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O'Reilly R, Yokoyama S, Boyle J, Kwong JC, McGeer A, To T, Sander B. The impact of acute pneumococcal disease on health state utility values: a systematic review. Qual Life Res 2021; 31:375-388. [PMID: 34273067 DOI: 10.1007/s11136-021-02941-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Streptococcus pneumoniae infections remain a significant source of morbidity and mortality worldwide. The purpose of this review was to summarize the impact of pneumococcal disease on health state utilities (HSU) in the acute phase of illness. METHODS We searched MEDLINE, EMBASE, EconLit, the Health Technology Assessment Database, the National Health Economic Evaluation Database, and Tufts Cost-Effectiveness Registry (up to January 2020) for primary studies. Eligible studies elicited HSU estimates using preference-based instruments for the acute phase of infection of pneumococcal syndromes including acute otitis media, pneumonia/lower respiratory tract infections, bacteremia/sepsis, and meningitis. Two reviewers independently conducted screening, data extraction and quality appraisal. RESULTS We screened 10,178 studies, of which 26 met our inclusion criteria. Cohort sizes ranged from 8 to 2060 respondents. The most frequently studied syndrome was pneumonia (n = 17), followed by acute otitis media (n = 9), meningitis (n = 7) and bacteremia/sepsis (n = 4). Overall, each syndrome was associated with a substantial impact on HSU. Bacteremia/sepsis (range: - 0.331 to 0.992) and meningitis (range: - 0.330 to 0.977) were generally associated with the lowest HSU, followed by pneumonia (range: - 0.054 to 0.998) and acute otitis media (range: 0.064 to 0.970). HSU estimates varied considerably by treatment setting, elicitation method and type of respondent. The only study to compare pneumococcal infections to non-pneumococcal infections in the same population revealed significantly lower HSU estimates among pneumococcal infections. CONCLUSIONS Pneumococcal syndromes are associated with decreased HSU estimates. Given the considerable heterogeneity in methods and source populations as well as study quality, care should be taken to select the most appropriate estimates.
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Affiliation(s)
- Ryan O'Reilly
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. .,Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto, ON, Canada. .,, 200 Elizabeth Avenue, Eaton Building, Room 10-248, Toronto, ON, M5G 2C4, Canada.
| | - Sayako Yokoyama
- Public Health Ontario, Toronto, ON, Canada.,University of Waterloo, Waterloo, ON, Canada
| | - Justin Boyle
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jeffrey C Kwong
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Public Health Ontario, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Centre for Vaccine-Preventable Diseases, University of Toronto, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada
| | - Allison McGeer
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Sinai Health System, Toronto, ON, Canada
| | - Teresa To
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,The Hospital for Sick Children (SickKids), Toronto, ON, Canada
| | - Beate Sander
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto, ON, Canada.,Public Health Ontario, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada
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2
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Moberly AC, Harris MS, Boyce L, Vasil K, Wucinich T, Pisoni DB, Baxter J, Ray C, Shafiro V. Relating quality of life to outcomes and predictors in adult cochlear implant users: Are we measuring the right things? Laryngoscope 2017; 128:959-966. [PMID: 28776711 DOI: 10.1002/lary.26791] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/13/2017] [Accepted: 06/16/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Current clinical outcome measures for adults receiving cochlear implants (CIs) consist of word and sentence recognition, primarily under quiet conditions. However, these measures may not adequately reflect patients' CI-specific quality of life (QOL). This study first examined traditional auditory-only speech recognition measures and other potentially relevant auditory measures as correlates of QOL in CI users. Second, scores on nonauditory tasks of language and cognition were examined as potential predictors of QOL. STUDY DESIGN Twenty-five postlingually deafened adults with CIs were assessed. METHODS Participants completed a validated CI-specific QOL measure (the Nijmegen Cochlear Implant Questionnaire) and were tested for word and sentence recognition in quiet, as well as sentence recognition in speech-shaped noise. Participants also completed assessments of audiovisual speech recognition, environmental sound identification, and a task of complex auditory verbal processing. Several nonauditory language and cognitive tasks were examined as potential predictors of QOL. RESULTS Quality-of-life scores significantly correlated with scores for audiovisual speech recognition and recognition of complex sentences in quiet but not sentences in noise or isolated words. No significant correlations were obtained between QOL and environmental sound identification or complex auditory verbal processing. Quality-of-life subdomain scores were predicted by several nonauditory language and cognitive tasks as well as some patient characteristics. CONCLUSION Postoperative measures of recognition of sentences in quiet and audiovisual sentence recognition correlate with CI-related QOL. Findings suggest that sentence recognition tasks are QOL-relevant outcomes but only explain a small fraction of the variability in QOL outcomes for this patient population. LEVEL OF EVIDENCE 4. Laryngoscope, 128:959-966, 2018.
