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Zaman K, Schuind AE, Adjei S, Antony K, Aponte JJ, Buabeng PB, Qadri F, Kemp TJ, Hossain L, Pinto LA, Sukraw K, Bhat N, Agbenyega T. Safety and immunogenicity of Innovax bivalent human papillomavirus vaccine in girls 9-14 years of age: Interim analysis from a phase 3 clinical trial. Vaccine 2024; 42:2290-2298. [PMID: 38431444 PMCID: PMC11007388 DOI: 10.1016/j.vaccine.2024.02.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/19/2024] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND World Health Organization human papillomavirus (HPV) vaccination recommendations include a single- or two-dose schedule in individuals 9-20 years old and advice for generating data on single-dose efficacy or immunobridging. The ongoing Phase 3 trial of Innovax's bivalent (types 16 and 18) HPV vaccine (Cecolin®) assesses in low- and middle-income countries alternative dosing schedules and generates data following one dose in girls 9-14 years old. Interim data for the 6-month dosing groups are presented. METHODS In Bangladesh and Ghana, 1,025 girls were randomized to receive either two doses of Cecolin at 6-, 12-, or 24-month intervals; one dose of Gardasil® followed by one dose of Cecolin at month 24; or two doses of Gardasil 6 months apart (referent). Serology was measured by enzyme-linked immunosorbent assay (ELISA) and, in a subset, by neutralization assays. Primary objectives include immunological non-inferiority of the Cecolin schedules to referent one month after the second dose. Safety endpoints include reactogenicity and unsolicited adverse events for 7 and 30 days post-vaccination, respectively, as well as serious adverse events throughout the study. RESULTS Interim analyses included data from the two groups on a 0, 6-month schedule with 205 participants per group. One month after Dose 2, 100% of participants were seropositive by ELISA and had seroconverted for both antigens. Non-inferiority of Cecolin to Gardasil was demonstrated. Six months following one dose, over 96% of participants were seropositive by ELISA for both HPV antigens, with a trend for higher geometric mean concentration following Cecolin administration. Reactogenicity and safety were comparable between both vaccines. CONCLUSIONS Cecolin in a 0, 6-month schedule elicits robust immunogenicity. Non-inferiority to Gardasil was demonstrated one month after a 0, 6-month schedule. Immunogenicity following one dose was comparable to Gardasil up to six months. Both vaccines were safe and well tolerated (ClinicalTrials.gov No. 04508309).
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Affiliation(s)
- Khalequ Zaman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Anne E Schuind
- PATH, Center for Vaccine Innovation and Access, Seattle, Washington, United States.
| | - Samuel Adjei
- Malaria Research Center, Agogo Presbyterian Hospital/Kwame Nkrumah University of Science and Technology, Agogo, Ghana
| | - Kalpana Antony
- PATH, Center for Vaccine Innovation and Access, Seattle, Washington, United States
| | - John J Aponte
- PATH, Center for Vaccine Innovation and Access, Seattle, Washington, United States
| | - Patrick By Buabeng
- Malaria Research Center, Agogo Presbyterian Hospital/Kwame Nkrumah University of Science and Technology, Agogo, Ghana
| | - Firdausi Qadri
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Troy J Kemp
- HPV Serology Laboratory, Vaccine, Immunity, and Cancer Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States
| | - Lokman Hossain
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Ligia A Pinto
- HPV Serology Laboratory, Vaccine, Immunity, and Cancer Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States
| | - Kristen Sukraw
- PATH, Center for Vaccine Innovation and Access, Seattle, Washington, United States
| | - Niranjan Bhat
- PATH, Center for Vaccine Innovation and Access, Seattle, Washington, United States
| | - Tsiri Agbenyega
- Malaria Research Center, Agogo Presbyterian Hospital/Kwame Nkrumah University of Science and Technology, Agogo, Ghana
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Dodd R, Awuor AO, Garcia Bardales PF, Khanam F, Mategula D, Onwuchekwa U, Sarwar G, Yousafzai MT, Ahmed N, Atlas HE, Amirul Islam Bhuiyan M, Colston JM, Conteh B, Diawara M, Dilruba N, Elwood S, Fatima I, Feutz E, Galagan SR, Haque S, Taufiqul Islam M, Karim M, Keita B, Kosek MN, Kotloff KL, Lefu C, Mballow M, Ndalama M, Ndeketa L, Ogwel B, Okonji C, Paredes Olortegui M, Pavlinac PB, Pinedo Vasquez T, Platts-Mills JA, Qadri F, Qureshi S, Rogawski McQuade ET, Sultana S, Traore MO, Cunliffe NA, Jahangir Hossain M, Omore R, Qamar FN, Tapia MD, Peñataro Yori P, Zaman K, McGrath CJ. Population Enumeration and Household Utilization Survey Methods in the Enterics for Global Health (EFGH): Shigella Surveillance Study. Open Forum Infect Dis 2024; 11:S17-S24. [PMID: 38532956 PMCID: PMC10962723 DOI: 10.1093/ofid/ofae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
Background Accurate estimation of diarrhea incidence from facility-based surveillance requires estimating the population at risk and accounting for case patients who do not seek care. The Enterics for Global Health (EFGH) Shigella surveillance study will characterize population denominators and healthcare-seeking behavior proportions to calculate incidence rates of Shigella diarrhea in children aged 6-35 months across 7 sites in Africa, Asia, and Latin America. Methods The Enterics for Global Health (EFGH) Shigella surveillance study will use a hybrid surveillance design, supplementing facility-based surveillance with population-based surveys to estimate population size and the proportion of children with diarrhea brought for care at EFGH health facilities. Continuous data collection over a 24 month period captures seasonality and ensures representative sampling of the population at risk during the period of facility-based enrollments. Study catchment areas are broken into randomized clusters, each sized to be feasibly enumerated by individual field teams. Conclusions The methods presented herein aim to minimize the challenges associated with hybrid surveillance, such as poor parity between survey area coverage and facility coverage, population fluctuations, seasonal variability, and adjustments to care-seeking behavior.
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Affiliation(s)
- Ryan Dodd
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Alex O Awuor
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu, Kenya
| | | | - Farhana Khanam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Donnie Mategula
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Department of Health Systems and Policy, Kamuzu University of Health Sciences, School of Global Public Health, Blantyre, Malawi
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Uma Onwuchekwa
- Centre Pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Golam Sarwar
- Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | | | - Naveed Ahmed
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Hannah E Atlas
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Md Amirul Islam Bhuiyan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Josh M Colston
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Bakary Conteh
- Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Manan Diawara
- Centre Pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Nasrin Dilruba
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Sarah Elwood
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Irum Fatima
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Erika Feutz
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Sean R Galagan
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Shahinur Haque
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Taufiqul Islam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mehrab Karim
- Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Belali Keita
- Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Margaret N Kosek
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Karen L Kotloff
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Clement Lefu
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Mamadou Mballow
- Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Maureen Ndalama
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Latif Ndeketa
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Department of Health Systems and Policy, Kamuzu University of Health Sciences, School of Global Public Health, Blantyre, Malawi
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Billy Ogwel
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu, Kenya
| | - Caleb Okonji
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu, Kenya
| | | | - Patricia B Pavlinac
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | | | - James A Platts-Mills
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Firdausi Qadri
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Sonia Qureshi
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | | | - Shazia Sultana
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | | | - Nigel A Cunliffe
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - M Jahangir Hossain
- Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Richard Omore
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu, Kenya
| | - Farah Naz Qamar
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Milagritos D Tapia
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Pablo Peñataro Yori
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - K Zaman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Christine J McGrath
- Department of Global Health, University of Washington, Seattle, Washington, USA
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Morozoff C, Ahmed N, Chinkhumba J, Islam MT, Jallow AF, Ogwel B, Zegarra Paredes LF, Sanogo D, Atlas HE, Badji H, Bar-Zeev N, Conteh B, Güimack Fajardo M, Feutz E, Haidara FC, Karim M, Mamby Keita A, Keita Y, Khanam F, Kosek MN, Kotloff KL, Maguire R, Mbutuka IS, Ndalama M, Ochieng JB, Okello C, Omore R, Perez Garcia KF, Qamar FN, Qudrat-E-Khuda S, Qureshi S, Rajib MNH, Shapiama Lopez WV, Sultana S, Witte D, Yousafzai MT, Awuor AO, Cunliffe NA, Jahangir Hossain M, Paredes Olortegui M, Tapia MD, Zaman K, Means AR. Quantifying the Cost of Shigella Diarrhea in the Enterics for Global Health (EFGH) Shigella Surveillance Study. Open Forum Infect Dis 2024; 11:S41-S47. [PMID: 38532961 PMCID: PMC10962725 DOI: 10.1093/ofid/ofad575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
Background Comparative costs of public health interventions provide valuable data for decision making. However, the availability of comprehensive and context-specific costs is often limited. The Enterics for Global Health (EFGH) Shigella surveillance study-a facility-based diarrhea surveillance study across 7 countries-aims to generate evidence on health system and household costs associated with medically attended Shigella diarrhea in children. Methods EFGH working groups comprising representatives from each country (Bangladesh, Kenya, Malawi, Mali, Pakistan, Peru, and The Gambia) developed the study methods. Over a 24-month surveillance period, facility-based surveys will collect data on resource use for the medical treatment of an estimated 9800 children aged 6-35 months with diarrhea. Through these surveys, we will describe and quantify medical resources used in the treatment of diarrhea (eg, medication, supplies, and provider salaries), nonmedical resources (eg, travel costs to the facility), and the amount of caregiver time lost from work to care for their sick child. To assign costs to each identified resource, we will use a combination of caregiver interviews, national medical price lists, and databases from the World Health Organization and the International Labor Organization. Our primary outcome will be the estimated cost per inpatient and outpatient episode of medically attended Shigella diarrhea treatment across countries, levels of care, and illness severity. We will conduct sensitivity and scenario analysis to determine how unit costs vary across scenarios. Conclusions Results from this study will contribute to the existing body of literature on diarrhea costing and inform future policy decisions related to investments in preventive strategies for Shigella.
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Affiliation(s)
- Chloe Morozoff
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Naveed Ahmed
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Jobiba Chinkhumba
- School of Global and Public Health, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Md Taufiqul Islam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research,Bangladesh Dhaka, Bangladesh
| | - Abdoulie F Jallow
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Billy Ogwel
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu, Kenya
| | | | - Doh Sanogo
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Hannah E Atlas
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Henry Badji
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Naor Bar-Zeev
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Bakary Conteh
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | | | - Erika Feutz
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Fadima C Haidara
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Mehrab Karim
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Adama Mamby Keita
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Youssouf Keita
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Farhana Khanam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research,Bangladesh Dhaka, Bangladesh
| | - Margaret N Kosek
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Karen L Kotloff
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Rebecca Maguire
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | | | - John Benjamin Ochieng
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu, Kenya
| | - Collins Okello
- Centre pour le Développement des Vaccins du Mali (CVD-Mali), Bamako, Mali
| | - Richard Omore
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu, Kenya
| | | | - Farah Naz Qamar
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Syed Qudrat-E-Khuda
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research,Bangladesh Dhaka, Bangladesh
| | - Sonia Qureshi
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Md Nazmul Hasan Rajib
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research,Bangladesh Dhaka, Bangladesh
| | | | - Shazia Sultana
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Desiree Witte
- Malawi Liverpool Wellcome Programme, Blantyre, Malawi
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | | | - Alex O Awuor
- Kenya Medical Research Institute, Center for Global Health Research (KEMRI-CGHR), Kisumu, Kenya
| | - Nigel A Cunliffe
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - M Jahangir Hossain
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | | | - Milagritos D Tapia
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - K Zaman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research,Bangladesh Dhaka, Bangladesh
| | - Arianna Rubin Means
- Department of Global Health, University of Washington, Seattle, Washington, USA
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Khanam F, Islam MT, Bhuiyan TR, Hossen MI, Rajib MNH, Haque S, Ireen M, Qudrat-E-Khuda S, Biswas PK, Bhuiyan MAI, Islam K, Rahman N, Alam Raz SMA, Mosharraf MP, Shawon Bhuiyan ME, Islam S, Ahmed D, Ahmmed F, Zaman K, Clemens JD, Qadri F. The Enterics for Global Health (EFGH) Shigella Surveillance Study in Bangladesh. Open Forum Infect Dis 2024; 11:S76-S83. [PMID: 38532962 PMCID: PMC10962752 DOI: 10.1093/ofid/ofad653] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
Background Shigella is an important cause of diarrhea in Bangladeshi children <5 years of age, with an incidence rate of 4.6 per 100 person-years. However, the report was more than a decade old, and data on Shigella consequences are similarly outdated and heterogeneously collected. Methods Facility-based disease surveillance is planned to be carried out under the Enterics for Global Health (EFGH) Shigella Surveillance Study consortium for 2 years with aims to optimize and standardize laboratory techniques and healthcare utilization and coverage survey, clinical and anthropometric data collection, safety monitoring and responsiveness, and other related activities. The EFGH is a cohesive network of multidisciplinary experts, capable of operating in concert to conduct the study to generate data that will pave the way for potential Shigella vaccine trials in settings with high disease burden. The study will be conducted within 7 country sites in Asia, Africa, and Latin America. Conclusions We outline the features of the Bangladesh site as part of this multisite surveillance network to determine an updated incidence rate and document the consequences of Shigella diarrhea in children aged 6-35 months, which will help inform policymakers and to implement the future vaccine trials.
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Affiliation(s)
- Farhana Khanam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Taufiqul Islam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Taufiqur Rahman Bhuiyan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Ismail Hossen
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Nazmul Hasan Rajib
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shahinur Haque
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mahzabeen Ireen
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Syed Qudrat-E-Khuda
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Prasanta Kumar Biswas
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Amirul Islam Bhuiyan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Kamrul Islam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Nazia Rahman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - S M Azadul Alam Raz
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Parvej Mosharraf
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Elias Shawon Bhuiyan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Sadia Islam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Dilruba Ahmed
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Faisal Ahmmed
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Khalequ Zaman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - John D Clemens
- Director General Office, International Vaccine Institute, Seoul, Republic of Korea
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Firdausi Qadri
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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5
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Im J, Islam MT, Ahmmed F, Kim DR, Tadesse BT, Kang S, Khanam F, Chowdhury F, Ahmed T, Firoj MG, Aziz AB, Hoque M, Jeon HJ, Kanungo S, Dutta S, Zaman K, Khan AI, Marks F, Kim JH, Qadri F, Clemens JD. Do Oral Cholera Vaccine and Water, Sanitation, and Hygiene Combine to Provide Greater Protection Against Cholera? Results From a Cluster-Randomized Trial of Oral Cholera Vaccine in Kolkata, India. Open Forum Infect Dis 2024; 11:ofad701. [PMID: 38274552 PMCID: PMC10810060 DOI: 10.1093/ofid/ofad701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Indexed: 01/27/2024] Open
Abstract
Background Oral cholera vaccine (OCV) and incremental improvements in household water, sanitation, and hygiene (WASH) within cholera-endemic areas can reduce cholera risk. However, we lack empiric evaluation of their combined impact. Methods We evaluated a cluster-randomized, placebo-controlled trial of OCV (Shanchol) in Kolkata, India. The study population included 108 777 individuals, and 106 879 nonpregnant individuals >1 year of age were eligible to receive 2 doses of OCV or placebo. We measured cholera risk in all household members assigned to OCV vs placebo and in all members of households with "Better" vs "Not Better" WASH, where WASH was classified according to validated criteria. Protection was measured by Cox proportional hazard models. Results Residence in an OCV household was associated with protective effectiveness (PE) of 54% (95% CI, 42%-64%; P < .001) and was similar regardless of Better (PE, 57%; 95% CI, 26%-75%; P = .002) or Not Better (PE, 53%; 95% CI, 40%-64%; P < .001) household WASH. Better WASH household residence was associated with PE of 30% (95% CI, 5%-48%; P = .023) and was similar in OCV (PE, 24%; 95% CI, -26% to 54%; P = .293) and placebo (PE, 29%; 95% CI, -3% to 51%; P = .069) households. When assessed conjointly, residence in OCV households with Better WASH was associated with the greatest PE against cholera at 69% (95% CI, 49%-81%; P < .001). Conclusions These findings suggest that the combination of a vaccine policy and improved WASH reduces cholera risk more than either would alone, although the magnitude of either intervention was not affected by the other. Future randomized trials investigating OCV and WASH interventions separately and together are recommended to further understand the interaction between OCV and WASH.
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Affiliation(s)
- Justin Im
- International Vaccine Institute, Seoul, Republic of Korea
| | - Md Taufiqul Islam
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Faisal Ahmmed
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Deok Ryun Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - Sophie Kang
- International Vaccine Institute, Seoul, Republic of Korea
| | - Farhana Khanam
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Fahima Chowdhury
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Tasnuva Ahmed
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Md Golam Firoj
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | | | - Masuma Hoque
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Hyon Jin Jeon
- International Vaccine Institute, Seoul, Republic of Korea
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Suman Kanungo
- ICMR–National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Shanta Dutta
- ICMR–National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Khalequ Zaman
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | | | - Florian Marks
- International Vaccine Institute, Seoul, Republic of Korea
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Jerome H Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Firdausi Qadri
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - John D Clemens
- International Vaccine Institute, Seoul, Republic of Korea
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
- Fielding School of Public Health, University of California–Los Angeles, Los Angeles, California, USA
- Vaccine Innovation Center, School of Medicine, Korea University, Seoul, Republic of Korea
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6
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Wang X, Velasquez Portocarrero DE, Cortese MM, Parashar U, Zaman K, Jiang B. Anti-rotavirus antibody measurement in a rotavirus vaccine trial: Choice of vaccine antigen in immunoassays does matter. Hum Vaccin Immunother 2023; 19:2167437. [PMID: 36715015 PMCID: PMC10012887 DOI: 10.1080/21645515.2023.2167437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
In a clinical trial of Bangladeshi infants who received three doses of RotaTeq (ages 6, 10, and 14 weeks), we did a head-to-head assessment of two vaccine virus strains to measure rotavirus IgA in sera. Serum samples collected at pre-dose 1 (age 6 weeks) and post-dose 3 (age 22 weeks) were tested for rotavirus IgA by EIA by using the matching vaccine strain (RotaTeq) and a different vaccine strain (Rotarix) as antigens. Overall, rotavirus IgA seropositivity and titers with each antigen were compared. At age 22 weeks (N = 531), the proportion of infants who tested rotavirus IgA seropositive was similar when measured using the RotaTeq (412/531 [78%]) or the Rotarix antigen (403/531 [76%]) in the EIA. However, the IgA geometric mean titer was higher when measured using the RotaTeq antigen as compared to that measured using the Rotarix antigen [218 (95%CI: 176-270) vs. 93 (77-111), p < .0001]. We have compared two globally licensed vaccines, the human monovalent, and the pentavalent reassortant, as antigens on a RotaTeq cohort, resulting in higher estimations of IgA antibodies in the same sample when measured using the RotaTeq antigen. Our findings support matching vaccine antigens in EIA for the most desired immunogenicity testing of the RotaTeq vaccine.
