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Black P, Britton A, Davis E, Dusan F, Gang R, Garner MG, Hamilton SA, Petrey A, Schipp M, Weerasinghe G, Wilks C. Dr Mike Nunn 9 February 1953-19 May 2023. Aust Vet J 2023; 101:460-461. [PMID: 37918954 DOI: 10.1111/avj.13285] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 11/04/2023]
Affiliation(s)
- P Black
- Essential Foresight, Mount Coolum, Queensland, Australia
| | - A Britton
- Australian Government Department of Agriculture, Fisheries and Forestry, Canberra, Australian Capital Territory, Australia
| | - E Davis
- Global Veterinary Solutions Pty Ltd, Yass, New South Wales, Australia
| | - F Dusan
- Australian Government Department of Foreign Affairs and Trade, Barton, Australian Capital Territory, Australia
| | - R Gang
- Department of Health Victoria, Melbourne, Victoria, Australia
| | | | - S A Hamilton
- Australian Government Department of Agriculture, Fisheries and Forestry, Canberra, Australian Capital Territory, Australia
| | - A Petrey
- Veterinary Public Health Chapter, Australian and New Zealand College of Veterinary Scientists, Eight Mile Plains, Queensland, Australia
| | - M Schipp
- Australian Government Department of Agriculture, Fisheries and Forestry, Canberra, Australian Capital Territory, Australia
| | - G Weerasinghe
- Australian Government Department of Agriculture, Fisheries and Forestry, Canberra, Australian Capital Territory, Australia
| | - C Wilks
- Melbourne Veterinary School, The University of Melbourne, Melbourne, Victoria, Australia
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Causey K, Fullman N, Sorensen RJD, Galles NC, Zheng P, Aravkin A, Danovaro-Holliday MC, Martinez-Piedra R, Sodha SV, Velandia-González MP, Gacic-Dobo M, Castro E, He J, Schipp M, Deen A, Hay SI, Lim SS, Mosser JF. Estimating global and regional disruptions to routine childhood vaccine coverage during the COVID-19 pandemic in 2020: a modelling study. Lancet 2021; 398:522-534. [PMID: 34273292 PMCID: PMC8285122 DOI: 10.1016/s0140-6736(21)01337-4] [Citation(s) in RCA: 172] [Impact Index Per Article: 57.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/17/2021] [Accepted: 06/08/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The COVID-19 pandemic and efforts to reduce SARS-CoV-2 transmission substantially affected health services worldwide. To better understand the impact of the pandemic on childhood routine immunisation, we estimated disruptions in vaccine coverage associated with the pandemic in 2020, globally and by Global Burden of Disease (GBD) super-region. METHODS For this analysis we used a two-step hierarchical random spline modelling approach to estimate global and regional disruptions to routine immunisation using administrative data and reports from electronic immunisation systems, with mobility data as a model input. Paired with estimates of vaccine coverage expected in the absence of COVID-19, which were derived from vaccine coverage models from GBD 2020, Release 1 (GBD 2020 R1), we estimated the number of children who missed routinely delivered doses of the third-dose diphtheria-tetanus-pertussis (DTP3) vaccine and first-dose measles-containing vaccine (MCV1) in 2020. FINDINGS Globally, in 2020, estimated vaccine coverage was 76·7% (95% uncertainty interval 74·3-78·6) for DTP3 and 78·9% (74·8-81·9) for MCV1, representing relative reductions of 7·7% (6·0-10·1) for DTP3 and 7·9% (5·2-11·7) for MCV1, compared to expected doses delivered in the absence of the COVID-19 pandemic. From January to December, 2020, we estimated that 30·0 million (27·6-33·1) children missed doses of DTP3 and 27·2 million (23·4-32·5) children missed MCV1 doses. Compared to expected gaps in coverage