The Lancet Infectious Disease
Aug 2010  Volume 10  Number 8  Pages 505 – 576
http://www.thelancet.com/journals/laninf/issue/current

Review
Changes in the burden of malaria in sub-Saharan Africa
Wendy Prudhomme O’Meara, Judith Nekesa Mangeni, Rick Steketee, Brian Greenwood

Preview
The burden of malaria in countries in sub-Saharan Africa has declined with scaling up of prevention, diagnosis, and treatment. To assess the contribution of specific malaria interventions and other general factors in bringing about these changes, we reviewed studies that have reported recent changes in the incidence or prevalence of malaria in sub-Saharan Africa. Malaria control in southern Africa (South Africa, Mozambique, and Swaziland) began in the 1980s and has shown substantial, lasting declines linked to scale-up of specific interventions.

The Pediatric Infectious Disease Journal
August 2010 – Volume 29 – Issue 8
http://journals.lww.com/pidj/pages/currenttoc.aspx

Sustained Decline in Cases of Rotavirus Gastroenteritis Presenting to the Children’s Hospital of Philadelphia in the New Rotavirus Vaccine Era
Clark, H Fred; Lawley, Diane; Matthijnssens, Jelle; DiNubile, Mark J.; Hodinka, Richard L.
Pediatric Infectious Disease Journal. 29(8):699-702, August 2010.
doi: 10.1097/INF.0b013e3181d73524

Abstract:
Background: A dramatic diminution in the number of rotavirus gastroenteritis cases during the 2007 to 2008 rotavirus season in the United States was likely attributable to the availability of an effective rotavirus vaccine for infants since February 2006. To exclude the possibility that factors other than vaccination accounted for the declining case frequency, we examined the 2008 to 2009 experience at the Children’s Hospital of Philadelphia (CHOP).

Methods: Infants with acute gastroenteritis presenting to CHOP have been monitored for the presence of rotavirus antigen in the stool by enzyme-linked immunosorbent assay (followed by serotyping if enzyme-linked immunosorbent assay-positive) since the 1994 to 1995 epidemic season.

Results: The number of community-acquired cases during the last full rotavirus season before licensure of a vaccine was 271 in 2005 to 2006, followed by 167 cases in 2006 to 2007 and 36 in 2007 to 2008. Between 2008 and 2009, 73 community-acquired cases were identified. Almost half of the cases were seen among children older than 2 years. Unlike the late-appearing 2007 to 2008 season, the 2008 to 2009 season paralleled the typical time course observed in the prevaccine era. G9P[8] strains caused 64% of the cases.

Conclusion: The sustained decline in the frequency of community-acquired rotavirus gastroenteritis has likely resulted from the use of the new rotavirus vaccines. The age distribution of children hospitalized for rotavirus gastroenteritis has shifted toward older children with the introduction of effective vaccines. The G9 serotype (not included in either vaccine) emerged as the most common cause of rotavirus gastroenteritis at CHOP during the 2008 to 2009 season.

The Pediatric Infectious Disease Journal
August 2010 – Volume 29 – Issue 8
http://journals.lww.com/pidj/pages/currenttoc.aspx

Parental Attitudes About Influenza Immunization and School-Based Immunization for School-Aged Children
Allison, Mandy A.; Reyes, Maria; Young, Paul; Calame, Lynne; Sheng, Xiaoming; Weng, Hsin-yi Cindy; Byington, Carrie L.
Pediatric Infectious Disease Journal. 29(8):751-755, August 2010.
doi: 10.1097/INF.0b013e3181d8562c

Abstract:
Objectives: Identify parental beliefs and barriers related to influenza immunization of school-aged children and acceptance of school-based influenza immunization.

Methods: We conducted a cross-sectional survey of parents of elementary school-aged children in November 2008. Outcomes were receipt of influenza vaccine, acceptance of school-based immunization, and barriers to immunization.

Results: Response rate was 65% (259/397). Parents reported that 26% of children had received the vaccine and 24% intended receipt. A total of 50% did not plan to immunize. Factors associated with receipt were belief that immunization is a social norm (adjusted odds ratios [AOR], 10.8; 95% CI, 2.8-41.8), belief in benefit (AOR, 7.8; CI, 1.8-33.8), discussion with a doctor (AOR, 7.0; CI, 2.9-16.8), and belief that vaccine is safe (AOR, 4.0; CI, 1.0-15.8). A total of 75% of parents would immunize their children at school if the vaccine were free, including 59% (76/129) who did not plan to immunize. Factors associated with acceptance of school-based immunization were belief in benefit (AOR, 6.1; 95% CI, 2.7-14.0), endorsement of medical setting barriers (AOR, 3.7; 95% CI, 1.3-10.3), and beliefs that immunization is a social norm (AOR, 3.3; 95% CI, 1.4-7.6) and that the child is susceptible to influenza (AOR, 2.6; 95% CI, 1.2-5.7). Medical setting barriers were competing time demands, inconvenience, and cost; school barriers were parents’ desire to be with children and competence of person delivering the vaccine.

Conclusions: School-based immunization programs can increase immunization coverage by targeting parents for whom time demands and inconvenience are barriers, demonstrating that immunization is a social norm, and addressing concerns about influenza vaccine benefit and safety.