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Affiliation(s)
- Aaron C Moberly
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Michael S Harris
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Lauren Boyce
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.,Department of Speech and Hearing Science, The Ohio State University, Columbus, Ohio, U.S.A
| | - Kara Vasil
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Taylor Wucinich
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.,Department of Speech and Hearing Science, The Ohio State University, Columbus, Ohio, U.S.A
| | - David B Pisoni
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, U.S.A
| | - Jodi Baxter
- Department of Speech and Hearing Science, The Ohio State University, Columbus, Ohio, U.S.A
| | - Christin Ray
- Department of Speech and Hearing Science, The Ohio State University, Columbus, Ohio, U.S.A
| | - Valeriy Shafiro
- Department of Communication Disorders and Sciences, Rush University, Chicago, Illinois, U.S.A
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Impact of Pediatric Acute Otitis Media on Child and Parental Quality of Life and Associated Productivity Loss in Malaysia: A Prospective Observational Study. Drugs Real World Outcomes 2016; 4:21-31. [PMID: 27888477 PMCID: PMC5332310 DOI: 10.1007/s40801-016-0099-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Acute otitis media (AOM) affects both child and parental quality of life (QoL). Data on QoL associated with AOM in Malaysia is sparse, and the burden of indirect costs have not been previously reported. OBJECTIVE To determine the effect of pediatric AOM on child and parental QoL in Malaysia and its economic impact (indirect costs). METHODS We utilized a set of QoL questionnaires (PAR-AOM-QOL, OM-6, and EQ-5D) combined with questions addressing work/productivity loss and financial costs associated with caring for a child during his or her illness in an observational, multicenter, prospective study. RESULTS One hundred and ten AOM patients aged ≤5 years were included in the analysis. The majority of respondents were the patient's mother. Parental QoL was negatively affected for both emotional and daily disturbance scales, but the level of disturbance was low. Using OM-6, the greatest negative impact was on the child's QoL, followed by caregiver concerns, physical suffering, and emotional distress. Using EQ-5D, a moderately positive relationship between parents' emotional disturbance and daily disturbance, and a weak, negative correlation between parental emotional disturbance and parental health status was found. Parents with paid employment took an average of 21 h from work to care for their child, at an average cost of 321.8 Malaysian ringgit (US$97) in addition to their contribution to direct medical costs. Productivity losses whilst at work, uncompensated wage losses, and leisure time losses are also reported. CONCLUSIONS This study found that AOM is associated with some negative impact on parental QoL and significant economic impact at both patient and societal levels. The findings provide useful data on healthcare resource utilization and disease burden of AOM in Malaysia.
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Abstract
Otitis media (OM) or middle ear inflammation is a spectrum of diseases, including acute otitis media (AOM), otitis media with effusion (OME; 'glue ear') and chronic suppurative otitis media (CSOM). OM is among the most common diseases in young children worldwide. Although OM may resolve spontaneously without complications, it can be associated with hearing loss and life-long sequelae. In developing countries, CSOM is a leading cause of hearing loss. OM can be of bacterial or viral origin; during 'colds', viruses can ascend through the Eustachian tube to the middle ear and pave the way for bacterial otopathogens that reside in the nasopharynx. Diagnosis depends on typical signs and symptoms, such as acute ear pain and bulging of the tympanic membrane (eardrum) for AOM and hearing loss for OME; diagnostic modalities include (pneumatic) otoscopy, tympanometry and audiometry. Symptomatic management of ear pain and fever is the mainstay of AOM treatment, reserving antibiotics for children with severe, persistent or recurrent infections. Management of OME largely consists of watchful waiting, with ventilation (tympanostomy) tubes primarily for children with chronic effusions and hearing loss, developmental delays or learning difficulties. The role of hearing aids to alleviate symptoms of hearing loss in the management of OME needs further study. Insertion of ventilation tubes and adenoidectomy are common operations for recurrent AOM to prevent recurrences, but their effectiveness is still debated. Despite reports of a decline in the incidence of OM over the past decade, attributed to the implementation of clinical guidelines that promote accurate diagnosis and judicious use of antibiotics and to pneumococcal conjugate vaccination, OM continues to be a leading cause for medical consultation, antibiotic prescription and surgery in high-income countries.
