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Satty A, Salih M, Abdalla FA, A Mahmoud AF, Gumma EAE, Saad Mohamed Khamis G, Adam AMA, Hassaballa AA, Hamed OMA, M S Mohammed Z. Statistical Analysis of Factors Associated with Diarrhea in Yemeni Children under Five: Insights from the 2022-2023 Multiple Indicator Cluster Survey. J Epidemiol Glob Health 2024:10.1007/s44197-024-00253-1. [PMID: 38856818 DOI: 10.1007/s44197-024-00253-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/29/2024] [Indexed: 06/11/2024] Open
Abstract
Diarrheal disease remains a significant cause of preventable morbidity and mortality in the pediatric population, particularly among children below five years of age. Although the occurrence of diarrheal episodes is on the decline, its impact continues to escalate at a concerning rate among children under the age of five, especially in developing countries. The objective of this paper is to investigate the factors associated with diarrhea in Yemeni children younger than five years, drawing on data from the latest edition of the Multiple Indicator Cluster Survey (MICS) Yemen conducted in 2022-2023. To identify factors associated with the prevalence of childhood diarrhea, bivariate analysis and multivariable logistic regression were utilized. The findings of this study suggest that age group 6-23, unimproved sanitation, and low-income households are associated with high risk of diarrhea in children under five years of age in Yemen. The study contributes additional evidence regarding factors that should be prioritized in public health strategies geared towards reducing diarrheal prevalence among Yemeni children.
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Affiliation(s)
- Ali Satty
- Department of Mathematics, College of Science, Northern Border University, Arar, Saudi Arabia.
| | - Mohyaldein Salih
- Department of Mathematics, College of Science, Northern Border University, Arar, Saudi Arabia
| | - Faroug A Abdalla
- Department of Computer Science, College of Science, Northern Border University, Arar, Saudi Arabia
| | - Ashraf F A Mahmoud
- Department of Computer Science, College of Science, Northern Border University, Arar, Saudi Arabia
| | - Elzain A E Gumma
- Department of Mathematics, College of Science, Northern Border University, Arar, Saudi Arabia
| | | | - Ahmed M A Adam
- Department of Mathematics, College of Science, Northern Border University, Arar, Saudi Arabia
| | - Abaker A Hassaballa
- Department of Mathematics, College of Science, Northern Border University, Arar, Saudi Arabia
| | - Omer M A Hamed
- Department of Finance, College of Business Administration, Northern Border University, Arar, Saudi Arabia
| | - Zakariya M S Mohammed
- Department of Mathematics, College of Science, Northern Border University, Arar, Saudi Arabia
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2
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Anaam M. Community pharmacists' treatment patterns and counselling of acute diarrhea in children: A simulation-based cross-sectional study. THE JOURNAL OF MEDICINE ACCESS 2024; 8:27550834241258673. [PMID: 38835340 PMCID: PMC11149438 DOI: 10.1177/27550834241258673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 05/15/2024] [Indexed: 06/06/2024]
Abstract
Background Diarrhea is a significant global health concern, particularly among children, and its impact is particularly pronounced in countries with limited resources and ongoing conflicts, such as Yemen. Diarrheal diseases remain one of the leading causes of morbidity and mortality in children under the age of 5 years worldwide. Objectives The aim of our study is to assess the treatment patterns and counseling of community pharmacists regarding the management of acute diarrhea in children in Yemen. Design A simulation-based cross-sectional study was carried out targeting community pharmacy professionals in Sana'a city. Methods A questionnaire and simulated client methods were used to assess the pharmacists' evaluation of a case based on five indicators including the child's age, diarrhea frequency, presence of fever, and blood or mucus. In addition, the pharmacists' recommendations and counseling were also evaluated. Results During the study, a total of 100 pharmacists were visited and evaluated using both a questionnaire and simulation. The results demonstrated that 43.0% of the pharmacists utilized all five indicators in the questionnaire, with a mere 3.0% using all five indicators in the simulation. Oral rehydration solution (ORS) alone was recommended by 42.0% of the pharmacists and in combination with other drugs by 47.0% in the questionnaire, and the rest (11.0%) recommended only other drugs; while in the simulation, 7.0% of the pharmacists referred the patients to clinic, only 6.0% recommended ORS alone, 47.0% gave ORS plus other drugs including antibiotics, and 40.0% dispensed only antibiotics. In regards to counseling, 89.0% of pharmacists reported that they would explain to the patient regarding the recommended medicine during the questionnaire, and only 36.0% gave any sort of explanation to the simulated client. Conclusion In the current study, community pharmacists did not ask enough questions to accurately evaluate a child with acute diarrhea during the simulation. This finding has apparently differed from their responses in the questionnaire. Furthermore, the pharmacists failed to provide sufficient dietary advice, and their recommendation of ORS was inadequate.
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Affiliation(s)
- Mohammed Anaam
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Saudi Arabia
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3
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Elbashir I, Aldoos NF, Mathew S, Al Thani AA, Emara MM, Yassine HM. Molecular epidemiology, genetic diversity, and vaccine availability of viral acute gastroenteritis in the middle East and North Africa (MENA) region. J Infect Public Health 2022; 15:1193-1211. [PMID: 36240530 DOI: 10.1016/j.jiph.2022.09.001] [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: 05/15/2022] [Revised: 08/26/2022] [Accepted: 09/11/2022] [Indexed: 11/18/2022] Open
Abstract
Acute gastroenteritis is the cause of considerable mortality and morbidity worldwide, particularly among children under five years in underdeveloped countries. Most acute gastroenteritis (AGE) cases are attributed to viral etiologies, including rotavirus, norovirus, adenovirus, astrovirus, and sapovirus. This paper aimed to determine the prevalence rate of different viral etiologies of AGE in the Middle East and North Africa (MENA) region. Moreover, this paper explored rotavirus phylogenetic relatedness, compared VP7 and VP4 antigenic regions of rotavirus with vaccine strains, and explored the availability of vaccines in the MENA region. The literature search identified 160 studies from 18 countries from 1980 to 2019. The overall prevalence of rotavirus, norovirus, adenovirus, astrovirus, and sapovirus were 29.8 %, 13.9 %, 6.3 %, 3.5 %, and 3.2 % of tested samples, respectively. The most common rotavirus genotype combinations in the MENA region were G1P[8], G9P[9], and G2P[4], whereas GII.4 was the predominant norovirus genotype all of which were reported in almost all the studies with genotyping data. The comparison of VP7 and VP4 between circulating rotavirus in the MENA region and vaccine strains has revealed discrete divergent regions, including the neutralizing epitopes. Rotavirus vaccine was introduced to most of the countries of the MENA region; however, only a few studies have assessed the effectiveness of vaccine introduction. This paper provides a comprehensive update on the prevalence of the different viral agents of AGE in the MENA region.
