From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary
Sociocultural Determinants of Anticipated Vaccine Acceptance for Acute Watery Diarrhea in Early Childhood in Katanga Province, Democratic Republic of Congo
Sonja Merten*, Christian Schaetti, Cele Manianga, Bruno Lapika, Raymond Hutubessy, Claire-Lise Chaignat and Mitchell Weiss
+ Author Affiliations
Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; Anthropologie, Université de Kinshasa, Kinshasa, Democratic Republic of Congo; Initiative for Vaccine Research and Global Task Force on Cholera Control, World Health Organization, Geneva, Switzerland
American Journal of Tropical Medicine and Hygiene
Published online July 22, 2013
Rotavirus and oral cholera vaccines have the potential to reduce diarrhea-related child mortality in low-income settings and are recommended by the World Health Organization. Uptake of vaccination depends on community support, and is based on local priorities. This study investigates local perceptions of acute watery diarrhea in childhood and anticipated vaccine acceptance in two sites in the Democratic Republic of Congo. In 2010, 360 randomly selected non-affected adults were interviewed by using a semi-structured questionnaire. Witchcraft and breastfeeding were perceived as potential cause of acute watery diarrhea by 51% and 48% of respondents. Despite misperceptions, anticipated vaccine acceptance at no cost was 99%. The strongest predictor of anticipated vaccine acceptance if costs were assumed was the educational level of the respondents. Results suggest that the introduction of vaccines is a local priority and local (mis)perceptions of illness do not compromise vaccine acceptability if the vaccine is affordable
Influenza vaccination for healthcare workers who care for people aged 60 or older living in long‐term care institutions
Roger E Thomas1,*, Tom Jefferson2, Toby J Lasserson3
The Cocchran Librrary
Editorial Group: Cochrane Acute Respiratory Infections Group
Published Online: 22 JUL 2013
Healthcare workers’ influenza rates are unknown but may be similar to those of the general public. Healthcare workers may transmit influenza to patients.
To identify all randomised controlled trials (RCTs) and non-RCTs assessing the effects of vaccinating healthcare workers on the incidence of laboratory-proven influenza, pneumonia, death from pneumonia and admission to hospital for respiratory illness in those aged 60 years or older resident in long-term care institutions (LTCIs).
We searched CENTRAL 2013, Issue 2, MEDLINE (1966 to March week 3, 2013), EMBASE (1974 to March 2013), Biological Abstracts (1969 to March 2013), Science Citation Index-Expanded (1974 to March 2013) and Web of Science (2006 to March 2013).
Randomised controlled trials (RCTs) and non-RCTs of influenza vaccination of healthcare workers caring for individuals aged 60 years or older in LTCIs and the incidence of laboratory-proven influenza and its complications (lower respiratory tract infection, or hospitalisation or death due to lower respiratory tract infection) in individuals aged 60 years or older in LTCIs.
Data collection and analysis
Two authors independently extracted data and assessed risk of bias.
We identified four cluster-RCTs (C-RCTs) (n = 7558) and one cohort study (n = 12,742) of influenza vaccination for HCWs caring for individuals ≥ 60 years in LTCFs. Three RCTs (5896 participants) provided outcome data that met our criteria. These three studies were comparable in study populations, intervention and outcome measures. The studies did not report adverse events. The principal sources of bias in the studies related to attrition and blinding. The pooled risk difference (RD) from the three cluster-RCTs for laboratory-proven influenza was 0 (95% confidence interval (CI) -0.03 to 0.03) and for hospitalisation was RD 0 (95% CI -0.02 to 0.02). The estimated risk of death due to lower respiratory tract infection was also imprecise (RD -0.02, 95% CI -0.06 to 0.02) in individuals aged 60 years or older in LTCIs. Adjusted analyses which took into account the cluster design did not differ substantively from the pooled analysis with unadjusted data.
The results for specific outcomes: laboratory-proven influenza or its complications (lower respiratory tract infection, or hospitalisation or death due to lower respiratory tract illness) did not identify a benefit of healthcare worker vaccination on these key outcomes. This review did not find information on co-interventions with healthcare worker vaccination: hand-washing, face masks, early detection of laboratory-proven influenza, quarantine, avoiding admissions, antivirals and asking healthcare workers with influenza or influenza-like-illness (ILI) not to work. This review does not provide reasonable evidence to support the vaccination of healthcare workers to prevent influenza in those aged 60 years or older resident in LTCIs. High-quality RCTs are required to avoid the risks of bias in methodology and conduct identified by this review and to test further these interventions in combination.
