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Grohskopf LA, Sokolow LZ, Broder KR, Walter EB, Bresee JS, Fry AM, Jernigan DB. Prevention and Control of Seasonal Influenza With Vaccines: Recommendations of the Advisory Committee on Immunization Practices-United States, 2017-18 Influenza Season. Am J Transplant 2017. [DOI: 10.1111/ajt.14511] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- L. A. Grohskopf
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA
| | - L. Z. Sokolow
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA
- Battelle Memorial Institute; Atlanta GA
| | - K. R. Broder
- Immunization Safety Office; National Center for Emerging and Zoonotic Infectious Diseases; CDC; Atlanta GA
| | | | - J. S. Bresee
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA
| | - A. M. Fry
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA
| | - D. B. Jernigan
- Influenza Division; National Center for Immunization and Respiratory Diseases; CDC; Atlanta GA
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Stout JE, Ostbye T, Walter EB, Hamilton CD. Tuberculosis knowledge and attitudes among physicians who treat young children in North Carolina, USA. Int J Tuberc Lung Dis 2006; 10:783-8. [PMID: 16848341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
SETTING North Carolina, USA. OBJECTIVE To understand physicians' knowledge and attitudes toward the treatment of young children with latent tuberculosis infection (LTBI) in a low-incidence region. DESIGN Cross-sectional survey of 525 pediatricians and 525 family practitioners in North Carolina. RESULTS Of 1050 surveys mailed, 149 (14%) were returned. In the previous year, 96% of responding physicians had treated children who had emigrated from a tuberculosis (TB) endemic country. During the last 2 years, 84% of physicians had not diagnosed any young children with TB disease, and 46% had not treated any young children with LTBI. Most (83%) physicians routinely placed tuberculin skin tests (TSTs), and 26% reported placing > 10 TSTs per month. Experience in treating children with LTBI was the only predictor of TB knowledge. Physicians were particularly confused about two issues: 1) TST among bacille Calmette-Guérin (BCG) vaccinated children and 2) treatment of young children with recent exposure to an adult with infectious TB. CONCLUSIONS Knowledge of important issues related to management of LTBI in children aged < 5 years was limited among physicians in an area with relatively low TB incidence. Creative methods must be developed to help physicians in low-incidence areas to appropriately diagnose and treat LTBI among young children.
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Affiliation(s)
- J E Stout
- Division of Infectious Diseases, Department of Medicine, Box 3306, Duke University Medical Center, Durham, NC 27710, USA.
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Abstract
OBJECTIVES We determined rates of prenatal HIV testing and investigated barriers to testing. METHODS We surveyed 1362 representative parturient women from 7 hospitals in 4 locations of the United States. RESULTS Overall, 89.9% of women reported being offered HIV testing and 69.6% reported being tested. Proportions of women not offered testing differed by location (range = 5.2%-16.3%), as did proportions not tested (range = 12.2%-54.4%). Among women who perceived that their clinicians had not recommended testing, 41.7% were tested, compared with 92.8% of women who perceived a strong recommendation (P < .05). Private insurance for prenatal care was also associated with not being tested. Women gave multiple reasons for not being tested, most commonly not being at risk, having been tested recently, and the test's not being offered or recommended, cited by 55.3%, 39.1% and 11.1% of women, respectively. CONCLUSIONS Although most parturient women were offered a prenatal HIV test and got tested, testing proportions did not reach national goals and differed significantly by location and payment status. Concern about testing consequences was not a major barrier. Perception of clinicians' recommendations strongly influenced testing. Changing provider practices will be essential to implementing universal prenatal HIV testing.
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Affiliation(s)
- R A Royce
- Department of Epidemiology, University of North Carolina at Chapel Hill, USA.