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Affiliation(s)
- Israa Elbashir
- Biomedical Research Center, Qatar University, 2713 Doha, Qatar.
| | - Noor F Aldoos
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar.
| | - Shilu Mathew
- Biomedical Research Center, Qatar University, 2713 Doha, Qatar.
| | - Asmaa A Al Thani
- Biomedical Research Center, Qatar University, 2713 Doha, Qatar; Department of Biomedical Sciences, College of Health Science-QU Health, Qatar University, Doha 2713, Qatar
| | - Mohamed M Emara
- Basic Medical Sciences Department, College of Medicine, QU Health, Qatar University, 2713 Doha, Qatar.
| | - Hadi M Yassine
- Biomedical Research Center, Qatar University, 2713 Doha, Qatar.
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Research progress of health care in Yemeni children during the war: review. Prim Health Care Res Dev 2022; 23:e55. [PMID: 36093681 PMCID: PMC9472320 DOI: 10.1017/s1463423622000421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Yemen crisis, which has been going on for more than six years, represents one of the most gruesome human plights in the modern history, especially children. OBJECTIVES This research aimed to present a comprehensive view of Yemeni children's studies during the ongoing war period, to come up with a comprehensive base that concerns humanitarians, researchers, decision-makers, and general public at large about the reality of the predicament of Yemeni child. METHOD We searched databases and identified 373 articles, of which 68 were included in this review. Review of literature between 2014 and 2020 is taken from academic sources, multilateral organizations, donors, and governmental and non-governmental organizations. The data are analyzed by date and governorates. RESULTS We chose 68 articles and divided them according to the diseases and health conditions as follows: infectious diseases (15 studies), non-infectious diseases (10 studies), blood-related diseases (7 studies), oral and dental problems (12 studies), accidents and injuries (2 studies), health system (16 studies), family and community (6 studies). Moreover, the studies were divided geographically as follows: 7 studies that were almost comprehensive for all governorates; additional studies were conducted for Amanat Al Asimah (21 studies), Taiz (12 studies), Aden and Al Hudaydah (7 studies for each), Dhamar and Ibb (6 studies for each), Abyan and Lahij (2 study for each). As for Al Bayda, Marib, Sana'a, and Socotra, each of them had one study. CONCLUSION Our assessment revealed that the ongoing Yemen crisis is underrated and largely neglected. The studies conducted so far do match the ground reality both in terms of inclusiveness and numbers.
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Zhang J, Cao J, Ye Q. Nonpharmaceutical interventions against the COVID-19 pandemic significantly decreased the spread of enterovirus in children. J Med Virol 2022; 94:3581-3588. [PMID: 35474224 PMCID: PMC9088497 DOI: 10.1002/jmv.27806] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/17/2022] [Accepted: 04/25/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Precise prevention and control measures have been adopted to impede the transmission of COVID-19 in China. This study was performed to investigate the effect of protective measures on gastrointestinal infection in children during the COVID-19 pandemic. METHODS The data on the rotavirus and adenovirus antigen tests were collected in outpatient children due to gastroenteritis from January 1, 2019, to December 31, 2020, at the Children's Hospital of Zhejiang University School of Medicine. According to age and month distribution, the positive number and rate of rotavirus and adenovirus in 2020 were compared with 2019. RESULTS A 3.8-fold and 4-fold reduction in the number of rotavirus- and adenovirus-positive patients in 2020 were found, respectively. The overall positive rate of rotavirus and adenovirus infection was drastically decreased in 2020 (rotavirus 2020: 18.18% vs 2019: 9.75%, P < 0.001; adenovirus 2020: 3.13% vs 2019: 1.58%, P < 0.001). The proportions of rotavirus and adenovirus in all age groups in 2020 decreased compared with those in 2019. The highest frequency of rotavirus infection occurred among children aged 1-3 years both in 2019 and 2020 (2019: 27.95% vs 2020: 17.19%, P < 0.001), while adenovirus infection was detected in children aged 3-5 years, which had the highest percent positivity (2019: 8.19% vs 2020: 4.46%; P < 0.001). An obvious peak prevalence of rotavirus incidence was found during December-April, and the percent positivity of rotavirus significantly decreased in 2020 (December 2019: 24.26% vs 2020: 8.44%, P < 0.001; January 2019: 40.67% vs 2020: 38.18%, P < 0.05; February 2019: 40.73% vs 2020: 15.04%, P < 0.001; March 2019: 31.47% vs 2020: 7.88%, P < 0.001; April 2019: 15.52% vs 2020: 4.78%, P < 0.001). The positive rate of adenovirus distributed throughout 2019 was 1.91%-4.86%, while the percent positivity during 2020 in the same period was much lower (0.00%-3.58%). CONCLUSIONS Our results confirmed that the preventive and control measures adopted during the COVID-19 pandemic and the collateral benefit of these interventions have significantly decreased the transmission of rotavirus or adenovirus. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Junfeng Zhang
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China
| | - JiaJia Cao
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China
| | - Qing Ye
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China
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6
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Ali S, Khan S, Khan SN, Rauf M, Khan MF, Majid A, Dawar FU, Akbar NU, Ullah R, Bari A, Khan MY. Molecular detection and prevalence of Rotavirus with acute gastroenteritis among the children of rural and urban areas. BRAZ J BIOL 2021; 83:e244365. [PMID: 34932615 DOI: 10.1590/1519-6984.244365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 04/19/2021] [Indexed: 11/22/2022] Open
Abstract
Rotavirus is the main infective agent of acute gastroenteritis (AGE) in children under the age of five years and causing significant morbidity as well as mortality throughout the world. The study was carried out to detect the prevalence rate, genotypes strain and risk factors of Rotavirus among the children of rural and urban areas of district Bannu Khyber Pakhtunkhwa Pakistan. A total of 180 stool samples were collected from children under the age of 5 years from two major hospitals of Bannu from January to December (2015). The samples were analyzed by Reverse-transcriptase Polymerase Chain Reaction (RT-PCR) for the detection of Rotavirus, positive samples were further processed for genotyping (G and P type) through specific PCR. Of the total, 41 (23%) samples were positive for Rotavirus. The most prevalent G genotypes found were: G3, G8, G9 (each 29%), followed by G10 (15%), and G11 (10%). Whereas the prevalent P genotypes were: P-8 (25%), P-4 and P-10 (each 20%), P-9 (15%), followed by P-6 and P-11 (each 10%). Moreover, Rotavirus infection was more prevalent in summer (23.73%) and winter (22.7%) than spring (20%) and autumn (21.4%). Rotavirus infection exhibited high frequency in June (14%), October (8%) and November (6%). It is concluded that Rotavirus is more prevalent in children and various genotypes (G and P) of Rotavirus are present in the study area. Lack of studies, awareness and rarer testing of Rotavirus are the principal reasons of virus prevalence in district Bannu, Pakistan.