Plain language summary
Influenza vaccination for healthcare workers who care for people aged 60 or older living in long-term care institutions
Older individuals in long-term care institutions (LTCIs) at risk of influenza may be infected by their healthcare workers. There are no accurate data on rates of laboratory-proven influenza in healthcare workers. Vaccinating healthcare workers against influenza may reduce infections acquired from this source. Because the signs and symptoms of influenza are similar to those of many other respiratory illnesses, it is important in studies testing the effects of influenza vaccination to prove by laboratory tests which are highly accurate whether residents in LTCIs actually have influenza or another respiratory illness.
Three randomised controlled trials (RCTs) (5896 participants) provided outcome data meeting our criteria. For risk of bias: randomisation was at low risk in two trials and unclear in one; allocation concealment and blinding in all three trials was unclear; incomplete outcome data in one trial was at low risk and in two at high risk; selective reporting all three trials was at low risk; performance bias (incomplete influenza vaccination of healthcare workers in the intervention arms) in all three trials was at high risk. No studies reported on adverse events. Vaccinating healthcare workers who care for those aged 60 or over in LTCIs showed no effect on laboratory-proven influenza or complications (lower respiratory tract infection, hospitalisation or death due to lower respiratory tract illness) in those aged 60 or over resident in LTCIs.
This review did not find information on other interventions used in conjunction with vaccinating healthcare workers (hand-washing, face masks, early detection of laboratory-proven influenza, quarantine, avoiding new admissions, prompt use of antivirals and asking healthcare workers with an influenza-like illness not to work.
There is no evidence that only vaccinating healthcare workers prevents laboratory-proven influenza or its complications (lower respiratory tract infection, hospitalisation or death due to lower respiratory tract infection) in individuals aged 60 or over in LTCIs and thus no evidence to mandate compulsory vaccination of healthcare workers. Other interventions, such as hand-washing, masks, early detection of influenza with nasal swabs, antivirals, quarantine, restricting visitors and asking healthcare workers with an influenza-like illness not to attend work, might protect individuals over 60 in LTCIs. High-quality randomised controlled trials testing combinations of these interventions are needed.
Providers lack of knowledge about herpes zoster in HIV-infected patients is among barriers to herpes zoster vaccination
M Aziz, MD, H Kessler, MD, G Huhn, MD MPH&TM
Rush University Medical Center/John H Stroger Hospital of Cook County, Chicago, IL, USA
M Aziz MD, Section of Infectious Diseases, Department of Medicine, Rush University Medical Center, 600 S. Paulina Street, Suites 140143, Chicago, IL, USA Email: Mariam_Aziz@rush.edu
Identification of perceptions about herpes zoster (HZ) disease, vaccine effectiveness and safety, and vaccine recommendations may impact immunization practices of physicians for HIV-infected patients. A survey was used to quantify knowledge of HZ as well as determine physician immunization perceptions and practices. There were 272/1700 respondents (16). Correct answers for the incidence of varicella zoster virus (VZV) infection in adults and incidence of HZ in HIV-infected patients were recorded by 14 and 10 of providers, respectively. Providers reported poor knowledge of the incidence of disease recurrence in HIV-infected patients (41 correct), potency of HZ vaccine (47.5 correct) and mechanism of protection against reactivation of VZV (66 correct). Most (88) agreed that HZ was a serious disease, and 73 believed that the burden of disease made vaccination important. A majority (75) did not vaccinate HIV patients with HZ vaccine regardless of antiretroviral therapy status. Barriers to administration included safety concerns, concern that vaccine would not prevent HZ, risk of HZ dissemination, reimbursement issues and lack of Infectious Diseases Society of America (IDSA) guidelines. Only 38 of providers agreed that CDC guidelines were clear and 50 believed that clinical trials were needed prior to use of HZ vaccine in HIV-infected patients. Education about HZ is needed among HIV providers. Providers perceived vaccination as important, but data on vaccine safety and clear guidance from the CDC on this issue are lacking.
[HTML] High HIV-1 prevalence, risk behaviours, and willingness to participate in HIV vaccine trials in fishing communities on Lake Victoria, Uganda
N Kiwanuka, A Ssetaala, J Mpendo, M Wambuzi… – Journal of the International …, 2013
Abstract Introduction: HIV epidemics in sub-Saharan Africa are generalized, but high-risk subgroups exist within these epidemics. A recent study among fisher-folk communities (FFC) in Uganda showed high HIV prevalence (28.8%) and incidence (4.9/100 person-years).
RotaFlash (PATH) – July 22, 2013