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Affiliation(s)
- Anne G. M. Schilder
- evidENT, Ear Institute, University College London, Royal National Throat Nose and Ear Hospital, 330 Grays Inn Road, London, WC1X 8DA UK
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tasnee Chonmaitree
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas USA
| | - Allan W. Cripps
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Queensland Australia
| | - Richard M. Rosenfeld
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York USA
| | | | - Mark P. Haggard
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Roderick P. Venekamp
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Holl K, Rosenlund M, Giaquinto C, Silfverdal SA, Carmona A, Larcombe J, Garcia-Sicilia J, Fuat A, Muñoz ME, Arroba ML, Sloesen B, Vollmar J, Pirçon JY, Liese JG. The Impact of Childhood Acute Otitis Media on Parental Quality of Life in a Prospective Observational Cohort Study. Clin Drug Investig 2016; 35:613-24. [PMID: 26350522 PMCID: PMC4579255 DOI: 10.1007/s40261-015-0319-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background and Objectives Acute otitis media (AOM) not only affects childhood quality of life (QoL), but can also affect parental QoL. We adapted a previously published questionnaire on the effect of childhood recurrent ear, nose and throat infections on parental QoL for use with AOM and used it in an observational, multicentre, prospective study of children with AOM. Methods The AOM-specific parental QoL questionnaire grouped 15 items into emotional, daily disturbance, total and overall parental QoL impact scores. The questionnaire was assessed using item-convergent and item-discriminant validity criteria and internal consistency reliability; and then used with parents of children aged <6 years diagnosed with AOM at 73 practices in Germany, Italy, Spain, Sweden and the UK. Bivariate analyses explored the differences in mean parental QoL impact scores by various characteristics. Results The questionnaire demonstrated good to excellent internal consistency reliability for the various components (Cronbach’s α 0.82–0.97). There were 1419 AOM episodes among 5882 healthy children over 1 year, of which 1063 episodes (74.9 %) among 852 children had a questionnaire. Parents reported interrupted sleep (68.4 %), worry (51.0 %), altered daily schedule (44.6 %) and less leisure time (41.5 %) with a score ≥3 (1 = least to 5 = most impact). Factors that adversely affected parental QoL included: increased parental perception of AOM severity, younger child age and multiple AOM episodes. Conclusions The AOM-specific parental QoL questionnaire demonstrated good performance across five European countries. Parental QoL was affected by childhood AOM proportionally to severity, number of episodes and younger child age. Electronic supplementary material The online version of this article (doi:10.1007/s40261-015-0319-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Mats Rosenlund
- Center for Pharmacoepidemiology, Unit of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,IMS Health, Stockholm, Sweden
| | - Carlo Giaquinto
- Department of Women's and Children's Health, University of Padova, Padua, Italy
| | - Sven-Arne Silfverdal
- Department of Clinical Sciences, Pediatrics, Umeå University, Förvaltningshuset, Umeå, Sweden
| | | | - James Larcombe
- Harbinson House Surgery, Sedgefield, Stockton-on-Tees, UK.,Centre for Integrated Health Care Research, University of Durham, Stockton-on-Tees, UK
| | | | - Ahmet Fuat
- Centre for Integrated Health Care Research, University of Durham, Stockton-on-Tees, UK.,Carmel Medical Practice, Darlington, UK
| | | | | | | | | | | | - Johannes G Liese
- Kinderklinik und Poliklinik, Universitätsklinikum Würzburg, Würzburg, Germany
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El-Nawawy AA, Hafez SF, Meheissen MA, Shahtout NM, Mohammed EE. Nasopharyngeal Carriage, Capsular and Molecular Serotyping and Antimicrobial Susceptibility of Streptococcus pneumoniae among Asymptomatic Healthy Children in Egypt. J Trop Pediatr 2015; 61:455-63. [PMID: 26428194 DOI: 10.1093/tropej/fmv060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Streptococcus pneumoniae is a major cause of childhood morbidity and mortality worldwide with increasing antimicrobial resistance. 600 randomly chosen asymptomatic healthy children aged 2-60 months attending Alexandria University Children's Hospital were evaluated for prevalence of nasopharyngeal (NP) carriage of S. pneumoniae. Prevalence of NP carriage was 29.2% (n = 175/600) Capsular serotyping was done using Quellung reaction. Vaccine covered serotypes (VST) represented 67.4% while non-vaccine serotypes (NVST) were 32.6%. The most common VST isolated were 19F (24.6%), 6B (14.3%) and 6A (10.9%). Confirmation of serotyping was performed by multiplex PCR which showed 100% concordance with the Quellung reaction. Antimicrobial susceptibility testing showed penicillin non-susceptibility of 15% (using non-meningitis penicillin MIC breakpoints) and 55% (using meningitis penicillin MIC breakpoints). Highest resistance was found in sulphamethoxazole-trimethoprim (55%), tetracyclins (49%), erythromycin (40%) and clindamycin (25%). This study revealed the epidemiological importance to evaluate regularly the prevalence, serotypes and the increasing antimicrobial resistance of S. pneumoniae in the community.