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Affiliation(s)
- Xiaoqian Wang
- Division of Viral Diseases, Centers for Diseases Control and Prevention (CDC), Atlanta, GA, USA
| | | | - Margaret M Cortese
- Division of Viral Diseases, Centers for Diseases Control and Prevention (CDC), Atlanta, GA, USA
| | - Umesh Parashar
- Division of Viral Diseases, Centers for Diseases Control and Prevention (CDC), Atlanta, GA, USA
| | - Khalequ Zaman
- Division of Infectious Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Baoming Jiang
- Division of Viral Diseases, Centers for Diseases Control and Prevention (CDC), Atlanta, GA, USA
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7
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Emery JC, Dodd PJ, Banu S, Frascella B, Garden FL, Horton KC, Hossain S, Law I, van Leth F, Marks GB, Nguyen HB, Nguyen HV, Onozaki I, Quelapio MID, Richards AS, Shaikh N, Tiemersma EW, White RG, Zaman K, Cobelens F, Houben RMGJ. Estimating the contribution of subclinical tuberculosis disease to transmission: An individual patient data analysis from prevalence surveys. eLife 2023; 12:e82469. [PMID: 38109277 PMCID: PMC10727500 DOI: 10.7554/elife.82469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/04/2023] [Indexed: 12/20/2023] Open
Abstract
Background Individuals with bacteriologically confirmed pulmonary tuberculosis (TB) disease who do not report symptoms (subclinical TB) represent around half of all prevalent cases of TB, yet their contribution to Mycobacterium tuberculosis (Mtb) transmission is unknown, especially compared to individuals who report symptoms at the time of diagnosis (clinical TB). Relative infectiousness can be approximated by cumulative infections in household contacts, but such data are rare. Methods We reviewed the literature to identify studies where surveys of Mtb infection were linked to population surveys of TB disease. We collated individual-level data on representative populations for analysis and used literature on the relative durations of subclinical and clinical TB to estimate relative infectiousness through a cumulative hazard model, accounting for sputum-smear status. Relative prevalence of subclinical and clinical disease in high-burden settings was used to estimate the contribution of subclinical TB to global Mtb transmission. Results We collated data on 414 index cases and 789 household contacts from three prevalence surveys (Bangladesh, the Philippines, and Viet Nam) and one case-finding trial in Viet Nam. The odds ratio for infection in a household with a clinical versus subclinical index case (irrespective of sputum smear status) was 1.2 (0.6-2.3, 95% confidence interval). Adjusting for duration of disease, we found a per-unit-time infectiousness of subclinical TB relative to clinical TB of 1.93 (0.62-6.18, 95% prediction interval [PrI]). Fourteen countries across Asia and Africa provided data on relative prevalence of subclinical and clinical TB, suggesting an estimated 68% (27-92%, 95% PrI) of global transmission is from subclinical TB. Conclusions Our results suggest that subclinical TB contributes substantially to transmission and needs to be diagnosed and treated for effective progress towards TB elimination. Funding JCE, KCH, ASR, NS, and RH have received funding from the European Research Council (ERC) under the Horizon 2020 research and innovation programme (ERC Starting Grant No. 757699) KCH is also supported by UK FCDO (Leaving no-one behind: transforming gendered pathways to health for TB). This research has been partially funded by UK aid from the UK government (to KCH); however, the views expressed do not necessarily reflect the UK government's official policies. PJD was supported by a fellowship from the UK Medical Research Council (MR/P022081/1); this UK-funded award is part of the EDCTP2 programme supported by the European Union. RGW is funded by the Wellcome Trust (218261/Z/19/Z), NIH (1R01AI147321-01), EDTCP (RIA208D-2505B), UK MRC (CCF17-7779 via SET Bloomsbury), ESRC (ES/P008011/1), BMGF (OPP1084276, OPP1135288 and INV-001754), and the WHO (2020/985800-0).
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Affiliation(s)
- Jon C Emery
- TB Modelling Group, TB Centre and Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical MedicineLondonUnited Kingdom
| | - Peter J Dodd
- School of Health and Related Research, University of SheffieldSheffieldUnited Kingdom
| | - Sayera Banu
- International Centre for Diarrhoeal Disease ResearchDhakaBangladesh
| | | | - Frances L Garden
- South West Sydney Clinical Campuses, University of New South WalesSydneyAustralia
- Ingham Institute of Applied Medical ResearchSydneyAustralia
| | - Katherine C Horton
- TB Modelling Group, TB Centre and Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical MedicineLondonUnited Kingdom
| | - Shahed Hossain
- James P. Grant School of Public Health, BRAC UniversityDhakaBangladesh
| | - Irwin Law
- Global Tuberculosis Programme, World Health OrganizationGenevaSwitzerland
| | - Frank van Leth
- Department of Health Sciences, VU UniversityAmsterdamNetherlands
- Amsterdam Public Health Research InstituteAmsterdamNetherlands
| | - Guy B Marks
- South West Sydney Clinical Campuses, University of New South WalesSydneyAustralia
- Woolcock Institute of Medical ResearchSydneyAustralia
| | - Hoa Binh Nguyen
- National Lung Hospital, National Tuberculosis Control ProgramHa NoiViet Nam
| | - Hai Viet Nguyen
- National Lung Hospital, National Tuberculosis Control ProgramHa NoiViet Nam
| | - Ikushi Onozaki
- Research Institute of Tuberculosis, Japan Anti-Tuberculosis AssociationTokyoJapan
| | | | - Alexandra S Richards
- TB Modelling Group, TB Centre and Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical MedicineLondonUnited Kingdom
| | - Nabila Shaikh
- TB Modelling Group, TB Centre and Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical MedicineLondonUnited Kingdom
- Sanofi PasteurReadingUnited Kingdom
| | | | - Richard G White
- TB Modelling Group, TB Centre and Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical MedicineLondonUnited Kingdom
| | - Khalequ Zaman
- International Centre for Diarrhoeal Disease ResearchDhakaBangladesh
| | - Frank Cobelens
- Department of Global Health and Amsterdam Institute for Global Health and Development, Amsterdam University Medical Centers, University of AmsterdamAmsterdamNetherlands
| | - Rein MGJ Houben
- TB Modelling Group, TB Centre and Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical MedicineLondonUnited Kingdom
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8
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Wilson E, Goswami J, Baqui AH, Doreski PA, Perez-Marc G, Zaman K, Monroy J, Duncan CJA, Ujiie M, Rämet M, Pérez-Breva L, Falsey AR, Walsh EE, Dhar R, Wilson L, Du J, Ghaswalla P, Kapoor A, Lan L, Mehta S, Mithani R, Panozzo CA, Simorellis AK, Kuter BJ, Schödel F, Huang W, Reuter C, Slobod K, Stoszek SK, Shaw CA, Miller JM, Das R, Chen GL. Efficacy and Safety of an mRNA-Based RSV PreF Vaccine in Older Adults. N Engl J Med 2023; 389:2233-2244. [PMID: 38091530 DOI: 10.1056/nejmoa2307079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) can cause substantial morbidity and mortality among older adults. An mRNA-based RSV vaccine, mRNA-1345, encoding the stabilized RSV prefusion F glycoprotein, is under clinical investigation. METHODS In this ongoing, randomized, double-blind, placebo-controlled, phase 2-3 trial, we randomly assigned, in a 1:1 ratio, adults 60 years of age or older to receive one dose of mRNA-1345 (50 μg) or placebo. The two primary efficacy end points were the prevention of RSV-associated lower respiratory tract disease with at least two signs or symptoms and with at least three signs or symptoms. A key secondary efficacy end point was the prevention of RSV-associated acute respiratory disease. Safety was also assessed. RESULTS Overall, 35,541 participants were assigned to receive the mRNA-1345 vaccine (17,793 participants) or placebo (17,748). The median follow-up was 112 days (range, 1 to 379). The primary analyses were conducted when at least 50% of the anticipated cases of RSV-associated lower respiratory tract disease had occurred. Vaccine efficacy was 83.7% (95.88% confidence interval [CI], 66.0 to 92.2) against RSV-associated lower respiratory tract disease with at least two signs or symptoms and 82.4% (96.36% CI, 34.8 to 95.3) against the disease with at least three signs or symptoms. Vaccine efficacy was 68.4% (95% CI, 50.9 to 79.7) against RSV-associated acute respiratory disease. Protection was observed against both RSV subtypes (A and B) and was generally consistent across subgroups defined according to age and coexisting conditions. Participants in the mRNA-1345 group had a higher incidence than those in the placebo group of solicited local adverse reactions (58.7% vs. 16.2%) and of systemic adverse reactions (47.7% vs. 32.9%); most reactions were mild to moderate in severity and were transient. Serious adverse events occurred in 2.8% of the participants in each trial group. CONCLUSIONS A single dose of the mRNA-1345 vaccine resulted in no evident safety concerns and led to a lower incidence of RSV-associated lower respiratory tract disease and of RSV-associated acute respiratory disease than placebo among adults 60 years of age or older. (Funded by Moderna; ConquerRSV ClinicalTrials.gov number, NCT05127434.).
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Affiliation(s)
- Eleanor Wilson
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Jaya Goswami
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Abdullah H Baqui
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Pablo A Doreski
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Gonzalo Perez-Marc
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Khalequ Zaman
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Jorge Monroy
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Christopher J A Duncan
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Mugen Ujiie
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Mika Rämet
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Lina Pérez-Breva
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Ann R Falsey
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Edward E Walsh
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Rakesh Dhar
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Lauren Wilson
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Jiejun Du
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Parinaz Ghaswalla
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Archana Kapoor
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Lan Lan
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Shraddha Mehta
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Runa Mithani
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Catherine A Panozzo
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Alana K Simorellis
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Barbara J Kuter
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Florian Schödel
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Wenmei Huang
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Caroline Reuter
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Karen Slobod
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Sonia K Stoszek
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Christine A Shaw
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Jacqueline M Miller
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Rituparna Das
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
| | - Grace L Chen
- From Moderna, Cambridge, MA (E.W., J.G., R. Dhar, L.W., J.D., P.G., A.K., L.L., S.M., R.M., C.A.P., A.K.S., B.J.K., F.S., W.H., C.R., K.S., S.K.S., C.A.S., J.M.M., R. Das, G.L.C.); Johns Hopkins Bloomberg School of Public Health, Baltimore (A.H.B.); Fundación Respirar-Vaccine Research Division (P.A.D.) and Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich (G.P.-M.) - both in Buenos Aires; International Center for Diarrheal Disease Research, Dhaka, Bangladesh (K.Z.); Clinical Site Partners, Winter Park, FL (J.M.); Translational and Clinical Research Institute, Newcastle University, and the National Institute for Health and Care Research Newcastle Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust - both in Newcastle upon Tyne, United Kingdom (C.J.A.D.); Center Hospital of the National Center for Global Health and Medicine, Tokyo (M.U.); Rokotetutkimusklinikka, Järvenpää, and Finnish Vaccine Research, Tampere - both in Finland (M.R.); Vaccine Research-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region (FISABIO) Public Health, Valencia, Spain (L.P.-B.); and the University of Rochester, Rochester, NY (A.R.F., E.E.W.)
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9
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Fry S, Chokephaibulkit K, Pallem S, Henry O, Pu Y, Akawung A, Kim JH, Yanni E, Tullio AN, Aurpibul L, Lee CMF, Ceballos A, Zaman K, Abadía de Regalado I, Ahmed K, Arias Fernandez DA, Taher SW, Caccavo J, Coutinho CM, D’Andrea Nores U, De León T, D’Silva EC, De Bernardi M, Dieser P, Falaschi A, Flores Acosta CDC, Gentile A, Teo IH, Kotze S, López-Medina E, Luca R, Lucion MF, Mantaring JBIIIV, Marín B, Moelo M, Mussi-Pinhata MM, Pinto J, Puthanakit T, Reyes O, Roa MF, Rodriguez Brieschke MT, Rodriguez CE, Rodriguez Niño JN, Schwarzbold AV, Sierra Garcia A, Sivapatham L, Soon R, Tinoco JC, Velásquez Penagos JA, Dos Santos G. Incidence of Respiratory Syncytial Virus-Associated Lower Respiratory Tract Illness in Infants in Low- and Middle-Income Regions During the Coronavirus Disease 2019 Pandemic. Open Forum Infect Dis 2023; 10:ofad553. [PMID: 38088983 PMCID: PMC10715683 DOI: 10.1093/ofid/ofad553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Indexed: 12/30/2023] Open
Abstract
Background Incidence data of respiratory syncytial virus-associated lower respiratory tract illness (RSV-LRTI) are sparse in low- and middle-income countries (LMICs). We estimated RSV-LRTI incidence rates (IRs) in infants in LMICs using World Health Organization case definitions. Methods This prospective cohort study, conducted in 10 LMICs from May 2019 to October 2021 (largely overlapping with the coronavirus disease 2019 [COVID-19] pandemic), followed infants born to women with low-risk pregnancies for 1 year from birth using active and passive surveillance to detect potential LRTIs, and quantitative reverse-transcription polymerase chain reaction on nasal swabs to detect RSV. Results Among 2094 infants, 32 (1.5%) experienced an RSV-LRTI (8 during their first 6 months of life, 24 thereafter). Seventeen (0.8%) infants had severe RSV-LRTI and 168 (8.0%) had all-cause LRTI. IRs (95% confidence intervals [CIs]) of first RSV-LRTI episode were 1.0 (.3-2.3), 0.8 (.3-1.5), and 1.6 (1.1-2.2) per 100 person-years for infants aged 0-2, 0-5, and 0-11 months, respectively. IRs (95% CIs) of the first all-cause LRTI episode were 10.7 (8.1-14.0), 11.7 (9.6-14.0), and 8.7 (7.5-10.2) per 100 person-years, respectively. IRs varied by country (RSV-LRTI: 0.0-8.3, all-cause LRTI: 0.0-49.6 per 100 person-years for 0- to 11-month-olds). Conclusions RSV-LRTI IRs in infants in this study were relatively low, likely due to reduced viral circulation caused by COVID-19-related nonpharmaceutical interventions. Clinical Trials Registration NCT03614676.
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Affiliation(s)
- Samantha Fry
- Department of Paediatrics and Child Health, Family Centre for Research with Ubuntu, Stellenbosch University, Cape Town, South Africa
| | - Kulkanya Chokephaibulkit
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | | | | | | | | | | | | | - Linda Aurpibul
- Research Institute for Health Science, Chiang Mai University, Chiang Mai, Thailand
| | | | - Ana Ceballos
- Instituto Médico Río Cuarto, Río Cuarto, Córdoba, Argentina
| | - Khalequ Zaman
- International Centre for Diarrhoeal Disease Research (icddr, b), Dhaka, Bangladesh
| | | | - Khatija Ahmed
- Setshaba Research Centre, Soshanguve, South Africa
- Faculty of Health Sciences, Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
| | | | | | - Juliana Caccavo
- Donación Francisco Santojanni Hospital, Buenos Aires, Argentina
| | - Conrado Milani Coutinho
- Department of Gynecology and Obstetrics, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | | | - Tirza De León
- Maternity Hospital José Domingo De Obaldia, San Pablo Viejo, Panama
| | | | | | - Pablo Dieser
- Instituto Médico Río Cuarto, Río Cuarto, Córdoba, Argentina
| | - Andrea Falaschi
- Dr Ramon Carrillo Hospital, Mendoza, Argentina
- Dr Diego Paroissien Hospital, Mendoza, Argentina
| | | | - Angela Gentile
- Epidemiology Department, Hospital de Niños Dr Ricardo Gutiérrez, Buenos Aires, Argentina
| | | | - Sheena Kotze
- Synexus Stanza Clinical Research Centre, Pretoria, South Africa
| | - Eduardo López-Medina
- Centro de Estudios en Infectología Pediátrica, Department of Pediatrics, Universidad del Valle, Valle del Cauca, Colombia
- Clinica Imbanaco, Grupo Quironsalud, Cali, Colombia
| | - Ruben Luca
- Hospital F. F. Santojanni C1407, Buenos Aires, Argentina
| | - Maria Florencia Lucion
- Epidemiology Department, Hospital de Niños Dr Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Jacinto Blas III V Mantaring
- Department of Clinical Epidemiology, University of the Philippines, Philippine General Hospital, Manila, Philippines
| | | | | | | | - Jorge Pinto
- Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Thanyawee Puthanakit
- Department of Pediatrics and Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Osvaldo Reyes
- Santo Tomás Hospital, Panama City, Panama
- Centro de Vacunación Internacional S.A., La Chorrera, Panama
- Member of the Sistema Nacional de Investigadores (SNI), Panama City, Panama
| | - Maria Fernanda Roa
- Department of Pediatrics, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Camilo Enrique Rodriguez
- Department of Gynecology and Obstetrics, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
- School of Medicine, University of the Andes, Bogotá, Colombia
| | | | - Alexandre Vargas Schwarzbold
- Hospital Universitário de Santa Maria, Centro de Pesquisa Clínica, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Alexandra Sierra Garcia
- Centro de Estudios en Infectología Pediátrica, Department of Pediatrics, Universidad del Valle, Valle del Cauca, Colombia
- Clinica Imbanaco, Grupo Quironsalud, Cali, Colombia
| | - Lavitha Sivapatham
- Department of Obstetrics and Gynecology, Ampang Hospital, Ampang, Malaysia
| | - Ruey Soon
- Department of Obstetrics and Gynecology, Sabah Women's and Children's Hospital, Kota Kinabalu, Malaysia
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10
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Ciszewski J, Taniuchi M, Lee B, Colgate ER, Platts-Mills JA, Haque R, Zaman K, Lopman B, Petri WA, Kirkpatrick BD, Rogawski McQuade ET. Differences in Rotavirus Shedding and Duration by Infant Oral Rotavirus Vaccination Status in Dhaka, Bangladesh 2011 - 2014. J Infect Dis 2023:jiad502. [PMID: 38019181 DOI: 10.1093/infdis/jiad502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/27/2023] [Accepted: 11/09/2023] [Indexed: 11/30/2023] Open
Abstract
To evaluate how breakthrough rotavirus disease contributes to transmission, we examined the impact of rotavirus vaccination on fecal shedding and duration of illness. We used multivariable linear regression to analyze rotavirus quantity by RT-qPCR and duration among 184 episodes of rotavirus diarrhea positive by ELISA in the PROVIDE study. Vaccinated children had less fecal viral shedding compared to unvaccinated children (mean difference = -0.59 log copies per gram of stool, 95% CI: -0.99, -0.19). Duration of illness was on average 0.47 days (95% CI: -0.23, 1.17) shorter among vaccinated children. Rotarix vaccination reduces shedding burden among breakthrough cases of RVGE.