for eligible children in 2020, these estimates represented an additional 8·5 million (6·5-11·6) children not routinely vaccinated with DTP3 and an additional 8·9 million (5·7-13·7) children not routinely vaccinated with MCV1 attributable to the COVID-19 pandemic. Globally, monthly disruptions were highest in April, 2020, across all GBD super-regions, with 4·6 million (4·0-5·4) children missing doses of DTP3 and 4·4 million (3·7-5·2) children missing doses of MCV1. Every GBD super-region saw reductions in vaccine coverage in March and April, with the most severe annual impacts in north Africa and the Middle East, south Asia, and Latin America and the Caribbean. We estimated the lowest annual reductions in vaccine delivery in sub-Saharan Africa, where disruptions remained minimal throughout the year. For some super-regions, including southeast Asia, east Asia, and Oceania for both DTP3 and MCV1, the high-income super-region for DTP3, and south Asia for MCV1, estimates suggest that monthly doses were delivered at or above expected levels during the second half of 2020. INTERPRETATION Routine immunisation services faced stark challenges in 2020, with the COVID-19 pandemic causing the most widespread and largest global disruption in recent history. Although the latest coverage trajectories point towards recovery in some regions, a combination of lagging catch-up immunisation services, continued SARS-CoV-2 transmission, and persistent gaps in vaccine coverage before the pandemic still left millions of children under-vaccinated or unvaccinated against preventable diseases at the end of 2020, and these gaps are likely to extend throughout 2021. Strengthening routine immunisation data systems and efforts to target resources and outreach will be essential to minimise the risk of vaccine-preventable disease outbreaks, reach children who missed routine vaccine doses during the pandemic, and accelerate progress towards higher and more equitable vaccination coverage over the next decade. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Kate Causey
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Nancy Fullman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Reed J D Sorensen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Natalie C Galles
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Aleksandr Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA; Department of Applied Mathematics, University of Washington, Seattle, WA, USA
| | | | - Ramon Martinez-Piedra
- Pan American Health Organization, Comprehensive Family Immunization Unit, Washington, DC, USA
| | - Samir V Sodha
- Department of Immunization, Vaccines and Biologicals, Word Health Organization, Geneva, Switzerland
| | | | - Marta Gacic-Dobo
- Department of Immunization, Vaccines and Biologicals, Word Health Organization, Geneva, Switzerland
| | - Emma Castro
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jiawei He
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Megan Schipp
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Amanda Deen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Jonathan F Mosser
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA; Pediatric Infectious Diseases, Seattle Children's Hospital, Seattle, WA, USA.
