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1.
J Infect Dis ; 224(12 Suppl 2): S285-S292, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34469557

RESUMO

BACKGROUND: The 10-valent conjugate vaccine (PCV10) was introduced into the Extended Program on Immunization in Madagascar. We assessed the impact of PCV10 on the targeted pneumococcal serotypes among children < 5 years of age at Centre Hospitalier Universitaire Mère Enfant Tsaralalàna. METHOD: Between 2012 and December 2018, cerebrospinal fluid (CSF) samples were collected and tested for S. pneumoniae by culture, and antigen tests. The Sentinel Site Laboratory (SSL) referred available CSF samples to the Regional Reference Laboratory (RRL) for real-time polymerase chain reaction confirmatory testing and serotyping. RESULTS: In total, 3616 CSF specimens were collected. The SSL referred 2716 to the RRL; 125 were positive for S. pneumoniae. At the RRL, 115 samples that tested positive for S. pneumoniae were serotyped; PCV10 serotypes accounted for 20%. Compared to the pre-PCV period, the proportion of S. pneumoniae detected declined from 22% to 6.6%, (P < .05), the proportion of PCV10 serotypes as the cause of pneumococcal meningitis cases declined by 26% following vaccine introduction. CONCLUSIONS: In our findings, PCV10 introduction resulted in a decline of meningitis caused by S. pneumoniae and PCV10 vaccine serotypes.


Assuntos
Líquido Cefalorraquidiano/microbiologia , Meningite Pneumocócica/epidemiologia , Meningite Pneumocócica/prevenção & controle , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/administração & dosagem , Streptococcus pneumoniae/genética , Vacinas Conjugadas/administração & dosagem , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Madagáscar/epidemiologia , Masculino , Infecções Pneumocócicas/epidemiologia , Vacinas Pneumocócicas/imunologia , Vigilância em Saúde Pública , Reação em Cadeia da Polimerase em Tempo Real , Sorogrupo , Sorotipagem , Streptococcus pneumoniae/isolamento & purificação , Vacinas Conjugadas/imunologia
2.
BMJ Glob Health ; 9(10)2024 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-39438072

RESUMO

Immunisation is a high priority for improving health outcomes. Yet, in many low-income and middle-income countries, achieving coverage targets independently is hindered by lack of domestic resources and reliance on partners' support. Both the 2001 Abuja Declaration and 2016 Addis Declaration were key political commitments to improving immunisation coverage; however, many signatories have yet to meet international targets. Despite signing the Global Vaccine Action Plan and Addis Declaration, the Democratic Republic of the Congo (DRC) was unable to fully disburse its portion of allocated funds to cover vaccines without support from Gavi, the Vaccine Alliance and the World Bank between 2017 and 2019. Additionally, during the same time, vaccine coverage outcomes indicated negative trends, with over 750 000 children considered 'zero-dose' in 2018. In 2019, a primary focus of the then newly elected President's agenda was universal healthcare. In collaboration with development partners and stakeholders, the first Presidential Forum was held as a public commitment to increasing childhood immunisation and ensuring the country remains polio-free. This article seeks to highlight the key outcomes of the Forum such as the signing of the Kinshasa Declaration, which formally set targets and specified national, provincial and community-level commitments to vaccination and polio eradication. As of 2023, three Forums have been conducted to reiterate political commitment to routine immunisation in the DRC. This type of high-level commitment could serve as a template for other countries struggling to have high engagement as targets for polio eradication and strengthened routine immunisation are set for 2025-2030.


Assuntos
Programas de Imunização , Poliomielite , Política , Humanos , República Democrática do Congo , Poliomielite/prevenção & controle , Erradicação de Doenças , Política de Saúde
3.
BMJ Open ; 7(4): e012959, 2017 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-28389483

