods: 1522 children aged 18–35 months were randomly sampled through household surveys in the Greater Accra Region (GAR), Northern Region (NR), and Volta Region (VR). The association between predictors and vaccination status was modeled using logistic regression with backwards elimination procedures. Predictors included child, caregiver, and household characteristics. Results: Coverage was high for infant vaccines (>85%) but lower for 2YL vaccines (ranging from 60.2% for MACV in GAR to 82.8% for MCV2 in VR). Predictors of vaccination status varied by region. Generally, older, first-born children, those living in rural settlements and those who received their recommended infant vaccines by their first birthday were the most likely to have received 2YL vaccines. Uptake was higher among those with older mothers and children whose caregivers were aware of the vaccination schedule. Conclusions: Improving infant immunization uptake through increased community awareness and targeted strategies, such as parental reminders about vaccination visits, may improve 2YL vaccination coverage.
Vaccination against Ebolavirus is an emerging public health tool during Ebola Virus Disease outbreaks. We examined demand issues related to deployment of Ebolavirus vaccine during the 2014–2015 ...outbreak in Sierra Leone.
A cluster survey was administered to a population-based sample in December 2014 (N = 3540), before any Ebola vaccine was available to the general public in Sierra Leone. Ebola vaccine demand was captured in this survey by three Likert-scale items that were used to develop a composite score and dichotomized into a binary outcome to define high demand. A multilevel logistic regression model was fitted to assess the associations between perceptions of who should be first to receive an Ebola vaccine and the expression of high demand for an Ebola vaccine.
The largest proportion of respondents reported that health workers (35.1%) or their own families (29.5%) should receive the vaccine first if it became available, rather than politicians (13.8%), vaccination teams (9.8%), or people in high risk areas (8.2%). High demand for an Ebola vaccine was expressed by 74.2% of respondents nationally. The odds of expressing high demand were 13 times greater among those who said they or their families should be the first to take the vaccine compared to those who said politicians should be the first recipients (adjusted odds ratio aOR 13.0 95% confidence interval CI 7.8–21.6). The ultra-brief measure of the Ebola vaccine demand demonstrated acceptable scale reliability (Cronbach’s α = 0.79) and construct validity (single-factor loadings > 0.50).
Perceptions of who should be the first to get the vaccine was associated with high demand for Ebola vaccine around the peak of the outbreak in Sierra Leone. Using an ultra-brief measure of Ebola vaccine demand is a feasible solution in outbreak settings and can help inform development of future rapid assessment tools.
The objective of this study was to examine the accuracy of indexing for "Appalachian Region"Mesh. Researchers performed a search in PubMed for articles published in 2019 using "Appalachian ...Region"Mesh or "Appalachia" or "Appalachian" in the title or abstract. Only 17.88% of the articles retrieved by the search were about Appalachia according to the ARC definition. Most articles retrieved appeared because they were indexed with state terms that were included as part of the mesh term. Database indexing and searching transparency is of growing importance as indexers rely increasingly on automated systems to catalog information and publications.
Background. Efforts are underway to strengthen Nigeria's routine immunization system, yet measuring impact poses a challenge. We document limitations in using administrative data from 12 states in ...Nigeria and explore alternative approaches. Methods. We compared state-reported coverage with the third dose of diphtheria-tetanus-pertussis vaccine (DTP3) to district-reported coverage and data from coverage surveys conducted during 2006-2013. We used district-reported data during 2010-2013 to calculate the annual change in immunization coverage, the percentage of the target population that was unimmunized, and the number of vaccine doses administered. Data quality indicators were also assessed. Results. State-reported DTP3 coverage was 66%-102% in 2010,49%-98% in 2011,38%-84% in 2012, and 75%-123% in 2013 and was a median 46%-114% greater than survey coverage during 2006-2013. The mean local government area (LGA)-reported coverage varied substantially (standard deviation range, 10%-33% across years). For 2010-2013, the mean annual percentage change in LGA-reported DTP3 coverage was - 15% from 2010 to 2011, -9% from 2011 to 2012, and 74% from 2012 to 2013; the mean annual percentage change in the percentage of the target population unimmunized was —62%, 426%, and —62%, respectively; and the mean annual percentage change in the number of doses administered was —13%, —7%, and 90%, respectively. Annually, a mean 14% of LGAs reported DTP3 coverage of >100%. Discussion. Assessing immunization system performance by using administrative data has notable limitations. In addition to long-term improvements in administrative data management, alternatives for measuring routine immunization performance should be considered.
•Globally, high number of children start but fail to complete all recommended vaccinations.•Vaccination reminder/recall strategies aim to nudge parents to return for future visits.•Few ...reminder/recall strategies have been evaluated in low or middle-income countries.•In Indonesia, we evaluated a vaccination-card based reminder intervention.•The intervention showed mild positive effects on vaccination timeliness.
Limited evidence is available about the effectiveness of strategies to remind caregivers when to bring children back for future vaccinations in low- and middle-income country settings. We evaluated the effectiveness of two reminder strategies based on home-based vaccination records (HBR) in Indonesia.