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Affiliation(s)
- S Ali
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S Khan
- University of Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S N Khan
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - M Rauf
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - M F Khan
- University of Hazara Dhodial, Department of Zoology, Mansehra, Khyber Pakhtunkhwa, Pakistan
| | - A Majid
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - F U Dawar
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - N Ul Akbar
- Kohat University of Science e Technology Kohat, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - R Ullah
- College of Pharmacy, Department of Pharmacognosy, King Saud University Riyadh, Riyadh, Saudi Arabia
| | - A Bari
- King Saud University Riyadh, College of Pharmacy, Department of Pharmaceutical Chemistry, Riyadh, Saudi Arabia
| | - M Y Khan
- Lancaster University, Lancaster Environmental Centre, Lancaster, United Kingdon
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7
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Low Frequency of Adenovirus, Rotavirus, and Norovirus in Pediatric Diarrheal Samples from Central Iran. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2021. [DOI: 10.5812/pedinfect.118470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Acute viral gastroenteritis is a disorder that affects children globally but mostly in developing countries. Adenoviruses, rotaviruses, and noroviruses are the leading viral causes of childhood gastroenteritis. Objectives: This study is the first to investigate the frequency of these viruses in diarrheal samples from pediatric patients living in central Iran. Methods: A total of 173 samples of pediatric diarrhea, from May 2015 to May 2016, were included in this descriptive cross-sectional study. The samples were analyzed using in-house developed PCR and reverse transcription (RT)-PCR methods to investigate the frequency of adenoviruses, rotaviruses, and noroviruses. Results: Out of 173 samples of pediatric diarrhea, eight were shown to contain enteric viruses (4.6%): (1) four with adenoviruses (2.3%); (2) three with rotaviruses (1.7%); and (3) one with a genogroup II norovirus (0.6%). Most of the positive samples were obtained from children under the age of seven. The most common additional clinical symptoms in pediatric patients with viral agents were fever, vomiting, and abdominal pain. Conclusions: In central Iran, adenoviruses and rotaviruses were rarely found as agents responsible for gastroenteritis. Although viral gastroenteritis in this area had less frequency than bacterial gastroenteritis, we need to monitor all enteropathogenic agents for longer periods to understand better real endemicity and the possibility of unexpected viral enteritis outbreaks.
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Epidemiological, molecular, and clinical features of rotavirus infections among pediatrics in Qatar. Eur J Clin Microbiol Infect Dis 2021; 40:1177-1190. [PMID: 33411172 DOI: 10.1007/s10096-020-04108-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 11/20/2020] [Indexed: 12/16/2022]
Abstract
Acute gastroenteritis (AGE) remains a major cause of diarrhea in developing and developed countries. Rotavirus (RV) is a leading cause of severe pediatric diarrhea worldwide. Here we report on the prevalence of circulating genotypes in association with demographics and clinical manifestations outcomes in Qatar. A total of 231 RV-positive fecal samples were collected from children suffering from AGE during 3 years study period between June 2016 and June 2019. The age of the subjects ranged between 2 months and 14 years (median of 16 months). The VP4 and VP7 were amplified and sequenced. Phylogenetic analyses were performed using MEGA7.0. Pearson's chi-squared test was used to determine significant differences for comparisons of general categorical variables. RV infections were most common in children between 1 and 3 years of age (49%), followed by those < 1 year and > 3 years of age (33% and 28%, respectively). RV infections were more frequent in males than females, with a ratio of 1.4:1. RV infections occurred throughout the year, with a noticeable increase in summer (42.8%) and a drop in winter (20.1%). RV genotypes G3P[8] (30.8%), G2P[8] (12.3%), G4P[8] (11.7%), and G1P[8] (10.4%) were the common genotypes during the study period. The G3P[8] strain detected in our study revealed similarities to the equine-like G3P[8] (10.3%; 24/231) (KT988229.1), Wa-like genomic constellation (9%; 21/231) (MF563894.1), and DS-1-like strains (6.4%; 15/231) (LC386081.1). Based on the Vesikari score system, severe clinical illness including diarrhea and vomiting (average frequency: 4 to 5 times/day) was recorded for G3P[8] group, followed by G9P[8], G4P[8], and G1P[8]. Higher incidence for G3P[8], G2P[8], G4P[8], and G1P[8] were reported in Qatari subjects compared to other nationalities. The multinational status of a small country explains the wide diversity of circulating RV genotypes in Qatar. The highest prevalence and severe illnesses were recorded to G3P[8], which is different from other surrounding countries/global levels.