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Affiliation(s)
- Jenna Ciszewski
- Department of Epidemiology, Emory University, Atlanta, GA, USA
| | - Mami Taniuchi
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
- Department of Civil and Environmental Engineering, University of Virginia, VA, USA
| | - Benjamin Lee
- Department of Paediatrics, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - E Ross Colgate
- Department of Microbiology and Molecular Genetics, Vaccine Testing Center, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - K Zaman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Benjamin Lopman
- Department of Epidemiology, Emory University, Atlanta, GA, USA
| | - William A Petri
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Beth D Kirkpatrick
- Department of Microbiology and Molecular Genetics, Vaccine Testing Center, Larner College of Medicine, University of Vermont, Burlington, VT, USA
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11
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Tadesse BT, Khanam F, Ahmmed F, Liu X, Islam MT, Kim DR, Kang SS, Im J, Chowdhury F, Ahmed T, Aziz AB, Hoque M, Park J, Pak G, Jeon HJ, Zaman K, Khan AI, Kim JH, Marks F, Qadri F, Clemens JD. Association Among Household Water, Sanitation, and Hygiene (WASH) Status and Typhoid Risk in Urban Slums: Prospective Cohort Study in Bangladesh. JMIR Public Health Surveill 2023; 9:e41207. [PMID: 37983081 PMCID: PMC10696503 DOI: 10.2196/41207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/30/2023] [Accepted: 10/05/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Typhoid fever, or enteric fever, is a highly fatal infectious disease that affects over 9 million people worldwide each year, resulting in more than 110,000 deaths. Reduction in the burden of typhoid in low-income countries is crucial for public health and requires the implementation of feasible water, sanitation, and hygiene (WASH) interventions, especially in densely populated urban slums. OBJECTIVE In this study, conducted in Mirpur, Bangladesh, we aimed to assess the association between household WASH status and typhoid risk in a training subpopulation of a large prospective cohort (n=98,087), and to evaluate the performance of a machine learning algorithm in creating a composite WASH variable. Further, we investigated the protection associated with living in households with improved WASH facilities and in clusters with increasing prevalence of such facilities during a 2-year follow-up period. METHODS We used a machine learning algorithm to create a dichotomous composite variable ("Better" and "Not Better") based on 3 WASH variables: private toilet facility, safe drinking water source, and presence of water filter. The algorithm was trained using data from the training subpopulation and then validated in a distinct subpopulation (n=65,286) to assess its sensitivity and specificity. Cox regression models were used to evaluate the protective effect of living in "Better" WASH households and in clusters with increasing levels of "Better" WASH prevalence. RESULTS We found that residence in households with improved WASH facilities was associated with a 38% reduction in typhoid risk (adjusted hazard ratio=0.62, 95% CI 0.49-0.78; P<.001). This reduction was particularly pronounced in individuals younger than 10 years at the first census participation, with an adjusted hazard ratio of 0.49 (95% CI 0.36-0.66; P<.001). Furthermore, we observed an inverse relationship between the prevalence of "Better" WASH facilities in clusters and the incidence of typhoid, although this association was not statistically significant in the multivariable model. Specifically, the adjusted hazard of typhoid decreased by 0.996 (95% CI 0.986-1.006) for each percent increase in the prevalence of "Better" WASH in the cluster (P=.39). CONCLUSIONS Our findings demonstrate that existing variations in household WASH are associated with differences in the risk of typhoid in densely populated urban slums. This suggests that attainable improvements in WASH facilities can contribute to enhanced typhoid control, especially in settings where major infrastructural improvements are challenging. These findings underscore the importance of implementing and promoting comprehensive WASH interventions in low-income countries as a means to reduce the burden of typhoid and improve public health outcomes in vulnerable populations.
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Affiliation(s)
- Birkneh Tilahun Tadesse
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Farhana Khanam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Faisal Ahmmed
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Xinxue Liu
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, United Kingdom
| | - Md Taufiqul Islam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Deok Ryun Kim
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Sophie Sy Kang
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Justin Im
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Fahima Chowdhury
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Tasnuva Ahmed
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Asma Binte Aziz
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Masuma Hoque
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Juyeon Park
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Gideok Pak
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Hyon Jin Jeon
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Khalequ Zaman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Ashraful Islam Khan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Jerome H Kim
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Florian Marks
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar
| | - Firdausi Qadri
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - John D Clemens
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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12
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Islam MT, Im J, Ahmmed F, Kim DR, Tadesse BT, Kang S, Khanam F, Chowdhury F, Ahmed T, Firoj MG, Aziz AB, Hoque M, Park J, Jeon HJ, Kanungo S, Dutta S, Zaman K, Khan AI, Marks F, Kim JH, Qadri F, Clemens JD. Better Existing Water, Sanitation, and Hygiene Can Reduce the Risk of Cholera in an Endemic Setting: Results From a Prospective Cohort Study From Kolkata, India. Open Forum Infect Dis 2023; 10:ofad535. [PMID: 38023545 PMCID: PMC10662546 DOI: 10.1093/ofid/ofad535] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Global cholera control efforts rely heavily on effective water, sanitation, and hygiene (WASH) interventions in cholera-endemic settings. Methods Using data from a large, randomized controlled trial of oral cholera vaccine conducted in Kolkata, India, we evaluated whether natural variations in WASH in an urban slum setting were predictive of cholera risk. From the control population (n = 55 086), baseline WASH data from a randomly selected "training subpopulation" (n = 27 634) were analyzed with recursive partitioning to develop a dichotomous ("better" vs "not better") composite household WASH variable from several WASH features collected at baseline, and this composite variable was then evaluated in a mutually exclusive "validation population" (n = 27 452). We then evaluated whether residents of better WASH households in the entire population (n = 55 086) experienced lower cholera risk using Cox regression models. Better WASH was defined by a combination of 4 dichotomized WASH characteristics including safe source of water for daily use, safe source of drinking water, private or shared flush toilet use, and always handwashing with soap after defecation. Results Residence in better WASH households was associated with a 30% reduction in risk of cholera over a 5-year period (adjusted hazard ratio, 0.70 [95% confidence interval, .49-.99]; P = .048). We also found that the impact of better WASH households on reducing cholera risk was greatest in young children (0-4 years) and this effect progressively declined with age. Conclusions The evidence suggests that modest improvements in WASH facilities and behaviors significantly modify cholera risk and may be an important component of cholera prevention and elimination strategies in endemic settings. Clinical Trials Registration. NCT00289224.
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Affiliation(s)
- Md Taufiqul Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Justin Im
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Faisal Ahmmed
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Deok Ryun Kim
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Birkneh Tilahun Tadesse
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Sophie Kang
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Farhana Khanam
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Fahima Chowdhury
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Tasnuva Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Golam Firoj
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Asma Binte Aziz
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Masuma Hoque
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Juyeon Park
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Hyon Jin Jeon
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Suman Kanungo
- National Institute of Cholera and Enteric Diseases, Indian Council of Medical Research, Kolkata, West Bengal, India
| | - Shanta Dutta
- National Institute of Cholera and Enteric Diseases, Indian Council of Medical Research, Kolkata, West Bengal, India
| | - Khalequ Zaman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Ashraful Islam Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Florian Marks
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Jerome H Kim
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Firdausi Qadri
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - John D Clemens
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Epidemiology, Public Health, Impact Unit, International Vaccine Institute, Seoul, Republic of Korea
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
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13
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Snider CJ, Zaman K, Wilkinson AL, Binte Aziz A, Yunus M, Haque W, Jones KAV, Wei L, Estivariz CF, Konopka-Anstadt JL, Mainou BA, Patel JC, Lickness JS, Pallansch MA, Wassilak SGF, Steven Oberste M, Anand A. Poliovirus type 1 systemic humoral and intestinal mucosal immunity induced by monovalent oral poliovirus vaccine, fractional inactivated poliovirus vaccine, and bivalent oral poliovirus vaccine: A randomized controlled trial. Vaccine 2023; 41:6083-6092. [PMID: 37652822 PMCID: PMC10895964 DOI: 10.1016/j.vaccine.2023.08.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/10/2023] [Accepted: 08/22/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND To inform response strategies, we examined type 1 humoral and intestinal immunity induced by 1) one fractional inactivated poliovirus vaccine (fIPV) dose given with monovalent oral poliovirus vaccine (mOPV1), and 2) mOPV1 versus bivalent OPV (bOPV). METHODS We conducted a randomized, controlled, open-label trial in Dhaka, Bangladesh. Healthy infants aged 5 weeks were block randomized to one of four arms: mOPV1 at age 6-10-14 weeks/fIPV at 6 weeks (A); mOPV1 at 6-10-14 weeks/fIPV at 10 weeks (B); mOPV1 at 6-10-14 weeks (C); and bOPV at 6-10-14 weeks (D). Immune response at 10 weeks and cumulative response at 14 weeks was assessed among the modified intention-to-treat population, defined as seroconversion from seronegative (<1:8 titers) to seropositive (≥1:8) or a four-fold titer rise among seropositive participants sustained to age 18 weeks. We examined virus shedding after two doses of mOPV1 with and without fIPV, and after the first mOPV1 or bOPV dose. The trial is registered at ClinicalTrials.gov (NCT03722004). FINDINGS During 18 December 2018 - 23 November 2019, 1,192 infants were enrolled (arms A:301; B:295; C:298; D:298). Immune responses at 14 weeks did not differ after two mOPV1 doses alone (94% [95% CI: 91-97%]) versus two mOPV1 doses with fIPV at 6 weeks (96% [93-98%]) or 10 weeks (96% [93-98%]). Participants who received mOPV1 and fIPV at 10 weeks had significantly lower shedding (p < 0·001) one- and two-weeks later compared with mOPV1 alone. Response to one mOPV1 dose was significantly higher than one bOPV dose (79% versus 67%; p < 0·001) and shedding two-weeks later was significantly higher after mOPV1 (76% versus 56%; p < 0·001) indicating improved vaccine replication. Ninety-nine adverse events were reported, 29 serious including two deaths; none were attributed to study vaccines. INTERPRETATION Given with the second mOPV1 dose, fIPV improved intestinal immunity but not humoral immunity. One mOPV1 dose induced higher humoral and intestinal immunity than bOPV. FUNDING U.S. Centers for Disease Control and Prevention.
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Affiliation(s)
- Cynthia J Snider
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA
| | - Khalequ Zaman
- icddr,b, 68 Shahid Tajuddin Ahmed Sarani, Dhaka 1212, Bangladesh
| | - Amanda L Wilkinson
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA.
| | - Asma Binte Aziz
- icddr,b, 68 Shahid Tajuddin Ahmed Sarani, Dhaka 1212, Bangladesh
| | - Mohammad Yunus
- icddr,b, 68 Shahid Tajuddin Ahmed Sarani, Dhaka 1212, Bangladesh
| | - Warda Haque
- icddr,b, 68 Shahid Tajuddin Ahmed Sarani, Dhaka 1212, Bangladesh
| | - Kathryn A V Jones
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA
| | - Ling Wei
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA
| | - Concepcion F Estivariz
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA
| | | | - Bernardo A Mainou
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA
| | - Jaymin C Patel
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA
| | - Jacquelyn S Lickness
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA
| | - Mark A Pallansch
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA
| | - Steven G F Wassilak
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA
| | - M Steven Oberste
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA
| | - Abhijeet Anand
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta, GA 30329, USA
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Wilkinson AL, Zaman K, Hoque M, Estivariz CF, Burns CC, Konopka-Anstadt JL, Mainou BA, Kovacs SD, An Q, Lickness JS, Yunus M, Snider CJ, Zhang Y, Coffee E, Abid T, Wassilak SGF, Pallansch MA, Oberste MS, Vertefeuille JF, Anand A. Immunogenicity of novel oral poliovirus vaccine type 2 administered concomitantly with bivalent oral poliovirus vaccine: an open-label, non-inferiority, randomised, controlled trial. Lancet Infect Dis 2023; 23:1062-1071. [PMID: 37178706 PMCID: PMC10503264 DOI: 10.1016/s1473-3099(23)00139-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Novel oral poliovirus vaccine type 2 (nOPV2) was developed by modifying the Sabin strain to increase genetic stability and reduce risk of seeding new circulating vaccine-derived poliovirus type 2 outbreaks. Bivalent oral poliovirus vaccine (bOPV; containing Sabin types 1 and 3) is the vaccine of choice for type 1 and type 3 outbreak responses. We aimed to assess immunological interference between nOPV2 and bOPV when administered concomitantly. METHODS We conducted an open-label, non-inferiority, randomised, controlled trial at two clinical trial sites in Dhaka, Bangladesh. Healthy infants aged 6 weeks were randomly assigned (1:1:1) using block randomisation, stratified by site, to receive nOPV2 only, nOPV2 plus bOPV, or bOPV only, at the ages of 6 weeks, 10 weeks, and 14 weeks. Eligibility criteria included singleton and full term (≥37 weeks' gestation) birth and parents intending to remain in the study area for the duration of study follow-up activities. Poliovirus neutralising antibody titres were measured at the ages of 6 weeks, 10 weeks, 14 weeks, and 18 weeks. The primary outcome was cumulative immune response for all three poliovirus types at the age of 14 weeks (after two doses) and was assessed in the modified intention-to-treat population, which was restricted to participants with adequate blood specimens from all study visits. Safety was assessed in all participants who received at least one dose of study product. A non-inferiority margin of 10% was used to compare single and concomitant administration. This trial is registered with ClinicalTrials.gov, NCT04579510. FINDINGS Between Feb 8 and Sept 26, 2021, 736 participants (244 in the nOPV2 only group, 246 in the nOPV2 plus bOPV group, and 246 in the bOPV only group) were enrolled and included in the modified intention-to-treat analysis. After two doses, 209 (86%; 95% CI 81-90) participants in the nOPV2 only group and 159 (65%; 58-70) participants in the nOPV2 plus bOPV group had a type 2 poliovirus immune response; 227 (92%; 88-95) participants in the nOPV2 plus bOPV group and 229 (93%; 89-96) participants in the bOPV only group had a type 1 response; and 216 (88%; 83-91) participants in the nOPV2 plus bOPV group and 212 (86%; 81-90) participants in the bOPV only group had a type 3 response. Co-administration was non-inferior to single administration for types 1 and 3, but not for type 2. There were 15 serious adverse events (including three deaths, one in each group, all attributable to sudden infant death syndrome); none were attributed to vaccination. INTERPRETATION Co-administration of nOPV2 and bOPV interfered with immunogenicity for poliovirus type 2, but not for types 1 and 3. The blunted nOPV2 immunogenicity we observed would be a major drawback of using co-administration as a vaccination strategy. FUNDING The US Centers for Disease Control and Prevention.
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Affiliation(s)
| | - Khalequ Zaman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Masuma Hoque
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Cara C Burns
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | - Qian An
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Mohammad Yunus
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Yiting Zhang
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Talha Abid
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | | | - Abhijeet Anand
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
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15
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Takeuchi H, Hasan SMT, Zaman K, Takanashi S, Hore SK, Yeasmin S, Ahmad SM, Alam MJ, Jimba M, Iwata T, Khan MA. Correction to: Impact of Haemophilus influenzae type b combination vaccination on asthma symptoms and pneumonia in 5-year-old children in rural Bangladesh: a longitudinal study and comparison with a previous cross-sectional study. Respir Res 2023; 24:210. [PMID: 37620870 PMCID: PMC10463310 DOI: 10.1186/s12931-023-02502-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Affiliation(s)
- Haruko Takeuchi
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo, 113-0033, Japan.
| | - S M Tafsir Hasan
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Khalequ Zaman
- Infectious Diseases Division, icddr,b, 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Sayaka Takanashi
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo, 113-0033, Japan
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku City, Tokyo, 162-8640, Japan
| | - Samar Kumar Hore
- Organization for Population Health Environment & Nutrition, Adilpur Shastitala, Taltala Kheyaghat Road, Abhaynagar, Jashore, 7460, Bangladesh
| | - Sultana Yeasmin
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Shaikh Meshbahuddin Ahmad
- Infectious Diseases Division, icddr,b, 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
- Department of Biochemistry and Microbiology, North South University, Bashundhara, Dhaka, 1212, Bangladesh
| | - Md Jahangir Alam
- Infectious Diseases Division, icddr,b, 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
- Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo, 113-0033, Japan
| | - Tsutomu Iwata
- The Graduate School of Humanities and Life Sciences, Tokyo Kasei University, 1-18-1 Kaga, Itabashi City, Tokyo, 173-8602, Japan
| | - Md Alfazal Khan
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
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16
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Englund JA, Cohen RA, Bianco V, Domachowske JB, Langley JM, Madhi SA, Zaman K, Bueso A, Ceballos A, Cousin L, Gandhi S, Gruselle O, Jose L, Klein NP, Koen A, Puthanaki T, Shi M, Silas P, Tangsathapornpong A, Teeratakulpisarn J, Vesikari T, Haars G, Leach A, Stoszek SK, Dieussaert I. Evaluation of clinical case definitions for respiratory syncytial virus lower respiratory tract infection in young children. J Pediatric Infect Dis Soc 2023:7152632. [PMID: 37142551 DOI: 10.1093/jpids/piad028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND Various case definitions of respiratory syncytial virus lower respiratory tract infection (RSV-LRTI) are currently proposed. We assessed the performance of three clinical case definitions against the World Health Organization definition recommended in 2015 (WHO 2015). METHODS In this prospective cohort study conducted in eight countries, 2401 children were followed up during 2 years from birth. Suspected LRTIs were detected via active and passive surveillance, followed by in-person clinical evaluation including single timepoint respiratory rate and oxygen saturation (by pulse oximetry) assessment, and nasopharyngeal sampling for RSV testing by polymerase chain reaction. Agreement between case definitions was evaluated using Cohen's κ statistics. RESULTS Of 1652 suspected LRTIs, 227 met the WHO 2015 criteria for RSV-LRTI; 73 were classified as severe. All alternative definitions were highly concordant with the WHO 2015 definition for RSV-LRTI (κ: 0.95-1.00), but less concordant for severe RSV-LRTI (κ: 0.47-0.82). Tachypnea was present for 196/226 (86.7%) WHO 2015 RSV-LRTIs and 168/243 (69.1%) LRTI/bronchiolitis/pneumonia cases, clinically diagnosed by non-study physicians. Low oxygen saturation levels were observed in only 55/226 (24.3%) WHO 2015 RSV-LRTIs. CONCLUSION Three case definitions for RSV-LRTI showed high concordance with the WHO 2015 definition, while agreement was lower for severe RSV-LRTI. In contrast to increased respiratory rate, low oxygen saturation was not a consistent finding in RSV-LRTIs and severe RSV-LRTIs. This study demonstrates that current definitions are highly concordant for RSV-LRTIs, but a standard definition is still needed for severe RSV-LRTI.
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Affiliation(s)
- Janet A Englund
- Seattle Children's Research Institute/University of Washington, Seattle, Washington, 98105, US
| | | | | | - Joseph B Domachowske
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, New York, 13210, US
| | - Joanne M Langley
- Canadian Center for Vaccinology (Dalhousie University, IWK Health and Nova Scotia Health), Halifax, Nova Scotia B3K 6R8, Canada
| | - Shabir A Madhi
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Khalequ Zaman
- International Centre for Diarrheal Disease, Dhaka 1212, Bangladesh
| | | | - Ana Ceballos
- Instituto Médico Río Cuarto, X5800 Río Cuarto, Córdoba, Argentina
| | | | | | | | - Lisa Jose
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Nicola P Klein
- Kaiser Permanente Vaccine Study Center, Oakland, California, 94612, US
| | - Anthonet Koen
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Thanyawee Puthanaki
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Meng Shi
- GSK, Rockville, Maryland, 20850, US
| | - Peter Silas
- Wee Care Pediatrics, Syracuse, Utah, 84075, US
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17
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Khanam F, Kim DR, Liu X, Voysey M, Pitzer VE, Zaman K, Pollard AJ, Qadri F, Clemens JD. Assessment of vaccine herd protection in a cluster-randomised trial of Vi conjugate vaccine against typhoid fever: results of further analysis. EClinicalMedicine 2023; 58:101925. [PMID: 37090439 PMCID: PMC10114505 DOI: 10.1016/j.eclinm.2023.101925] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 04/25/2023] Open
Abstract
Background A cluster-randomised trial of Vi-tetanus toxoid (Vi-TT) conjugate vaccine conducted in urban Bangladeshi children found a high level of direct protection by Vi-TT but no significant vaccine herd protection. We reassessed the trial using a "fried egg" analysis to evaluate whether herd protection might have been obscured by transmission of typhoid into the clusters from the outside. Methods A participant- and observer-blind, cluster-randomised trial was conducted between February 14, 2018 and August 12, 2019 in three wards of Mirpur, a densely populated urban area of Dhaka, Bangladesh. Children 9 months to under 16 years of age in 150 geographic clusters, which had a total of 311,289 persons present at baseline or entering during follow-up, were randomised by cluster to a single-dose of Vi-TT or Japanese encephalitis (JE) vaccine. Vi-TT protection against typhoid fever, detected at 8 treatment centres serving the study population, was compared in the original clusters for the trial, and for progressively more central subclusters ("yolks" of the "fried egg") of the cluster residents. If transmission of typhoid into the clusters had diluted observed vaccine herd protection, we hypothesised that analysis of the innermost "yolks" would reveal vaccine herd protection that was not evident in analysis of the entire clusters. The trial is registered at www.isrctn.com as ISRCTN11643110. Findings At ≤18 months of follow-up, total vaccine effectiveness (protection of Vi-TT recipients relative to JE vaccine recipients) was 85% (95% CI: 76%, 90%); indirect effectiveness (protection of non-Vi-TT recipients in Vi-TT clusters relative to non-JE vaccine recipients in JE vaccine clusters) was 17% (95% CI: -13%, 40%); and overall effectiveness (protection of all residents in the Vi-TT clusters relative to all residents of the JE vaccine clusters) was 57% (95% CI: 44%, 66%). Analyses of subpopulations in inner 75%, 50% and 25% "yolks" of the clusters failed to reveal significant changes in any of these estimates. Interpretation Our analysis did not reveal Vi-TT herd protection in the trial. Consideration should be given to exploring whether targeting adults as well as children with Vi-TT yields appreciable levels of vaccine herd protection. Funding Bill & Melinda Gates Foundation (OPP1151153, INV-025388).