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Clements DA, Zaref JI, Bland CL, Walter EB, Coplan PM. Partial uptake of varicella vaccine and the epidemiological effect on varicella disease in 11 day-care centers in North Carolina. Arch Pediatr Adolesc Med 2001; 155:455-61. [PMID: 11296072 DOI: 10.1001/archpedi.155.4.455] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The increasing use of varicella vaccine in children attending day care has rapidly decreased the incidence of wild-type varicella disease. The herd immunity noted is significant and will have an effect on the epidemiology of natural varicella. OBJECTIVE To monitor the change in varicella incidence in day-care attendees after the licensure of varicella vaccine. DESIGN A prospective observational cohort study design. SETTING Eleven private day-care centers and preschools in North Carolina participated in the study from January 1, 1995, through December 31, 1999. PARTICIPANTS All children in the 11 centers were eligible for participation. Some participated more actively, supplying information on a regular basis. Others participated passively. Day-care personnel provided information about all cases of varicella. INTERVENTIONS None. MAIN OUTCOME VARIABLES The change in the incidence of varicella disease was documented as the use of varicella vaccine increased. RESULTS Varicella vaccine coverage increased substantially from 4.4% in 1995 to 63.1% in December 1999. The vaccination rate accelerated dramatically in 1996 and 1997, leveled off in 1998, and rose again in 1999. Cumulative varicella incidence decreased from 16.74 cases per 1000 person-months in July 1996 to 1.53 cases per 1000 person-months in December 1999 in unvaccinated children. CONCLUSIONS The varicella vaccination rate continued to increase slowly in the day-care population after an initial rapid uptake. The decrease in varicella disease is greater than the increase in varicella vaccination. This herd effect is welcome and even apparent in the unvaccinated children younger than 1 year.
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Affiliation(s)
- D A Clements
- Campus Box 3810, Duke University Medical Center, Durham, NC 27710, USA.
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Ickovics JR, Ethier KA, Koenig LJ, Wilson TE, Walter EB, Fernandez MI. Infant birth weight among women with or at high risk for HIV infection: the impact of clinical, behavioral, psychosocial, and demographic factors. Health Psychol 2001. [PMID: 11129354 DOI: 10.1037//0278-6133.19.6.515] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of these analyses was to provide a prospective examination of the impact of HIV on birth weight using clinical, behavioral, psychosocial, and demographic correlates. HIV-positive (n = 319) and HIV-negative (n = 220) pregnant women matched for HIV risk factors (i.e., drug use and sexual risk behaviors) were interviewed during the 3rd trimester of pregnancy and 6 weeks postpartum. Medical chart reviews were also conducted for the HIV-seropositive pregnant women to verify pregnancy-related and birth outcome data. In a logistic regression analysis, model chi2(9, N = 518) = 124.8, p < .001, controlling for parity and gestational age, women who were HIV seropositive were 2.6 times more likely to have an infant with low birth weight. In addition, Black women and those who did not live with their partners were more than 2 times as likely to have infants with low birth weight, and those who smoked were 3.2 times more likely to have infants with low birth weight. Knowing that women with HIV, those who are Black, and those not living with a partner are at highest risk for adverse birth outcomes can help those in prenatal clinics and HIV specialty clinics to target resources and develop prevention interventions. This is particularly important for women with HIV because birth weight is associated with risk of HIV transmission from mother to child.
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Affiliation(s)
- J R Ickovics
- Department of Epidemiology and Public Health and Yale Center for Interdisciplinary Research on AIDS, Yale University School of Medicine, New Haven, Connecticut 06520-8034, USA.