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Affiliation(s)
- Ahmed A El-Nawawy
- Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt
| | - Soad F Hafez
- Department of Microbiology, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt
| | - Marwa A Meheissen
- Department of Microbiology, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt
| | - Nehal M Shahtout
- Department of Microbiology, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt
| | - Essam E Mohammed
- Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, 21131 Egypt
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7
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Capretta NR, Moberly AC. Does quality of life depend on speech recognition performance for adult cochlear implant users? Laryngoscope 2015; 126:699-706. [DOI: 10.1002/lary.25525] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 06/15/2015] [Accepted: 06/30/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Natalie R. Capretta
- Department of Otolaryngology-Head and Neck Surgery; The Ohio State University Wexner Medical Center; Columbus Ohio U.S.A
| | - Aaron C. Moberly
- Department of Otolaryngology-Head and Neck Surgery; The Ohio State University Wexner Medical Center; Columbus Ohio U.S.A
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8
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Kitamura K, Iino Y, Kamide Y, Kudo F, Nakayama T, Suzuki K, Taiji H, Takahashi H, Yamanaka N, Uno Y. Clinical Practice Guidelines for the diagnosis and management of acute otitis media (AOM) in children in Japan – 2013 update. Auris Nasus Larynx 2015; 42:99-106. [DOI: 10.1016/j.anl.2014.09.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 09/05/2014] [Accepted: 09/18/2014] [Indexed: 11/28/2022]
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Heidemann CH, Godballe C, Kjeldsen AD, Johansen ECJ, Faber CE, Lauridsen HH. Otitis Media and Caregiver Quality of Life: Psychometric Properties of the Modified Danish Version of the Caregiver Impact Questionnaire. Otolaryngol Head Neck Surg 2014; 151:142-9. [PMID: 24687943 DOI: 10.1177/0194599814528245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 02/26/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Otitis media in children may have a considerable impact on caregiver quality of life. The disease-specific Caregiver Impact Questionnaire is designed to assess caregiver quality of life in relation to child otitis media. Assessment of the psychometric properties of this instrument is limited. This study assesses the psychometric properties of this instrument including validity, reproducibility, responsiveness, and interpretability. STUDY DESIGN Longitudinal validation study. SETTING Secondary care units. METHODS Analyses were based on data from 435 families. Validity was assessed using confirmatory factor analysis, internal consistency, and hypothesis testing. Test-retest reliability and measures of smallest detectable change were investigated in the assessment of reproducibility. Responsiveness was investigated by means of hypothesis testing and receiver operating characteristic analysis. An anchor-based distribution method was applied for determining minimal important change as perceived by the respondent. RESULTS Factor analysis confirmed the hypothesized 1-factor structure with an acceptable fit. Cronbach's alpha was .90. In the analysis of construct validity, 88.9% of the hypothesized correlations were correctly predicted. Intraclass correlation coefficient was 0.87 and smallest detectable change corresponded to approximately one-fourth of the scale. Responsiveness was found to be good and a change score of 13.8 represented minimal important change. CONCLUSION The modified Danish version of the Caregiver Impact Questionnaire is a valid and reproducible measurement tool that is also sensitive to measuring change in the current setting. A change score representing minimal important change as perceived by the respondent is proposed. Results of this study support the use of this instrument.
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Affiliation(s)
- Christian Hamilton Heidemann
- Department of ENT Head & Neck Surgery, Odense University Hospital, Odense C, Denmark Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense M, Denmark
| | - Christian Godballe
- Department of ENT Head & Neck Surgery, Odense University Hospital, Odense C, Denmark Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense M, Denmark
| | - Anette Drøhse Kjeldsen
- Department of ENT Head & Neck Surgery, Odense University Hospital, Odense C, Denmark Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense M, Denmark
| | | | - Christian Emil Faber
- Department of ENT Head & Neck Surgery, Odense University Hospital, Odense C, Denmark Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense M, Denmark
| | - Henrik Hein Lauridsen
- Research Unit for Clinical Biomechanics, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
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Rose M, Zielen S. Impact of infant immunization programs with pneumococcal conjugate vaccine in Europe. Expert Rev Vaccines 2014; 8:1351-64. [PMID: 19803758 DOI: 10.1586/erv.09.78] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Markus Rose
- Children's Hospital, Goethe University, Theodor Stern Kai 7, 60590 Frankfurt, Germany.
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11
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Clinical practice guidelines for the diagnosis and management of acute otitis media (AOM) in children in Japan. Auris Nasus Larynx 2012; 39:1-8. [DOI: 10.1016/j.anl.2011.09.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 08/25/2011] [Accepted: 10/21/2011] [Indexed: 11/21/2022]
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Quality of life in children with recurrent acute otitis media in southwestern of iran. Indian J Otolaryngol Head Neck Surg 2012; 66:267-70. [PMID: 24533396 DOI: 10.1007/s12070-012-0479-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2010] [Accepted: 01/03/2012] [Indexed: 10/14/2022] Open
Abstract
Otitis media (OM) is one of the most common disorders in childhood and may have a considerable impact on quality of life and functional health status of children. The aim of the study was to assess the quality of life in children with recurrent acute otitis media before and after the treatment by using a questionnaire. A multicentre survey base study. This study was conducted at Imam Khomeini and Apadana Hospitals in the southwestern region of Iran between Sep 2008 and March 2009. Regardless of primary complaint, all patients completed a demographic, health-related quality of life (HRQoL) and OM-6 surveys. A total of 246 patients included in this study. The mean age of patients in this study was 2.62 years. One month follow-up questionnaires were obtained from 180 patients for a 73.17% response rate, and 12 weeks follow-up questionnaires were obtained from 150 patients for a 61.38% response rate. The children with recurrent AOM had poorer scores t. Quality of life of children with three or more episodes of AOM in the preceding year was poorer than that of children with 2-3 episodes.