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Affiliation(s)
- Farhana Khanam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Corresponding author. Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
| | | | - Xinxue Liu
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Merryn Voysey
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Virginia E. Pitzer
- Department of Epidemiology of Microbial Disease and Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - K. Zaman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Andrew J. Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Firdausi Qadri
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - John D. Clemens
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- International Vaccine Institute, Seoul, South Korea
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Center for Vaccine Innovation, Korea University, Seoul, South Korea
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18
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Chowdhury F, Aziz AB, Ahmmed F, Ahmed T, Kang SS, Im J, Park J, Tadesse BT, Islam MT, Kim DR, Hoque M, Pak G, Khanam F, McMillan NAJ, Liu X, Zaman K, Khan AI, Kim JH, Marks F, Qadri F, Clemens JD. The interplay between WASH practices and vaccination with oral cholera vaccines in protecting against cholera in urban Bangladesh: Reanalysis of a cluster-randomized trial. Vaccine 2023; 41:2368-2375. [PMID: 36898931 PMCID: PMC10102718 DOI: 10.1016/j.vaccine.2023.02.054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 02/06/2023] [Accepted: 02/16/2023] [Indexed: 03/11/2023]
Abstract
The current global initiative to end Cholera by 2030 emphasizes the use of oral cholera vaccine (OCV) combined with feasible household Water-Sanitation-Hygiene (WASH) interventions. However, little is known about how improved WASH practices and behaviors and OCV interact to reduce the risk of cholera. We reanalyzed two arms of a cluster-randomized trial in urban Bangladesh, to evaluate the effectiveness of OCV given as a 2-dose regimen. One arm (30 clusters, n = 94,675) was randomized to vaccination of persons aged one year and older with OCV, and the other arm (30 clusters, n = 80,056) to no intervention. We evaluated the prevention of cholera by household WASH, classified at baseline using a previously validated rule, and OCV over 2 years of follow-up. When analyzed by assignment to OCV clusters rather than receipt of OCV, in comparison to persons living in "Not Better WASH" households in the control clusters, reduction of severe cholera (the primary outcome) was similar for persons in "Not Better WASH" households in vaccine clusters (46%, 95% CI:24,62), for persons in "Better WASH" households in the control clusters (48%, 95% CI:25,64), and for persons in "Better WASH" households in the vaccine clusters (48%, 95% CI:16,67). In contrast, when analyzed by actual receipt of a complete OCV regimen, , in comparison to persons in "Not Better WASH" households in the control clusters, protection against severe cholera increased steadily from 39% (95% CI:13,58) in residents of "Better WASH" households in the control clusters to 57% (95% CI:35,72) in vaccinated persons in "Not Better WASH" households to 63% (95% CI:21,83) in vaccinated persons in "Better WASH" households. This analysis suggests that improved household WASH and OCV received may interact to provide greater protection against cholera. However, the divergence between findings related to intent to vaccinate versus those pertaining to actual receipt of OCV underscores the need for further research on this topic.
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Affiliation(s)
- Fahima Chowdhury
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh; Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | | | - Faisal Ahmmed
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Tasnuva Ahmed
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Sophie Sy Kang
- International Vaccine Institute, Seoul, Republic of Korea
| | - Justin Im
- International Vaccine Institute, Seoul, Republic of Korea
| | - Juyeon Park
- International Vaccine Institute, Seoul, Republic of Korea; Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | | | - Md Taufiqul Islam
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Deok Ryun Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Masuma Hoque
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Gideok Pak
- International Vaccine Institute, Seoul, Republic of Korea
| | - Farhana Khanam
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Nigel A J McMillan
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Xinxue Liu
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford OX3 9DU, United Kingdom
| | - Khalequ Zaman
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Ashraful Islam Khan
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Jerome H Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Florian Marks
- International Vaccine Institute, Seoul, Republic of Korea; Department of Medicine, University of Cambridge, Cambridge, United Kingdom; University of Antananarivo, Antananarivo, Madagascar
| | - Firdausi Qadri
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - John D Clemens
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh; International Vaccine Institute, Seoul, Republic of Korea; UCLA Fielding School of Public Health, Los Angeles, CA 90095-1772, USA
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19
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Øverbø J, Aziz A, Zaman K, Clemens J, Halle Julin C, Qadri F, Stene-Johansen K, Biswas R, Islam S, Rahman Bhuiyan T, Haque W, Sandbu S, Elahee ME, Ali M, Dembinski JL, Dudman S. Immunogenicity and safety of a two-dose regimen with hepatitis E virus vaccine in healthy adults in rural Bangladesh: A randomized, double-blind, controlled, phase 2/pilot trial. Vaccine 2023; 41:1059-1066. [PMID: 36599736 DOI: 10.1016/j.vaccine.2022.12.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Hepatitis E virus (HEV) is a major cause of acute viral hepatitis worldwide and it contributes to considerable maternal and neonatal mortality and morbidity in many low-income countries like Bangladesh. A three-dose regimen of a vaccine against HEV (HEV 239) has shown promising results in China. The effects and safety of this vaccine in other populations and with different dosing regimens remains uncertain. OBJECTIVES Investigate the immune response and safety of a two-dose regimen with the HEV 239 vaccine among healthy adults. Examine the feasibility of conducting a larger HEV 239 vaccine trial in rural Bangladesh. METHODS One-hundred healthy men and non-pregnant women 16-39 years old were randomized in a 1:1 ratio to receive two doses of either the study (HEV) or control (Hepatitis B virus, HBV) vaccine (at 0, 1 month). Blood samples were collected at day 0, day 60 and 2 years after vaccination. The primary endpoints were the proportion and severity of adverse events up to 2 months after dose one and the longitudinal shift in anti-HEV IgG levels from day 0 to day 60 and 2 years after vaccination. RESULTS Adverse events to HEV 239 were comparable to the control vaccine, mild in severity and resolved within one to nine days. All participants in the study group seroconverted and achieved high levels of HEV IgG antibodies that remained positive for two years in all but one. A T-cell response was detected one month after HEV 239 vaccination. CONCLUSION Our results show that two doses of the HEV 239 vaccine produces broad and likely functional immune responses against HEV that remain for at least two years. The safety profile was acceptable and a phase four study of HEV 239 in rural Bangladesh is feasible. CLINICALTRIALS gov Identifier: NCT02759991.
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Affiliation(s)
- Joakim Øverbø
- Norwegian Institute of Public Health, Oslo, Norway; University of Oslo, Oslo, Norway.
| | - Asma Aziz
- University of Oslo, Oslo, Norway; International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh; International Vaccine Institute, Seoul, Republic of Korea
| | - K Zaman
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh
| | - John Clemens
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh; International Vaccine Institute, Seoul, Republic of Korea; UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | | | - Firdausi Qadri
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh
| | | | - Rajib Biswas
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh
| | - Shaumik Islam
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh
| | | | - Warda Haque
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh
| | - Synne Sandbu
- Norwegian Institute of Public Health, Oslo, Norway
| | - Manzoor E Elahee
- International Centre for Diarrheal Diseases Research (icddr,b), Dhaka, Bangladesh
| | | | | | - Susanne Dudman
- University of Oslo, Oslo, Norway; Oslo University Hospital, Oslo, Norway
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20
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Sarker AR, Khan AI, Islam MT, Chowdhury F, Khanam F, Kang S, Ahmmed F, Im J, Kim DR, Tadesse BT, Ahmed T, Aziz AB, Hoque M, Park J, Liu X, Pak G, Zaman K, Marks F, Kim JH, Clemens JD, Qadri F. Cost of oral cholera vaccine delivery in a mass immunization program for children in urban Bangladesh. Vaccine X 2022; 12:100247. [PMID: 36545347 PMCID: PMC9761845 DOI: 10.1016/j.jvacx.2022.100247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Cholera poses a substantial health burden in the developing world due to both epidemic and endemic diseases. The World Health Organization recommends oral cholera vaccines for mass vaccination campaigns in addition to traditional prevention practices and treatments in resource-poor settings. In many developing countries like Bangladesh, the major challenge behind implementing mass vaccination campaigns concerns the affordability of the oral cholera vaccine (OCV). Vaccination of children with OCV is not only an impactful approach for controlling cholera at the population level and reducing childhood morbidity but is also considered more cost-effective than vaccinating all ages. The aim of the study was to estimate the cost of an OCV campaign for children from a societal perspective using empirical study. A total of 66,311 children aged 1 to 14 years old were fully vaccinated with two doses of the OCV Shanchol while 9,035 individuals received one dose of this vaccine. The estimated societal cost per individual for full vaccination was US$ 6.11, which includes the cost of vaccine delivery estimated at US$ 1.95. The cost per single dose was estimated at US$ 2.86. The total provider cost for full vaccination was estimated at US$ 6.01 and the recipient cost at US$ 0.10. Our estimation of OCV delivery costs for children was relatively higher than what was found in a similar mass OCV campaign for all age groups, indicating that there may be additional cost factors to consider in targeted vaccine campaigns. This analysis provides useful benchmarks for the possible costs related to delivery of OCV to children and future OCV cost-effectiveness models should factor in these possible cost disparities. Attempts to reduce the cost per dose are likely to have a greater impact on the cost of similar vaccination campaigns in many resource-poor settings.
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Affiliation(s)
- Abdur Razzaque Sarker
- Population Studies Division, Bangladesh Institute of Development Studies (BIDS), Bangladesh,Health Economics Unit, University of Birmingham, Birmingham, United Kingdom
| | - Ashraful Islam Khan
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh,Corresponding author at: International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
| | - Md. Taufiqul Islam
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Fahima Chowdhury
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Farhana Khanam
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sophie Kang
- International Vaccine Institute, Seoul, Republic of Korea
| | - Faisal Ahmmed
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Justin Im
- International Vaccine Institute, Seoul, Republic of Korea
| | - Deok Ryun Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Birkneh Tilahun Tadesse
- International Vaccine Institute, Seoul, Republic of Korea,Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, 14186 Stockholm, Sweden,Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
| | - Tasnuva Ahmed
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Masuma Hoque
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Juyeon Park
- International Vaccine Institute, Seoul, Republic of Korea,Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge CB2 0AW, United Kingdom
| | - Xinxue Liu
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford OX3 9DU, United Kingdom
| | - Gideok Pak
- International Vaccine Institute, Seoul, Republic of Korea
| | - Khalequ Zaman
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Florian Marks
- International Vaccine Institute, Seoul, Republic of Korea,Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge CB2 0AW, United Kingdom,University of Antananarivo, Antananarivo, Madagascar,Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Jerome H. Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - John D. Clemens
- International Vaccine Institute, Seoul, Republic of Korea,UCLA Fielding School of Public Health, Los Angeles, CA 90095-1772, USA
| | - Firdausi Qadri
- International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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21
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Øverbø J, Aziz A, Zaman K, Julin CH, Qadri F, Stene-Johansen K, Biswas R, Islam S, Bhuiyan TR, Haque W, Sandbu S, Dembinski JL, Dudman S. Stability and Feasibility of Dried Blood Spots for Hepatitis E Virus Serology in a Rural Setting. Viruses 2022; 14:v14112525. [PMID: 36423134 PMCID: PMC9692628 DOI: 10.3390/v14112525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 11/16/2022] Open
Abstract
Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. In many low-income countries it causes large outbreaks and disproportionally affects pregnant women and their offspring. Surveillance studies to find effective preventive interventions are needed but are hampered by the lack of funding and infrastructure. Dried blood spots (DBS) offer an easier and more robust way to collect, transport, and store blood samples compared to plasma/serum samples, and could ease some of the barriers for such studies. In this study we optimize an HEV IgG ELISA for DBS samples and validate it on 300 paired DBS and plasma samples collected in rural areas of Bangladesh from participants in a HEV vaccine study. We demonstrate that HEV IgG in blood stored as DBS is stable for two months at up to 40 °C, and for five freeze-thaw cycles. The specificity was 97% and the overall sensitivity of the DBS assay was 81%. The sensitivity was higher in samples from vaccinated participants (100%) compared to previously infected participants (59%), reflecting a positive correlation between IgG titer and sensitivity. We found a strong correlation between DBS and plasma samples with an r2 of 0.90, but with a higher degree of difference between individual paired samples. Our study shows that DBS offers a stable alternative to plasma/serum for HEV IgG measurements and can facilitate serological studies, particularly in resource limited areas.
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Affiliation(s)
- Joakim Øverbø
- Norwegian Institute of Public Health, NO-0213 Oslo, Norway
- Department of Microbiology, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway
- Correspondence: (J.Ø.); (S.D.)
| | - Asma Aziz
- Department of Microbiology, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
- International Vaccine Institute, Seoul 08826, Republic of Korea
| | - K. Zaman
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | | | - Firdausi Qadri
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | | | - Rajib Biswas
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | - Shaumik Islam
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | | | - Warda Haque
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | - Synne Sandbu
- Norwegian Institute of Public Health, NO-0213 Oslo, Norway
| | | | - Susanne Dudman
- Department of Microbiology, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway
- Oslo University Hospital, NO-0424 Oslo, Norway
- Correspondence: (J.Ø.); (S.D.)
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22
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Velasquez-Portocarrero DE, Wang X, Cortese MM, Snider CJ, Anand A, Costantini VP, Yunus M, Aziz AB, Haque W, Parashar U, Sisay Z, Soeters HM, Hyde TB, Jiang B, Zaman K. Head-to-head comparison of the immunogenicity of RotaTeq and Rotarix rotavirus vaccines and factors associated with seroresponse in infants in Bangladesh: a randomised, controlled, open-label, parallel, phase 4 trial. Lancet Infect Dis 2022; 22:1606-1616. [PMID: 35961362 DOI: 10.1016/s1473-3099(22)00368-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/03/2022] [Accepted: 05/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND A head-to-head comparison of the most widely used oral rotavirus vaccines has not previously been done, particularly in a high child mortality setting. We therefore aimed to compare the immunogenicity of RotaTeq (Merck, Kenilworth, NJ, USA) and Rotarix (GlaxoSmithKline, Rixensart, Belgium) rotavirus vaccines in the same population and examined risk factors for low seroresponse. METHODS We did a randomised, controlled, open-label, parallel, phase 4 trial in urban slums within Mirpur and Mohakahli (Dhaka, Bangladesh). We enrolled eligible participants who were healthy infants aged 6 weeks and full-term (ie, >37 weeks' gestation). We randomly assigned participants (1:1), using block randomisation via a computer-generated electronic allocation with block sizes of 8, 16, 24, and 32, to receive either three RotaTeq vaccine doses at ages 6, 10, and 14 weeks or two Rotarix doses at ages 6 and 10 weeks without oral poliovirus vaccine. Coprimary outcomes were the rotavirus-specific IgA seroconversion in both vaccines, and the comparison of the rotavirus IgA seroconversion by salivary secretor phenotype in each vaccine arm. Seroconversion at age 18 weeks in the RotaTeq arm and age of 14 weeks in the Rotarix arm was used to compare the complete series of each vaccine. Seroconversion at age 14 weeks was used to compare two RotaTeq doses versus two Rotarix doses. Seroconversion at age 22 weeks was used to compare the immunogenicity at the same age after receiving the full vaccine series. Safety was assessed for the duration of study participation. This study is registered with ClinicalTrials.gov, NCT02847026. FINDINGS Between Sept 1 and Dec 8, 2016, a total of 1144 infants were randomly assigned to either the RotaTeq arm (n=571) or Rotarix arm (n=573); 1080 infants (531 in the RotaTeq arm and 549 in the Rotarix arm) completed the study. Rotavirus IgA seroconversion 4 weeks after the full series occurred in 390 (73%) of 531 infants age 18 weeks in the RotaTeq arm and 354 (64%) of 549 infants age 14 weeks in the Rotarix arm (p=0·01). At age 14 weeks, 4 weeks after two doses, RotaTeq recipients had lower seroconversion than Rotarix recipients (268 [50%] of 531 vs 354 [64%] of 549; p<0·0001). However, at age 22 weeks, RotaTeq recipients had higher seroconversion than Rotarix recipients (394 [74%] of 531 vs 278 [51%] of 549; p<0·0001). Among RotaTeq recipients, seroconversion 4 weeks after the third dose was higher than after the second dose (390 [73%] of 531 vs 268 [50%] of 531; p<0·0001]. In the RotaTeq arm, rotavirus IgA seroconversion was lower in non-secretors than in secretors at ages 14 weeks (p=0·08), 18 weeks (p=0·01), and 22 weeks (p=0·02). Similarly, in the Rotarix arm, rotavirus IgA seroconversion was lower in non-secretors than in secretors at ages 14 weeks (p=0·02) and 22 weeks (p=0·01). 65 (11%) of 571 infants had adverse events in the RotaTeq arm compared with 63 (11%) of 573 infants in the Rotarix arm; no adverse events were attributed to the use of either vaccine. One death due to aspiration occurred in the RotaTeq arm, which was not related to the vaccine. INTERPRETATION RotaTeq induced a higher magnitude and longer duration of rotavirus IgA response than Rotarix in this high child mortality setting. Additional vaccination strategies should be evaluated to overcome the suboptimal performance of current oral rotavirus vaccines in these settings. FUNDING US Centers for Disease Control and Prevention.
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Affiliation(s)
| | - Xiaoqian Wang
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Abhijeet Anand
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Md Yunus
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Asma B Aziz
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Warda Haque
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Umesh Parashar
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Zufan Sisay
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Heidi M Soeters
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Terri B Hyde
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Baoming Jiang
- US Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Khalequ Zaman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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23
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Islam MT, Date K, Khan AI, Bhuiyan TR, Khan ZH, Ahmed S, Hossain M, Khaton F, Zaman K, McMillan NAJ, Anand A, An Q, Zhang C, Weldon WC, Yu A, Luby S, Qadri F. Co-administration of Oral Cholera Vaccine With Oral Polio Vaccine Among Bangladeshi Young Children: A Randomized Controlled Open Label Trial to Assess Interference. Clin Infect Dis 2022; 76:263-270. [PMID: 36136760 PMCID: PMC9839191 DOI: 10.1093/cid/ciac782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/19/2022] [Accepted: 09/19/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cholera remains a public health threat for low- and middle-income countries, particularly in Asia and Africa. Shanchol™, an inactivated oral cholera vaccine (OCV) is currently in use globally. OCV and oral poliovirus vaccines (OPV) could be administered concomitantly, but the immunogenicity and safety of coadministration among children aged 1-3 years is unknown. METHODS We undertook an open-label, randomized, controlled, inequality trial in Dhaka city, Bangladesh. Healthy children aged 1-3 years were randomly assigned to 1 of 3 groups: bivalent OPV (bOPV)-alone, OCV-alone, or combined bOPV + OCV and received vaccines on the day of enrollment and 28 days later. Blood samples were collected on the day of enrollment, day 28, and day 56. Serum poliovirus neutralizing antibodies and vibriocidal antibodies against Vibrio cholerae O1 were assessed using microneutralization assays. RESULTS A total of 579 children aged 1‒3 years were recruited, 193 children per group. More than 90% of the children completed visits at day 56. Few adverse events following immunization were recorded and were equivalent among study arms. On day 28, 60% (90% confidence interval: 53%-67%) and 54% (46%-61%) of participants with co-administration of bOPV + OCV responded to polioviruses type 1 and 3, respectively, compared to 55% (47%-62%) and 46% (38%-53%) in the bOPV-only group. Additionally, >50% of participants showed a ≥4-fold increase in vibriocidal antibody titer responses on day 28, comparable to the responses observed in OCV-only arm. CONCLUSIONS Co-administration of bOPV and OCV is safe and effective in children aged 1-3 years and can be cost-beneficial. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (NCT03581734).