RESUMO

OBJECTIVE: The aim of this study was to estimate the proportion of rubella disease in a measles case-based surveillance in Cameroon prior to rubella vaccine introduction into the national immunisation programme. DESIGN: This was a cross-sectional study for rubella infection in Cameroon for the period 2008 to 2014. SETTING: Patients suspected with measles from the 10 regions of Cameroon were recruited according to the WHO measles case definition and were tested for rubella IgM antibodies accompanied with the case report/investigation forms. PARTICIPANTS: All persons with rash and fever within 14 days of onset of rash according to the standard WHO African Regional Office (WHO/AFRO) case definition for a suspected measles case. OUTCOME MEASURES: Descriptive analyses and simple logistic regressions were performed. OR were estimated. RESULTS: A total of 9907 serum samples from people with fever and rash were received in the laboratory from 2008 to 2014. A total of 7489 (75.59%) measles-negative samples were tested for rubella; 699 (9.3%) were positive for rubella IgM antibodies. Logistic regression analysis was done using IgM antibodies detection as the outcome variable. Age, sex and setting were explanatory variables. Logistic regression analysis revealed that, comparing the proportion of rubella IgM seropositivity status by age, the association to a positive rubella IgM increased with age from 1 to 4 years (OR 7.11; 95% CI 4.35 to 12.41; p<0.0001), through 5 to 9 years (OR 13.07; 95% CI 7.93 to 22.93; p<0.001), to 10 to 14 years of age (OR 13.86; 95% CI 8.06 to 25.12; p<0.001). Persons aged ≥15 years were also more likely to have rubella infection than children under one (OR 3.69; 95% CI 1.85 to 7.48; p=0.0001). There were also significant associations with sex, with males being less associated to a positive rubella serology than females (OR 1.33; 95% CI 1.14 to 1.56; p=0.0001). No statistically significant difference in proportion of rubella cases was observed between urban and rural populations (OR 1.11; 95% CI 0.94 to 1.31; p=0.208). CONCLUSIONS: This study reveals that rubella virus circulates in Cameroon, with important number of cases in children under 15 years. This finding supports the planned introduction of rubella-containing vaccines into the Expanded Program on Immunization.


Assuntos
Sarampo/epidemiologia , Rubéola (Sarampo Alemão)/epidemiologia , Adolescente , Adulto , Idoso , Anticorpos Antivirais/imunologia , Camarões/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Monitoramento Epidemiológico , Feminino , Humanos , Programas de Imunização , Imunoglobulina M , Lactente , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Rubéola (Sarampo Alemão)/imunologia , Rubéola (Sarampo Alemão)/prevenção & controle , Vacina contra Rubéola/uso terapêutico , Adulto Jovem
4.
J Clin Virol ; 62: 80-3, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25542478

RESUMO

BACKGROUND: The World Health Organization (WHO) poliovirus eradication program includes careful surveillance of acute-flaccid paralysis (AFP) and mass and routine immunization with oral polio vaccine (OPV). In populations with low vaccine coverage, the live-attenuated Sabin strains, OPV types 1, 2 and 3, can evolve into virulent vaccine-derived polioviruses (VDPVs) and circulate in the community. Until recently, circulating VDPVs (cVDPVs) had not been reported in Cameroon despite the fact that VDPV2 outbreaks have occurred in nearby countries. OBJECTIVES: This study aimed to characterize virus isolates from four AFP patients infected with cVDPV2 in the Extreme North region of Cameroon in 2013. STUDY DESIGN: The complete VP1 region of the four VDPV strains was sequenced and the relationships with cVDPVs from neighboring countries were investigated. RESULTS: All four patients were infected by cVDPV2 strains showing 1.2-2.0% nucleotide difference compared to the reference Sabin 2 VP1 sequence. Phylogenetic analysis indicated that the VDPV strains were genetically linked to cVDPV2 lineages of the recent Chad cVDPV2 outbreak. CONCLUSIONS: The circulation of pathogenic VDPVs suggests that there are localized immunization gaps in some districts like Makary, Mada and Kolofata in Cameroon. To avoid poliomyelitis outbreaks in Cameroon, especially in the districts close to neighboring countries with ongoing cVDPV outbreaks, high polio vaccine coverage is essential.


Assuntos
Poliomielite/epidemiologia , Poliomielite/virologia , Vacinas contra Poliovirus/efeitos adversos , Adolescente , Adulto , Camarões/epidemiologia , Proteínas do Capsídeo/genética , Criança , Feminino , Geografia , Humanos , Masculino , Filogenia , Poliomielite/prevenção & controle , Poliovirus/classificação , Poliovirus/genética , Poliovirus/imunologia , Poliovirus/isolamento & purificação , Vacinas contra Poliovirus/genética , Adulto Jovem
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