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James M Stuart
The WHO Strategic Advisory Group of Experts is reviewing the technical evidence to inform policy on optimal use of infant pneumococcal conjugate vaccines (PCV)(1). Since 2010, multivalent vaccines (PCV-10, PCV-13) have been successfully introduced with the support of Gavi the Vaccine Alliance into infant immunisation programmes across the developing world(2). One recommended schedule consists of three doses under the age of 6 months (3+0), with the aim of providing maximum protection to infants, the age group at highest risk of pneumococcal disease(3)...
February 28, 2017: Tropical Medicine & International Health: TM & IH
Cheryl Cohen, Claire von Mollendorf, Linda de Gouveia, Sarona Lengana, Susan Meiring, Vanessa Quan, Arthermon Nguweneza, David P Moore, Gary Reubenson, Mamokgethi Moshe, Shabir A Madhi, Brian Eley, Ute Hallbauer, Heather Finlayson, Sheeba Varughese, Katherine L O'Brien, Elizabeth R Zell, Keith P Klugman, Cynthia G Whitney, Anne von Gottberg
BACKGROUND: The 13-valent pneumococcal conjugate vaccine (PCV13) was designed to include disease-causing serotypes that are important in low-income and middle-income countries. Vaccine effectiveness estimates are scarce in these settings. South Africa replaced PCV7 with PCV13 in 2011 using a 2 + 1 schedule. We aimed to assess the effectiveness of two or more doses of PCV13 against invasive pneumococcal disease in children with HIV infection and in those not infected with HIV. METHODS: Cases of invasive pneumococcal disease in children aged 5 years or younger were identified through national laboratory-based surveillance...
March 2017: Lancet Global Health
Chelsea Clinton, Devi Sridhar
In this report we assess who pays for cooperation in global health through an analysis of the financial flows of WHO, the World Bank, the Global Fund to Fight HIV/AIDS, TB and Malaria, and Gavi, the Vaccine Alliance. The past few decades have seen the consolidation of influence in the disproportionate roles the USA, UK, and the Bill & Melinda Gates Foundation have had in financing three of these four institutions. Current financing flows in all four case study institutions allow donors to finance and deliver assistance in ways that they can more closely control and monitor at every stage...
January 27, 2017: Lancet
Silvia Nardelli, Sanath Allampati, Oliviero Riggio, Kevin D Mullen, Ravi Prakash, Stefania Gioia, Ariel Unser, Melanie B White, Andrew C Fagan, James B Wade, Alessio Farcomeni, Edith A Gavis, Jasmohan S Bajaj
BACKGROUND: Hepatic encephalopathy (HE) is considered reversible regarding mental status but may not be cognitively in single-center studies. AIM: To evaluate persistence of learning impairment in prior HE compared to those who never experienced HE (no-HE) in a multicenter study. METHODS: A total of 174 outpatient cirrhotics from three centers (94 Virginia, 30 Ohio, and 50 Rome; 36 prior HE) underwent psychometric hepatic encephalopathy score (PHES) and inhibitory control (ICT) testing at baseline and then at least 7 days apart...
December 30, 2016: Digestive Diseases and Sciences
Sachin N Desai, Lorenzo Pezzoli, Kathryn P Alberti, Stephen Martin, Alejandro Costa, William Perea, Dominique Legros
Cholera remains an important but neglected public health threat, affecting the health of the poorest populations and imposing substantial costs on public health systems. Cholera can be eliminated where access to clean water, sanitation, and satisfactory hygiene practices are sustained, but major improvements in infrastructure continue to be a distant goal. New developments and trends of cholera disease burden, the creation of affordable oral cholera vaccines (OCVs) for use in developing countries, as well as recent evidence of vaccination impact has created an increased demand for cholera vaccines...
March 4, 2017: Human Vaccines & Immunotherapeutics
Anagha Loharikar, Laure Dumolard, Susan Chu, Terri Hyde, Tracey Goodman, Carsten Mantel
Since the global Expanded Program on Immunization (EPI) was launched in 1974, vaccination against six diseases (tuberculosis, polio, diphtheria, tetanus, pertussis, and measles) has prevented millions of deaths and disabilities (1). Significant advances have been made in the development and introduction of vaccines, and licensed vaccines are now available to prevent 25 diseases (2,3). Historically, new vaccines only became available in low-income and middle-income countries decades after being introduced in high-income countries...
October 21, 2016: MMWR. Morbidity and Mortality Weekly Report
Hani Kim, Florian Marks, Uros Novakovic, Peter J Hotez, Robert E Black
OBJECTIVE: To examine the current partnerships to improve the childhood immunization programme in the Democratic Peoples' Republic of Korea (DPRK) in the context of the political determinants of health equity. METHODS: A literature search was conducted to identify public health collaborations with the DPRK government. Based on the amount of publicly accessible data and a shared approach in health-system strengthening among the partners in immunization programmes, the search focused on these partnerships...