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Affiliation(s)
| | - Kashmira Date
- Current affiliation: Global Medical Affairs Lead for Vaccines, Global Public Health at Johnson & Johnson
| | - Ashraful Islam Khan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Taufiqur Rahman Bhuiyan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Zahid Hasan Khan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shamim Ahmed
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Motaher Hossain
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Fatema Khaton
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - K Zaman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Nigel A J McMillan
- Infectious Diseases and Immunology, Menzies Health Institute Queensland and School of Pharmacy and Medical Science, Griffith University, Gold Coast, Australia
| | - Abhijeet Anand
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Qian An
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Chenhua Zhang
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - William C Weldon
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alexander Yu
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Stephen Luby
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Firdausi Qadri
- Correspondence: F. Qadri, Mucosal Immunology and Vaccinology Unit, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh ()
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24
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Kang S, Chowdhury F, Park J, Ahmed T, Tadesse BT, Islam MT, Kim DR, Im J, Aziz AB, Hoque M, Pak G, Khanam F, Ahmmed F, Liu X, Zaman K, Khan AI, Kim JH, Marks F, Qadri F, Clemens JD. Are better existing WASH practices in urban slums associated with a lower long-term risk of severe cholera? A prospective cohort study with 4 years of follow-up in Mirpur, Bangladesh. BMJ Open 2022; 12:e060858. [PMID: 36130764 PMCID: PMC9494564 DOI: 10.1136/bmjopen-2022-060858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To investigate the association between existing household water quality, sanitation and hygiene (WASH) practices and severe cholera risk in a dense urban slum where cholera is highly endemic. DESIGN, SETTING AND PARTICIPANTS We assembled a large prospective cohort within a cluster randomised trial evaluating the effectiveness of oral cholera vaccine. Our dynamic cohort population (n=193 576) comprised individuals living in the 'non-intervention' clusters of the trial, and were followed over 4 years. This study was conducted in a dense urban slum community of Dhaka, Bangladesh and cholera surveillance was undertaken in 12 hospitals serving the study area. PRIMARY OUTCOME MEASURE First severe cholera episode detected during follow-up period. METHODS We applied a machine learning algorithm on a training subpopulation (n=96 943) to develop a binary ('better', 'not better') composite WASH variable predictive of severe cholera. The WASH rule was evaluated for performance in a separate validation subpopulation (n=96 633). Afterwards, we used Cox regression models to evaluate the association between 'better' WASH households and severe cholera risk over 4 years in the entire study population. RESULTS The 'better' WASH rule found that water quality and access were the most significant factors associated with severe cholera risk. Members of 'better' WASH households, constituting one-third of the population, had a 47% reduced risk of severe cholera (95% CI: 29 to 69; p<0.001), after adjusting for covariates. The protective association between living in a 'better' WASH household and severe cholera persisted in all age groups. CONCLUSIONS Salutary existing household WASH practices were associated with a significantly reduced long-term risk of severe cholera in an urban slum of Dhaka. These findings suggest that WASH adaptations already practised in the community may be important for developing and implementing effective and sustainable cholera control programmes in similar settings. TRIAL REGISTRATION NUMBER This article is a re-analysis of data from a cluster randomized trial; can be found on ClinicalTrials.gov NCT01339845.
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Affiliation(s)
- Sophie Kang
- Epidemiology, Public Health, and Impact Unit, International Vaccine Institute, Gwanak-gu, The Republic of Korea
| | - Fahima Chowdhury
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Griffith University Menzies Health Institute Queensland, Nathan, Queensland, Australia
| | - Juyeon Park
- Epidemiology, Public Health, and Impact Unit, International Vaccine Institute, Gwanak-gu, The Republic of Korea
| | - Tasnuva Ahmed
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Birkneh Tilahun Tadesse
- Epidemiology, Public Health, and Impact Unit, International Vaccine Institute, Gwanak-gu, The Republic of Korea
| | - Md Taufiqul Islam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Deok Ryun Kim
- Epidemiology, Public Health, and Impact Unit, International Vaccine Institute, Gwanak-gu, The Republic of Korea
| | - Justin Im
- Epidemiology, Public Health, and Impact Unit, International Vaccine Institute, Gwanak-gu, The Republic of Korea
| | - Asma Binte Aziz
- Epidemiology, Public Health, and Impact Unit, International Vaccine Institute, Gwanak-gu, The Republic of Korea
| | - Masuma Hoque
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Gideok Pak
- Epidemiology, Public Health, and Impact Unit, International Vaccine Institute, Gwanak-gu, The Republic of Korea
| | - Farhana Khanam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Faisal Ahmmed
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Xinxue Liu
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
| | - K Zaman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Ashraful Islam Khan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Jerome H Kim
- International Vaccine Institute, Gwanak-gu, The Republic of Korea
| | - Florian Marks
- Epidemiology, Public Health, and Impact Unit, International Vaccine Institute, Gwanak-gu, The Republic of Korea
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Firdausi Qadri
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - John D Clemens
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- International Vaccine Institute, Gwanak-gu, The Republic of Korea
- Fielding School of Public Health, University of California, Los Angeles, California, USA
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25
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Anser MK, Ahmad M, Khan MA, Nassani AA, Askar SE, Zaman K, Abro MMQ, Kabbani A. Prevention of COVID-19 pandemic through technological innovation: ensuring global innovative capability, absorptive capacity, and adaptive healthcare competency. Int J Environ Sci Technol (Tehran) 2022; 20:1-12. [PMID: 36093340 PMCID: PMC9440456 DOI: 10.1007/s13762-022-04494-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/24/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
The study examines the role of technology transfer in preventing communicable diseases, including COVID-19, in a heterogeneous panel of selected 65 countries. The study employed robust least square regression and innovation accounting matrixes to get robust inferences. The results found that overall technological innovation, including innovative capability, absorptive capacity, and healthcare competency, helps reduce infectious diseases, including the COVID-19 pandemic. Patent applications, scientific and technical journal articles, trade openness, hospital beds, and physicians are the main factors supporting the reduction of infectious diseases, including the COVID-19 pandemic. Due to inadequate research and development, healthcare infrastructure expenditures have caused many communicable diseases. The increasing number of mobile phone subscribers and healthcare expenditures cannot minimize the coronavirus pandemic globally. The impulse response function shows an increasing number of patent applications, mobile penetration, and hospital beds that will likely decrease infectious diseases, including COVID-19. In contrast, insufficient resource spending would likely increase death rates from contagious diseases over a time horizon. It is high time to digitalize healthcare policies to control coronavirus worldwide.
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Affiliation(s)
- M. K. Anser
- School of Public Administration, Xi’an University of Architecture and Technology, Xi’an, 710000 China
- Department of Business Administration, The Superior University, Lahore, 54000 Pakistan
| | - M. Ahmad
- School of Economics, Zhejiang University, Hangzhou, 310058 China
| | - M. A. Khan
- Department of Economics, The University of Haripur, Haripur, 22620 Pakistan
| | - A. A. Nassani
- Department of Management, College of Business Administration, King Saud University, P.O. Box 71115, Riyadh, 11587 Saudi Arabia
| | - S. E. Askar
- Department of Statistics and Operations Research, College of Science, King Saud University, P.O. Box 11451, Riyadh, 11587 Saudi Arabia
| | - K. Zaman
- Department of Management, Aleppo University, Aleppo, Syria
| | - M. M. Q. Abro
- Department of Management, College of Business Administration, King Saud University, P.O. Box 71115, Riyadh, 11587 Saudi Arabia
| | - A. Kabbani
- Department of Management, Aleppo University, Aleppo, Syria
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26
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Boni V, Pistilli B, Braña I, Shapiro GI, Trigo J, Moreno V, Castellano D, Fernández C, Kahatt C, Alfaro V, Siguero M, Zeaiter A, Longo F, Zaman K, Antón A, Paredes A, Huidobro G, Subbiah V. Lurbinectedin, a selective inhibitor of oncogenic transcription, in patients with pretreated germline BRCA1/2 metastatic breast cancer: results from a phase II basket study. ESMO Open 2022; 7:100571. [PMID: 36037567 PMCID: PMC9588879 DOI: 10.1016/j.esmoop.2022.100571] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Lurbinectedin, a selective inhibitor of oncogenic transcription, has shown preclinical antitumor activity against homologous recombination repair-deficient models and preliminary clinical activity in BRCA1/2 breast cancer. PATIENTS AND METHODS This phase II basket multitumor trial (NCT02454972) evaluated lurbinectedin 3.2 mg/m2 1-h intravenous infusion every 3 weeks in a cohort of 21 patients with pretreated germline BRCA1/2 breast cancer. Patients with any hormone receptor and human epidermal growth factor receptor 2 status were enrolled. The primary efficacy endpoint was overall response rate (ORR) according to RECIST v1.1. Secondary endpoints included duration of response (DoR), progression-free survival (PFS), overall survival (OS) and safety. RESULTS Confirmed partial response (PR) was observed in six patients [ORR = 28.6%; 95% confidence interval (CI) 11.3% to 52.2%] who had received a median of two prior advanced chemotherapy lines. Lurbinectedin was active in both BRCA mutations: four PRs in 11 patients (36.4%) with BRCA2 and two PRs in 10 patients (20.0%) with BRCA1. Median DoR was 8.6 months, median PFS was 4.1 months and median OS was 16.1 months. Stable disease (SD) was observed in 10 patients (47.6%), including 3 with unconfirmed response in a subsequent tumor assessment [ORR unconfirmed = 42.9% (95% CI 21.8% to 66.0%)]. Clinical benefit rate (PR + SD ≥ 4 months) was 76.2% (95% CI 52.8% to 91.8%). No objective response was observed among patients who had received prior poly (ADP-ribose) polymerase inhibitors. The most common treatment-related adverse events (AEs) were nausea (61.9%), fatigue (38.1%) and vomiting (23.8%). These AEs were mostly grade 1/2. The most common grade 3/4 toxicity was neutropenia (42.9%: grade 4, 23.8%: with no febrile neutropenia). CONCLUSIONS This phase II study met its primary endpoint and showed activity of lurbinectedin in germline BRCA1/2 breast cancer. Lurbinectedin showed a predictable and manageable safety profile. Considering the exploratory aim of this trial as well as previous results in other phase II studies, further development of lurbinectedin in this indication is warranted.
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Affiliation(s)
- V Boni
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Madrid, Spain
| | | | - I Braña
- Hospital Universitario Vall D'Hebron (VHIO), Barcelona, Spain
| | | | - J Trigo
- Hospital Universitario Virgen De La Victoria, IBIMA, Málaga, Spain
| | - V Moreno
- START Madrid-FJD, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - D Castellano
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - C Kahatt
- PharmaMar, Colmenar Viejo, Madrid, Spain
| | - V Alfaro
- PharmaMar, Colmenar Viejo, Madrid, Spain
| | - M Siguero
- PharmaMar, Colmenar Viejo, Madrid, Spain
| | - A Zeaiter
- PharmaMar, Colmenar Viejo, Madrid, Spain
| | - F Longo
- Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - K Zaman
- University Hospital CHUV, Lausanne, Switzerland
| | - A Antón
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - A Paredes
- Hospital Universitario Donostia, Donostia-San Sebastián, Spain
| | - G Huidobro
- Hospital Universitario de Vigo Alvaro Cunqueiro, Pontevedra, Spain
| | - V Subbiah
- The University of Texas MD Anderson Cancer Center, Houston, USA.
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27
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Langley JM, Bianco V, Domachowske JB, Madhi SA, Stoszek SK, Zaman K, Bueso A, Ceballos A, Cousin L, D'Andrea U, Dieussaert I, Englund JA, Gandhi S, Gruselle O, Haars G, Jose L, Klein NP, Leach A, Maleux K, Nguyen TLA, Puthanakit T, Silas P, Tangsathapornpong A, Teeratakulpisarn J, Vesikari T, Cohen RA. Incidence of respiratory syncytial virus lower respiratory tract infections during the first 2 years of life: A prospective study across diverse global settings. J Infect Dis 2022; 226:374-385. [PMID: 35668702 PMCID: PMC9417131 DOI: 10.1093/infdis/jiac227] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/01/2022] [Indexed: 11/15/2022] Open
Abstract
Background The true burden of lower respiratory tract infections (LRTIs) due to respiratory syncytial virus (RSV) remains unclear. This study aimed to provide more robust, multinational data on RSV-LRTI incidence and burden in the first 2 years of life. Methods This prospective, observational cohort study was conducted in Argentina, Bangladesh, Canada, Finland, Honduras, South Africa, Thailand, and United States. Children were followed for 24 months from birth. Suspected LRTIs were detected via active (through regular contacts) and passive surveillance. RSV and other viruses were detected from nasopharyngeal swabs using PCR-based methods. Results Of 2401 children, 206 (8.6%) had 227 episodes of RSV-LRTI. Incidence rates (IRs) of first episode of RSV-LRTI were 7.35 (95% confidence interval [CI], 5.88–9.08), 5.50 (95% CI, 4.21–7.07), and 2.87 (95% CI, 2.18–3.70) cases/100 person-years in children aged 0–5, 6–11, and 12–23 months. IRs for RSV-LRTI, severe RSV-LRTI, and RSV hospitalization tended to be higher among 0–5 month olds and in lower-income settings. RSV was detected for 40% of LRTIs in 0–2 month olds and for approximately 20% of LRTIs in older children. Other viruses were codetected in 29.2% of RSV-positive nasopharyngeal swabs. Conclusions A substantial burden of RSV-LRTI was observed across diverse settings, impacting the youngest infants the most. Clinical Trials Registration. NCT01995175.
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Affiliation(s)
- Joanne M Langley
- Canadian Center for Vaccinology (Dalhousie University, IWK Health and Nova Scotia Health) Halifax, Nova Scotia B3K 6R8, Canada
| | | | - Joseph B Domachowske
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, New York, NY 13210, US
| | - Shabir A Madhi
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg 2050, South Africa
| | | | - Khalequ Zaman
- International Centre for Diarrheal Disease, Dhaka 1212, Bangladesh
| | | | - Ana Ceballos
- Instituto Medico Rio Cuarto, X5800 Rio Cuarto, Cordoba, Argentina
| | - Luis Cousin
- Tecnologia en Investigacion, San Pedro Sula, 15032, Honduras
| | - Ulises D'Andrea
- Instituto Medico Rio Cuarto, X5800 Rio Cuarto, Cordoba, Argentina
| | | | - Janet A Englund
- Seattle Children's Research Institute/University of Washington, Seattle, Washington, WA 98105, US
| | | | | | | | - Lisa Jose
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Nicola P Klein
- Kaiser Permanente Vaccine Study Center, Oakland, California, CA 94612, US
| | | | | | | | - Thanyawee Puthanakit
- the Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Peter Silas
- Wee Care Pediatrics, Syracuse, Utah, UT 84075, US
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Aziz AB, Verma H, Jeyaseelan V, Yunus M, Nowrin S, Moore DD, Mainou BA, Mach O, Sutter RW, Zaman K. One Full or Two Fractional Doses of Inactivated Poliovirus Vaccine for Catch-up Vaccination in Older Infants: A Randomized Clinical Trial in Bangladesh. J Infect Dis 2022; 226:1319-1326. [PMID: 35575051 PMCID: PMC9574668 DOI: 10.1093/infdis/jiac205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/24/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The polio eradication endgame called for the removal of trivalent oral poliovirus vaccine (OPV) and introduction of bivalent (types 1 and 3) OPV and inactivated poliovirus vaccine (IPV). However, supply shortages have delayed IPV administration to tens of millions of infants, and immunogenicity data are currently lacking to guide catch-up vaccination policies. METHODS We conducted an open-label randomized clinical trial assessing 2 interventions, full or fractional-dose IPV (fIPV, one-fifth of IPV), administered at age 9-13 months with a second dose given 2 months later. Serum was collected at days 0, 60, 67, and 90 to assess seroconversion, priming, and antibody titer. None received IPV or poliovirus type 2-containing vaccines before enrolment. RESULTS A single fIPV dose at age 9-13 months yielded 75% (95% confidence interval [CI], 6%-82%) seroconversion against type 2, whereas 2 fIPV doses resulted in 100% seroconversion compared with 94% (95% CI, 89%-97%) after a single full dose (P < .001). Two doses of IPV resulted in 100% seroconversion. CONCLUSIONS Our study confirmed increased IPV immunogenicity when administered at an older age, likely due to reduced interference from maternally derived antibodies. Either 1 full dose of IPV or 2 doses of fIPV could be used to vaccinate missed cohorts, 2 fIPV doses being antigen sparing and more immunogenic. CLINICAL TRIAL REGISTRATION NCT03890497.
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Affiliation(s)
- Asma B Aziz
- Correspondence: Dr. Asma Binte Aziz, MBBS, MPH, PhD Research Fellow, International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, South Korea ()
| | | | | | - Mohammad Yunus
- International Centre for Diarrheal Disease, Bangladesh, Dhaka, Bangladesh
| | - Samarea Nowrin
- International Centre for Diarrheal Disease, Bangladesh, Dhaka, Bangladesh
| | - Deborah D Moore
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Ondrej Mach
- World Health Organization, Geneva, Switzerland
| | | | - Khalequ Zaman
- International Centre for Diarrheal Disease, Bangladesh, Dhaka, Bangladesh
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29
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Tadesse BT, Khanam F, Ahmed F, Im J, Islam MT, Kim DR, Kang SS, Liu X, Chowdhury F, Ahmed T, Aziz AB, Hoque M, Park J, Pak G, Zaman K, Khan AI, Pollard AJ, Kim JH, Marks F, Qadri F, Clemens JD. Prevention of typhoid by Vi conjugate vaccine and achievable improvements in household WASH: Evidence from a cluster-randomized trial in Dhaka, Bangladesh. Clin Infect Dis 2022; 75:1681-1687. [PMID: 35412603 DOI: 10.1093/cid/ciac289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Typhoid fever contributes to approximately 135,000 deaths annually. Achievable improvements in household water-hygiene-sanitation (WASH) combined with vaccination using typhoid conjugate vaccines (TCVs) may be an effective preventive strategy. However, little is known about how improved WASH and vaccination interact to lower the risk of typhoid. METHODS 61,654 urban Bangladeshi children aged 9 months to <16 years, residing in 150 clusters with a baseline population of 205,760 residents, were randomized 1: 1 by cluster to Vi-tetanus toxoid TCV or Japanese Encephalitis (JE) vaccine. Surveillance for blood culture-confirmed typhoid fever was conducted over two years. Existing household WASH status was assessed at baseline as Better or Not Better using previously validated criteria. The reduction in typhoid risk among all residents associated with living in TCV clusters, Better WASH households, or both was evaluated using mixed-effects Poisson regression models. RESULTS The adjusted reduced risk of typhoid among all residents living in the clusters assigned to TCV was 55% (95% confidence interval (CI): 43%,65%; p < 0.001), and that of living in Better WASH households, regardless of cluster, was 37% (95%CI: 24%,48%; p < 0.001). The highest risk of typhoid was observed in persons living in households with Not Better WASH in the JE clusters. In comparison with these persons, those living in households with Better WASH in the TCV clusters had an adjusted reduced risk of 71% (95%CI: 59%, 80%; p < 0.001). CONCLUSION Implementation of TCV programs combined with achievable and culturally acceptable household WASH practices were independently associated with a significant reduction in typhoid risk.
