1
|
Yitbarek K, Tilahun T, Debela T, Abdena D, Girma T. Measles epidemiology and vaccination coverage in Oromia Region, Ethiopia: Evidence from surveillance, 2011-2018. Vaccine 2021; 39:4351-4358. [PMID: 34147294 DOI: 10.1016/j.vaccine.2021.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 05/15/2021] [Accepted: 06/07/2021] [Indexed: 11/18/2022]
Abstract
Despite a reported high coverage of measles-containing vaccine (MCV), low-income countries including, Ethiopia, have sustained high measles transmission with frequent outbreaks. We investigated the distribution of measles infection and vaccination in Oromia Regional State, Ethiopia. According to the World Health Organization (WHO) and the Ethiopian measles case classification guidelines, measles cases were classified as laboratory-confirmed, clinically compatible, and epidemiologically linked. We derived measles vaccination coverage estimates using reported measles vaccine efficacy and, the proportion of measles cases vaccinated with measles vaccine at least once from the surveillance data. We calculated measles effective reproduction number (Re) in the region. Almost twenty-five thousand measles cases were reported through the surveillance system, with more than 50% of the suspected and confirmed measles cases reported in 2015. Measles had sustained and high transmission rate with uneven distribution among the zones. Children between 1 and 4 years of age and MCV unvaccinated individuals were the most affected groups. In all the zones, the average surveillance-estimated MCV coverage among both infants and under-five children was significantly lower than the WHO recommended minimum 90% threshold herd-immunity. With this level of vaccination coverage, an infected case can transmit to more than four individuals. Nevertheless, the administrative coverage reports for the concurrent period were consistently above 90%. The estimated MCV coverage across the Oromia region was well below the recommended herd-immunity threshold. It partly explains the apparent mismatch of sustained measles transmission and outbreaks despite the very high administrative coverage estimates. Oromia regional health bureau, in collaboration with key stakeholders, should make a concerted effort to increase the effective-coverage of MCV to at least 90%. Additionally, multiple-dose MCV has to be scaled-up and accompanied with appropriate geographic and age targeting using evidence from surveillance data. Immediate programmatic action is needed to improve the quality of measles surveillance.
Collapse
Affiliation(s)
- Kiddus Yitbarek
- Department of Health Policy and Management, Jimma University, Jimma, Ethiopia.
| | - Tizta Tilahun
- Fenot Project, Harvard T.H. Chan School of Public Health, Department of Global Health and Population, Addis Ababa, Ethiopia; College of Medicine and Health Sciences, Bahir Dar University, Ethiopia
| | | | - Dereje Abdena
- Oromia Regional Health Bureau, Addis Ababa, Ethiopia
| | - Tsinuel Girma
- Fenot Project, Harvard T.H. Chan School of Public Health, Department of Global Health and Population, Addis Ababa, Ethiopia
| |
Collapse
|
2
|
Dror AA, Kassis-Karayanni N, Oved A, Daoud A, Eisenbach N, Mizrachi M, Rayan D, Francis S, Layous E, Gutkovich YE, Taiber S, Srouji S, Chordekar S, Goldenstein S, Ziv Y, Ronen O, Gruber M, Avraham KB, Sela E. Auditory Performance in Recovered SARS-COV-2 Patients. Otol Neurotol 2021; 42:666-670. [PMID: 33967243 PMCID: PMC8115428 DOI: 10.1097/mao.0000000000003037] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE While COVID-19 symptoms impact rhinology (anosmia) and laryngology (airways), two major disciplines of the otolaryngology armamentarium, the virus has seemed to spare the auditory system. A recent study, however, reported changes in otoacoustic emission (OAE) signals measured in SARS-COV-2 positive patients. We sought to assess the effect of COVID-19 infection on auditory performance in a cohort of recovered SARS-COV-2 patients and controls. To avoid a potential bias of previous audiological dysfunction not related to SARS-COV-2 infection, the study encompasses patients with normal auditory history. We hypothesized that if SARS-COV-2 infection predisposes to hearing loss, we would observe subtle and early audiometric deficits in our cohort in the form of subclinical auditory changes. STUDY DESIGN Cross-sectional study. SETTING Tertiary referral center. PATIENTS The Institutional Review Board approved the study and we recruited participants who had