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Walter EB, Royce RA, Fernández MI, DeHovitz J, Ickovics JR, Lampe MA. New mothers' knowledge and attitudes about perinatal human immunodeficiency virus infection. Obstet Gynecol 2001; 97:70-6. [PMID: 11152911 DOI: 10.1016/s0029-7844(00)01070-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To assess new mothers' attitudes toward perinatal human immunodeficiency virus (HIV) testing, their knowledge about perinatal HIV, and their trust of government and scientists. METHODS In a cross-sectional survey of 1362 postpartum women at four United States locations in 1997, a standardized interview was administered to new mothers 24-48 hours postpartum to determine their HIV test acceptance, attitudes, and knowledge. RESULTS Seventy-five percent of women who were offered HIV tests reported being tested. Although 95% of women were aware of perinatal HIV transmission, only 60% knew that HIV can be transmitted through breast-feeding, and only 51% knew of medication to prevent perinatal transmission. Eighty-four percent of women thought that all pregnant women should be tested for HIV, and 60% thought that prenatal HIV testing should be legally mandated. Twenty percent of women indicated mistrust of government and scientists regarding origins of HIV and potential cures for AIDS. Knowledge about perinatal transmission was unrelated to receipt of prenatal HIV tests. When other factors were controlled for, mistrust was not significantly associated with getting tested. CONCLUSION Incomplete knowledge of prevention of perinatal HIV transmission and mistrust were prevalent among new mothers. Knowledge deficits or mistrust did not appear to reduce reported prenatal test rates, but our data suggest that future public health efforts need to educate women about methods of preventing perinatal HIV transmission and at enhancing their trust in the public health system.
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Affiliation(s)
- E B Walter
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA.
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Ickovics JR, Ethier KA, Koenig LJ, Wilson TE, Walter EB, Fernandez MI. Infant birth weight among women with or at high risk for HIV infection: the impact of clinical, behavioral, psychosocial, and demographic factors. Health Psychol 2000; 19:515-23. [PMID: 11129354 DOI: 10.1037/0278-6133.19.6.515] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of these analyses was to provide a prospective examination of the impact of HIV on birth weight using clinical, behavioral, psychosocial, and demographic correlates. HIV-positive (n = 319) and HIV-negative (n = 220) pregnant women matched for HIV risk factors (i.e., drug use and sexual risk behaviors) were interviewed during the 3rd trimester of pregnancy and 6 weeks postpartum. Medical chart reviews were also conducted for the HIV-seropositive pregnant women to verify pregnancy-related and birth outcome data. In a logistic regression analysis, model chi2(9, N = 518) = 124.8, p < .001, controlling for parity and gestational age, women who were HIV seropositive were 2.6 times more likely to have an infant with low birth weight. In addition, Black women and those who did not live with their partners were more than 2 times as likely to have infants with low birth weight, and those who smoked were 3.2 times more likely to have infants with low birth weight. Knowing that women with HIV, those who are Black, and those not living with a partner are at highest risk for adverse birth outcomes can help those in prenatal clinics and HIV specialty clinics to target resources and develop prevention interventions. This is particularly important for women with HIV because birth weight is associated with risk of HIV transmission from mother to child.
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Affiliation(s)
- J R Ickovics
- Department of Epidemiology and Public Health and Yale Center for Interdisciplinary Research on AIDS, Yale University School of Medicine, New Haven, Connecticut 06520-8034, USA.
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Fernández MI, Wilson TE, Ethier KA, Walter EB, Gay CL, Moore J. Acceptance of HIV testing during prenatal care. Perinatal Guidelines Evaluation Project. Public Health Rep 2000; 115:460-8. [PMID: 11236018 PMCID: PMC1308602 DOI: 10.1093/phr/115.5.460] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The purpose of this study was to assess the factors associated with acceptance of HIV testing during pregnancy on the part of women receiving prenatal care at public clinics. METHODS Trained interviewers recruited and interviewed 1,357 women receiving prenatal care at clinics in Florida, Connecticut, and New York City. RESULTS Eighty-six percent of participants reported having been tested or having signed a consent form to be tested. Acceptance of testing was found to be related to strong beliefs about the benefits of testing, knowledge about vertical transmission, perceived provider endorsement of testing, and social support. Women who declined testing said they did so because they did not perceive themselves to be at risk for HIV (21%) or they faced administrative difficulties (16%) with some aspect of the testing process (for example, scheduling, limited availability of pre-test counselors). CONCLUSIONS Acceptance rates can be increased when women understand the modes of vertical transmission and the role of medication regimens in preventing transmission; believe that prenatal identification of HIV can promote the health of mother and child; and perceive their providers as strongly endorsing testing. These points can be woven into a brief pre-test counseling message and made a routine component of prenatal care.