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Affiliation(s)
| | - Farhana Khanam
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Faisal Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Justin Im
- International Vaccine Institute, Seoul, Republic of Korea
| | - Md Taufiqul Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Deok Ryun Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Sophie Sy Kang
- International Vaccine Institute, Seoul, Republic of Korea
| | - Xinxue Liu
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford OX3 9DU, UK
| | - Fahima Chowdhury
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Tasnuva Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | - Masuma Hoque
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Juyeon Park
- International Vaccine Institute, Seoul, Republic of Korea.,Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK, CB2 0AW
| | - Gideok Pak
- International Vaccine Institute, Seoul, Republic of Korea
| | - Khalequ Zaman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Ashraful Islam Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford OX3 9DU, UK
| | - Jerome H Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Floriano Marks
- International Vaccine Institute, Seoul, Republic of Korea.,Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK, CB2 0AW.,University of Antananarivo, Antananarivo, Madagascar
| | - Firdausi Qadri
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - John D Clemens
- International Vaccine Institute, Seoul, Republic of Korea.,International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.,UCLA Fielding School of Public Health, Los Angeles, CA 90095-1772, USA
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Zaman K, Yunus M, Aziz AB, Feser J, Mooney J, Tang Y, Ellison DW, Thaisomboonsuk B, Zhang L, Neuzil KM, Marfin AA, Letson GW. Antibody persistence and immune memory response following primary vaccination and boosting with live attenuated SA 14-14-2 Japanese encephalitis vaccine (CD-JEV) in Bangladesh: A phase 4 open-label clinical trial. Vaccine X 2022; 10:100143. [PMID: 35243320 PMCID: PMC8857502 DOI: 10.1016/j.jvacx.2022.100143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/22/2021] [Accepted: 01/25/2022] [Indexed: 11/30/2022] Open
Abstract
Despite a lack of measurable antibody four years after primary vaccination, the anamnestic response to a booster dose of live, attenuated SA 14-14-2 Japanese encephalitis vaccine indicates immunity persists. Live, attenuated SA 14-14-2 Japanese encephalitis vaccine is safe and well-tolerated.
Introduction Japanese encephalitis (JE) virus is one of the leading causes of viral encephalitis across temperate and tropical zones of Asia. The live attenuated SA 14-14-2 JE vaccine (CD-JEV) is one of three vaccines prequalified by the World Health Organization (WHO) to prevent JE. WHO currently recommends a single CD-JEV dose for infants in endemic settings. However, in the absence of long-term immunogenicity data, WHO has indicated a need for long-term immunogenicity studies to inform optimal dosing schedules and determine the need for booster doses. Methods This Phase 4, open-label clinical study measured neutralizing antibody (NAb) titers in Bangladeshi children three and four years after primary CD-JEV vaccination and 7 and 28 days after a booster CD-JEV vaccination given four years after primary vaccination. The study also assessed the tolerability and safety of the booster dose. A NAb titer of ≥1:10 was considered seroprotective. Results Of 560 children vaccinated between 10 and 12 months of age with CD-JEV three years earlier and enrolled in this study from 30 July 2015 through 03 January 2016, 52 (9.3%; 95% CI: 7.2–12.0) had a seroprotective titer at enrollment. One year later, of 533 children, 66 (12.4%; 95% CI: 9.9–15.5) had a seroprotective titer before receiving a booster dose. Of 524 children who received a booster CD-JEV dose, 479 (91.4%; 95% CI: 88.7–93.5) and 514 (98.1%; 95% CI: 96.5–99.0) were seroprotected 7 and 28 days later, respectively. The geometric mean titer (GMT) was 6 (95% CI: 6–6) at baseline, 105 (95% CI: 93–119) 7 days post-booster, and 167 (95% CI: 152–183) 28 days post-booster. No vaccine-associated neurologic adverse events or other serious adverse events were noted following the booster dose. Conclusions Although most children did not have measurable antibody titers three and four years after a single primary CD-JEV dose, more than 90% of seronegative children had a strong anamnestic response within one week of a booster dose. This suggests that these children were immune despite the absence of measurable NAb prior to their booster. ClinicalTrials.gov Identifier: NCT02514746.
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Affiliation(s)
- K Zaman
- International Centre for Diarrheal Disease Research, 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Md Yunus
- International Centre for Diarrheal Disease Research, 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Asma B Aziz
- International Centre for Diarrheal Disease Research, 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Jodi Feser
- Center for Vaccine Innovation and Access, PATH, 2201 Westlake Ave, Suite 200, Seattle, Washington 98121, USA
| | - Jessica Mooney
- Center for Vaccine Innovation and Access, PATH, 2201 Westlake Ave, Suite 200, Seattle, Washington 98121, USA
| | - Yuxiao Tang
- Center for Vaccine Innovation and Access, PATH, 2201 Westlake Ave, Suite 200, Seattle, Washington 98121, USA
| | - Damon W Ellison
- Armed Forces Research Institute of Medicine Sciences, 315/6 Rajvithi Rd., Bangkok 10400, Thailand
| | - Butsaya Thaisomboonsuk
- Armed Forces Research Institute of Medicine Sciences, 315/6 Rajvithi Rd., Bangkok 10400, Thailand
| | - Lei Zhang
- Chengdu Institute of Biological Products Co., Ltd., 379, 3rd, Jinhua Road, Jinjiang District, Chengdu 61002, China
| | - Kathleen M Neuzil
- Center for Vaccine Innovation and Access, PATH, 2201 Westlake Ave, Suite 200, Seattle, Washington 98121, USA
| | - Anthony A Marfin
- Center for Vaccine Innovation and Access, PATH, 2201 Westlake Ave, Suite 200, Seattle, Washington 98121, USA
| | - G William Letson
- Center for Vaccine Innovation and Access, PATH, 2201 Westlake Ave, Suite 200, Seattle, Washington 98121, USA
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31
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Im J, Khanam F, Ahmmed F, Kim DR, Kang S, Tadesse BT, Chowdhury F, Ahmed T, Aziz AB, Hoque M, Islam MT, Park J, Liu X, Sur D, Pak G, Jeon HJ, Zaman K, Khan AI, Qadri F, Marks F, Kim JH, Clemens JD. Prevention of Typhoid Fever by Existing Improvements in Household Water, Sanitation, and Hygiene, and the Use of the Vi Polysaccharide Typhoid Vaccine in Poor Urban Slums: Results from a Cluster-Randomized Trial. Am J Trop Med Hyg 2022; 106:1149-1155. [PMID: 35385827 PMCID: PMC8991341 DOI: 10.4269/ajtmh.21-1034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/12/2021] [Indexed: 11/07/2022] Open
Abstract
Modest improvements in household water, sanitation, and hygiene (WASH) and typhoid vaccination can reduce typhoid risk in endemic settings. However, empiric evaluation of their combined impact is lacking. A total of 62,756 persons residing in 80 clusters in a Kolkata slum were allocated randomly 1:1 to either the typhoid Vi polysaccharide (ViPS) vaccine or hepatitis A (Hep A) vaccine. Surveillance was conducted for 2 years before and 2 years after vaccination. We classified households as having "better" or "not better" WASH, and calculated the prevalence of better WASH households in clusters using previously validated criteria. We evaluated the protection by better household WASH, better household WASH prevalence, and ViPS vaccination against typhoid in all cluster members present at baseline using Cox proportional hazard models. Overall, ViPS vaccination was associated with a 55% (P < 0.001; 95% CI, 35-69) reduction of typhoid risk and was similar regardless of better WASH in the residence. Living in a better WASH household was associated with a typhoid risk reduction of 31% (P = 0.16; 95% CI, -16 to 59) overall. The reduction was 48% (P = 0.05; 95% CI, -1 to 73) in Hep A clusters, 6% (P = 0.85; 95% CI, -82 to 51) in ViPS clusters, and 57% (P < 0.05; 95% CI, 15-78) in the population during the 2 years preceding the trial. These findings demonstrate a preventive association of better household WASH in the non-ViPS population, but, unexpectedly, an absence of additional protection from ViPS by better WASH in the ViPS population. This analysis highlights the importance of assessing the combination of WASH in conjunction with typhoid vaccines, and has implications for the evaluation of new-generation typhoid conjugate vaccines.
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Affiliation(s)
- Justin Im
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - Faisal Ahmmed
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Deok Ryun Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Sophie Kang
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - Fahima Chowdhury
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Tasnuva Ahmed
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | - Masuma Hoque
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md. Taufiqul Islam
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Juyeon Park
- International Vaccine Institute, Seoul, Republic of Korea
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Xinxue Liu
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Dipika Sur
- National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India
| | - Gideok Pak
- International Vaccine Institute, Seoul, Republic of Korea
| | - Hyon Jin Jeon
- International Vaccine Institute, Seoul, Republic of Korea
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Khalequ Zaman
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Ashraful Islam Khan
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Firdausi Qadri
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Florian Marks
- International Vaccine Institute, Seoul, Republic of Korea
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
- University of Antananarivo, Antananarivo, Madagascar
| | - Jerome H. Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - John D. Clemens
- International Vaccine Institute, Seoul, Republic of Korea
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
- University of California Los Angeles Fielding School of Public Health, Los Angeles, California
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32
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Sultana R, Bhuiyan TR, Sathi AS, Sharmin S, Yeasmin S, Uddin MI, Bhuiyan MS, Mannoor K, Karim MM, Zaman K, Qadri F. Developing and validating a modified enzyme linked immunosorbent assay method for detecting HEV IgG antibody from dried blood spot (DBS) samples in endemic settings. Microbes Infect 2022; 24:104890. [PMID: 34628012 PMCID: PMC8960178 DOI: 10.1016/j.micinf.2021.104890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/22/2021] [Accepted: 09/22/2021] [Indexed: 12/20/2022]
Abstract
Serological analysis is an integral part of laboratory practice nowadays. The present study was aimed to develop and validate a modified Enzyme linked Immunosorbent Assay (ELISA) for determination of IgG antibody against Hepatitis E Virus (HEV) using dried blood spots (DBS) and corresponding plasma samples. A total of 65 samples (45 HEV patients, 20 healthy controls) were analyzed. DBS and plasma samples demonstrated equivalent optical densities for detecting anti-HEV IgG. A highly significant correlation was observed between plasma and DBS sample absorbances (R2 = 0.98; p < 0.001) at dilution 1:200, indicating true agreement between the two procedures. The assay exhibited decent linearity and showed no effect of physiological hematocrit on assay performance. Data suggested recommendable promise in using DBS as a suitable alternative to plasma samples to determine HEV IgG antibody evidenced by significant correlation with plasma results. Therefore, identical method for processing DBS specimens including it's proper storage is recommended for implementation of a modified ELISA in different settings.
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Affiliation(s)
- Rosy Sultana
- Institute for Developing Science and Health Initiatives (ideSHi), Mohakhali, Dhaka, Bangladesh; Department of Microbiology, University of Dhaka, Dhaka, Bangladesh; Department of Immunology, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Taufiqur Rahman Bhuiyan
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Afsana Shirin Sathi
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Salma Sharmin
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Sharmina Yeasmin
- Department of Gynecology and Obstetrics, Bangladesh Institute of Health Sciences and General Hospital, Dhaka, Bangladesh
| | - Muhammad Ikhtear Uddin
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Md Saruar Bhuiyan
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Kaiissar Mannoor
- Institute for Developing Science and Health Initiatives (ideSHi), Mohakhali, Dhaka, Bangladesh
| | | | - K Zaman
- Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh
| | - Firdausi Qadri
- Institute for Developing Science and Health Initiatives (ideSHi), Mohakhali, Dhaka, Bangladesh; Enteric and Respiratory Infections, Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh; Department of Immunology, Bangladesh University of Health Sciences, Dhaka, Bangladesh.
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Carbonell-Estrany X, Simões EAF, Bont LJ, Gentile A, Homaira N, Scotta MC, Stein RT, Torres JP, Sheikh J, Broor S, Khuri-Bulos N, Nokes DJ, Munywoki PK, Bassat Q, Sharma AK, Basnet S, Garba M, De Jesus-Cornejo J, Lupisan SP, Nunes MC, Divarathna M, Fullarton JR, Rodgers-Gray BS, Keary I, Reñosa MDC, Verwey C, Moore DP, Noordeen F, Kabra S, do Vale MS, Paternina-De La Ossa R, Mariño C, Figueras-Aloy J, Krilov L, Berezin E, Zar HJ, Paudel K, Safadi MAP, Dbaibo G, Jroundi I, Jha R, Rafeek RAM, Pinheiro RDS, Bracht M, Muthugala R, Lanari M, Martinón-Torres F, Mitchell I, Irimu G, Pandey A, Krishnan A, Mejias A, da Costa MSC, Shrestha S, Pernica JM, de Carvalho FC, Jalango RE, Ibrahim H, Ewa A, Ensinck G, Ulloa-Gutierrez R, Miralha AL, Lucion MF, Hassan MZ, Akhtar Z, Aleem MA, Chowdhury F, Rojo P, Sande C, Musau A, Zaman K, Helena L, Arlant F, Ghimire P, Price A, Subedi KU, Brenes-Chacon H, Goswami DR, Rahman MZ, Hossain ME, Chisti MJ, Vain NE, Lim A, Chiu A, Papenburg J, Juarez MDV, Senaratne T, Arunasalam S, Strand TA, Ayuk A, Ogunrinde O, Tavares LVDS, Garba C, Garba BI, Dawa J, Gordon M, Osoro E, Agoti CN, Nyawanda B, Ngama M, Tabu C, Mathew JL, Cornacchia A, Rai GK, Jain A, Giongo MS, Paes BA. Identifying the research, advocacy, policy and implementation needs for the prevention and management of respiratory syncytial virus lower respiratory tract infection in low- and middle-income countries. Front Pediatr 2022; 10:1033125. [PMID: 36440349 PMCID: PMC9682277 DOI: 10.3389/fped.2022.1033125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/12/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION The high burden of respiratory syncytial virus (RSV) infection in young children disproportionately occurs in low- and middle-income countries (LMICs). The PROUD (Preventing RespiratOry syncytial virUs in unDerdeveloped countries) Taskforce of 24 RSV worldwide experts assessed key needs for RSV prevention in LMICs, including vaccine and newer preventive measures. METHODS A global, survey-based study was undertaken in 2021. An online questionnaire was developed following three meetings of the Taskforce panellists wherein factors related to RSV infection, its prevention and management were identified using iterative questioning. Each factor was scored, by non-panellists interested in RSV, on a scale of zero (very-low-relevance) to 100 (very-high-relevance) within two scenarios: (1) Current and (2) Future expectations for RSV management. RESULTS Ninety questionnaires were completed: 70 by respondents (71.4% physicians; 27.1% researchers/scientists) from 16 LMICs and 20 from nine high-income (HI) countries (90.0% physicians; 5.0% researchers/scientists), as a reference group. Within LMICs, RSV awareness was perceived to be low, and management was not prioritised. Of the 100 factors scored, those related to improved diagnosis particularly access to affordable point-of-care diagnostics, disease burden data generation, clinical and general education, prompt access to new interventions, and engagement with policymakers/payers were identified of paramount importance. There was a strong need for clinical education and local data generation in the lowest economies, whereas upper-middle income countries were more closely aligned with HI countries in terms of current RSV service provision. CONCLUSION Seven key actions for improving RSV prevention and management in LMICs are proposed.