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Xiao X, Tang A, Cox KS, Wen Z, Callahan C, Sullivan NL, Nahas DD, Cosmi S, Galli JD, Minnier M, Verma D, Babaoglu K, Su H, Bett AJ, Vora KA, Chen Z, Zhang L. Characterization of potent RSV neutralizing antibodies isolated from human memory B cells and identification of diverse RSV/hMPV cross-neutralizing epitopes. MAbs 2019; 11:1415-1427. [PMID: 31402751 PMCID: PMC6816417 DOI: 10.1080/19420862.2019.1654304] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection in young children and older adults. Currently, no licensed vaccine is available, and therapeutic options are limited. The primary target of neutralizing antibodies to RSV is the surface fusion (F) glycoprotein. Understanding the recognition of antibodies with high neutralization potencies to RSV F antigen will provide critical insights in developing efficacious RSV antibodies and vaccines. In this study, we isolated and characterized a panel of monoclonal antibodies (mAbs) with high binding affinity to RSV prefusion F trimer and neutralization potency to RSV viruses. The mAbs were mapped to previously defined antigenic sites, and some that mapped to the same antigenic sites showed remarkable diversity in specificity, binding, and neutralization potencies. We found that the isolated site III mAbs shared highly conserved germline V-gene usage, but had different cross-reactivities to human metapneumovirus (hMPV), possibly due to the distinct modes/angles of interaction with RSV and hMPV F proteins. Furthermore, we identified a subset of potent RSV/hMPV cross-neutralizing mAbs that target antigenic site IV and the recently defined antigenic site V, while the majority of the mAbs targeting these two sites only neutralize RSV. Additionally, the isolated mAbs targeting site Ø were mono-specific for RSV and showed a wide range of neutralizing potencies on different RSV subtypes. Our data exemplify the diversity of anti-RSV mAbs and provide new insights into the immune recognition of respiratory viruses in the Pneumoviridae family.
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Affiliation(s)
- Xiao Xiao
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA.,MRL Postdoctoral Research Program, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Aimin Tang
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Kara S Cox
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Zhiyun Wen
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Cheryl Callahan
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Nicole L Sullivan
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Deborah D Nahas
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Scott Cosmi
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA.,Eurofins Lancaster Laboratories Professional Scientific Services , Lancaster , PA , USA
| | - Jennifer D Galli
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Michael Minnier
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA.,On-Board Services , East Windsor , NJ , USA.,AgileOne , Torrence , CA , USA
| | - Deeptak Verma
- Department of Chemistry Modeling and Informatics, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Kerim Babaoglu
- Department of Chemistry Modeling and Informatics, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Hua Su
- Department of Chemistry Modeling and Informatics, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Andrew J Bett
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Kalpit A Vora
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Zhifeng Chen
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA
| | - Lan Zhang
- Department of Infectious Diseases and Vaccines Research, Merck & Co., Inc ., Kenilworth , NJ , USA
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10
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Jeon H, Jung JH, Yoon JA, Choi H. Strabismus Is Correlated with Gross Motor Function in Children with Spastic Cerebral Palsy. Curr Eye Res 2019; 44:1258-1263. [PMID: 31189336 DOI: 10.1080/02713683.2019.1631851] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To investigate the correlation between clinical features of strabismus and motor dysfunction classified according to the Gross Motor Function Classification System (GMFCS) in patients with spastic cerebral palsy (CP).Methods: In this retrospective, cross-sectional study in single tertiary medical center, 62 patients who are diagnosed with spastic CP who had an ophthalmic examination between 2006 and 2014 were included. Only patients with vision sufficient to fixate were included and patients with restrictive or paralytic strabismus were excluded. The types of CP were classified as diplegia, hemiplegia, or quadriplegia for distribution of motor impairment. The GMFCS was used to grade gross motor dysfunction, which was then classified as mild (grade 1, 2 and 3) or severe (grade 4 and 5) motor impairment. Strabismus was investigated in terms of direction, constancy, and deviation angle. The relationship between strabismus characteristics and the level of GMFCS and type of CP were assessed.Results: Thirty-eight and 24 patients had mild or severe motor deficit, respectively. Forty patients had strabismus, which was more frequent in patients with severe motor impairment.(P = .014) Exotropia and esotropia occurred with similar frequency. Constant and large-angle strabismus was frequently observed in patients with severe motor impairment.(P < .005, 0.027) The topographical subtype of CP was not related to clinical features of strabismus.Conclusions: The prevalence of strabismus is higher in severe motor impairment. The constancy and angle of strabismus was related to the severity of motor impairment while the topographical subtype of CP has no significant relationship.
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Affiliation(s)
- Hyeshin Jeon
- Department of Ophthalmology, Pusan National University Hospital, Busan, South Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Jae Ho Jung
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
| | - Jin A Yoon
- Department of Rehabilitation medicine, Pusan National University Hospital, Busan, South Korea
| | - Heeyoung Choi
- Department of Ophthalmology, Pusan National University Hospital, Busan, South Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
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11
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Badur S, Öztürk S, Pereira P, AbdelGhany M, Khalaf M, Lagoubi Y, Ozudogru O, Hanif K, Saha D. Systematic review of the rotavirus infection burden in the WHO-EMRO region. Hum Vaccin Immunother 2019; 15:2754-2768. [PMID: 30964372 PMCID: PMC6930073 DOI: 10.1080/21645515.2019.1603984] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Rotavirus gastroenteritis imposes a heavy burden on low- and middle-income countries. The World Health Organization defines the Eastern Mediterranean region (WHO-EMRO) as a diverse area in terms of socioeconomic status and health indicators. Rotavirus vaccination has been introduced, at least partially, in 19 out of the 22 EM countries; however, vaccine coverage remains low, and data on rotavirus disease burden is scarce.Available data on rotavirus prevalence, seasonality, vaccination status, and genotype evolution was systematically compiled following a literature review that identified 165 relevant WHO-EMRO epidemiology studies published between 1990 and 2017.Although the infectious agents responsible for acute gastroenteritis vary over time, rotavirus remained the leading cause of acute gastroenteritis in children, as seen in 76.3% of reviewed publications. Younger children (<2 years old) were at higher risk and thus increased vaccination coverage and surveillance systems are required to reduce the rotavirus gastroenteritis burden in WHO-EMRO countries.