In this cluster-randomized controlled trial involving 3616 children <1 year of age, 90 health facilities were randomly assigned to either a control group or one of two intervention groups: (1) HBR-only group, where healthcare workers provided an HBR to any child without an HBR during a vaccination visit and instructed the caregiver to keep it at home between visits, or (2) HBR + sticker group, where, in addition to HBR provision, healthcare workers placed vaccination appointment reminder stickers on the HBR. The primary outcome was receipt of the third dose of diphtheria-tetanus-pertussis-containing vaccine (DTPcv3) within 7 months and the secondary outcome was receipt of a timely DTPcv3 dose.
Control group DTPcv3 coverage was 81%. In intention-to-treat analysis, neither intervention group had significantly different DTPcv3 coverage compared with the control group (RR = 0.94, 95% confidence interval CI 0.87; 1.02 for HBR-only group; RR = 0.97, 95% CI 0.90; 1.04 for HBR + sticker group) by study end. However, children in the HBR + sticker group were 50% more likely to have received a DTPcv3 vaccination (RR = 1.46, 95% CI 1.02, 2.09) within 60 days of DTPcv1 vaccination, compared with children in the control group; children in the HBR-only group were not more likely to have done so (RR = 1.05, 95% CI 0.71, 1.55).
Reminder stickers had an immediate effect on coverage by improving the proportion of children who received a timely DTPcv3 dose but no effect on the proportion who received DTPcv3 after 7 months. Coupling reminder stickers with strategies to address other reasons why children do not return for vaccination visits should be further explored.
Routine Vaccination Coverage - Worldwide, 2020 Muhoza, Pierre; Danovaro-Holliday, M Carolina; Diallo, Mamadou S ...
MMWR. Morbidity and mortality weekly report,
10/2021, Letnik:
70, Številka:
43
Journal Article, Newsletter
Odprti dostop
Endorsed by the World Health Assembly in 2020, the Immunization Agenda 2030 (IA2030) strives to reduce morbidity and mortality from vaccine-preventable diseases across the life course (1). This ...report, which updates a previous report (2), presents global, regional,* and national vaccination coverage estimates and trends as of 2020. Changes are described in vaccination coverage and the numbers of unvaccinated and undervaccinated children as measured by receipt of the first and third doses of diphtheria, tetanus, and pertussis-containing vaccine (DTP) in 2020, when the COVID-19 pandemic began, compared with 2019. Global estimates of coverage with the third dose of DTP (DTP3) and a polio vaccine (Pol3) decreased from 86% in 2019 to 83% in 2020. Similarly, coverage with the first dose of measles-containing vaccine (MCV1) dropped from 86% in 2019 to 84% in 2020. The last year that coverage estimates were at 2020 levels was 2009 for DTP3 and 2014 for both MCV1 and Pol3. Worldwide, 22.7 million children (17% of the target population) were not vaccinated with DTP3 in 2020 compared with 19.0 million (14%) in 2019. Children who did not receive the first DTP dose (DTP1) by age 12 months (zero-dose children) accounted for 95% of the increased number. Among those who did not receive DTP3 in 2020, approximately 17.1 million (75%) were zero-dose children. Global coverage decreased in 2020 compared with 2019 estimates for the completed series of Haemophilus influenzae type b (Hib), hepatitis B vaccine (HepB), human papillomavirus vaccine (HPV), and rubella-containing vaccine (RCV). Full recovery from COVID-19-associated disruptions will require targeted, context-specific strategies to identify and catch up zero-dose and undervaccinated children, introduce interventions to minimize missed vaccinations, monitor coverage, and respond to program setbacks (3).
Nanopore sequencing in microgravity McIntyre, Alexa B R; Rizzardi, Lindsay; Yu, Angela M ...
NPJ microgravity,
10/2016, Letnik:
2, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Rapid DNA sequencing and analysis has been a long-sought goal in remote research and point-of-care medicine. In microgravity, DNA sequencing can facilitate novel astrobiological research and close ...monitoring of crew health, but spaceflight places stringent restrictions on the mass and volume of instruments, crew operation time, and instrument functionality. The recent emergence of portable, nanopore-based tools with streamlined sample preparation protocols finally enables DNA sequencing on missions in microgravity. As a first step toward sequencing in space and aboard the International Space Station (ISS), we tested the Oxford Nanopore Technologies MinION during a parabolic flight to understand the effects of variable gravity on the instrument and data. In a successful proof-of-principle experiment, we found that the instrument generated DNA reads over the course of the flight, including the first ever sequenced in microgravity, and additional reads measured after the flight concluded its parabolas. Here we detail modifications to the sample-loading procedures to facilitate nanopore sequencing aboard the ISS and in other microgravity environments. We also evaluate existing analysis methods and outline two new approaches, the first based on a wave-fingerprint method and the second on entropy signal mapping. Computationally light analysis methods offer the potential for
species identification, but are limited by the error profiles (stays, skips, and mismatches) of older nanopore data. Higher accuracies attainable with modified sample processing methods and the latest version of flow cells will further enable the use of nanopore sequencers for diagnostics and research in space.
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