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Affiliation(s)
| | - Eric A F Simões
- Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO, United States.,Department of Epidemiology, Center for Global Health, Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Louis J Bont
- Laboratory of Translational Immunology and Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Angela Gentile
- Epidemiology Department, Austral University, Buenos Aires, Argentina.,Ricardo Gutiérrez Children Hospital, Buenos Aires, Argentina
| | - Nusrat Homaira
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,Respiratory Department, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Marcelo Comerlato Scotta
- Pontificia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Renato T Stein
- Pontificia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Juan P Torres
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Jarju Sheikh
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Shobha Broor
- All India Institute of Medical Sciences, New Delhi, India
| | | | - D James Nokes
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.,School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Patrick K Munywoki
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,Institución Catalana de Investigación y Estudios Avanzados (ICREA), Barcelona, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Arun K Sharma
- Department of Paediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Sudha Basnet
- Department of Paediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.,University of Bergen, Bergen, Norway
| | - Maria Garba
- Ahmadu Bello University/Teaching Hospital, Zaria, Nigeria
| | | | - Socorro P Lupisan
- RITM-Tohoku Research Collaborating Center for Emerging Infections, Manila, Philippines
| | - Marta C Nunes
- South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa.,Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Maduja Divarathna
- Diagnostic and Research Virology Laboratory, Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | | | - Ian Keary
- Violicom Medical Limited, Aldermaston, United Kingdom
| | | | - Charl Verwey
- Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - David P Moore
- Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Faseeha Noordeen
- Diagnostic and Research Virology Laboratory, Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Sushil Kabra
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Rolando Paternina-De La Ossa
- Hospital Santa Casa de Ribeirão Preto, São Paulo, Brazil.,Centro Universitário Barão de Mauá, Ribeirão Preto, São Paulo, Brazil
| | | | | | - Leonard Krilov
- NYU Long Island School of Medicine, Mineola, NY, United States
| | | | - Heather J Zar
- Child Health and the SA-MRC Unit on Child and Adolescent Health, Department of Paediatrics, University of Cape Town (UCT), Cape Town, South Africa
| | | | | | - Ghassan Dbaibo
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Imane Jroundi
- School of Medicine and Pharmacy, University Mohamed V, Rabat, Morocco
| | - Runa Jha
- National Public Health Laboratory, Ministry of Health & Population, Teku, Kathmandu, Nepal
| | - Rukshan A M Rafeek
- Diagnostic and Research Virology Laboratory, Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | | | | | | | | | | | - Grace Irimu
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Apsara Pandey
- Department of Pediatric Nursing, Maharajgunj Nursing Campus, Institute of Medicine, Tribhuwan University, Kathmandu, Nepal.,Pediatric Nurses Association of Nepal, Kathmandu, Nepal
| | - Anand Krishnan
- All India Institute of Medical Sciences, New Delhi, India
| | - Asuncion Mejias
- Nationwide Childrens Hospital, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA
| | | | | | | | | | | | - Hafsat Ibrahim
- Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Atana Ewa
- University of Calabar/University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Gabriela Ensinck
- Hospital de Niños Víctor J. Vilela de Rosario, Santa Fe, Argentina
| | - Rolando Ulloa-Gutierrez
- Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense del Seguro Social (CCSS), San José, Costa Rica
| | | | - Maria Florencia Lucion
- Epidemiology Department, Austral University, Buenos Aires, Argentina.,Ricardo Gutiérrez Children Hospital, Buenos Aires, Argentina
| | - Md Zakiul Hassan
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Zubair Akhtar
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Fahmida Chowdhury
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Pablo Rojo
- University Hospital October 12, Madrid, Spain
| | - Charles Sande
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Khalequ Zaman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Luiza Helena
- Metropolitan University of Santos, São Paulo, Brazil
| | | | - Prakash Ghimire
- Department of Paediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - April Price
- London Health Sciences Centre, London, ON, Canada
| | | | - Helena Brenes-Chacon
- Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense del Seguro Social (CCSS), San José, Costa Rica
| | - Doli Rani Goswami
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | | | | | - Nestor E Vain
- Hospital Sanatorio Trinidad, Buenos Aires, Argentina
| | - Audrey Lim
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Aaron Chiu
- The Children's Hospital of Winnipeg, Winnipeg, MB, Canada
| | | | - Maria Del Valle Juarez
- Epidemiology Department, Austral University, Buenos Aires, Argentina.,Ricardo Gutiérrez Children Hospital, Buenos Aires, Argentina
| | | | - Shiyamalee Arunasalam
- Diagnostic and Research Virology Laboratory, Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Adaeze Ayuk
- University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | | | - Comfort Garba
- Ahmadu Bello University/Teaching Hospital, Zaria, Nigeria
| | - Bilkisu I Garba
- Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Jeanette Dawa
- Washington State University - Global Health Kenya, Nairobi, Kenya
| | - Michelle Gordon
- Orillia Soldiers' Memorial Hospital, Orillia, Ontario, Canada
| | - Eric Osoro
- Washington State University - Global Health Kenya, Nairobi, Kenya
| | - Charles N Agoti
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Bryan Nyawanda
- Kenya Medical Research Institute- Center for Global Health Research, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
| | - Mwanajuma Ngama
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Joseph L Mathew
- Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | | | - Ganesh Kumar Rai
- Nepal Pediatric Society (NEPAS), Kanti Children's Hospital, Kathmandu, Nepal
| | - Amita Jain
- King George's Medical University, Uttar Pradesh, India
| | | | - Bosco A Paes
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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34
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Meiring JE, Shakya M, Khanam F, Voysey M, Phillips MT, Tonks S, Thindwa D, Darton TC, Dongol S, Karkey A, Zaman K, Baker S, Dolecek C, Dunstan SJ, Dougan G, Holt KE, Heyderman RS, Qadri F, Pitzer VE, Basnyat B, Gordon MA, Clemens J, Pollard AJ. Burden of enteric fever at three urban sites in Africa and Asia: a multicentre population-based study. The Lancet Global Health 2021; 9:e1688-e1696. [PMID: 34798028 PMCID: PMC8609278 DOI: 10.1016/s2214-109x(21)00370-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 05/29/2021] [Accepted: 07/30/2021] [Indexed: 12/13/2022] Open
Abstract
Background Enteric fever is a serious public health concern in many low-income and middle-income countries. Numerous data gaps exist concerning the epidemiology of Salmonella enterica serotype Typhi (S Typhi) and Salmonella enterica serotype Paratyphi (S Paratyphi), which are the causative agents of enteric fever. We aimed to determine the burden of enteric fever in three urban sites in Africa and Asia. Methods In this multicentre population-based study, we did a demographic census at three urban sites in Africa (Blantyre, Malawi) and Asia (Kathmandu, Nepal and Dhaka, Bangladesh) between June 1, 2016, and Sept 25, 2018. Households were selected randomly from the demographic census. Participants from within the geographical census area presenting to study health-care facilities were approached for recruitment if they had a history of fever for 72 h or more (later changed to >48 h) or temperature of 38·0°C or higher. Facility-based passive surveillance was done between Nov 11, 2016, and Dec 31, 2018, with blood-culture collection for febrile illness. We also did a community-based serological survey to obtain data on Vi-antibody defined infections. We calculated crude incidence for blood-culture-confirmed S Typhi and S Paratyphi infection, and calculated adjusted incidence and seroincidence of S Typhi blood-culture-confirmed infection. Findings 423 618 individuals were included in the demographic census, contributing 626 219 person-years of observation for febrile illness surveillance. 624 S Typhi and 108 S Paratyphi A isolates were collected from the blood of 12 082 febrile patients. Multidrug resistance was observed in 44% S Typhi isolates and fluoroquinolone resistance in 61% of S Typhi isolates. In Blantyre, the overall crude incidence of blood-culture confirmed S Typhi was 58 cases per 100 000 person-years of observation (95% CI 48–70); the adjusted incidence was 444 cases per 100 000 person-years of observation (95% credible interval [CrI] 347–717). The corresponding rates were 74 (95% CI 62–87) and 1062 (95% CrI 683–1839) in Kathmandu, and 161 (95% CI 145–179) and 1135 (95% CrI 898–1480) in Dhaka. S Paratyphi was not found in Blantyre; overall crude incidence of blood-culture-confirmed S Paratyphi A infection was 6 cases per 100 000 person-years of observation (95% CI 3–11) in Kathmandu and 42 (95% CI 34–52) in Dhaka. Seroconversion rates for S Typhi infection per 100 000 person-years estimated from anti-Vi seroconversion episodes in serological surveillance were 2505 episodes (95% CI 1605–3727) in Blantyre, 7631 (95% CI 5913–9691) in Kathmandu, and 3256 (95% CI 2432–4270) in Dhaka. Interpretation High disease incidence and rates of antimicrobial resistance were observed across three different transmission settings and thus necessitate multiple intervention strategies to achieve global control of these pathogens. Funding Wellcome Trust and the Bill & Melinda Gates Foundation.
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Affiliation(s)
- James E Meiring
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi; Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.
| | - Mila Shakya
- Oxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, Nepal; Patan Academy of Health Sciences, Patan Hospital, Lalitpur, Nepal
| | - Farhana Khanam
- International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Merryn Voysey
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Maile T Phillips
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Susan Tonks
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Deus Thindwa
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi; College of Medicine, University of Malawi, Blantyre, Malawi
| | - Thomas C Darton
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Sabina Dongol
- Oxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, Nepal; Patan Academy of Health Sciences, Patan Hospital, Lalitpur, Nepal
| | - Abilasha Karkey
- Oxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, Nepal; Patan Academy of Health Sciences, Patan Hospital, Lalitpur, Nepal
| | - K Zaman
- International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Stephen Baker
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Christiane Dolecek
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK; Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Sarah J Dunstan
- The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, Australia
| | - Gordon Dougan
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Kathryn E Holt
- Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, VIC, Australia; Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
| | - Robert S Heyderman
- National Institute for Health Research Global Health Research Unit on Mucosal Pathogens, Division of Infection and Immunity, University College London, London, UK
| | - Firdausi Qadri
- International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Virginia E Pitzer
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Buddha Basnyat
- Oxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, Nepal; Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Melita A Gordon
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi; College of Medicine, University of Malawi, Blantyre, Malawi; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - John Clemens
- International Centre for Diarrhoeal Diseases Research, Bangladesh, Dhaka, Bangladesh
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
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35
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Famulare M, Wong W, Haque R, Platts-Mills JA, Saha P, Aziz AB, Ahmed T, Islam MO, Uddin MJ, Bandyopadhyay AS, Yunus M, Zaman K, Taniuchi M. Multiscale model for forecasting Sabin 2 vaccine virus household and community transmission. PLoS Comput Biol 2021; 17:e1009690. [PMID: 34932560 PMCID: PMC8726461 DOI: 10.1371/journal.pcbi.1009690] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/11/2020] [Revised: 01/04/2022] [Accepted: 11/29/2021] [Indexed: 11/19/2022] Open
Abstract
Since the global withdrawal of Sabin 2 oral poliovirus vaccine (OPV) from routine immunization, the Global Polio Eradication Initiative (GPEI) has reported multiple circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreaks. Here, we generated an agent-based, mechanistic model designed to assess OPV-related vaccine virus transmission risk in populations with heterogeneous immunity, demography, and social mixing patterns. To showcase the utility of our model, we present a simulation of mOPV2-related Sabin 2 transmission in rural Matlab, Bangladesh based on stool samples collected from infants and their household contacts during an mOPV2 clinical trial. Sabin 2 transmission following the mOPV2 clinical trial was replicated by specifying multiple, heterogeneous contact rates based on household and community membership. Once calibrated, the model generated Matlab-specific insights regarding poliovirus transmission following an accidental point importation or mass vaccination event. We also show that assuming homogeneous contact rates (mass action), as is common of poliovirus forecast models, does not accurately represent the clinical trial and risks overestimating forecasted poliovirus outbreak probability. Our study identifies household and community structure as an important source of transmission heterogeneity when assessing OPV-related transmission risk and provides a calibratable framework for expanding these analyses to other populations. Trial Registration: ClinicalTrials.gov This trial is registered with clinicaltrials.gov, NCT02477046.
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Affiliation(s)
- Michael Famulare
- Institute for Disease Modeling, Global Good, Intellectual Ventures, Bellevue, Washington, United States of America
| | - Wesley Wong
- Institute for Disease Modeling, Global Good, Intellectual Ventures, Bellevue, Washington, United States of America
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - James A. Platts-Mills
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, United States of America
| | - Parimalendu Saha
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Asma B. Aziz
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Tahmina Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Ohedul Islam
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Jashim Uddin
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, United States of America
| | | | - Mohammed Yunus
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Khalequ Zaman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mami Taniuchi
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, Virginia, United States of America
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36
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Ross AG, Alam M, Rahman M, Qadri F, Mahmood SS, Zaman K, Chau TN, Chattopadhyay A, Chaudhuri SPG. Rise of informal slums and the next global pandemic. J Infect Dis 2021; 224:S910-S914. [PMID: 34668553 DOI: 10.1093/infdis/jiab492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Informal slums are growing exponentially in the developing world and these will serve as the breeding ground for a future global pandemic. Virtually every sustainable development goal is unmet in slums around the globe thus we must act now to divert a global humanitarian crisis.
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Affiliation(s)
- Allen G Ross
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Munirul Alam
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mahbubur Rahman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Firdausi Qadri
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shehrin S Mahmood
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - K Zaman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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37
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Subbiah V, Paz-Ares L, Besse B, Zaman K, Sala M, Fernández C, Siguero M, Kahatt C, Lopez-Vilariño J, Zeaiter A, Arrondeau J, Delord J, Martínez M, Wannesson L, Antón A, Trigo J. MA16.01 Subsequent Systemic Therapy After Lurbinectedin Discontinuation in Patients With Small-cell Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.194] [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: 11/27/2022]
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38
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Aktar A, Ali MA, Haque MA, Hossain S, Jasmine T, Zaman K, Islam MA, Ahmad F, Sharmin M, Pandit P, Ali MS. Prevalence of Hepatitis B Virus Infection among Children with Liver Disease Admitted In Mymensingh Medical College Hospital. Mymensingh Med J 2021; 30:897-902. [PMID: 34605453] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Hepatitis B virus infection is an important cause of liver disease. Hepatitis B Virus may present with varying degree of severity. In older children, 5-10% cases leading to chronic liver disease, cirrhosis and hepatocellular carcinoma. This descriptive cross sectional study was done to assess the prevalence of Hepatitis B Virus infection among hospitalized children with liver disease in pediatric department of Mymensingh Medical College Hospital, Bangladesh from December 2015 to October 2016. All the children of both sexes having age between six months to twelve years admitted in the pediatric ward with acute or chronic liver disease were included in this study by purposive sampling. A written consent was obtained from legal guardian of children before inclusion. Ethical clearance was obtained from competent authority. A detailed history was taken from parents in each case according to pre-designed questionnaire about demography of the patients and the risk factors of the liver disease. A thorough clinical examination and available relevant investigations like serological testing for HBV infection was done in all patients. We had figure out the seropositivity of HBV among patients having liver disease by doing HBsAg and Anti-HBc IgM. Progress of the patient was monitored by daily clinical examinations and by investigating HBsAg and Anti-HBc IgM. Finally data analysis was done by SPSS version 21.0. Among total 100 patients most (44%) patients were in 7-10 years old and most (62%) of the participants were male. Acute liver disease was 58% cases and chronic liver disease was 42% cases. HBsAg was positive in 1 case among acute liver disease and 5 cases among chronic cases. Total 6 (six) patients were found positive for HBsAg. Anti HBc IgM was positive in 4 patients among acute liver disease. Among these Anti HBc IgM positive (4) patients only one had both HBsAg and Anti HBc IgM positive. So, four patients were confirming suffered from acute viral hepatitis because they had anti HBc IgM positive. On the contrary 5 patients suffered from chronic hepatitis by hepatitis B because they were only HBsAg positive. So, in this study 9 patients (9%) were confirming suffered from HBV infection. Possible transmission factors of hepatitis B were history of (H/O) blood transfusion/trauma/parenteral injection, H/O umbilical sepsis, H/O maternal illness/infection during pregnancy. HBV still is a major cause of morbidity. All the children with liver disease should be routinely tested for HBV.
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Affiliation(s)
- A Aktar
- Dr Asma Aktar, Junior Consultant, Department of Paediatrics, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
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39
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Danier J, Callegaro A, Soni J, Carmona A, Kosalaraska P, Rivera L, Friel D, Pu W, Vantomme V, Dbaibo G, Innis BL, Schuind A, Zaman K, Wilson J. Association Between Hemagglutination Inhibition Antibody Titers and Protection Against Reverse-Transcription Polymerase Chain Reaction–Confirmed Influenza Illness in Children 6–35 Months of Age: Statistical Evaluation of a Correlate of Protection. Open Forum Infect Dis 2021; 9:ofab477. [PMID: 35083365 PMCID: PMC8786493 DOI: 10.1093/ofid/ofab477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/23/2021] [Indexed: 11/25/2022] Open
Abstract
Background Data from a randomized controlled efficacy trial of an inactivated quadrivalent influenza vaccine in children 6–35 months of age were used to determine whether hemagglutination inhibition (HI) antibody titer against A/H1N1 and A/H3N2 is a statistical correlate of protection (CoP) for the risk of reverse-transcription polymerase chain reaction (RT-PCR)–confirmed influenza associated with the corresponding strain. Methods The Prentice criteria were used to statistically validate strain-specific HI antibody titer as a CoP. The probability of protection was identified using the Dunning model corresponding to a prespecified probability of protection at an individual level. The group-level protective threshold was identified using the Siber approach, leading to unbiased predicted vaccine efficacy (VE). A case-cohort subsample was used for this exploratory analysis. Results Prentice criteria confirmed that HI titer is a statistical CoP for RT-PCR–confirmed influenza. The Dunning model predicted a probability of protection of 49.7% against A/H1N1 influenza and 54.7% against A/H3N2 influenza at an HI antibody titer of 1:40 for the corresponding strain. Higher titers of 1:320 were associated with >80% probability of protection. The Siber method predicted VE of 61.0% at a threshold of 1:80 for A/H1N1 and 46.6% at 1:113 for A/H3N2. Conclusions The study validated HI antibody titer as a statistical CoP, by demonstrating that HI titer is correlated with clinical protection against RT-PCR–confirmed influenza associated with the corresponding influenza strain and is predictive of VE in children 6–35 months of age. Clinical Trials Registration NCT01439360.
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Affiliation(s)
| | | | | | | | | | - Luis Rivera
- National Autonomous University of Santo Domingo, Santo Domingo, Dominican Republic
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40
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Zaman K, Kovacs SD, Vanderende K, Aziz A, Yunus M, Khan S, Snider CJ, An Q, Estivariz CF, Oberste MS, Pallansch MA, Anand A. Assessing the immunogenicity of three different inactivated polio vaccine schedules for use after oral polio vaccine cessation, an open label, phase IV, randomized controlled trial. Vaccine 2021; 39:5814-5821. [PMID: 34481702 DOI: 10.1016/j.vaccine.2021.08.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND After global oral poliovirus vaccine (OPV) cessation, the Strategic Advisory Group of Experts on Immunization (SAGE) currently recommends a two-dose schedule of inactivated poliovirus vaccine (IPV) beginning ≥14-weeks of age to achieve at least 90% immune response. We aimed to compare the immunogenicity of three different two-dose IPV schedules started before or at 14-weeks of age. METHODS We conducted a randomized, controlled, open-label, inequality trial at two sites in Dhaka, Bangladesh. Healthy infants at 6-weeks of age were randomized into one of five arms to receive two-dose IPV schedules at different ages with and without OPV. The three IPV-only arms are presented: Arm C received IPV at 14-weeks and 9-months; Arm D received IPV at 6-weeks and 9-months; and Arm E received IPV at 6 and 14-weeks. The primary outcome was immune response defined as seroconversion from seronegative (<1:8) to seropositive (≥1:8) after vaccination, or a four-fold rise in antibody titers and median reciprocal antibody titers to all three poliovirus types measured at 10-months of age. FINDINGS Of the 987 children randomized to Arms C, D, and E, 936 were included in the intention-to-treat analysis. At 10-months, participants in Arm C (IPV at 14-weeks and 9-months) had ≥99% cumulative immune response to all three poliovirus types which was significantly higher than the 77-81% observed in Arm E (IPV at 6 and 14-weeks). Participants in Arm D (IPV at 6-weeks and 9-months) had cumulative immune responses of 98-99% which was significantly higher than that of Arm E (p value < 0.0001) but not different from Arm C. INTERPRETATION Results support current SAGE recommendations for IPV following OPV cessation and provide evidence that the schedule of two full IPV doses could begin as early as 6-weeks.
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Affiliation(s)
- Khalequ Zaman
- International Centre for Diarrheal Disease, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Stephanie D Kovacs
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Kristin Vanderende
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - Asma Aziz
- International Centre for Diarrheal Disease, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Mohammed Yunus
- International Centre for Diarrheal Disease, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Sara Khan
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - Cynthia J Snider
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - Qian An
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - Concepcion F Estivariz
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - M Steven Oberste
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - Mark A Pallansch
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
| | - Abhijeet Anand
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA
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Abstract
Safe and effective rotavirus vaccines (RVs) are needed to reduce the enormous public health burden of rotavirus illness in developing countries. Vaccination is critical for effective control of rotavirus infection since it cannot be prevented with improvements in water and sanitation. The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) has completed several groundbreaking RV trials (Phase I–Phase IV). The safety, immunogenicity, efficacy, and effectiveness of different RVs were evaluated among both urban and rural populations. In this study, we present the results, policy implications, and lessons learned for successful implementation of these trials as well as future directions for rotavirus vaccination in Bangladesh.