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Hemalatha R, Pandey A, Kinyoki D, Ramji S, Lodha R, Kumar GA, Kassebaum NJ, Borghi E, Agrawal D, Gupta SS, Laxmaiah A, Kar A, Mathai M, Varghese CM, Awasthi S, Bansal PG, Chakma JK, Collison M, Dwivedi S, Golechha MJ, Gonmei Z, Jerath SG, Kant R, Khera AK, Krishnankutty RP, Kurpad AV, Ladusingh L, Malhotra R, Mamidi RS, Manguerra H, Mathew JL, Mutreja P, Nimmathota A, Pati A, Purwar M, Radhakrishna KV, Raina N, Sankar MJ, Saraf DS, Schipp M, Sharma R, Shekhar C, Sinha A, Sreenivas V, Reddy KS, Bekedam HJ, Swaminathan S, Lim SS, Dandona R, Murray CJ, Hay SI, Toteja G, Dandona L. Mapping of variations in child stunting, wasting and underweight within the states of India: the Global Burden of Disease Study 2000-2017. EClinicalMedicine 2020; 22:100317. [PMID: 32510044 PMCID: PMC7264980 DOI: 10.1016/j.eclinm.2020.100317] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND To inform actions at the district level under the National Nutrition Mission (NNM), we assessed the prevalence trends of child growth failure (CGF) indicators for all districts in India and inequality between districts within the states. METHODS We assessed the trends of CGF indicators (stunting, wasting and underweight) from 2000 to 2017 across the districts of India, aggregated from 5 × 5 km grid estimates, using all accessible data from various surveys with subnational geographical information. The states were categorised into three groups using their Socio-demographic Index (SDI) levels calculated as part of the Global Burden of Disease Study based on per capita income, mean education and fertility rate in women younger than 25 years. Inequality between districts within the states was assessed using coefficient of variation (CV). We projected the prevalence of CGF indicators for the districts up to 2030 based on the trends from 2000 to 2017 to compare with the NNM 2022 targets for stunting and underweight, and the WHO/UNICEF 2030 targets for stunting and wasting. We assessed Pearson correlation coefficient between two major national surveys for district-level estimates of CGF indicators in the states. FINDINGS The prevalence of stunting ranged 3.8-fold from 16.4% (95% UI 15.2-17.8) to 62.8% (95% UI 61.5-64.0) among the 723 districts of India in 2017, wasting ranged 5.4-fold from 5.5% (95% UI 5.1-6.1) to 30.0% (95% UI 28.2-31.8), and underweight ranged 4.6-fold from 11.0% (95% UI 10.5-11.9) to 51.0% (95% UI 49.9-52.1). 36.1% of the districts in India had stunting prevalence 40% or more, with 67.0% districts in the low SDI states group and only 1.1% districts in the high SDI states with this level of stunting. The prevalence of stunting declined significantly from 2010 to 2017 in 98.5% of the districts with a maximum decline of 41.2% (95% UI 40.3-42.5), wasting in 61.3% with a maximum decline of 44.0% (95% UI 42.3-46.7), and underweight in 95.0% with a maximum decline of 53.9% (95% UI 52.8-55.4). The CV varied 7.4-fold for stunting, 12.2-fold for wasting, and 8.6-fold for underweight between the states in 2017; the CV increased for stunting in 28 out of 31 states, for wasting in 16 states, and for underweight in 20 states from 2000 to 2017. In order to reach the NNM 2022 targets for stunting and underweight individually, 82.6% and 98.5% of the districts in India would need a rate of improvement higher than they had up to 2017, respectively. To achieve the WHO/UNICEF 2030 target for wasting, all districts in India would need a rate of improvement higher than they had up to 2017. The correlation between the two national surveys for district-level estimates was poor, with Pearson correlation coefficient of 0.7 only in Odisha and four small north-eastern states out of the 27 states covered by these surveys. INTERPRETATION CGF indicators have improved in India, but there are substantial variations between the districts in their magnitude and rate of decline, and the inequality between districts has increased in a large proportion of the states. The poor correlation between the national surveys for CGF estimates highlights the need to standardise collection of anthropometric data in India. The district-level trends in this report provide a useful reference for targeting the efforts under NNM to reduce CGF across India and meet the Indian and global targets.