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Affiliation(s)
- M I Fernández
- Department of Epidemiology Public Health, University of Miami School of Medicine, Florida 33101, USA.
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Abstract
BACKGROUND Varicella vaccine has been licensed for use in the United States since the spring of 1995. The acceptance of the vaccine and its effect on varicella incidence in children is important. AIM To document the effectiveness of the varicella vaccine in children attending day care in 11 centers in North Carolina. METHODS A dynamic cohort study design was used in 11 day-care centers in North Carolina. Multiple cross-sectional evaluations were performed and children were noted to be vaccinated or not and diseased or not. Vaccine effectiveness was estimated by comparing the varicella attack rate in the vaccinated with the varicella attack rate in the unvaccinated. Person time was used as the denominator for all calculations. RESULTS During the study period February 1, 1996, to September 1, 1997, 134 cases of varicella occurred in the unvaccinated and 11 cases occurred in the vaccinated children. The attack rates in the vaccinated and unvaccinated were 2.49 and 14.66, respectively, for an overall vaccine effectiveness of 83% for mild/moderate disease. CONCLUSIONS In the day-care setting varicella vaccine demonstrated benefit in preventing and modifying wild-type varicella disease.
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Walter EB, Hornick RB, Poland GA, Tucker R, Bland CL, Clements DA, Rhamstine CC, Jacobson RM, Brown L, Gress JO, Harris KE, Wiens BL, Nalin DR. Concurrent administration of inactivated hepatitis A vaccine with immune globulin in healthy adults. Vaccine 1999; 17:1468-73. [PMID: 10195783 DOI: 10.1016/s0264-410x(98)00370-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
301 healthy adult volunteers were randomized to one of three treatment groups: inactivated hepatitis A vaccine alone; inactivated hepatitis A vaccine with immune globulin (Ig) concurrently; or Ig alone. The first two treatment groups received a second dose of hepatitis A vaccine at week 24. Anti-HAV was measured 4, 8, 12, 24 and 28 weeks after the primary immunization. When comparing subjects receiving inactivated hepatitis A vaccine alone to those receiving vaccine and Ig, the seropositivity rates were not significantly different at 4, 8, 12 and 28 weeks, but at week 24 the seropositivity rate was lower in the group receiving both vaccine and Ig compared to the group receiving vaccine alone (92.0% compared to 97.0%). At weeks 8, 12 and 24 the geometric mean titers (GMTs) were significantly lower for subjects receiving both vaccine and Ig. The GMTs were not significantly different after the second dose of vaccine. At all time points, the lower serum antibody concentrations observed in subjects receiving both inactivated hepatitis A vaccine and Ig were nevertheless substantially higher than the cutoff for assay seropositivity and much higher than after Ig alone; these differences are therefore clinically insignificant.
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Affiliation(s)
- E B Walter
- Department of Pediatrics, Duke University Medical Center, Durham, NC 27704, USA.
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Affiliation(s)
- E B Walter
- Duke Children's Primary Care, Duke University Medical Center, Durham, NC, USA
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Walter EB, Lampe MA, Livingston E, Royce RA. How do North Carolina prenatal care providers counsel and test pregnant women for HIV? Survey measures knowledge of HIV testing benefits. N C Med J 1998; 59:105-9. [PMID: 9558898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- E B Walter
- Dept. of Pediatrics, Duke University Medical Center, Durham, USA
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Rennels MB, Hohenboken MJ, Reisinger KS, Clements DA, Walter EB, Blatter MM, Nonenmacher J, Hackell JG. Comparison of acellular pertussis-diphtheria-tetanus toxoids and Haemophilus influenzae type b vaccines administered separately vs. combined in younger vs. older toddlers. Pediatr Infect Dis J 1998; 17:164-6. [PMID: 9493818 DOI: 10.1097/00006454-199802000-00019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- M B Rennels
- Department of Pediatrics and Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, USA.