been positive for SARS-COV-2 infection, according to an Reverse Transcription Polymerase Chain Reaction (RT-PCR) test on two nasopharyngeal swabs. The patients included in this study were asymptomatic for the SARS-COV-2 infection and were evaluated following recovery, confirmed by repeated swab testing. The control group comprised healthy individuals matched for age and sex, and with a normal auditory and otologic history. INTERVENTIONS The eligibility to participate in this study included a normal audiogram, no previous auditory symptoms, normal otoscopy examination with an intact tympanic membrane, and bilateral tympanometry type A. None of our volunteers reported any new auditory symptoms following SARS-COV-2 infection. Ototacoustic emissions (OAE) and auditory brainstem response (ABR) measurements were used to evaluate the auditory function. MAIN OUTCOME MEASURES OAE and ABR measurements. RESULTS We have found no significant differences between recovered asymptomatic SARS-COV-2 patients and controls in any of transitory evoked otoacoustic emission (TEOAE), distortion product otoacoustic emissions (DPOAE), or ABR responses. CONCLUSIONS There is no cochlear dysfunction represented by ABR, TEOAE, and DPOAE responses in recovered COVID-19 asymptomatic patients. Retrocochlear function was also preserved as evident by the ABR responses. A long-term evaluation of a larger cohort of SARS-COV-2 patients will help to identify a possible contribution of SARS-COV-2 infection to recently published anecdotal auditory symptoms associated with COVID-19.
Collapse
Affiliation(s)
- Amiel A. Dror
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Najla Kassis-Karayanni
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Adi Oved
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Amani Daoud
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Netanel Eisenbach
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Matti Mizrachi
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Doaa Rayan
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Shawky Francis
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Eli Layous
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Yoni Evgeni Gutkovich
- Motion Sickness and Human Performance Laboratory, The Israel Naval Medical Institute, Haifa
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Shahar Taiber
- Department of Human Molecular Genetics & Biochemistry
| | - Samer Srouji
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Oral and Maxillofacial Department
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Shai Chordekar
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
- Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
- Speech & Hearing Center, Hadassah University Medical Center, Jerusalem, Israel
| | - Sonia Goldenstein
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Yael Ziv
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Ohad Ronen
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | - Maayan Gruber
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| | | | - Eyal Sela
- Department of Otolaryngology–Head and Neck Surgery
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed
- Infectious Disease Prevention and Control Unit, Galilee Medical Center, Nahariya
| |
Collapse
|
3
|
Dixon C, Lamanna J, Wheeler AR. Direct loading of blood for plasma separation and diagnostic assays on a digital microfluidic device. LAB ON A CHIP 2020; 20:1845-1855. [PMID: 32338260 DOI: 10.1039/d0lc00302f] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Finger-stick blood sampling is convenient for point of care diagnostics, but whole blood samples are problematic for many assays because of severe matrix effects associated with blood cells and cell debris. We introduce a new digital microfluidic (DMF) diagnostic platform with integrated porous membranes for blood-plasma separation from finger-stick blood volumes, capable of performing complex, multi-step, diagnostic assays. Importantly, the samples can be directly loaded onto the device by a finger "dab" for user-friendly operation. We characterize the platform by comparison to plasma generated via the "gold standard" centrifugation technique, and demonstrate a 21-step rubella virus (RV) IgG immunoassay yielding a detection limit of 1.9 IU mL-1, below the diagnostic cut-off. We propose that this work represents a critical next step in DMF based portable diagnostic assays-allowing the analysis of whole blood samples without pre-processing.
