scholarly journals Rotavirus infection in Northern Territory before and after vaccination

2012 ◽  
Vol 33 (2) ◽  
pp. 61 ◽  
Author(s):  
Thomas Snelling ◽  
Peter Markey ◽  
Jonathan Carapetis ◽  
Ross Andrews
Keyword(s):  
Disease Burden ◽  
Northern Territory ◽  
Vaccine Effectiveness ◽  
Older Children ◽  
Rotavirus Gastroenteritis ◽  
Rotavirus Vaccines ◽  
Indigenous Children ◽  
Resource Poor ◽  
Before And After ◽  
High Disease Burden

Globally, rotavirus vaccines have been found to have reduced effectiveness in resource-poor and high disease burden settings. Prior to vaccination, the burden of rotavirus gastroenteritis was substantially higher among Indigenous children in the Northern Territory (NT) than among other Australian children, giving rise to concern about the likely impact of vaccination in this population. Post-licensure studies in the NT indicate that vaccination protects infants against hospitalisation in this setting, but vaccine effectiveness (VE) among older children and against heterotypic serotypes needs to be more clearly determined.

scholarly journals Emergence of Double- and Triple-Gene Reassortant G1P[8] Rotaviruses Possessing a DS-1-Like Backbone after Rotavirus Vaccine Introduction in Malawi

2017 ◽  
Vol 92 (3) ◽  
Author(s):  
Khuzwayo C. Jere ◽  
Chrispin Chaguza ◽  
Naor Bar-Zeev ◽  
Jenna Lowe ◽  
Chikondi Peno ◽  
...  
Keyword(s):  
Amino Acid ◽  
Vaccine Effectiveness ◽  
Recent Common Ancestor ◽  
Rotavirus Vaccine ◽  
Careful Evaluation ◽  
African Countries ◽  
Vaccine Introduction ◽  
Rotavirus Gastroenteritis ◽  
Structural Conformation ◽  
Rotavirus Vaccines

ABSTRACT To combat the high burden of rotavirus gastroenteritis, multiple African countries have introduced rotavirus vaccines into their childhood immunization programs. Malawi incorporated a G1P[8] rotavirus vaccine (Rotarix) into its immunization schedule in 2012. Utilizing a surveillance platform of hospitalized rotavirus gastroenteritis cases, we examined the phylodynamics of G1P[8] rotavirus strains that circulated in Malawi before (1998 to 2012) and after (2013 to 2014) vaccine introduction. Analysis of whole genomes obtained through next-generation sequencing revealed that all randomly selected prevaccine G1P[8] strains sequenced ( n = 32) possessed a Wa-like genetic constellation, whereas postvaccine G1P[8] strains ( n = 18) had a DS-1-like constellation. Phylodynamic analyses indicated that postvaccine G1P[8] strains emerged through reassortment events between human Wa- and DS-1-like rotaviruses that circulated in Malawi from the 1990s and hence were classified as atypical DS-1-like reassortants. The time to the most recent common ancestor for G1P[8] strains was from 1981 to 1994; their evolutionary rates ranged from 9.7 × 10 −4 to 4.1 × 10 −3 nucleotide substitutions/site/year. Three distinct G1P[8] lineages chronologically replaced each other between 1998 and 2014. Genetic drift was the likely driver for lineage turnover in 2005, whereas replacement in 2013 was due to reassortment. Amino acid substitution within the outer glycoprotein VP7 of G1P[8] strains had no impact on the structural conformation of the antigenic regions, suggesting that it is unlikely that they would affect recognition by vaccine-induced neutralizing antibodies. While the emergence of DS-1-like G1P[8] rotavirus reassortants in Malawi was therefore likely due to natural genotype variation, vaccine effectiveness against such strains needs careful evaluation. IMPORTANCE The error-prone RNA-dependent RNA polymerase and the segmented RNA genome predispose rotaviruses to genetic mutation and genome reassortment, respectively. These evolutionary mechanisms generate novel strains and have the potential to lead to the emergence of vaccine escape mutants. While multiple African countries have introduced a rotavirus vaccine, there are few data describing the evolution of rotaviruses that circulated before and after vaccine introduction. We report the emergence of atypical DS-1-like G1P[8] strains during the postvaccine era in Malawi. Three distinct G1P[8] lineages circulated chronologically from 1998 to 2014; mutation and reassortment drove lineage turnover in 2005 and 2013, respectively. Amino acid substitutions within the outer capsid VP7 glycoprotein did not affect the structural conformation of mapped antigenic sites, suggesting a limited effect on the recognition of G1-specific vaccine-derived antibodies. The genes that constitute the remaining genetic backbone may play important roles in immune evasion, and vaccine effectiveness against such atypical strains needs careful evaluation.

scholarly journals Determination of a Viral Load Threshold To Distinguish Symptomatic versus Asymptomatic Rotavirus Infection in a High-Disease-Burden African Population