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Dale JC, Cochran CJ, Roy L, Jernigan E, Buchanan GR. Health-related quality of life in children and adolescents with sickle cell disease. J Pediatr Health Care 2011; 25:208-15. [PMID: 21700135 PMCID: PMC3124665 DOI: 10.1016/j.pedhc.2009.12.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 12/24/2009] [Accepted: 12/30/2009] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess health-related quality of life (HRQOL) in children and adolescents with sickle cell disease (SCD). DESIGN, SETTING, AND PARTICIPANTS The PedsQL 4.0 Generic Scales, a multidimensional self-report instrument that has been shown to be valid and reliable for use in children and adolescents with chronic illness, consists of 23 items that assess physical, emotional, social, and school functioning. Questionnaires were administered to 124 children and adolescents (ages 8 to 18 years, child self-report) with SCD (100 sickle cell anemia, 24 sickle β zero thalassemia) and their parents (parent-proxy report). Summary scores for children's and parents' ratings of overall HRQOL and psychosocial health and subscale scores for physical, emotional, social, and school functioning were compared with published data for healthy children. Both summary and subscale scores for children with SCD also were compared with those of their parents. RESULTS Children with SCD and their parents rated overall HRQOL and all subdomains of HRQOL lower than did healthy children and their parents (P < .001). Children with SCD rated their own HRQOL significantly better than their parents did for overall HRQOL and all subdomains (P < .001) except emotional functioning (P = .06). CONCLUSIONS Children with SCD and their parents perceived overall HRQOL and all HRQOL subdomains to be lower than scores reported in healthy children. Therefore, successful therapeutic efforts to improve HRQOL could represent important advances in the health of children with SCD.
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Abstract
Clinical question: What is the best treatment for acute otitis media in children? Results: Watchful waiting, followed by amoxicillin treatment, if necessary, is the best first-line treatment for acute otitis media in children aged six months or older.
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Affiliation(s)
- Jacques Cherpillod
- Ear, Nose and Throat Department, Childrens' University Hospital, Lausanne, Switzerland
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15
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Quality of life of children and their caregivers during an AOM episode: development and use of a telephone questionnaire. Health Qual Life Outcomes 2010; 8:75. [PMID: 20659326 PMCID: PMC2915973 DOI: 10.1186/1477-7525-8-75] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Accepted: 07/26/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The negative consequences of acute otitis media (AOM) on the quality of life (QOL) of children and their families need to be measured to assess benefits of preventive interventions. METHODS A new questionnaire was specifically designed for use in telephone surveys. A random sample of Canadian families was selected using random-digit dialling. Caregivers of children 6-59 months of age who experienced at least one AOM episode during the last 12 months were interviewed. Multidimensional severity and global QOL scores were measured both for affected children and their caregivers. Internal consistency of scores was assessed using standard tests. RESULTS Of the 502 eligible caregivers who completed the survey, 161 (32%) reported at least one AOM episode during the last 12 months and these cases were included in the analysis. Average severity was 2.6 for children and 2.4 for caregivers on a 1 to 4 scale (maximum severity). Cronbach alpha values were 0.78 and 0.81 for the severity score of children and caregivers respectively. Average QOL was 3.4 for children and 3.5 for caregivers on a 1 to 5 scale (best QOL). There was moderate to high correlation between severity and QOL scores, and between these scores and duration of AOM episodes. CONCLUSIONS The questionnaire was easy to use during telephone interviews and results suggest good reliability and validity of the different scores to measure AOM severity and QOL of children and their caregivers during an AOM episode.
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16
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Lucero MG, Dulalia VE, Nillos LT, Williams G, Parreño RAN, Nohynek H, Riley ID, Makela H. Pneumococcal conjugate vaccines for preventing vaccine-type invasive pneumococcal disease and X-ray defined pneumonia in children less than two years of age. Cochrane Database Syst Rev 2009; 2009:CD004977. [PMID: 19821336 PMCID: PMC6464899 DOI: 10.1002/14651858.cd004977.pub2] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Pneumonia, caused by Streptococcus pneumoniae, is a major cause of morbidity and mortality among children in low-income countries. The effectiveness of pneumococcal conjugate vaccines (PCVs) against invasive pneumococcal disease (IPD), pneumonia, and mortality needs to be evaluated. OBJECTIVES To update the 2004 review on the efficacy of PCVs in preventing vaccine-serotypes IPD (VT-IPD) , X-ray defined pneumonia among HIV-1 negative children, and other new outcomes. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, issue 1), which contains the Cochrane Acute Respiratory Infections Group's Specialised Register; MEDLINE (1990 to Week 4 February 2009); and EMBASE (1974 to March 2009). SELECTION CRITERIA Randomised controlled trials (RCTs) comparing PCV with placebo, or another vaccine, in children under two with IPD and clinical / radiographic pneumonia as outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently identified studies, extracted data, and evaluated their corresponding risks of bias. Differences were resolved by discussion. Meta-analysis used the inverse variance method. MAIN RESULTS We identified 11 publications from six RCTs conducted in Africa, US, Philippines and Finland where 57,015 children received PCV; while 56,029 received placebo or another vaccine. Seven publications provided high quality evidence on PCV efficacy against IPD and four provided moderate quality evidence against pneumonia. None of the five trials with all-cause mortality data were powered to investigate this outcome. Only two trials have data on all-cause admissions.The main analysis for this review involved HIV-1 negative children and used the pooled results of random-effects model, intent-to-treat analysis (ITT).Pooled vaccine efficacy (VE) for VT-IPD was 80% (95% confidence interval (CI) 58% to 90%, P < 0.0001); all serotypes-IPD, 58% (95% CI 29% to 75%, P = 0.001); World Health Organization X-ray defined pneumonia was 27% (95% CI 15% to 36%, P < 0.0001); clinical pneumonia, 6% (95% CI 2% to 9%, P = 0.0006); and all-cause mortality, 11% (95% CI -1% to 21%, P = 0.08). Analysis involving HIV-1 positive children had similar findings. AUTHORS' CONCLUSIONS PCV is effective in preventing IPD, X-ray defined pneumonia, and clinical pneumonia among HIV-1 negative and HIV-1 positive children under two years. The impact was greater for VT-IPD than for all serotypes-IPD, and for X-ray defined pneumonia than for clinical pneumonia. An 11% reduction with a 95% CI of -1% to 21% and a P = 0.08 is compatible with reduction in all-cause mortality.
