: The objective of the study was to assess compliance of the WHO and UNICEF estimates of national immunization coverage (WUENIC) against the 18 criteria of the Guidelines for Accurate and Transparent ...Health Estimates Reporting (GATHER) that define and promote good practice in reporting of global health estimates.
: We conducted a desk review of the WUENIC estimation and reporting process vis-à-vis each of the 18 GATHER criteria to complete a self-assessment of compliance with GATHER.
: Overall, WUENIC estimates are fully compliant with 17 of the GATHER criteria and partially compliant with one criterion-criterion 11, which is related to candidate model evaluation and final model selection.
: The GATHER criteria provide a useful framework for documenting WUENIC's compliance with contemporary reporting requirements. Given the role of vaccination coverage estimates in global monitoring and guiding disease control efforts, WHO and UNICEF strive to produce and publish robust estimates of vaccination coverage through a transparent process that emphasizes country involvement.
What is already known about this topic? High routine childhood vaccination coverage achieved during 2015–2019 declined globally for most vaccines during 2019–2021 because of COVID-19 pandemic ...disruptions. What is added by this report? In 2021, the estimated global coverage with 3 doses of diphtheria-tetanus-pertussis–containing vaccine as well as the first dose of measles-containing vaccine decreased to 81%, the lowest level since 2008. Globally, 25.0 million children were unvaccinated or incompletely vaccinated in 2021, 5.9 million more than in 2019. What are the implications for public health practice? Reversing declining vaccination trends and addressing immunity gaps, as well as extending previous gains in vaccination coverage beyond prepandemic levels, requires targeted and context-specific approaches that prioritize routine vaccination as an essential health service and improve access to vaccination across the life span.
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).
Background: The objective of the study was to assess compliance of the WHO and UNICEF estimates of national immunization coverage (WUENIC) against the 18 criteria of the Guidelines for Accurate and ...Transparent Health Estimates Reporting (GATHER) that define and promote good practice in reporting of global health estimates. Methods: We conducted a desk review of the WUENIC estimation and reporting process vis-à-vis each of the 18 GATHER criteria to complete a self-assessment of compliance with GATHER. Results: Overall, WUENIC estimates are fully compliant with 17 of the GATHER criteria and partially compliant with one criterion—criterion 11, which is related to candidate model evaluation and final model selection. Conclusion: The GATHER criteria provide a useful framework for documenting WUENIC’s compliance with contemporary reporting requirements. Given the role of vaccination coverage estimates in global monitoring and guiding disease control efforts, WHO and UNICEF strive to produce and publish robust estimates of vaccination coverage through a transparent process that emphasizes country involvement.
Estimates of national immunization coverage are crucial for guiding policy and decision-making in national immunization programs and setting the global immunization agenda. WHO and UNICEF estimates ...of national immunization coverage (WUENIC) are produced annually for various vaccine-dose combinations and all WHO Member States using information from multiple data sources and a deterministic computational logic approach. This approach, however, is incapable of characterizing the uncertainties inherent in coverage measurement and estimation. It also provides no statistically principled way of exploiting and accounting for the interdependence in immunization coverage data collected for multiple vaccines, countries and time points. Here, we develop Bayesian hierarchical modeling approaches for producing accurate estimates of national immunization coverage and their associated uncertainties. We propose and explore two candidate models: a balanced data single likelihood (BDSL) model and an irregular data multiple likelihood (IDML) model, both of which differ in their handling of missing data and characterization of the uncertainties associated with the multiple input data sources. We provide a simulation study that demonstrates a high degree of accuracy of the estimates produced by the proposed models, and which also shows that the IDML model is the better model. We apply the methodology to produce coverage estimates for select vaccine-dose combinations for the period 2000-2019. A contributed R package {\tt imcover} implementing the No-U-Turn Sampler (NUTS) in the Stan programming language enhances the utility and reproducibility of the methodology.
Platelets are small, anucleate cells that travel as resting discoid fragments in the circulation. Their average circulating life span is 8–9 days, and their formation is an elegant and finely ...orchestrated series of cellular processes known as megakaryocytopoiesis and thrombopoiesis. This involves the commitment of haematopoietic stem cells, proliferation, terminal differentiation of megakaryocytic progenitors and maturation of megakaryocytes to produce functional platelets. This complex process occurs in specialised endosteal and vascular niches in the bone marrow where megakaryocytes form proplatelet projections, releasing platelets into the circulation. Upon contact with an injured blood vessel, they prevent blood loss through processes of adhesion, activation and aggregation. Platelets play a central role in cardiovascular disease (CVD), both in the development of atherosclerosis and as the cellular mediator in the development of thrombosis. Platelets have diverse roles not limited to thrombosis/haemostasis, also being involved in many vascular inflammatory conditions. Depending on the physiological context, platelet functions may be protective or contribute to adverse thrombotic and inflammatory outcomes. In this chapter, we will discuss platelets in context of their formation and function. Because of their multifaceted role in maintaining physiological homeostasis, current and development of platelet function testing platforms will be discussed.
Cardiovascular disease (CVD) risk factors can be classed as modifiable or non-modifiable. Physical inactivity and obesity represent major behavioural risk factors for the initiation, development and ...progression of CVD. Platelet dysfunction is pivotal to the aetiology of CVD, a chronic vascular inflammatory condition, which is characterised by a lag time between onset and clinical manifestation. This indicates the role of epigenetic drift, defined by stochastic patterns of gene expression not dependent on dynamic changes in coding DNA. The epigenome, a collection of chemical marks on DNA and histones, is established during embryogenesis and modified by age and lifestyle. Biogenesis and effector function of non-coding RNA, such as microRNA, play a regulatory role in gene expression and thus the epigenetic mechanism. In this chapter, we will focus on the effect of the modifiable risk factors of physical activity/inactivity and overweight/obesity on platelet function, via epigenetic changes in both megakaryocytopoiesis and thrombopoiesis. We will also discuss the role of acute exercise on platelet function and the impact of cardiorespiratory fitness (CRF) on platelet responses to acute exercise. This chapter will highlight the potential role of platelets as circulating functional biomarkers of epigenetic drift to implement, optimise and monitor CVD preventive management strategies.
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