Collapse
Affiliation(s)
- Christopher Dixon
- Department of Chemistry, University of Toronto, 80. St. George Street, Toronto, Ontario M5S 3H6, Canada.
| | | | | |
Collapse
|
4
|
Boattini M, Bianco G, Charrier L, Iannaccone M, Masuelli G, Coggiola M, Sacchi A, Pittaluga F, Cavallo R. Rubella serosurvey and factors related to vaccine hesitancy in childbearing women in Italy. Prev Med Rep 2019; 15:100945. [PMID: 31367512 PMCID: PMC6646802 DOI: 10.1016/j.pmedr.2019.100945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 06/21/2019] [Accepted: 07/03/2019] [Indexed: 11/25/2022] Open
Abstract
Voluntary termination of pregnancy (VTP), pre-conception and post-partum phases, as well as Occupational Medicine consultation for healthcare workers are opportunities for screening and vaccinating rubella seronegative childbearing women. However, data about vaccination acceptance following these phases is rarely reported. A retrospective study over a 2-year period (2016-2017) was performed, evaluating the prevalence of rubella seronegative women which underwent VTP (wVTP), mothers in early puerperal phase (mEPP) and childbearing healthcare workers (CbHW) aged 15-49 years. Anti-rubella vaccination rates and factors associated with vaccine hesitancy (VH) were investigated. Anti-rubella IgG titres were assessed in 8623 women. Seroprevalence of rubella susceptibility was 7.9% (wVTP 6.4%; mEPP 17.4%; CbHW 9.3%). Anti-rubella vaccination rates were found to be different in the three groups (wVTP 37.1%; mEPP 10.9%; CbHW 25.4%), specifically in 2016 and among women born in Italy. VH rate was higher in 2017, especially among wVTP and CbHW. Anti-rubella vaccination rates in wVTP vs. mEPP was higher in women born in Italy but not in those born abroad. Multivariable analyses demonstrated significantly higher risk of VH for mEPP (OR 8.2; 95% CI: 3.9-16.9) and women reporting history of allergy to drugs, food or environmental agents (OR 2.7; 95% CI: 1.4-5.1). During the analyzed period childbearing women included in this study were not adequately protected against rubella. Anti-rubella vaccination rates were widely unsatisfactory. Being mEPP and reporting allergy were significantly associated to higher rates of VH. Tailored strategies targeting on vaccine safety are needed for retention of these women in immunisation programmes.
Collapse
Affiliation(s)
- Matteo Boattini
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Gabriele Bianco
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Lorena Charrier
- Department of Public Health and Paediatrics, University of Torino, Turin, Italy
| | - Marco Iannaccone
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Giulia Masuelli
- Infectious Diseases Obstetrics and Gynaecology, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Maurizio Coggiola
- Occupational Medicine, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Alessandra Sacchi
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Fabrizia Pittaluga
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| | - Rossana Cavallo
- Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy
| |
Collapse
|
5
|
Hoffman HJ, Dobie RA, Losonczy KG, Themann CL, Flamme GA. Kids Nowadays Hear Better Than We Did: Declining Prevalence of Hearing Loss in US Youth, 1966-2010. Laryngoscope 2018; 129:1922-1939. [DOI: 10.1002/lary.27419] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/08/2018] [Accepted: 05/30/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Howard J. Hoffman
- Epidemiology and Statistics Program; National Institute on Deafness and Other Communication Disorders, National Institutes of Health; Bethesda Maryland
| | - Robert A. Dobie
- Department of Otolaryngology-Head and Neck Surgery; The University of Texas Health Science Center at San Antonio; San Antonio Texas
| | - Katalin G. Losonczy
- Epidemiology and Statistics Program; National Institute on Deafness and Other Communication Disorders, National Institutes of Health; Bethesda Maryland
| | - Christa L. Themann
- Hearing Loss Prevention Team, Engineering and Physical Hazards Branch; National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Gregory A. Flamme
- Stephenson and Stephenson Research and Consulting, LLC-West; Forest Grove Oregon U.S.A
| |
Collapse
|