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Saloga J, Knop J, Rihs HP, Dumont B, Rozynek P, Lundberg M, Cremer R, Brüning T, Raulf-Heimsoth M, Yeang HY, Sander I, Arif SAM, Fleischer C, Brüning T, Pöppelmann M, Grobe K, Becker WM, Petersen A, Wicklein D, Lindner B, Lepp U, Altmann F, Hipler UC, Frank U, Schliemann-Willers S, Kaatz M, Eisner P, Kasche A, Krämer U, Klaus S, Buters J, Traidl-Hoffmann C, Ring J, Behrendt H, Huss-Marp J, Brockow K, Darsow U, Risse U, Böttcher I, Sellinghausen I, Brand P, Klostermann B, Mariant V, Jakob T, Hochrein H, Müller MJ, Wagner H, Baron JM, Schiffer R, Bostonci Ö, Merk HF, Zwadlo-Klarwasser G, Schäkel K, Kannagi R, Kniep B, Goto Y, Mitsuoka C, Zwirner J, Soruri A, von Kietzell M, Rieber P, Lisewski M, Mommert S, Kapp A, Zwirner J, Werfet T, Gutzmer R, Langer K, Werfel T, Soewarto D, Köllisch G, Howaldt M, Sandholzer N, Kreramer E, Hrabé deAngelis M, Balling R, Ollert M, Pfeffer K, Wolf E, Flaswinkel H, Ngoumou G, Schäfer D, Mattes J, Moseler M, Kühr J, Kopp MV, Gutzmer R, Wittmann M, Janssen S, Köther B, Alter M, Stünkel T, Hausdirjg M, Ho TC, Buerke M, Lehr AH, Lux C, Schipp M, Galle RP, Finotto S, Bünder R, Mittermann I, Herz U, Valenta R, Renz H, Seidel-Guvenot W, Goez R, Maurer M, Metz M, Blessing M, Schramm C, Steinbrink K, Köllisch GV, Mempel M, Bauer S, Völcker V, Kasche A, Fesq H, Feussner I, Schober W, Buters J, Hueltner L, Lippert U, Artuc M, Babina M, Blaschke V, Zachmann K, Neumann C, Henz BM, Stassen M, Müller C, Richter C, Neudörfl C, Hüttner L, Bhakdi S, Walev I, Schmitt E, Mageri M, Maurer M, Hartmann K, Artuc M, Hermes B, Mekori YA, Henz BM, Breit S, Schöpf P, Dugas M, Schiffl H, Ruëff F, Przybilla B, Forssmann U, Härtung I, Bälder R, Escher SE, Spodsberg N, Dulkys Y, Walden M, Heitland A, Braun A, Forssmann WG, Elsner J, Raap U, Deneka N, Bruder M, Wedi B, Feser A, Plötz SG, Kreyling W, Schober W, Weichenmeier I, Papo D, Eberlein-König B, Berresheim HW, Grimm V, Winneke G, Kleine-Tebbe J, Breuer K, Vieths S, Worm M, Kunkel G, Wahn U, Lau S, Errlmann SM, Sauer I, Termeer C, Salman S, Averbeck M, Simon JC, Heine G, Frotscher B, Anton K, Mahnke K, Qian Y, Enk A, Enk AH, Beinghausen I, Darcan Y, Seitzer U, Ahmed J, Sudowe S, Ludwig-Portugall I, Ross R, Reske-Kunz AB, Maurer T, Lipford G, Wagner H, Rueff F, Bauer C, Gosepath J, Mewes T, Ziegler E, Ziegler EA, Flagge A, Hipler UC, Baumbach H, Zintl F, Eisner P, Mainz J, Huber S, Protschka M, Burg J, Galle PR, Lohse AW, Podlech J, Köhler H, Wegmann M, Heimann S, Fehrenbach A, Wagner U, Alfke H, Fehrenbach H, Beier J, Semmler D, Beeh KM, Kornmann O, Buhl R, Quarcoo D, Ahrens B, Meeuw A, Reese G, Vieths S, Hameimann E, Heratizadeh A, Wulf A, Constien A, Tetau D, Lingelbach A, Rakoski J, Fiedler EM, Zuberbier T, Weidermiller M, Winterkamp S, Schwab D, Nabe A, Nägel A, Maiss J, Mühldorfer SDN, Hahn EG, Raithel M, Weidenhiller M, Abel R, Baenkler HW, Mühldorfer S, Funkt G, Klinik I, Scheibenzuber M, Meyer-Pittroff R, Reese I, Oppel T, Hartmann K, Pfützner W, Biedermann T, Sing A, Dechene M, Staubach P, Hanau A, Magerl M, Eckhardt-Henn A, Onnen K, Kromminga A, Lüdtke R, Tschentscher I, Lange J, Berkenheide S, Kuehr J, Simon D, von Gunten S, Borelli S, Braathen LR, Simon HU, Fokken N, Wittmann M, Mrabet-Dahbi S, Klotz M, Heeg K, Soost S, Lee H, Klinger R, Becker D, Bruchhausen S, Jaeger C, Hartschuh W, Jappe U. 15. Mainzer Allergie-Workshop 2003. Allergo J 2003. [DOI: 10.1007/bf03361093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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