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Walter EB, Simmons SS, Bland CL, Clements DA. Modified varicella-like syndrome in children previously vaccinated with live attenuated measles, mumps, rubella and varicella vaccine. Pediatr Infect Dis J 1997; 16:626-7. [PMID: 9194116 DOI: 10.1097/00006454-199706000-00016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- E B Walter
- Vaccine and Infectious Diseases Epidemiology Unit, Duke University Medical Center, Durham, NC 27704, USA.
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Affiliation(s)
- S P Combs
- Department of Pediatrics, Duke University Medical Center, Durham, NC 27705, USA
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Clements DA, Armstrong CB, Ursano AM, Moggio MM, Walter EB, Wilfert CM. Over five-year follow-up of Oka/Merck varicella vaccine recipients in 465 infants and adolescents. Pediatr Infect Dis J 1995; 14:874-9. [PMID: 8584315 DOI: 10.1097/00006454-199510000-00011] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A total of 465 healthy infants and adolescents ages 12 months to 17 years without a known history of varicella or recent exposure to varicella-zoster virus VZV were immunized with live attenuated Oka/Merck varicella vaccine from November, 1984, through April, 1989. The vaccine administered was from 1 of 7 production lots containing from 950 to 3265 plaque-forming units and was well-tolerated with few side effects. The seroconversion rate for seronegative subjects was 94.6% (403 of 426). This varied by lot from 85% (950 plaque-forming units) to 100% (3010 and 3265 plaque-forming units). Breakthrough disease after exposure to varicella in seroconverters during 5 to 10 years of follow-up was 18.6% (75 of 403). The breakthrough disease was characterized by a maculopapular rash with a median of 35 lesions, most of which were macules. Breakthrough disease lasted a median of 5 days and the median temperature was 99 degrees F; 65.3% (49 of 75) of subjects were afebrile and 2.7% (2 of 75) of subjects had temperatures of > 102.9 degrees F. Varicella vaccine provides excellent (94.6%) seroconversion, and most children who developed breakthrough disease (18.6%) experienced a modified, milder form of illness than has been observed with natural varicella in unvaccinated subjects.
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Affiliation(s)
- D A Clements
- Duke Vaccine Unit, Duke University Medical Center, Durham, NC 27710, USA
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Walter EB, Elliott AJ, Regan AN, Drucker RP, Clements DA, Wilfert CM. Maternal acceptance of voluntary human immunodeficiency virus antibody testing during the newborn period with the Guthrie card. Pediatr Infect Dis J 1995; 14:376-81. [PMID: 7638013 DOI: 10.1097/00006454-199505000-00008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In order to provide the opportunity for women delivering newborns to have human immunodeficiency virus (HIV) testing we piloted a hospital-based voluntary HIV testing program during the newborn period using the Guthrie card. During the study period 789 women were offered newborn HIV antibody testing. Test acceptance during the newborn period (61.0%) was comparable to that reported for the prenatal period (60.6%). Overall 77.4% of women were tested in the newborn period or reported being tested in the prenatal period. Prenatal test acceptance best predicted newborn HIV test acceptance (odds ratio, 3.37; 95% confidence interval, 2.40 to 4.74). When compared to HIV testing during the newborn period prenatal HIV testing is preferable because it enables the recognition of HIV infection early during pregnancy and allows the mother the option to elect zidovudine therapy and potentially prevent infection in her newborn. However, when prenatal HIV testing is not routinely made available or cannot be assured, women should be offered the opportunity to be tested during the newborn period.