May 9, 2016: Tropical Medicine & International Health: TM & IH
Emilia Vynnycky, Elisabeth J Adams, Felicity T Cutts, Susan E Reef, Ann Marie Navar, Emily Simons, Lay-Myint Yoshida, David W J Brown, Charlotte Jackson, Peter M Strebel, Alya J Dabbagh
BACKGROUND: The burden of Congenital Rubella Syndrome (CRS) is typically underestimated in routine surveillance. Updated estimates are needed following the recent WHO position paper on rubella and recent GAVI initiatives, funding rubella vaccination in eligible countries. Previous estimates considered the year 1996 and only 78 (developing) countries. METHODS: We reviewed the literature to identify rubella seroprevalence studies conducted before countries introduced rubella-containing vaccination (RCV)...
2016: PloS One
Grant A Mackenzie, Philip C Hill, David J Jeffries, Ilias Hossain, Uchendu Uchendu, David Ameh, Malick Ndiaye, Oyedeji Adeyemi, Jayani Pathirana, Yekini Olatunji, Bade Abatan, Bilquees S Muhammad, Augustin E Fombah, Debasish Saha, Ian Plumb, Aliu Akano, Bernard Ebruke, Readon C Ideh, Bankole Kuti, Peter Githua, Emmanuel Olutunde, Ogochukwu Ofordile, Edward Green, Effua Usuf, Henry Badji, Usman N A Ikumapayi, Ahmad Manjang, Rasheed Salaudeen, E David Nsekpong, Sheikh Jarju, Martin Antonio, Sana Sambou, Lamin Ceesay, Yamundow Lowe-Jallow, Momodou Jasseh, Kim Mulholland, Maria Knoll, Orin S Levine, Stephen R Howie, Richard A Adegbola, Brian M Greenwood, Tumani Corrah
BACKGROUND: Little information is available about the effect of pneumococcal conjugate vaccines (PCVs) in low-income countries. We measured the effect of these vaccines on invasive pneumococcal disease in The Gambia where the 7-valent vaccine (PCV7) was introduced in August, 2009, followed by the 13-valent vaccine (PCV13) in May, 2011. METHODS: We conducted population-based surveillance for invasive pneumococcal disease in individuals aged 2 months and older who were residents of the Basse Health and Demographic Surveillance System (BHDSS) in the Upper River Region, The Gambia, using standardised criteria to identify and investigate patients...
June 2016: Lancet Infectious Diseases
Jasmohan S Bajaj, Naga S Betrapally, Phillip B Hylemon, Leroy R Thacker, Kalyani Daita, Dae Joong Kang, Melanie B White, Ariel B Unser, Andrew Fagan, Edith A Gavis, Masoumeh Sikaroodi, Swati Dalmet, Douglas M Heuman, Patrick M Gillevet
Diabetes (DM) is prevalent in cirrhosis and may modulate the risk of hospitalization through gut dysbiosis. We aimed to define the role of gut microbiota on 90-day hospitalizations and of concomitant DM on microbiota. Cirrhotic outpatients with/without DM underwent stool and sigmoid mucosal microbial analysis and were followed for 90 days. Microbial composition was compared between those with/without DM, and those who were hospitalized/not. Regression/ROC analyses for hospitalizations were performed using clinical and microbial features...
December 22, 2015: Scientific Reports
Feng-Jen Tsai, Howard Lee, Victoria Y Fan
BACKGROUND: This paper aimed to compare the health systems strengthening (HSS) framework of Gavi and WHO and to analyze resource allocation in HSS by Gavi. METHODS: Among 76 countries which received HSS funding from Gavi from 2006 to 2013, summary reports of 44 countries and approved proposals of 10 countries were collected. After comparing the HSS framework of WHO and Gavi, each activity described in documents was categorized according to Gavi's framework and funding allocation was analyzed...
July 2016: International Health
Mette M Lauridsen, Leroy R Thacker, Melanie B White, Ariel Unser, Richard K Sterling, Richard T Stravitz, Scott Matherly, Puneet Puri, Arun J Sanyal, Edith A Gavis, Velimir Luketic, Muhammad S Siddiqui, Douglas M Heuman, Michael Fuchs, Jasmohan S Bajaj
BACKGROUND & AIMS: Minimal hepatic encephalopathy (MHE) has been linked to higher real-life rates of automobile crashes and poor performance in driving simulation studies, but the link between driving simulator performance and real-life automobile crashes has not been clearly established. Furthermore, not all patients with MHE are unsafe drivers, but it is unclear how to distinguish them from unsafe drivers. We investigated the link between performance on driving simulators and real-life automobile accidents and traffic violations...
May 2016: Clinical Gastroenterology and Hepatology
Melissa A Penny, Robert Verity, Caitlin A Bever, Christophe Sauboin, Katya Galactionova, Stefan Flasche, Michael T White, Edward A Wenger, Nicolas Van de Velde, Peter Pemberton-Ross, Jamie T Griffin, Thomas A Smith, Philip A Eckhoff, Farzana Muhib, Mark Jit, Azra C Ghani
BACKGROUND: The phase 3 trial of the RTS,S/AS01 malaria vaccine candidate showed modest efficacy of the vaccine against Plasmodium falciparum malaria, but was not powered to assess mortality endpoints. Impact projections and cost-effectiveness estimates for longer timeframes than the trial follow-up and across a range of settings are needed to inform policy recommendations. We aimed to assess the public health impact and cost-effectiveness of routine use of the RTS,S/AS01 vaccine in African settings...