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Affiliation(s)
- Selim Badur
- MENA, Medical & Clinical Emerging Markets, GSK, Istanbul, Turkey
| | - Serdar Öztürk
- MENA, Medical & Clinical Emerging Markets, GSK, Istanbul, Turkey
| | - Priya Pereira
- Global Medical Affairs Rota/MMRV, GSK, Wavre, Belgium
| | | | - Mansour Khalaf
- EM Central Vaccines Medical/Clinical, GSK, Jeddah, Saudi Arabia
| | - Youness Lagoubi
- EM Central Vaccines Medical/Clinical, GSK, Casablanca, Morocco
| | - Onur Ozudogru
- EM Central Vaccines Medical/Clinical, GSK, Dubai, United Arab Emirates
| | - Kashif Hanif
- EM Central Vaccines Medical/Clinical, GSK, Karachi, Pakistan
| | - Debasish Saha
- Epidemiology/Health Economics EM, GSK, Wavre, Belgium
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Almalki SSR. Circulating rotavirus G and P strains post rotavirus vaccination in Eastern Mediterranean Region. Saudi Med J 2018; 39:755-766. [PMID: 30106412 DOI: 10.15537/smj.2018.8.21394] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To detect changes in circulating strains of rotavirus in the Eastern Mediterranean Region post rotavirus immunization drive. METHODS We searched MEDLINE, PubMed, ScienceDirect, and the Cochrane Library and specific database website (Nutrition and Food Sciences) for relevant articles. Our search included websites of a number of relevant organizations in addition to gray literature search. Of the 2198 articles found, we included only 35 studies after excluding irrelevant, ineligible, duplicated, and very low-quality papers. RESULTS Thirty pre-vaccination studies reported frequent rotavirus strains among children below 5 years of age. G1P[8] has been identified as the most dominant type prior to vaccination in Eastern Mediterranean Region (EMR) countries. Five post-vaccination studies conducted in 3 countries (Saudi Arabia, Morocco, and Yemen) illustrated that G1P[8] is the most prevalent strain in Saudi Arabia, and the incidence of G2P[4] has increased from 21.6% to 33.3%. In Yemen, G1P[4] is the most prevalent strain (87.5%), followed by G9P[8] (57%) and G1P[8] (18.5%). Furthermore, in Yemen, G9P[8] were the most prevalent strains accounting to 57% and 14% in G9P[4], post vaccination. Finally, in Morocco, G1P[8] was not reported 3 years post vaccination; however, incidence of G9P[8] was reported at 67% and G2P[4] at 33%. CONCLUSIONS Rotavirus circulating strain prevalence in EMR countries has changed post vaccination, and G9P[8], G2P[4], and G9P[4] have become more dominant. Proportion of rotavirus strains in these countries after vaccination has significantly reduced. There is an increase in circulating strain G2P[4] in the post-vaccination period, which needs further monitoring.
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Affiliation(s)
- Shaia S R Almalki
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Al Baha University, Kingdom of Saudi Arabia. E-mail.
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Tian Y, Chughtai AA, Gao Z, Yan H, Chen Y, Liu B, Huo D, Jia L, Wang Q, MacIntyre CR. Prevalence and genotypes of group A rotavirus among outpatient children under five years old with diarrhea in Beijing, China, 2011-2016. BMC Infect Dis 2018; 18:497. [PMID: 30285635 PMCID: PMC6168998 DOI: 10.1186/s12879-018-3411-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 09/24/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Rotavirus is a leading cause of severe diarrheal disease, and one of the common causes of death in children aged under five years old. The dominant epidemic strains may change in different years in the same area. In order to provide evidence for rotavirus epidemic control and inform vaccine development, we analyzed epidemiological patterns and genetic characteristics of rotavirus in Beijing during 2011-2016. METHODS Stool specimens of outpatient children under five years old were collected from three children's hospitals on a weekly basis. Group A rotavirus antigens were detected using enzyme-linked immunosorbent assay (ELISA) kit. The partial VP4 genes and VP7 genes of rotavirus were both amplified and sequenced. Genotyping and phylogenetic analyses were performed. Logistic regression and Chi-square tests were performed to determine differences across age groups, districts and years in rotavirus prevalence and genotype distribution. RESULTS A total of 3668 stool specimens from children with acute diarrhea identified through hospital-based surveillance were collected from 2011 to 2016 in Beijing. A total of 762 (20.8%) specimens tested positive for rotavirus. The rotavirus-positive rate was highest among the 1-2 years old age group (29.0%, 310/1070). November, December and January were the highest rotavirus-positive rate months each year. G9 was the most common G genotype (64.4%, 461/716), and P [8] was the most common P genotype (87.0%, 623/716) among the 716 rotavirus-positive specimens. G9P [8], G3P [8] and G2P [4] were the most common strains. The rotavirus-positive rates of samples in 2012 and 2013 were higher than that in 2011, and the dominant genotype changed from G3P [8] to G9P [8] in 2012 and 2013. VP7 gene sequences of G9 strains in this study clustered into two main lineages. Most of the G9 strains exhibited the highest nucleotide similarity (99.1%~ 100.0%) to the strain found in Japan (MI1128). VP4 gene sequences of P [8] strains were almost P[8]b. CONCLUSIONS Rotavirus accounted for more than one fifth of childhood diarrhea in Beijing during the study period. Targeted measures such as immunization with effective rotavirus vaccines should be carried out to reduce the morbidity and mortality due to rotavirus.