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Affiliation(s)
- Marilla G Lucero
- Research Institute for Tropical MedicineDepartment of Epidemiology and BiostatisticsAlabangMuntinlupa CityPhilippines1781
| | - Vernoni E Dulalia
- Research Institute for Tropical MedicineDepartment of Epidemiology and BiostatisticsAlabangMuntinlupa CityPhilippines1781
| | - Leilani T Nillos
- Research Institute for Tropical MedicineDepartment of Epidemiology and BiostatisticsAlabangMuntinlupa CityPhilippines1781
| | - Gail Williams
- School of Population Health, Queensland UniversityAustralian Centre for International and Tropical Health and NutritionHerston RoadHerstonQueenslandAustralia4006
| | - Rhea Angela N Parreño
- Research Institute for Tropical MedicineDepartment of Epidemiology and BiostatisticsAlabangMuntinlupa CityPhilippines1781
| | - Hanna Nohynek
- National Institute for Health and WelfareDepartment of Vaccines, Unit of Clinical TrialsMannerheimintie 166HelsinkiFinland00300
| | - Ian D Riley
- School of Population Health, Queensland UniversityAustralian Centre for International and Tropical Health and NutritionHerston RoadHerstonQueenslandAustralia4006
| | - Helena Makela
- National Institute for Health and WelfareDepartment of Vaccines, Unit of Clinical TrialsMannerheimintie 166HelsinkiFinland00300
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Forgie S, Zhanel G, Robinson J. La prise en charge de l'otite moyenne aiguë. Paediatr Child Health 2009. [DOI: 10.1093/pch/14.7.461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
Otitis media (OM) is one of the most frequent diseases in young children, one of the most common reasons for a child to visit a physician, and also the most common indication for antibiotic prescribing. OM-related hearing loss due to middle ear effusion can delay language acquisition, alter behaviour, and influence quality of life. Conclusive evidence is, however, lacking. More insight into the individual risk factors is required in order to answer the question of why some children recover from OM spontaneously while others need specific intervention.
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Affiliation(s)
- Maroeska M Rovers
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
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de Miguel Martínez I, Ramos Macías Á. Serotipos de Streptococcus pneumoniae aislados en niños con otitis media aguda. Enferm Infecc Microbiol Clin 2009; 27:61-2. [DOI: 10.1016/j.eimc.2008.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Accepted: 02/25/2008] [Indexed: 10/20/2022]
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Beutels P, Scuffham PA, MacIntyre CR. Funding of drugs: do vaccines warrant a different approach? THE LANCET. INFECTIOUS DISEASES 2008; 8:727-33. [PMID: 18992409 PMCID: PMC7129011 DOI: 10.1016/s1473-3099(08)70258-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Vaccines have features that require special consideration when assessing their cost-effectiveness. These features are related to herd immunity, quality-of-life losses in young children, parental care and work loss, time preference, uncertainty, eradication, macroeconomics, and tiered pricing. Advisory committees on public funding for vaccines, or for pharmaceuticals in general, should be knowledgable about these special features. We discuss key issues and difficulties in decision making for vaccines against rotavirus, human papillomavirus, varicella-zoster virus, influenza virus, and Streptococcus pneumoniae. We argue that guidelines for economic evaluation should be reconsidered generally to recommend (1) modelling options for the assessment of interventions against infectious diseases; (2) a wider perspective to account for impacts on third parties, if relevant; (3) a wider scope of costs than health-care system costs alone, if appropriate; and (4) alternative discounting techniques to explore social time preference over long periods.
