From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary
2017, vol. 45, no2, pp. 157-164 [8 page(s) (article)]
Tetanus and diphtheria immunity in refugees in Europe in 2015
Auteur(s) / Author(s)
Jablonka Alexandra (1 2) ; Behrens Georg M. N. (1 2) ; Stange Marcus (3) ; Dopfer Christian (4 5) ; Grote Ulrike (6) ; Hansen Gesine (4 5) ; Schmidt Reinhold Ernst (1 2) ; Happle Christine (4 5)
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Department of Clinical Immunology and Rheumatology, Hannover Medical School, 30625, Hannover, Germany
(2) German Center for Infection Research, Hannover, Germany
(3) Department of Paediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
(4) Department of Pedatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
(5) German Center for Lung Research, BREATH, Hannover, Germany
(6) Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
Current political crises in the Middle East and economic discrepancies led millions of people to leave their home countries and to flee to Western Europe. This development raises unexpected challenges for receiving health care systems. Although pan-European initiatives strive for updated and optimized vaccination strategies, little data on immunity against vaccine-preventable diseases in the current refugee population exist.
We quantified serum IgG against tetanus and diphtheria (TD) in n = 678 refugees currently seeking shelter in six German refugee centers.
Reflecting current migration statistics in Europe, the median age within the cohort was 26 years, with only 23.9 % of female subjects. Insufficient IgG levels without long-term protection against tetanus were found in 56.3 % of all refugees. 76.1 % of refugees had no long-term protection against diphtheria. 47.7 % of subjects needed immediate vaccination against tetanus, and 47.7 % against diphtheria. For both diseases, an age-dependent decline in protective immunity occurred.
We observed a considerably low rate of tetanus-protected refugees, and the frequency of diphtheria-immune refugees was far from sufficient to provide herd immunity. These findings strongly support recent intentions to implement and enforce stringent guidelines for refugee vaccination in the current crisis.
Biomedical Informatics Insights
Volume 9: 1–13 2017
Using Spatial Analysis to Inform Community Immunization Strategies
Moises E Maravi1, Lauren E Snyder1, L Dean McEwen1, Kathryn DeYoung1 and Arthur J Davidson1,2,3
1Denver Public Health, Denver, CO, USA. 2Colorado School of Public Health, University of
Colorado, Aurora, CO, USA. 3Department of Family Medicine, University of Colorado Anschutz
Medical Campus, Aurora, CO, USA.
Introduction: Recent pertussis outbreaks in the United States suggest our response to local disease outbreaks (eg, vaccine-preventable Bordetella pertussis) may benefit from understanding and applying spatial analytical methods that use data from immunization information systems at a subcounty level.
Methods: A 2012 study on Denver, CO, residents less than 19 years of age confirmed pertussis cases and immunization information system records were geocoded and aggregated to the census tract (CT) level. An algorithm assessed whether individuals were up-to-date (UTD) for pertussis vaccines. Pearson, Spearman, and Kendall correlations assessed relations between disease incidence and pertussis vaccine coverage. Using spatial analysis software, disease incidence and UTD rates were spatially weighted, and smoothed. Global and local autocorrelations based on univariate Moran’s I spatial autocorrelation statistics evaluated whether a CT’s rate belong to a cluster based on incidence or UTD measures.
Results : Overall disease incidence rate was 116.8/100 000. Assessment of pertussis vaccination coverage was available for 90% of the population. Among 134 672 Denver residents less than 19 years old, 103 496 (77%) were UTD for pertussis vaccines. Raw correlation coefficients showed weak relationships between incidence and immunization rates due to the presence of outliers. With geospatial and clustering analysis, estimates and correlation coefficients were improved with statistically significant Moran’s I values for global and local autocorrelations rejecting the null hypothesis that incidence or UTD rates were randomly distributed. With evidence indicating the presence of clusters, smoothed and weighted disease incidence and UTD rates in 144 CTs identified 21 CTs (15%) for potential public health intervention.
Conclusions: Correlation of raw disease incidence and vaccine UTD rates in subcounty regions showed limited association, providing limited information for decision making. By assessing for clusters using spatial analysis methods, we identified CTs with higher incidence and lower immunization coverage for targeted public health interventions.