January 23, 2016: Lancet
Fidèle Ngabo, Ann Levin, Susan A Wang, Maurice Gatera, Celse Rugambwa, Celestin Kayonga, Philippe Donnen, Philippe Lepage, Raymond Hutubessy
BACKGROUND: Detailed cost evaluations of delivery of new vaccines such as pneumococcal conjugate, human papillomavirus (HPV), and rotavirus vaccines in low and middle-income countries are scarce. This paper differs from others by comparing the costs of introducing multiple vaccines in a single country and then assessing the financial and economic impact at the time and implications for the future. The objective of the analysis was to understand the introduction and delivery cost per dose or per child of the three new vaccines in Rwanda to inform domestic and external financial resource mobilization...
December 16, 2015: Vaccine
Moses Muia Masika, Javier Gordon Ogembo, Sophie Vusha Chabeda, Richard G Wamai, Nelly Mugo
BACKGROUND: Vaccines against human papillomavirus (HPV) infection have the potential to reduce the burden of cervical cancer. School-based delivery of HPV vaccines is cost-effective and successful uptake depends on school teachers' knowledge and acceptability of the vaccine. The aim of this study is to assess primary school teachers' knowledge and acceptability of HPV vaccine and to explore facilitators and barriers of an ongoing Gavi Alliance-supported vaccination program in Kitui County, Kenya...
2015: PloS One
Phuc Le, Ulla K Griffiths, Dang Duc Anh, Luisa Franzini, Wenyaw Chan, J Michael Swint
BACKGROUND: With GAVI support, Vietnam introduced Haemophilus influenzae type b (Hib) vaccine in 2010 without evidence on cost-effectiveness. We aimed to analyze the cost-effectiveness of Hib vaccine from societal and governmental perspectives. METHOD: We constructed a decision-tree cohort model to estimate the costs and effectiveness of Hib vaccine versus no Hib vaccine for the 2011 birth cohort. The disease burden was estimated from local epidemiologic data and literature...
August 26, 2015: Vaccine
Michèle Anne Barocchi, Rino Rappuoli
Thanks to the Global Alliance for Vaccines and Immunization (GAVI), the Vaccine Fund and the Bill & Melinda Gates Foundation, the global health community has made enormous progress in providing already existing vaccines to developing countries. However, there still exists a gap to develop vaccines for which there is no market in the Western world, owing to low economic incentives for the private sector to justify the investments necessary for vaccine development. In many cases, industry has the technologies, but lacks the impetus to direct resources to develop these vaccine products...
June 19, 2015: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
Rolando Herrero, Paula González, Lauri E Markowitz
Oncogenic human papillomavirus (HPV) infection is the cause of nearly all cervical cancers and a proportion of other anogenital and oropharyngeal cancers. A bivalent vaccine containing HPV 16 and 18 and a quadrivalent vaccine containing HPV 6, 11, 16, and 18 antigens are in use in vaccination programmes around the world. In clinical trials, three vaccine doses provided 90-100% protection against cervical infection and pre-cancer related to HPV 16 and 18 in women aged 15-26 years who were not infected at vaccination...
May 2015: Lancet Oncology
Preeti Patel, Rachael Cummings, Bayard Roberts
BACKGROUND: Global Health Initiatives (GHIs) respond to high-impact communicable diseases in resource-poor countries, including health systems support, and are major actors in global health. GHIs could play an important role in countries affected by armed conflict given these countries commonly have weak health systems and a high burden of communicable disease. The aim of this study is to explore the influence of two leading GHIs, the Global Fund and the GAVI Alliance, on the health systems of conflict-affected countries...
2015: Conflict and Health
Mainga Hamaluba, Rama Kandasamy, Shyam R Upreti, Giri R Subedi, Shrijana Shrestha, Shiva Bhattarai, Meeru Gurung, Rahul Pradhan, Merryn Voysey, Santosh Gurung, Shachi Pradhan, Anushil K Thapa, Rakesh Maharjan, Usha Kiran, Simon A Kerridge, Jason Hinds, Fiona van der Klis, Matthew D Snape, David R Murdoch, Sarah Kelly, Dominic F Kelly, Neelam Adhikari, Stephen Thorson, Andrew J Pollard
BACKGROUND: Use of pneumococcal conjugate vaccines (PCVs) in resource-poor countries has focused on early infant immunisation with little emphasis on protection in late infancy and beyond. Boosting of the immune response later in infancy might provide improved persistence of immunogenicity into early childhood, however data are scarce. The aim of this study was to investigate if a two-dose prime with booster at age 9 months compared with a three-dose prime-only PCV schedule provided non-inferior immunogenicity in early infancy and superior persistence of antibody responses in early childhood...
April 2015: Lancet Infectious Diseases
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