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Affiliation(s)
- K Zaman
- International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Asma B Aziz
- International Vaccine Institute (IVI), 08826 Seoul, Republic of Korea
| | - Md Yunus
- International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Firdausi Qadri
- International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Allen G Ross
- International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - John D Clemens
- International Vaccine Institute (IVI), 08826 Seoul, Republic of Korea.,UCLA Fielding School of Public Health, Los Angeles, CA 90095-1772, USA
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Wicki A, Mamot C, Hasler-Strub U, Riniker S, Li Q, Holer L, Baertschi D, Zaman K, von Moos R, Dedes K, Novak U, Bodmer A, Ritschard R, Obermann E, Ackermann C, Membrez-Antonioli V, Zuerrer U, Caspar C, Rochlitz C, Winterhalder R. 268P Anti-EGFR-immunoliposomes loaded with doxorubicin in patients with advanced triple-negative, EGFR positive breast cancer: A multicenter single arm phase II trial [SAKK 24/14]. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Brooks WA, Zaman K, Goswami D, Prosperi C, Endtz HP, Hossain L, Rahman M, Ahmed D, Rahman MZ, Banu S, Shikder AU, Jahan Y, Nahar K, Chisti MJ, Yunus M, Khan MA, Matin FB, Mazumder R, Shahriar Bin Elahi M, Saifullah M, Alam M, Bin Shahid ASMS, Haque F, Sultana S, Higdon MM, Haddix M, Feikin DR, Murdoch DR, Hammitt LL, O’Brien KL, Deloria Knoll M. The Etiology of Childhood Pneumonia in Bangladesh: Findings From the Pneumonia Etiology Research for Child Health (PERCH) Study. Pediatr Infect Dis J 2021; 40:S79-S90. [PMID: 34448747 PMCID: PMC8448409 DOI: 10.1097/inf.0000000000002648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Pneumonia remains the leading infectious cause of death among children <5 years, but its cause in most children is unknown. We estimated etiology for each child in 2 Bangladesh sites that represent rural and urban South Asian settings with moderate child mortality. METHODS As part of the Pneumonia Etiology Research for Child Health study, we enrolled children 1-59 months of age with World Health Organization-defined severe and very severe pneumonia, plus age-frequency-matched controls, in Matlab and Dhaka, Bangladesh. We applied microbiologic methods to nasopharyngeal/oropharyngeal swabs, blood, induced sputum, gastric and lung aspirates. Etiology was estimated using Bayesian methods that integrated case and control data and accounted for imperfect sensitivity and specificity of the measurements. RESULTS We enrolled 525 cases and 772 controls over 24 months. Of the cases, 9.1% had very severe pneumonia and 42.0% (N = 219) had infiltrates on chest radiograph. Three cases (1.5%) had positive blood cultures (2 Salmonella typhi, 1 Escherichia coli and Klebsiella pneumoniae). All 4 lung aspirates were negative. The etiology among chest radiograph-positive cases was predominantly viral [77.7%, 95% credible interval (CrI): 65.3-88.6], primarily respiratory syncytial virus (31.2%, 95% CrI: 24.7-39.3). Influenza virus had very low estimated etiology (0.6%, 95% CrI: 0.0-2.3). Mycobacterium tuberculosis (3.6%, 95% CrI: 0.5-11.0), Enterobacteriaceae (3.0%, 95% CrI: 0.5-10.0) and Streptococcus pneumoniae (1.8%, 95% CrI: 0.0-5.9) were the only nonviral pathogens in the top 10 etiologies. CONCLUSIONS Childhood severe and very severe pneumonia in young children in Bangladesh is predominantly viral, notably respiratory syncytial virus.
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Affiliation(s)
- W. Abdullah Brooks
- From the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Khalequ Zaman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Doli Goswami
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Christine Prosperi
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Hubert P. Endtz
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
- Department of Clinical Microbiology & Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Fondation Mérieux, Lyon, France
| | - Lokman Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Mustafizur Rahman
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Dilruba Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Mohammed Ziaur Rahman
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sayera Banu
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Arif Uddin Shikder
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Yasmin Jahan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
- Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kamrun Nahar
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | | | - Mohammed Yunus
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | | | | | - Razib Mazumder
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | | | - Muhammad Saifullah
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Muntasir Alam
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Fahim Haque
- Virology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sabiha Sultana
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Melissa M. Higdon
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Meredith Haddix
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Daniel R. Feikin
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - David R. Murdoch
- Department of Pathology, University of Otago, Christchurch, New Zealand
- Microbiology Unit, Canterbury Health Laboratories, Christchurch, New Zealand
| | - Laura L. Hammitt
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Maria Deloria Knoll
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Harbeck N, Lüftner D, Breitenstein U, Jackisch C, Müller V, Schmidt M, Balic M, Rinnerthaler G, Schwitter M, Zaman K, Wrobel D, Guth D, Terhaag J, Zaiss M, Schinköthe T, Bartsch R. 200TiP ELEANOR: A multi-national, prospective, non-interventional study (NIS) in patients with human epidermal growth factor receptor (HER2) positive, early breast cancer (eBC) observing real-life extended adjuvant treatment with neratinib and concurrent use of the eHealth solution CANKADO. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.481] [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: 11/16/2022] Open
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45
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Qadri F, Khanam F, Liu X, Theiss-Nyland K, Biswas PK, Bhuiyan AI, Ahmmed F, Colin-Jones R, Smith N, Tonks S, Voysey M, Mujadidi YF, Mazur O, Rajib NH, Hossen MI, Ahmed SU, Khan A, Rahman N, Babu G, Greenland M, Kelly S, Ireen M, Islam K, O'Reilly P, Scherrer KS, Pitzer VE, Neuzil KM, Zaman K, Pollard AJ, Clemens JD. Protection by vaccination of children against typhoid fever with a Vi-tetanus toxoid conjugate vaccine in urban Bangladesh: a cluster-randomised trial. Lancet 2021; 398:675-684. [PMID: 34384540 PMCID: PMC8387974 DOI: 10.1016/s0140-6736(21)01124-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Typhoid fever remains a major cause of morbidity and mortality in low-income and middle-income countries. Vi-tetanus toxoid conjugate vaccine (Vi-TT) is recommended by WHO for implementation in high-burden countries, but there is little evidence about its ability to protect against clinical typhoid in such settings. METHODS We did a participant-masked and observer-masked cluster-randomised trial preceded by a safety pilot phase in an urban endemic setting in Dhaka, Bangladesh. 150 clusters, each with approximately 1350 residents, were randomly assigned (1:1) to either Vi-TT or SA 14-14-2 Japanese encephalitis (JE) vaccine. Children aged 9 months to less than 16 years were invited via parent or guardian to receive a single, parenteral dose of vaccine according to their cluster of residence. The study population was followed for an average of 17·1 months. Total and overall protection by Vi-TT against blood culture-confirmed typhoid were the primary endpoints assessed in the intention-to-treat population of vaccinees or all residents in the clusters. A subset of approximately 4800 participants was assessed with active surveillance for adverse events. The trial is registered at www.isrctn.com, ISRCTN11643110. FINDINGS 41 344 children were vaccinated in April-May, 2018, with another 20 412 children vaccinated at catch-up vaccination campaigns between September and December, 2018, and April and May, 2019. The incidence of typhoid fever (cases per 100 000 person-years) was 635 in JE vaccinees and 96 in Vi-TT vaccinees (total Vi-TT protection 85%; 97·5% CI 76 to 91, p<0·0001). Total vaccine protection was consistent in different age groups, including children vaccinated at ages under 2 years (81%; 95% CI 39 to 94, p=0·0052). The incidence was 213 among all residents in the JE clusters and 93 in the Vi-TT clusters (overall Vi-TT protection 57%; 97·5% CI 43 to 68, p<0·0001). We did not observe significant indirect vaccine protection by Vi-TT (19%; 95% CI -12 to 41, p=0·20). The vaccines were well tolerated, and no serious adverse events judged to be vaccine-related were observed. INTERPRETATION Vi-TT provided protection against typhoid fever to children vaccinated between 9 months and less than 16 years. Longer-term follow-up will be needed to assess the duration of protection and the need for booster doses. FUNDING The study was funded by the Bill & Melinda Gates Foundation.
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Affiliation(s)
- Firdausi Qadri
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
| | - Farhana Khanam
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Xinxue Liu
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Katherine Theiss-Nyland
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | | | - Amirul Islam Bhuiyan
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Faisal Ahmmed
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Rachel Colin-Jones
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Nicola Smith
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Susan Tonks
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Merryn Voysey
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Yama F Mujadidi
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Olga Mazur
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Nazmul Hasan Rajib
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Ismail Hossen
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shams Uddin Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Arifuzzaman Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Nazia Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Golap Babu
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Melanie Greenland
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Sarah Kelly
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Mahzabeen Ireen
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Kamrul Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Peter O'Reilly
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Karin Sofia Scherrer
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Virginia E Pitzer
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT USA
| | | | - K Zaman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - John D Clemens
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; University of California Los Angeles, Fielding School of Public Health, Los Angeles, CA, USA
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Im J, Islam MT, Ahmmed F, Kim DR, Islam Khan A, Zaman K, Ali M, Marks F, Qadri F, Kim J, Clemens JD. Can Existing Improvements of Water, Sanitation, and Hygiene (WASH) in Urban Slums Reduce the Burden of Typhoid Fever in These Settings? Clin Infect Dis 2021; 72:e720-e726. [PMID: 32964216 DOI: 10.1093/cid/ciaa1429] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/17/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sustained investments in water, sanitation, and hygiene (WASH) have lagged in resource-poor settings; incremental WASH improvements may, nonetheless, prevent diseases such as typhoid in disease-endemic populations. METHODS Using prospective data from a large cohort in urban Kolkata, India, we evaluated whether baseline WASH variables predicted typhoid risk in a training subpopulation (n = 28 470). We applied a machine learning algorithm to the training subset to create a composite, dichotomous (good, not good) WASH variable based on 4 variables, and evaluated sensitivity and specificity of this variable in a validation subset (n = 28 470). We evaluated in Cox regression models whether residents of "good" WASH households experienced a lower typhoid risk after controlling for potential confounders. We constructed virtual clusters (radius 50 m) surrounding each household to evaluate whether a prevalence of good WASH practices modified the typhoid risk in central household members. RESULTS Good WASH practices were associated with protection in analyses of all households (hazard ratio [HR] = 0.57; 95% confidence interval [CI], .37-.90; P = .015). This protection was evident in persons ≥5 years old at baseline (HR = 0.47; 95% CI, .34-.93; P = .005) and was suggestive, though not statistically significant, in younger age groups (HR = 0.61; 95% CI, .27-1.38; P = .235). The level of surrounding household good WASH coverage was also associated with protection (HR = 0.988; 95% CI, .979-.996; P = .004, for each percent coverage increase). However, collinearity between household WASH and WASH coverage prevented an assessment of their independent predictive contributions. CONCLUSIONS In this typhoid-endemic setting, natural variation in household WASH was associated with typhoid risk. If replicated elsewhere, these findings suggest that WASH improvements may enhance typhoid control, short of major infrastructural investments.
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Affiliation(s)
- Justin Im
- International Vaccine Institute, Seoul, Republic of Korea
| | - Md Taufiqul Islam
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Faisal Ahmmed
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Deok Ryun Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Ashraful Islam Khan
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Khalequ Zaman
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammad Ali
- Johns Hopkins University, Baltimore, Maryland, USA
| | - Florian Marks
- International Vaccine Institute, Seoul, Republic of Korea.,Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Firdausi Qadri
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Jerome Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - John D Clemens
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.,University of California Los Angeles Fielding School of Public Health, Los Angeles, California, USA
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Zaman K, Ali A, Islam MN, Azam MS, Huda SA, Badiuzzaman M, Aktar A, Haque MA. Comparison of Nutritional Status of Children with Congenital Heart Diseases with Minor Illness of Other Children in a Tertiary Level Hospital. Mymensingh Med J 2021; 30:594-600. [PMID: 34226443] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This cross sectional comparative analytical study was undertaken with the objectives to find out the nutritional status of children with congenital heart disease by anthropometric measurement and was compared it with those of children having minor illness and without any congenital heart disease in indoor and outdoor Department of Paediatrics of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from December 2015 to November 2016. Purposive sampling was done. One hundred children aged 6 to 60 months with congenital heart disease confirmed by echocardiogram were taken as Group A and one hundred children of same age and sex matched having minor illness and without any congenital heart disease were taken as Group B. Age of the patients ranged from 6 to 60 months. There was no obvious difference of socio-demographic status between two groups. Most of the patient (64.0%) had acyanotic congenital heart disease among them VSD was commonest (68.8%). Thirty-six percent (36.0%) patient had cyanotic congenital heart disease and among them Tetralogy of Fallots (83.3%) was commonest. There were significant differences regarding weight, height and MUAC values in between two Groups. Underweight (51%), Stunting (50%) and Wasting (29%) all were higher in congenital heart disease than that of Group B where they were 28%, 31% and 13% respectively and the differences were statistically significant (p<0.05). The findings of this study imply that malnutrition is very common among children with congenital heart disease. So, anthropometric measurement should be done in each and every child with congenital heart disease.
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Affiliation(s)
- K Zaman
- Dr Kishwar Zaman, Registrar, Department of Pediatrics, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
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48
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Ali M, Qadri F, Kim DR, Islam MT, Im J, Ahmmed F, Khan AI, Zaman K, Marks F, Kim JH, Clemens JD. Effectiveness of a killed whole-cell oral cholera vaccine in Bangladesh: further follow-up of a cluster-randomised trial. Lancet Infect Dis 2021; 21:1407-1414. [PMID: 34146473 DOI: 10.1016/s1473-3099(20)30781-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/24/2020] [Accepted: 09/24/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Killed whole-cell oral cholera vaccines (OCVs) are widely used for prevention of cholera in developing countries. However, few studies have evaluated the protection conferred by internationally recommended OCVs for durations beyond 2 years of follow-up. METHODS In this study, we followed up the participants of a cluster-randomised controlled trial for 2 years after the end of the original trial. Originally, we had randomised 90 geographical clusters in Dhaka slums in Bangladesh in equal numbers (1:1:1) to a two-dose regimen of OCV alone (targeted to people aged 1 year or older), a two-dose regimen of OCV plus a water-sanitation-hygiene (WASH) intervention, or no intervention. There was no masking of group assignment. The WASH intervention conferred little additional protection to OCV and was discontinued at 2 years of follow-up. Surveillance for severe cholera was continued for 4 years. Because of the short duration and effect of the WASH intervention, we combined the two OCV intervention groups. The primary outcomes were OCV overall protection (protection of all members of the intervention clusters) and total protection (protection of individuals who got vaccinated in the intervention clusters) against severe cholera, which we assessed by multivariable survival models appropriate for cluster-randomised trials. This trial is registered on ClinicalTrials.gov, NCT01339845. FINDINGS The study was done between April 17, 2011, and Nov 1, 2015. 268 896 participants were present at the time of the first dose, with 188 206 in the intervention group and 80 690 in the control group. OCV coverage of the two groups receiving OCV was 66% (123 659 of 187 214 participants). During 4 years of follow-up, 441 first episodes of severe cholera were detected (243 episodes in the vaccinated groups and as 198 episodes in the unvaccinated group). Overall OCV protection was 36% (95% CI 19 to 49%) and total OCV protection was 46% (95% CI 32 to 58). Cumulative total vaccine protection was notably lower for people vaccinated before the age of 5 years (24%; -30 to 56) than for people vaccinated at age 5 years or older (49%; 35 to 60), although the differences in protection for the two age groups were not significant (p=0·3308). Total vaccine protection dropped notably (p=0·0115) after 3 years in children vaccinated at 1-4 years of age. INTERPRETATION These findings provide further evidence of long-term effectiveness of killed whole-cell OCV, and therefore further support for the use of killed whole-cell OCVs to control endemic cholera, but indicate that protection is shorter-lived in children vaccinated before the age of 5 years than in people vaccinated at the age of 5 years or older. FUNDING Bill & Melinda Gates Foundation. TRANSLATION For the Bengali translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Mohammad Ali
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MA, USA
| | - Firdausi Qadri
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.
| | | | - Md Taufiqul Islam
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Justin Im
- International Vaccine Institute, Seoul, South Korea
| | - Faisal Ahmmed
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Ashraful Islam Khan
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - K Zaman
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Florian Marks
- International Vaccine Institute, Seoul, South Korea; Department of Medicine, University of Cambridge, Cambridge, UK
| | - Jerome H Kim
- International Vaccine Institute, Seoul, South Korea
| | - John D Clemens
- International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh; UCLA Fielding School of Public Health, Los Angeles, CA, USA
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Clipet-Jensen C, Andersen A, Jensen AKG, Aaby P, Zaman K. Out-of-Sequence Vaccinations With Measles Vaccine and Diphtheria-Tetanus-Pertussis Vaccine: A Reanalysis of Demographic Surveillance Data From Rural Bangladesh. Clin Infect Dis 2021; 72:1429-1436. [PMID: 32185375 DOI: 10.1093/cid/ciaa291] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 03/16/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Due to delays in vaccinations, diphtheria-tetanus-whole-cell-pertussis (DTP) is often given with or after measles vaccine (MV)-out of sequence. We reanalyzed data from Matlab, Bangladesh, to examine how administration of MV and DTP out-of-sequence was associated with child survival. METHODS In sum, 36 650 children born between 1986 and 1999 were followed with registration of vaccinations and survival. Controlling for background factors using Cox proportional hazards models, survival was analyzed between 9 and 24 months of age. We measured the mortality rate ratio (MRR) to compare vaccination groups. Oral polio vaccine (OPV) campaigns, which started in 1995, reduced the mortality rate and reduced the difference between vaccination groups. In the main analysis, we therefore censored for OPV campaigns; there were 151 nonaccident deaths before the OPV campaigns. RESULTS Compared with MV administered alone (MV-only), DTP administered with or after MV had MRR 2.20 (1.31-3.70), and DTP-only had MRR 1.78 (1.01-3.11). Compared with MV-only, DTP administered with MV had a female-male MRR 0.56 (0.13-2.38), significantly different to DTP administered after MV, which had MRR 14.83 (1.88-117.1), test of interaction P = .011. Compared with having DTP (no MV) as most recent vaccination, MV-only had a nonaccident MRR of 0.56 (0.32-0.99). CONCLUSION The negative effects of non-live DTP with or after live MV are not explained merely by selection bias. These observations support a live-vaccine-last policy where DTP should not be given with or after MV.
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Affiliation(s)
- Clara Clipet-Jensen
- Research Centre for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark
| | - Andreas Andersen
- Research Centre for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark
| | - Aksel Karl Georg Jensen
- Research Centre for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark.,Section of Biostatistics, University of Copenhagen, Denmark
| | - Peter Aaby
- Research Centre for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark.,Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau
| | - K Zaman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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50
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Khanam F, Darton TC, Ross AGP, Zaman K, Pollard AJ, Clemens JD, Qadri F. Case Report: Typhoid Fever Complicated by Ileal Perforation in an Urban Slum of Dhaka, Bangladesh. Am J Trop Med Hyg 2021; 104:1755-1757. [PMID: 33755582 PMCID: PMC8103489 DOI: 10.4269/ajtmh.20-1448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/11/2021] [Indexed: 11/07/2022] Open
Abstract
Intestinal perforation is one of the most dangerous complications of typhoid fever and demands urgent hospitalization, diagnosis, and surgical management to reduce morbidity and prevent mortality. Here, we report a case of typhoidal intestinal perforation in a 19 year-old young man detected by passive surveillance during a cluster-randomized trial with Vi-tetanus toxoid conjugate vaccine (Typhoid Vaccine Acceleration Consortium: TyVAC) in an urban slum area in Mirpur, Dhaka, Bangladesh. The patient presented with a high-grade fever, lower abdominal pain, and vomiting and was admitted to a healthcare facility. Physical examination and preoperative investigations of the patient suggested a presumptive diagnosis of intestinal perforation, and the patient was transferred to a tertiary-level hospital for surgical management. A positive blood culture, intraoperative findings, and histopathology of an intestinal biopsy confirmed ileal perforation due to typhoid fever. This case report highlights the need for prompt diagnosis and appropriate pre- and postoperative management of patients who appear with the symptoms of typhoidal intestinal perforation. This report further demonstrates the importance of systematic surveillance and proper evaluation to determine the true incidence rate of typhoid fever and intestinal perforation in Bangladesh.
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Affiliation(s)
- Farhana Khanam
- icddr,b, (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh;,School of Medical Science, Griffith University, Gold Coast, Australia
| | - Thomas C. Darton
- Department of Infection, Immunity and Cardiovascular Disease, The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, United Kingdom
| | - Allen G. P. Ross
- icddr,b, (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - K. Zaman
- icddr,b, (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Andrew J. Pollard
- Oxford Vaccine Group, Department of Paediatrics, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - John D. Clemens
- icddr,b, (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Firdausi Qadri
- icddr,b, (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh;,Address correspondence to Firdausi Qadri, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sharani, Dhaka 1212, Bangladesh. E-mail:
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