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Affiliation(s)
- Yi Tian
- Institute for Infectious Disease and Endemic Disease Control, Beijing Municipal Center for Disease Prevention and Control, Beijing, China
- Institute for Infectious Disease and Endemic Disease Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Abrar Ahmad Chughtai
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Zhiyong Gao
- Institute for Infectious Disease and Endemic Disease Control, Beijing Municipal Center for Disease Prevention and Control, Beijing, China
- Institute for Infectious Disease and Endemic Disease Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Hanqiu Yan
- Institute for Infectious Disease and Endemic Disease Control, Beijing Municipal Center for Disease Prevention and Control, Beijing, China
- Institute for Infectious Disease and Endemic Disease Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Yanwei Chen
- Institute for Infectious Disease and Endemic Disease Control, Beijing Municipal Center for Disease Prevention and Control, Beijing, China
- Institute for Infectious Disease and Endemic Disease Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Baiwei Liu
- Institute for Infectious Disease and Endemic Disease Control, Beijing Municipal Center for Disease Prevention and Control, Beijing, China
- Institute for Infectious Disease and Endemic Disease Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Da Huo
- Institute for Infectious Disease and Endemic Disease Control, Beijing Municipal Center for Disease Prevention and Control, Beijing, China
- Institute for Infectious Disease and Endemic Disease Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Lei Jia
- Institute for Infectious Disease and Endemic Disease Control, Beijing Municipal Center for Disease Prevention and Control, Beijing, China
- Institute for Infectious Disease and Endemic Disease Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Quanyi Wang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Municipal Center for Disease Prevention and Control, Beijing, China
- Institute for Infectious Disease and Endemic Disease Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Chandini Raina MacIntyre
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
- College of Public Service and Community Solutions, and College of Health Solutions, Arizona State University, Phoenix, USA
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Ahmed MLCB, Weddih A, Benhafid M, Bollahi MA, Sidatt M, Makhalla K, Mokdad AH, Heukelbach J, Filali-Maltouf A. Hospitalizations and Deaths Associated with Diarrhea and Respiratory Diseases among Children Aged 0⁻5 Years in a Referral Hospital of Mauritania. Trop Med Infect Dis 2018; 3:tropicalmed3030103. [PMID: 30274499 PMCID: PMC6161072 DOI: 10.3390/tropicalmed3030103] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 08/30/2018] [Accepted: 09/11/2018] [Indexed: 11/16/2022] Open
Abstract
Diarrhea and respiratory diseases are the leading causes of morbidity and mortality among <5-year-olds worldwide, but systematic data are not available from Mauritania. We conducted a hospital-based retrospective study. Data on admissions to Mauritania's National Referral Hospital (the main pediatric referral center in the country), due to diarrhea and respiratory diseases, during 2011⁻2014, were analyzed. A total of 3695 children <5 years were hospitalized during this period; 665 (18.0%) due to respiratory diseases, and 829 (22.4%) due to diarrhea. Case fatality rates in the respiratory diseases and diarrhea groups were 18.0% (120/665) and 14.1% (117/829), respectively. The highest frequency of deaths due to diarrhea occurred in the age group 2⁻5 years (16/76; 21.0%), and due to respiratory diseases in the age group 6⁻12 months (32/141; 22.6%). We conclude that case fatality rates caused by respiratory diseases and diarrhea are extremely high in children hospitalized at the National Referral Hospital. These data call for intensified efforts to reduce deaths among hospitalized Mauritanian children, and also for integrated control measures to prevent and reduce the burden of both diseases. Additional studies are needed to show the effectiveness of the introduction of vaccination programs for pneumococcal diseases and rotavirus infection in the child population, which were launched in November 2013 and December 2014, respectively.
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Affiliation(s)
- Mohamed Lemine Cheikh Brahim Ahmed
- Department of Biology, University Mohammed V, Rabat 10010, Morocco.
- Department of Virology, National Institute of Hygiene, Rabat 10010, Morocco.
- Institut National de Recherche en Santé Publique (INRSP), Nouakchott 2373, Mauritania.
| | - Abdellahi Weddih
- Ministry of Health and University of Nouakchott, Department of Pediatrics, Nouakchott 2373, Mauritania.
| | - Mohammed Benhafid
- Department of Virology, National Institute of Hygiene, Rabat 10010, Morocco.
| | - Mohamed Abdellahi Bollahi
- Institut National de Recherche en Santé Publique (INRSP), Nouakchott 2373, Mauritania.
- Ministry of Health and University of Nouakchott, Department of Pediatrics, Nouakchott 2373, Mauritania.
| | - Mariem Sidatt
- Ministry of Health and University of Nouakchott, Department of Pediatrics, Nouakchott 2373, Mauritania.
| | - Khattry Makhalla
- Ministry of Health and University of Nouakchott, Department of Pediatrics, Nouakchott 2373, Mauritania.
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WD 98195, USA.
| | - Jorg Heukelbach
- Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza CE60430-140, Brazil.
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townville, QLD 4810, Australia.
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Mchaile DN, Philemon RN, Kabika S, Albogast E, Morijo KJ, Kifaro E, Mmbaga BT. Prevalence and genotypes of Rotavirus among children under 5 years presenting with diarrhoea in Moshi, Tanzania: a hospital based cross sectional study. BMC Res Notes 2017; 10:542. [PMID: 29084598 PMCID: PMC5661935 DOI: 10.1186/s13104-017-2883-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 10/27/2017] [Indexed: 12/03/2022] Open
Abstract
Background Diarrhoea is a main cause of morbidity and mortality in children under 5 responsible for approximately four billion cases and 1.1 million deaths annually. In developing countries, it causes two million deaths each year. The major causative organism responsible is Rotavirus which is responsible for one-third of hospitalizations with approximately 40% mortality. Results The prevalence of Rotavirus infection was 26.4% (73/277). The predominant strain of Rotavirus found was G1 21/73 (53.8%), followed by G8 9/73 (23.1%), G12 5/73 (12.8%), G9 3/73(7.7%) and G4 1/73 (2.6%). All serotypes identified were in children who had completed Rotavirus vaccination except for one who had G8 in whom the vaccine was introduced after they had completed immunizations. Conclusion The overall prevalence of rotavirus has reduced from 33.2% in 2009 to 26.4% in 2016. We have found G1 to be the predominant serotype as well as other circulating serotypes namely G4, G8, G9 and G12. Despite a reduction in prevalence, there is a need for further rotavirus surveillance in the region. Electronic supplementary material The online version of this article (10.1186/s13104-017-2883-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Deborah N Mchaile
- Department of Pediatrics and Child Health, Kilimanjaro Christian Medical Centre, Moshi, Tanzania. .,Kilimanjaro Christian Medical University College, Moshi, Tanzania.
