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Quinn JA, Munoz FM, Gonik B, Frau L, Cutland C, Mallett-Moore T, Kissou A, Wittke F, Das M, Nunes T, Pye S, Watson W, Ramos AMA, Cordero JF, Huang WT, Kochhar S, Buttery J. Preterm birth: Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data. Vaccine 2016; 34:6047-6056. [PMID: 27743648 PMCID: PMC5139808 DOI: 10.1016/j.vaccine.2016.03.045] [Citation(s) in RCA: 235] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 03/15/2016] [Indexed: 12/27/2022]
Abstract
Preterm birth is commonly defined as any birth before 37 weeks completed weeks of gestation. An estimated 15 million infants are born preterm globally, disproportionately affecting low and middle income countries (LMIC). It contributes directly to estimated one million neonatal deaths annually and is a significant contributor to childhood morbidity. However, in many clinical settings, the information available to calculate completed weeks of gestation varies widely. Accurate dating of the last menstrual period (LMP), as well as access to clinical and ultrasonographic evaluation are important components of gestational age assessment antenatally. This case definition assign levels of confidence to categorisation of births as preterm, utilising assessment modalities which may be available across different settings. These are designed to enable systematic safety evaluation of vaccine clinical trials and post-implementation programmes of immunisations in pregnancy.
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Affiliation(s)
- Julie-Anne Quinn
- SAEFVIC, Murdoch Childrens Research Institute, Victoria, Australia; Infection and Immunity, Monash Children's Hospital, Department of Paediatrics, The Ritchie Centre, Hudson Institute, Monash University, Australia
| | - Flor M Munoz
- Departments of Pediatrics and Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Bernard Gonik
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA
| | | | - Clare Cutland
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Department of Science and Technology National Research Foundation, Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Aimee Kissou
- Department of Pediatrics, Souro Sanou Teaching Hospital, Bobo-Dioulasso, Burkina Faso
| | | | | | | | - Savia Pye
- Communicable Disease Prevention and Control, Nova Scotia, Canada
| | | | | | - Jose F Cordero
- University of Puerto Rico Graduate School of Public Health, Medical Sciences Campus, San Juan 00935, Puerto Rico
| | | | | | - Jim Buttery
- SAEFVIC, Murdoch Childrens Research Institute, Victoria, Australia; Infection and Immunity, Monash Children's Hospital, Department of Paediatrics, The Ritchie Centre, Hudson Institute, Monash University, Australia.
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Rigato PO, Fusaro AE, Victor JR, Sato MN. Maternal immunization to modulate the development of allergic response and pathogen infections. Immunotherapy 2011; 1:141-56. [PMID: 20635979 DOI: 10.2217/1750743x.1.1.141] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
This article reviews recent experimental approaches of preventive strategies regarding allergy and infections by pathogens, particularly in early childhood, by targeting maternal immunomodulation. Basic research is essential to understand maternal vaccination as a strategy to control allergic disease and bacterial and viral infections; thus, providing support for future translational research. The environmental stimuli and host genetic factors, along with maternal influences in early life when immune systems are developing and during postnatal life, are essential for the decision between tolerance induction or allergen sensitization. Maternal immunomodulation strategies should serve as a challenge when attempting to halt the spread of allergy responses and viral infections, until the innate and adaptive arms of the immune system of the neonates are competent.
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Affiliation(s)
- Paula Ordonhez Rigato
- Laboratório de Dermatologia e Imunodeficiências - LIM56, Faculdade de Medicina da Universidade de São Paulo, Instituto de Medicina Tropical - Prédio II, Av Dr Enéas de Carvalho Aguiar, 500, 3 masculine andar, 05403-05000, São Paulo, Brazil
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Risk factors for mortality in neonatal tetanus: a 15-year experience in Sagamu, Nigeria. World J Pediatr 2010; 6:71-5. [PMID: 20143215 DOI: 10.1007/s12519-010-0010-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Accepted: 03/20/2009] [Indexed: 10/19/2022]
Abstract
BACKGROUND Neonatal tetanus (NNT) is a major cause of newborn deaths especially in the developing world. While efforts aimed at eradicating NNT should be sustained, it is equally imperative to reduce death among affected infants. Therefore, the factors associated with mortality rate in this condition need to be studied. METHODS The records of infants with NNT over a 15-year period (1991-2005) were reviewed. A statistical comparison of the survivors and fatalities for relevant clinical characteristics was done, and the determinants of fatality rate were also determined using logistic regression. RESULTS Ninety-six of 151 newborns with NNT died, giving a mortality rate of 63.6%. The case fatality rate during the study period varied between 33.3% and 100%. More deaths occurred in the infants with low birth weight (P=0.004) within 1 day at the onset of symptoms (P<0.001), whose mothers aged 18 years or less (P=0.001) belonged to socio-economic class V (P=0.001). Determinants of mortality in these infants with NNT included low socio-economic class (P=0.002), no antitetanus vaccination (P=0.006), presentation with spasms (P<0.001), and non-administration of anti-tetanus serum during treatment (P=0.013). CONCLUSIONS The mortality rate in infants with NNT remains signifi cantly high in Nigeria. Improved maternal anti-tetanus vaccination and timely recognition and treatment of affected infants may jointly reduce the incidence and fatality rate of NNT.
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Fetuga BM, Ogunlesi TA, Adekanmbi F, Olanrewaju D. Neonatal tetanus in the babies of Nigerian mothers immunised against Tetanus. Trop Doct 2009; 39:135-7. [PMID: 19535745 DOI: 10.1258/td.2008.080293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The objective of this study was to describe the clinical characteristics of babies with neonatal tetanus (NNT) whose mothers were immunised against tetanus and determine the outcome of their hospitalisation. The hospital records of babies affected by NNT whose mothers received at least two doses of anti-tetanus vaccine during pregnancy were identified and compared with similarly affected babies whose mothers were not immunised against tetanus during pregnancy in a Nigerian hospital. Out of 175 cases of NNT, the mothers of 24 (13.7%) babies were immunised against tetanus during pregnancy while the mothers of 151 (86.3%) were not. The proportions of babies of immunised mothers and unimmunised mothers who presented within the first three days of life, within a day of the onset of symptoms and with spasms were similar. Nevertheless, the survival rate was higher (62.5% vs. 26.5%; P = 0.0004) among babies of immunised mothers. Despite similarities in clinical presentation of babies of mothers with and without anti-tetanus vaccination, the survival rate was higher for the former.
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Affiliation(s)
- Bolanle Musili Fetuga
- Olabisi Onabanjo University - Paediatrics, Sagamu, Ogun State Sagamu 121001NG, Nigeria
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