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Affiliation(s)
- E B Walter
- Duke Vaccine and Infectious Epidemiology Unit, Department of Pediatrics, Duke University Medical Center, Durham, NC 27704, USA
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Walter EB, Simmons SS, Clements DA. Anti-polyribosylribitol phosphate antibody levels 5 years after a primary series of Haemophilus influenzae type B conjugate vaccine. J Infect Dis 1994; 170:1050-1. [PMID: 7930710 DOI: 10.1093/infdis/170.4.1050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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Walter EB, Katz SL, Bellini WJ. Measles immunity in HIV-infected children. Pediatr AIDS HIV Infect 1994; 5:300-4. [PMID: 11361371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
In a retrospective study, sera from 84 children of human immunodeficiency virus (HIV)-seropositive mothers (35 HIV-infected and 49 uninfected children) with a known date of receipt of measles, mumps, and rubella vaccine were tested for antibody to measles vaccine by an indirect enzyme immunoassay (EIA) method and/or microneutralization (NEUT). At the time of last measurement, 21/35 (60.0%) HIV-infected children remained seropositive by either EIA or NEUT. Forty seven of forty-nine (95.9%) uninfected children had evidence of measles antibody. Six HIV-infected children had a documented loss of antibody over time. The majority of HIV-infected children had antibody to measles vaccine virus, which in some cases decreased over time.
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Affiliation(s)
- E B Walter
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
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Walter EB, Drucker RP, Clements DA. A major barrier to universal hepatitis B immunization of infants. Arch Pediatr Adolesc Med 1994; 148:538-9. [PMID: 8180652 DOI: 10.1001/archpedi.1994.02170050096023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Affiliation(s)
- E B Walter
- Department of Pediatrics, Duke University Medical Center, Durham, NC
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Affiliation(s)
- E B Walter
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina 27710
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Walter EB, Moggio MV, Drucker RP, Wilfert CM. Immunogenicity of Haemophilus b conjugate vaccine (meningococcal protein conjugate) in children with prior invasive Haemophilus influenzae type b disease. Pediatr Infect Dis J 1990; 9:632-5. [PMID: 2235187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Children younger than 2 years of age with previous invasive Haemophilus influenzae (Hib) type b disease may not develop protective antibodies to antigens of Hib and may be at risk of developing a second episode of Hib disease. Twenty-three children with prior Hib disease were immunized with Haemophilus b conjugate vaccine (meningococcal protein conjugate). Children 12 to 24 months of age were given one dose of vaccine and children younger than 12 months of age were given 2 doses 2 months apart. Antibody to the polysaccharide capsule of Hib (PRP) was measured by radioimmunoassay. Eighteen children had preimmunization serum antibody concentrations less than 0.150 micrograms/ml. All 18 children responded with greater than 0.150 micrograms/ml of antibody after a single dose of vaccine. Only 1 of the 23 children had a preimmunization serum antibody concentration greater than 1.000 micrograms/ml. Seventeen children ultimately responded with greater than 1.000 micrograms/ml of antibody (P less than 0.0001), concentrations of antibody thought to correlate with protection. Haemophilus b conjugate vaccine (meningococcal protein conjugate) is immunogenic in children with invasive Hib disease. Children younger than 2 years of age with invasive Hib disease should be subsequently immunized with a Hib conjugate vaccine.
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Affiliation(s)
- E B Walter
- Department of Pediatrics, Duke University Medical Center, Durham, NC 27710
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Walter EB, McKinney RE, Lane BA, Weinhold KJ, Wilfert CM. Interpretation of western blots of specimens from children infected with human immunodeficiency virus type 1: implications for prognosis and diagnosis. J Pediatr 1990; 117:255-8. [PMID: 2380826 DOI: 10.1016/s0022-3476(05)80540-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- E B Walter
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina 27710
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Abstract
We have reported a case of neonatal Torulopsis glabrata peritonitis and ventriculitis associated with a ventriculoperitoneal shunt. Treatment of fungemia and ventriculitis with amphotericin B and 5-fluorocytosine was successful.
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Affiliation(s)
- E B Walter
- Department of Pediatrics, Duke University Medical Center, Durham, NC 27710
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