| | - Rune N Philemon
- Department of Pediatrics and Child Health, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Sonia Kabika
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Evelyn Albogast
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Kikoti J Morijo
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Emmanuel Kifaro
- Department of Veterinary Microbiology and Parasitology, Sokoine University of Agriculture (SUA), Morogoro, Tanzania
| | - Blandina T Mmbaga
- Department of Pediatrics and Child Health, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Kilimanjaro Clinical Research Institute, Moshi, Tanzania
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Zaraket H, Charide R, Kreidieh K, Dbaibo G, Melhem NM. Update on the epidemiology of rotavirus in the Middle East and North Africa. Vaccine 2017; 35:6047-6058. [PMID: 28986034 DOI: 10.1016/j.vaccine.2017.09.067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/07/2017] [Accepted: 09/22/2017] [Indexed: 12/16/2022]
Abstract
Rotavirus (RV) is the leading cause of severe acute gastroenteritis (AGE) worldwide. Consequently, we conducted a systematic literature review on articles studying RV in the 25 countries of the MENA region during the past 15years (2000-2015). The methods and reporting were set according to the 2015 preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) and based on the elements from the international prospective register of systematic reviews (PROSPERO). Our literature search identified 169 studies meeting our predefined inclusion criteria. Studies reporting on RV were conducted in 19 out of the 24 countries of the MENA region. The largest number of studies was reported in Turkey (n=32), Iran (n=31), Saudi Arabia (n=19) and Egypt (n=17). The majority of studies reporting on RV gastroenteritis rates were clinical observational studies. In 115 studies out of 169, RV was reported among in-patients whereas 35 studies reported RV among outpatients. The predominantly reported RV genotype in the region was G1[P8] followed by G2[P4] and G9[P8]. The majority of studies (n=108) were conducted among children less than 5years of age whereas the remaining studies reported on AGE among other age groups and rarely adults. In MENA countries, RV infection was reported all year round with peaks described in cold as well as hot months. This systematic review provides a current update on the epidemiology of RV-associated gastroenteritis in countries of the MENA region and draws attention to the major gaps existing in the continuous monitoring of RV.
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Affiliation(s)
- Hassan Zaraket
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Rana Charide
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Khalil Kreidieh
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon; Medical Laboratory Sciences Program, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Ghassan Dbaibo
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Department of Pediatrics and Adolescent Medicine, Division of Pediatric Infectious Diseases, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nada M Melhem
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Medical Laboratory Sciences Program, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
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Ali Z, Harastani H, Hammadi M, Reslan L, Ghanem S, Hajar F, Sabra A, Haidar A, Inati A, Rajab M, Fakhouri H, Ghanem B, Baasiri G, Gerbaka B, Zaraket H, Matar GM, Dbaibo G. Rotavirus Genotypes and Vaccine Effectiveness from a Sentinel, Hospital-Based, Surveillance Study for Three Consecutive Rotavirus Seasons in Lebanon. PLoS One 2016; 11:e0161345. [PMID: 27571515 PMCID: PMC5003350 DOI: 10.1371/journal.pone.0161345] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 08/03/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction Globally, rotavirus (RV) is the leading cause of gastroenteritis (GE) in children. Longitudinal data about changes in RV genotype distribution and vaccine effectiveness (VE) are scarce. This study was conducted in Lebanon over 3 consecutive RV seasons to estimate the rate of RVGE hospitalization, identify RV genotypes, determine the seasonal and geographical variations, and calculate RV VE. Materials and Methods This prospective, multicenter, hospital-based surveillance study was conducted between 2011 and 2013 and enrolled children (<5 years) admitted for GE. Socio-demographic and clinical data about the current episode of GE at admission were collected. Genotypes were determined from stool samples testing positive for RV by PCR. Results Of 1,414 cases included in the final analysis, 83% were <2 years old and 55.6% were boys. Median duration of hospitalization was 4 days and 91.6% of GE cases were severe (Vesikari score ≥11). PCR testing showed that 30.3% of subjects were RV-positive of which 62.1% had fever versus 71.1% of RV-negative subjects (P = 0.001). RV was predominantly detected in the cold season from November till March (69.9%). G and P genotype pairs for all RV-positive stool specimens showed a predominance of G1P[8] in 36% (n = 154) of specimens, G9P[8] in 26.4% (n = 113), and G2P[4] in 17.8% (n = 76). RV-negative subjects were more likely to be RV-vaccinated (21%) compared to the RV-positive subjects (11.3%) (P<0.001), with a vaccine breakthrough rate of 18.8%. The ratio of RV1-vaccinated for each RV5-vaccinated subject was 7.8 and VE against RV disease was 68.4% (95%CI, 49.6%-80.2%). Conclusion RV is a major cause of GE requiring hospitalization of children under 5 years of age in Lebanon. A few genotypes predominated over the three RV seasons studied. Mass RV vaccination will likely decrease the burden of hospitalization due to RV. VE is similar to what has been observed for other middle-income countries.
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Affiliation(s)
- Zainab Ali
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Houda Harastani
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Moza Hammadi
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Lina Reslan
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Soha Ghanem
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Farah Hajar
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Ahmad Sabra
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Amjad Haidar
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Adlette Inati
- Department of Pediatrics, Nini Hospital, Tripoli, Lebanon
| | - Mariam Rajab
- Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon
| | - Hassan Fakhouri
- Department of Pediatrics, Rafic Hariri University Hospital, Beirut, Lebanon
| | - Bassam Ghanem
- Department of Pediatrics, Nabatieh Governmental Hospital, Nabatieh, Lebanon
| | | | - Bernard Gerbaka
- Department of Pediatrics, Hôtel-Dieu de France University Hospital, Beirut, Lebanon
| | - Hassan Zaraket
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ghassan M. Matar
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ghassan Dbaibo
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
- * E-mail: ;
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Amood AL-Kamarany M, Al-Areqi L, Mujally A, Alkarshy F, Nasser A, Jumaan AO. Diarrheal Diseases Hospitalization in Yemen before and after Rotavirus Vaccination. SCIENTIFICA 2016; 2016:8485417. [PMID: 27437161 PMCID: PMC4942629 DOI: 10.1155/2016/8485417] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 04/19/2016] [Accepted: 05/05/2016] [Indexed: 06/06/2023]
Abstract
The study aims to assess the impact of rotavirus vaccine introduction on diarrheal diseases hospitalization and to identify the rotavirus genotypes most prevalent before and after vaccine introduction among children ≤ 5 years of age. Rotarix™ ® rotavirus vaccine is currently licensed for infants in Yemen and was introduced in 2012. The vaccination course consists of two doses. The first dose is administrated at 6 weeks of age and the second dose is completed by 10 weeks. Based on a longitudinal observational study, we assessed the impact of vaccination on rotavirus hospitalization before and after vaccination among children ≤ 5 years of age at the Yemeni-Swedish Hospital (YSH) in Taiz, Yemen. Prevaccination covered January 2009-July 2012 during which 2335 fecal samples were collected from children ≤ 5 years old. Postvaccination covered January 2013-December 2014 during which 1114 fecal samples were collected. Rotavirus was detected by Enzyme Linkage Immunosorbent Assay (ELISA). The incidence of rotavirus hospitalization decreased from 43.79% in 2009 to 10.54% in 2014. Hospitalization due to rotavirus diarrhea was reduced by 75.93%. Vaccine coverage increased from 23% in 2012 to 72% in 2014. Also, the results showed that the most predominant genotypes in prevaccination period were G2P[4] (55.0%), followed by G1P[8] (15.0%), while in postvaccination period G1P[8] (31%) was the predominant genotype, followed by G9P[8] (27.5%). In conclusion, rotavirus vaccination in Yemen resulted in sharp reduction in diarrheal hospitalization. A successful rotavirus vaccination program in Yemen will rely upon efficient vaccine delivery systems and sustained vaccine efficacy against diverse and evolving rotavirus strains.
