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Assessment of seroprevalence against poliovirus among Italian adolescents and adults | Human Vaccines & Immunotherapeutics.

[Pay to View Full Text] [Received 05 Sep 2018, Accepted 05 Nov 2018, Accepted author version posted online: 14 Nov 2018]

Abstract.

In 2002, the WHO European Region was declared polio-free. Nonetheless global eradication has not yet been completed and the reintroduction from at risk areas is still possible. This seroprevalence study evaluated samples collected from each Italian region in the 12−50 years old age range to assess protection against Poliovirus (PV) 1, 2 and 3 among subjects immunised with different vaccination schedules. 1073 samples (50.5% females) were examined. WHO standardized microneutralization assay was used. Seroprotection rates were 92.9%, 96.2% and 83.4%, for PV1, PV2 and PV3, respectively. Geometric Mean Titres (GMTs) were higher for PV2 (52.8) and PV1 (41.1) than for PV3 (21.0). Increasing the age, a decreasing trend in seropositivity was observed, in particular for PV3. The 2017–2019 Italian National Immunisation Plan emphasises, as primary objective, the maintenance of the polio-free status and strongly validates the 2 + 1 schedule in the first year of life with IPV vaccine associated with the administration of booster doses at 6 years and during the adolescence. Surveillance system and high population immunity are crucial to ensure the maintenance of polio-free status.


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Vaccine hesitancy among mobile pastoralists in Chad: a qualitative study | International Journal for Equity in Health.

[Open Access] [Received: 24 January 2018; Accepted: 14 October 2018; Published: 14 November 2018]

Abstract.

Background.

Demand side barriers to vaccination among rural and hard-to-reach populations in Chad are not yet well understood. Although innovative approaches such as linking human and animal vaccination increase vaccination uptake among mobile pastoralist communities, vaccination coverage in these communities is still lower than for rural settled populations. We hypothesize that mobile pastoralists’ communities in Chad face specific demand side barriers to access vaccination services. Understanding the factors that caregivers in these communities consider, explicitly or implicitly, in order to decide whether or not to vaccinate a child, in addition to understanding the provider’s perspectives, are essential elements to tailor vaccination programmes towards increasing vaccination acceptance and uptake.

Methods.

We conducted a qualitative study in a rural health district in southern Chad in April 2016 with 12 key informant in-depth interviews and four focus group discussions (FGDs) including 35 male and female participants. Participants in the study included caregivers, traditional chiefs, local and religious leaders from mobile pastoralist communities, and health officials and staff. We conducted a content analysis using a pre-defined set of categories for vaccine hesitancy covering issues on harmful effects of vaccination, mistrust with vaccination programmes/services, issues with the health system and other issues.

Results.

The groups of demand side barriers reported most frequently in focus group discussions were mistrust on the expanded programme on immunization (EPI) and polio vaccination outreach services (53%, n = 94), followed by health system issues (34%, n = 94), and concerns related to potential harm of vaccines (13%, n = 94). Concerns identified by caregivers, health professionals and community leaders followed a similar pattern with issues on programme mistrust being most frequently reported and issues with harm least frequently reported. None of the health professionals reported concerns about vaccinations being potentially harmful.

Conclusion.

Mobile pastoralist communities face specific demand side barriers to vaccination. Understanding these barriers is essential to reduce vaccine hesitancy and increase vaccination uptake. Local health systems must plan for the periodic presence of pastoralist communities in their zones of responsibility and create more mutual trust.


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Radiographic and Clinical Outcomes of Surgical Correction in Poliomyelitis-Related Spinal Deformities:A Comparison between Three Types of Pelvic Instrumentations | World Neurosurgery.

[Pay to View Full Text] [Received 2 September 2018, Revised 29 October 2018, Accepted 31 October 2018, Available online 12 November 2018] [In Press, Accepted Manuscript]

Abstract.

Objective.

To compare the clinical and radiographic outcomes of correction surgery in patients with Poliomyelitis-related spinal deformity (PSD) using 3 types of pelvic fixation and investigate the incidence and risk factors for complications.

Methods.

We reviewed 42 patients with PSD who underwent spino-pelvic reconstruction at a single institution between 2000 and 2016, including 15 patients with Galveston technique, 13 patients with iliac screw fixations and 14 with S2-Alar-Iliac (S2AI) Screws fixations. Demographic data, radiographic parameters, and complications were analyzed. Health-related quality of life was determined by SRS-22 questionnaires and the Oswestry Disability Index (ODI) scores.

Results.

After surgery, correction rate of the main curve was 51.7%, 57.8% and 52.1% in three groups, with significant improvement for regional kyphosis, coronal balance and pelvic obliquity (PO) (P<0.05). The correction of PO was similar between 3 types of pelvic fixation, but patients treated with S2AI fixation had significant less surgical time (P<0.05) and blood loss (P<0.006). The overall complication rate was 40.5% with a major complication rate of 23.8%. Age at surgery (P=0.006) and > grade 2 SRS-Schwab osteotomy (P=0.036) were significant risk factors for complications. There was a significant improvement of SRS-22 and ODI scores at final follow-up in three groups.

Conclusion.

This study showed a satisfactory correction of spino-pelvic deformity for 42 patients with PSD. Compared to the Galveston technique and IS fixation, the use of S2AI significantly decrease surgical time and estimated blood loss while obtaining similar correction of PO. Age at surgery and > grade 2 SRS-Schwab osteotomy were significant risk factors for complications.


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Global Routine Vaccination Coverage — 2017 | Morbidity and Mortality Weekly Report (MMWR).

[Open Access] [November 16, 2018 / 67(45);1261–1264]

Summary

What is already known about this topic?

Since 1974, global coverage with vaccines to prevent diphtheria, tetanus, pertussis, polio, and measles has increased from <5% to 85%.

What is added by this report?

Global coverage with the third dose of diphtheria and tetanus toxoids and pertussis-containing vaccine (DTP3), third dose of polio vaccine, and first dose of measles-containing vaccine has remained at 84%–85% since 2010. In 2017, 62% of children who did not receive DTP3 lived in 10 countries; positive trends in vaccination coverage (2007–2017) were observed in seven of these countries.

What are the implications for public health practice?

Prioritizing countries with the highest number of unvaccinated children to implement context-specific strategies has the potential to increase immunization coverage globally.


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Polio this week as of 13 November 2018 | GPEI.

  • Summary of new viruses this week: Afghanistan –one wild poliovirus type 1 (WPV1) positive environmental sample. Pakistan –four WPV1 positive environmental samples. Papua New Guinea – one case of circulating vaccine-derived poliovirus type 1 (cVDPV1). – Nigeria – two cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) and seven cVDPV2 positive environmental samples. See country sections [in source article] for more details.
  • As the year draws to a close, endemic and outbreak countries are making concerted efforts to eradicate the last strong holds of polio, by conducting large-scale immunization activities before the end of the year.

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