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Affiliation(s)
- Philippe Beutels
- Centre for Health Economics Research and Modelling Infectious Diseases, Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
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Dinleyici EC, Yargic ZA. Pneumococcal conjugated vaccines: impact of PCV-7 and new achievements in the postvaccine era. Expert Rev Vaccines 2008; 7:1367-1394. [DOI: 10.1586/14760584.7.9.1367] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Benninger MS. Acute bacterial rhinosinusitis and otitis media: changes in pathogenicity following widespread use of pneumococcal conjugate vaccine. Otolaryngol Head Neck Surg 2008; 138:274-8. [PMID: 18312870 DOI: 10.1016/j.otohns.2007.11.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Revised: 10/12/2007] [Accepted: 11/14/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Acute bacterial rhinosinusitis and acute otitis media are two of the most common respiratory tract infections. The common pathogenic bacteria associated with these infections are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus. With the recent widespread use of pneumococcal conjugate vaccine, there is evidence that there is a shift of both the pneumococcal serotypes and the distribution of pathogenic bacteria. The purpose of this article was to investigate whether the literature supports changes in pathogenicity of acute bacterial rhinosinusitis and otitis media after widespread use of conjugate pneumococcal vaccine. DATA SOURCES MEDLINE search of the literature was performed between 1995 and 2007. REVIEW METHODS Literature review of changes in distribution of pathogens, resistance rates, and pneumococcal serotype changes before and after widespread use of conjugate pneumococcal vaccine. RESULTS There is evidence that the distribution of pneumococcal serotypes has changed after the widespread use of conjugate pneumococcal vaccine. There appears to be both less invasive and noninvasive pneumococcal disease and with childhood immunization there also appears to be a protective effect on adults (herd immunity). Increases in nonvaccine serotypes, some with high levels of resistance are being identified in some communities. There is also growing evidence that there may be an increasing prevalence of Haemophilus influenzae in these infections. CONCLUSIONS Widespread use of conjugate pneumococcal vaccine has led to decreasing incidence of pneumococcal otitis media and likely also acute bacterial rhinosinusitis, which may have implications for treatment recommendations for these infections.
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de Miguel-Martínez I, Ramos-Macías Á, Borkoski Barreiro S. Efecto de la vacuna heptavalente contra Streptococcus pneumoniae en niños con implante coclear. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2008. [DOI: 10.1016/s0001-6519(08)73249-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Efficacy of Heptavalent Pneumococcal Conjugate Vaccine in Children With Cochlear Implant. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s2173-5735(08)70178-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Oosterhuis-Kafeja F, Beutels P, Van Damme P. Immunogenicity, efficacy, safety and effectiveness of pneumococcal conjugate vaccines (1998–2006). Vaccine 2007; 25:2194-212. [PMID: 17267077 DOI: 10.1016/j.vaccine.2006.11.032] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2006] [Revised: 11/16/2006] [Accepted: 11/16/2006] [Indexed: 11/22/2022]
Abstract
In this paper we present an overview of the literature on efficacy and safety trials of the various pneumococcal conjugate vaccines on the market (PCV7) and in development (PCV9, PCV11 and allegedly PCV10 and PCV13), as well as of observations from post-licensure studies. Seven- (PCV7) and nine-valent PCV (PCV9) are reported to be sufficiently immunogenic after administration of a 3+1 schedule in infants in various RCTs. PncOMPC (PCV7 with a protein of N. meningitidis as a carrier) is less immunogenic, though this may have no repercussions for the protective efficacy against clinical disease. PCV7 is 82-97% efficacious against vaccine serotype (VT) IPD, 90% efficacious against (clinically diagnosed) pneumococcal pneumonia, and, like the 11-valent PCV, 57% efficacious against VT acute otitis media. Naturally, it would be of paramount public health interest if the same levels of efficacy and effectiveness could be achieved with fewer doses. Trials studying 2+1 vaccination schedules for PCV7 and PCV9 generally show that the percentage of infants achieving the protective cut-off set by the World Health Organization (WHO) 1 month after the last priming dose, is comparable to that found at the same time point in studies administering 3+1 schedules. PCVs are generally very well tolerated and safe, also when co-administered with other childhood vaccines. As more and more countries are using these vaccines routinely, post marketing surveillance studies will further establish the safety profile of PCVs.