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Affiliation(s)
- Mohammed Amood AL-Kamarany
- Department of Pharmacy Practice, Faculty of Clinical Pharmacy and Tropical Medicine Center, Hodeidah University, P.O. Box 3114, Hodeidah, Yemen
- Program of Health and Drug, Tihama Foundation for Drug Studies and Research, Hodeidah, Yemen
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Sepanlou SG, Malekzadeh F, Delavari F, Naghavi M, Forouzanfar MH, Moradi-Lakeh M, Malekzadeh R, Poustchi H, Pourshams A. Burden of Gastrointestinal and Liver Diseases in Middle East and North Africa: Results of Global Burden of Diseases Study from 1990 to 2010. Middle East J Dig Dis 2015; 7:201-15. [PMID: 26609348 PMCID: PMC4655840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Gastrointestinal and liver diseases (GILDs) are major causes of death and disability in Middle East and North Africa (MENA). However, they have different patterns in countries with various geographical, cultural, and socio-economic status. We aimed to compare the burden of GILDs in Iran with its neighboring countries using the results of the Global Burden of Disease (GBD) Study in 2010. METHODS Classic metrics of GBD have been used including: age-standardized rates (ASRs) of death, years of life lost due to premature death (YLL), years of life lost due to disability (YLD), and disability adjusted life years (DALY). All countries neighboring Iran have been selected. In addition, all other countries classified in the MENA region were included. Five major groups of gastrointestinal and hepatic diseases were studied including: infections of gastrointestinal tract, gastrointestinal and pancreatobilliary cancers, acute hepatitis, cirrhosis, and other digestive diseases. RESULTS The overall burden of GILDs is highest in Afghanistan, Pakistan, and Egypt. Diarrheal diseases have been replaced by gastrointestinal cancers and cirrhosis in most countries in the region. However, in a number of countries including Afghanistan, Pakistan, Turkmenistan, Egypt, and Yemen, communicable GILDs are still among top causes of mortality and morbidity in addition to non-communicable GILDs and cancers. These countries are experiencing the double burden. In Iran, burden caused by cancers of stomach and esophagus are considerably higher than other countries. Diseases that are mainly diagnosed in outpatient settings have not been captured by GBD. CONCLUSION Improving the infrastructure of health care system including cancer registries and electronic recording of outpatient care is a necessity for better surveillance of GILDs in MENA. In contrast to expensive treatment, prevention of most GILDs is feasible and inexpensive. The health care systems in the region can be strengthened for prevention and control.
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Affiliation(s)
- Sadaf Ghajarieh Sepanlou
- 1 Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
,2 Liver and Pancreatobilliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
, These two authors contributed equally to this paper
| | - Fatemeh Malekzadeh
- 1 Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
,3 Non-Communicable Disease Research Center, Endocrine and Metabolism Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
, These two authors contributed equally to this paper
| | - Farnaz Delavari
- 1 Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Naghavi
- 4 Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Maziar Moradi-Lakeh
- 4 Institute for Health Metrics and Evaluation, Seattle, WA, USA
,5 Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- 1 Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
,2 Liver and Pancreatobilliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
,6 Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hossein Poustchi
- 1 Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
,2 Liver and Pancreatobilliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
,6 Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Akram Pourshams
- 1 Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
,2 Liver and Pancreatobilliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
,6 Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
,Corresponding Author: Akram Pourshams, MD Digestive Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, N. Kargar St. Tehran, Iran Tel: + 98 21 82415104 Fax: + 98 21 82415400
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Yin Y, Metselaar HJ, Sprengers D, Peppelenbosch MP, Pan Q. Rotavirus in organ transplantation: drug-virus-host interactions. Am J Transplant 2015; 15:585-93. [PMID: 25693470 DOI: 10.1111/ajt.13135] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 11/21/2014] [Accepted: 12/01/2014] [Indexed: 01/25/2023]
Abstract
Although rotavirus is usually recognized as the most common etiology of diarrhea in young children, it can in fact cause severe diseases in organ transplantation recipients irrespective of pediatric or adult patients. This comprehensive literature analysis revealed 200 cases of rotavirus infection with 8 related deaths in the setting of organ transplantation been recorded. Based on published cohort studies, an average incidence of 3% (187 infections out of 6176 organ recipients) was estimated. Rotavirus infection often causes severe gastroenteritis complications and occasionally contributes to acute cellular rejection in these patients. Immunosuppressive agents, universally used after organ transplantation to prevent organ rejection, conceivably play an important role in such a severe pathogenesis. Interestingly, rotavirus can in turn affect the absorption and metabolism of particular immunosuppressive medications via several distinct mechanisms. Even though rotaviral enteritis is self-limiting in general, infected transplantation patients are usually treated with intensive care, rehydration and replacement of nutrition, as well as applying preventive strategies. This article aims to properly assess the clinical impact of rotavirus infection in the setting of organ transplantation and to disseminate the interactions among the virus, host and immunosuppressive medications.
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Affiliation(s)
- Y Yin
- Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, the Netherlands
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