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Burton DC, Bigogo GM, Audi AO, Williamson J, Munge K, Wafula J, Ouma D, Khagayi S, Mugoya I, Mburu J, Muema S, Bauni E, Bwanaali T, Feikin DR, Ochieng PM, Mogeni OD, Otieno GA, Olack B, Kamau T, Van Dyke MK, Chen R, Farrington P, Montgomery JM, Breiman RF, Scott JAG, Laserson KF. Risk of Injection-Site Abscess among Infants Receiving a Preservative-Free, Two-Dose Vial Formulation of Pneumococcal Conjugate Vaccine in Kenya. PLoS One 2015; 10:e0141896. [PMID: 26509274 PMCID: PMC4625023 DOI: 10.1371/journal.pone.0141896] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 10/14/2015] [Indexed: 01/01/2023] Open
Abstract
There is a theoretical risk of adverse events following immunization with a preservative-free, 2-dose vial formulation of 10-valent-pneumococcal conjugate vaccine (PCV10). We set out to measure this risk. Four population-based surveillance sites in Kenya (total annual birth cohort of 11,500 infants) were used to conduct a 2-year post-introduction vaccine safety study of PCV10. Injection-site abscesses occurring within 7 days following vaccine administration were clinically diagnosed in all study sites (passive facility-based surveillance) and, also, detected by caregiver-reported symptoms of swelling plus discharge in two sites (active household-based surveillance). Abscess risk was expressed as the number of abscesses per 100,000 injections and was compared for the second vs first vial dose of PCV10 and for PCV10 vs pentavalent vaccine (comparator). A total of 58,288 PCV10 injections were recorded, including 24,054 and 19,702 identified as first and second vial doses, respectively (14,532 unknown vial dose). The risk ratio for abscess following injection with the second (41 per 100,000) vs first (33 per 100,000) vial dose of PCV10 was 1.22 (95% confidence interval [CI] 0.37–4.06). The comparator vaccine was changed from a 2-dose to 10-dose presentation midway through the study. The matched odds ratios for abscess following PCV10 were 1.00 (95% CI 0.12–8.56) and 0.27 (95% CI 0.14–0.54) when compared to the 2-dose and 10-dose pentavalent vaccine presentations, respectively. In Kenya immunization with PCV10 was not associated with an increased risk of injection site abscess, providing confidence that the vaccine may be safely used in Africa. The relatively higher risk of abscess following the 10-dose presentation of pentavalent vaccine merits further study.
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Affiliation(s)
- Deron C. Burton
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
- International Emerging Infections Program, Global Disease Detection Response Center, CDC, Kisumu and Nairobi, Kenya
- * E-mail:
| | - Godfrey M. Bigogo
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
- International Emerging Infections Program, Global Disease Detection Response Center, CDC, Kisumu and Nairobi, Kenya
| | - Allan O. Audi
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
- International Emerging Infections Program, Global Disease Detection Response Center, CDC, Kisumu and Nairobi, Kenya
| | - John Williamson
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
- Center for Global Health, CDC, Atlanta, Georgia, United States of America
| | - Kenneth Munge
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Dominic Ouma
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
- International Emerging Infections Program, Global Disease Detection Response Center, CDC, Kisumu and Nairobi, Kenya
| | - Sammy Khagayi
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
| | - Isaac Mugoya
- Division of Vaccines and Immunization, Ministry of Public Health and Sanitation, Nairobi, Kenya
| | - James Mburu
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Shadrack Muema
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
- International Emerging Infections Program, Global Disease Detection Response Center, CDC, Kisumu and Nairobi, Kenya
| | - Evasius Bauni
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Daniel R. Feikin
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
- International Emerging Infections Program, Global Disease Detection Response Center, CDC, Kisumu and Nairobi, Kenya
| | - Peter M. Ochieng
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
- International Emerging Infections Program, Global Disease Detection Response Center, CDC, Kisumu and Nairobi, Kenya
| | - Ondari D. Mogeni
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
- International Emerging Infections Program, Global Disease Detection Response Center, CDC, Kisumu and Nairobi, Kenya
| | - George A. Otieno
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
- International Emerging Infections Program, Global Disease Detection Response Center, CDC, Kisumu and Nairobi, Kenya
| | - Beatrice Olack
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
- International Emerging Infections Program, Global Disease Detection Response Center, CDC, Kisumu and Nairobi, Kenya
| | - Tatu Kamau
- Division of Vaccines and Immunization, Ministry of Public Health and Sanitation, Nairobi, Kenya
| | | | - Robert Chen
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia, United States of America
| | | | - Joel M. Montgomery
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
- International Emerging Infections Program, Global Disease Detection Response Center, CDC, Kisumu and Nairobi, Kenya
| | - Robert F. Breiman
- International Emerging Infections Program, Global Disease Detection Response Center, CDC, Kisumu and Nairobi, Kenya
- Center for Global Health, CDC, Atlanta, Georgia, United States of America
| | - J. Anthony G. Scott
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Kayla F. Laserson
- Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Research and Public Health Collaboration, Kisumu and Nairobi, Kenya
- Center for Global Health, CDC, Atlanta, Georgia, United States of America
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Otieno GA, Bigogo GM, Nyawanda BO, Aboud F, Breiman RF, Larson CP, Feikin DR. Caretakers' perception towards using zinc to treat childhood diarrhoea in rural western Kenya. J Health Popul Nutr 2013; 31:321-329. [PMID: 24288945 PMCID: PMC3805881 DOI: 10.3329/jhpn.v31i3.16823] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Zinc treatment for diarrhoea can shorten the course and prevent future episodes among children worldwide. However, knowledge and acceptability of zinc among African mothers is unknown. We identified children aged 3 to 59 months, who had diarrhoea within the last three months and participated in a home-based zinc treatment study in rural Kenya. Caretakers of these children were enrolled in two groups; zinc-users and non-users. A structured questionnaire was administered to all caretakers, inquiring about knowledge and appropriate use of zinc. Questions on how much the caretakers were willing to pay for zinc were asked. Proportions were compared using Mantel-Haenszel test, and medians were compared using Wilcoxon Rank Sum test. Among 109 enrolled caretakers, 73 (67%) used zinc, and 36 (33%) did not. Sixty-four (88%) caretakers in zinc-user group reported satisfaction with zinc treatment. Caretakers in the zinc-user group more often correctly identified appropriate zinc treatment (98%-100%) than did those in the non-user group (64-72%, p<0.001). Caretakers in the zinc-user group answered more questions about zinc correctly or favourably (median 10 of 11) compared to those in the non-user group (median 6.3 of 11, p<0.001). Caretakers in the zinc-user group were willing to pay more for a course of zinc in the future than those in the non-user group (median US$ 0.26, p<0.001). Caretakers of children given zinc recently had favourable impressions on the therapy and were willing to pay for it in the future. Active promotion of zinc treatment in clinics and communities in Africa could lead to greater knowledge, acceptance, and demand for zinc.
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Affiliation(s)
- George A Otieno
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya;
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