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Abstract
The "wait and see" approach in acute otitis media (AOM), consisting of postponing the antibiotic administration for a few days, has been advocated mainly to counteract the increased bacterial resistance in respiratory infections. This approach is not justified in children less than 2 years of age and this for several reasons. First, AOM is an acute inflammation of the middle ear caused in about 70% of cases by bacteria. Redness and bulging of the tympanic membrane are characteristic findings in bacterial AOM. Second, AOM is associated with long-term dysfunction of the inflamed eustachian tube (ET), particularly in children less than 2 years of age. In this age group, the small calibre of the ET together with its horizontal direction result in impaired clearance, ventilation and protection of the middle ear. Third, recent prospective studies have shown poor long-term prognosis of AOM in children below 2 years with at least 50% of recurrences and persisting otitis media with effusion (OME) in about 35% 6 months after AOM. Viruses elicit AOM in about 30% of children. A prolonged course of AOM has been observed when bacterial and viral infections are combined because viral infection is also associated with ET dysfunction in young children. Bacterial and viral testing of the nasopharyngeal aspirate is an excellent tool both for initial treatment and recurrence of AOM. Antibiotic treatment of AOM is mandatory in children less than 2 years of age to decrease inflammation in the middle ear but also of the ET particularly during the first episode. The best choice is amoxicillin because of its superior penetration in the middle ear. Streptococci pneumoniae with intermediary bacterial resistance to penicillin are particularly associated with recurrent AOM. Therefore the dosage of amoxicillin should be 90 mg/kg per day in three doses. In recurrent AOM with beta-lactamase-producing bacilli, amoxicillin should be associated with clavulanic acid at a dose of 6.4 mg/kg per day. The duration of the treatment is not established yet but 10 days is reasonable for a first episode of AOM. OME may be a precursor initiating AOM but also a complication thereof. OME needs a watchful waiting approach. When associated with deafness for 2-3 months in children over 2 years of age, an antibiotic should be given according to the results of the bacterial resistance in the nasopharyngeal aspirate. The high rate of complications of tympanostomy tube insertion outweighs the beneficial effect on hearing loss. The poor results of this procedure are due to the absence of effects on ET dysfunction. Pneumococcal vaccination has little beneficial effects on recurrent AOM and its use in infants needs further studies. Treatment with amoxicillin is indicated in all children younger than 2 years with a first episode of AOM presenting with redness and bulging of the tympanic membrane. Combined amoxicillin and clavulanic acid should be given in patients with beta-lactamase-producing bacteria. The duration of treatment is estimated to be at least 10 days depending on the findings by pneumo-otoscopy and tympanometry. Bacterial and viral testing of the nasopharyngeal aspirate is highly recommended particularly in children in day care centres as well as for regular follow-up. The high recurrence rate is due to the long-lasting dysfunction of the eustachian tube and the immune immaturity of children less than 2 years of age.
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Affiliation(s)
- Lucien Corbeel
- Department of Pediatrics, University Hospital, Herestraat 49, Leuven, Belgium.
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Clarke SC. Control of pneumococcal disease in the United Kingdom – the start of a new era. J Med Microbiol 2006; 55:975-980. [PMID: 16849715 DOI: 10.1099/jmm.0.46579-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In 2000, a multi-valent pneumococcal conjugate vaccine, known as Prevnar, was licensed for use in infants and young children in the USA. The subsequent introduction of the vaccine into the childhood immunization schedule in that country led to a significant decrease in pneumococcal disease. The vaccine is effective against invasive and non-invasive pneumococcal infection, can be used in young children as well as adults and, like all conjugate vaccines, provides long-lasting immunity. Moreover, it reduces the incidence of antibiotic resistance because a number of resistant serotypes are targeted by the vaccine. Prevnar, also known as Prevenar, has since been licensed in numerous countries, including the UK. On 8 February 2006, the Departments of Health in England, Scotland and Wales announced the inclusion of Prevenar in the childhood immunization schedule. This announcement has important implications for pneumococcal infection, disease surveillance and immunization policy in the UK.
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Affiliation(s)
- Stuart C Clarke
- Hampshire and Isle of Wight Health Protection Unit, Oakley Road and Molecular Microbiology Group, Division of Infection Inflammation and Repair, University of Southampton Medical School, Southampton, UK
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Abstract
PURPOSE OF REVIEW To concisely review data published over the past year on three topics pertinent to the practicing pediatrician: immunizations, neonatal jaundice, and animal-induced injuries. RECENT FINDINGS Updates on immunizations, including varicella and pneumococcus in the post-vaccine era, use of a polyvalent conjugated meningococcal vaccine, and influenza vaccination during a vaccine shortage are discussed. Mortality and morbidity from varicella, and risk of invasive disease from pneumococcal infections have declined. The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention released guidelines for the use of a tetravalent meningococcal conjugate vaccine in adolescents 11 years and older. Infants at younger gestational age are at higher risk for developing hyperbilirubinemia. The American Academy of Pediatrics has released new guidelines emphasizing breastfeeding, systematic pre-discharge assessment for risk factors, early follow-up and intervention. Use of home nursing services in the postnatal period is cost-effective. Although the incidence of rabies is low, many receive postexposure prophylaxis. Spider bites cause fewer systemic effects in children than adults. Pet reptile carriage of salmonella necessitates handwashing after handling of animals. SUMMARY Recommendations for adolescent meningococcal vaccination, and the impact of varicella and pneumococcal immunization on our communities reflect an evolution in our management of infectious diseases. The latest practice guidelines on hyperbilirubinemia emphasize close follow-up of all newborns after postpartum discharge and even more careful evaluation of those infants near term. Education on rabies prophylaxis, spider bites, and salmonella from pet reptiles should focus on judicious use of resources and the proper handling of pets.
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Affiliation(s)
- Melissa S Lee
- Harvard Combined Program in Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
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