2015 ◽  
Vol 53 (6) ◽  
pp. 1951-1954 ◽  
Author(s):  
A. Bennett ◽  
N. Bar-Zeev ◽  
K. C. Jere ◽  
J. E. Tate ◽  
U. D. Parashar ◽  
...  
Keyword(s):  
Viral Load ◽  
Acute Gastroenteritis ◽  
Gold Standard ◽  
Disease Burden ◽  
Rotavirus Vaccine ◽  
Quantitative Real Time Pcr ◽  
Rotavirus Gastroenteritis ◽  
Asymptomatic Children ◽  
High Disease Burden

We evaluated quantitative real-time PCR to establish the diagnosis of rotavirus gastroenteritis in a high-disease-burden population in Malawi using enzyme immunoassay as the gold standard diagnostic test. In 146 children with acute gastroenteritis and 65 asymptomatic children, we defined a cutoff point in the threshold cycle value (26.7) that predicts rotavirus-attributable gastroenteritis in this population. These data will inform the evaluation of direct and indirect rotavirus vaccine effects in Africa.

576 PREDICTORS OF HIGH DISEASE BURDEN IN CHILDREN WITH ACUTE RECURRENT OR CHRONIC PANCREATITIS*

2021 ◽  
Vol 160 (6) ◽  
pp. S-112-S-113
Author(s):  
Aliye Uc ◽  
Laura Rubin ◽  
Gretchen Cress ◽  
Ying Yuan ◽  
Mark Lowe
Keyword(s):  
Chronic Pancreatitis ◽  
Disease Burden ◽  
High Disease Burden

Effectiveness of rotavirus vaccines for prevention of rotavirus gastroenteritis-associated hospitalizations in Israel: A case-control study

2010 ◽  
Vol 6 (6) ◽  
pp. 450-454 ◽  
Author(s):  
Khitam Muhsen ◽  
Lester Shulman ◽  
Eias Kasem ◽  
Uri Rubinstein ◽  
Jacob Shachter ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Rotavirus Gastroenteritis ◽  
Rotavirus Vaccines ◽  
Control Study

Renal Osteodystrophy in Children with Chronic Renal Failure: An Unexpectedly Common and Incapacitating Complication

PEDIATRICS ◽  
1982 ◽  
Vol 70 (5) ◽  
pp. 742-750 ◽  
Author(s):  
Anthony C. Hsu ◽  
Sang Whay Kooh ◽  
Donald Fraser ◽  
William A. Cumming ◽  
Victor L. Fornasier
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Renal Osteodystrophy ◽  
Age At Onset ◽  
Growth Zone ◽  
Growth Patterns ◽  
Bone Lesions ◽  
Older Children ◽  
Before And After ◽  
End Stage

The incidence, age at onset, and progression of the biochemical, radiographic, and histologic characteristics of renal osteodystrophy were studied in 50 children in whom chronic renal failure had been recently diagnosed. During a ten-year observation period, 19 patients progressed to end-stage renal failure and radiographic signs of renal osteodystrophy developed in 15 of these (79%). Renal osteodystrophy developed in all nine patients whose chronic renal failure was diagnosed before 3 years of age and in six of the ten children with later onset of failure. The mean interval from diagnosis of renal failure to development of osteodystrophy was 1.4 years. Radiographically, growth zone lesions predominated in the younger children, whereas cortical erosions were more prevalent in the older children. Histologic examination, performed in 38 patients, showed both defective mineralization and excessive resorption and was a more sensitive diagnostic index than radiography. Noticeable deformities developed in one third of the patients with osteodystrophy, despite medical treatment including vitamin D2 therapy. Deformities were particularly frequent and Severe in patients whose renal failure developed in infancy. In all 13 patients whose growth patterns were studied before and after osteodystrophy developed, the onset of bone lesions was associated with a deterioration of growth, indicating that osteodystrophy plays a major role in causing the growth retardation commonly observed in children with chronic renal failure.

scholarly journals Genomics research in Africa and its impact on global health: insights from African researchers

2018 ◽  
Vol 3 ◽  
Author(s):  
N. S. Munung ◽  
B. M. Mayosi ◽  
J. de Vries
Keyword(s):  
Global Health ◽  
Disease Surveillance ◽  
Disease Burden ◽  
Research Priorities ◽  
Treatment And Prevention ◽  
Genomics Research ◽  
African Populations ◽  
Research Findings ◽  
Depth Interviews ◽  
High Disease Burden

Africa may be heading for an era of genomics medicine. There are also expectations that genomics may play a role in reducing global health inequities. However, the near lack of genomics studies on African populations has led to concerns that genomics may widen, rather than close, the global health inequity gap. To prevent a possible genomics divide, the genomics ‘revolution’ has been extended to Africa. This is motivated, in part, by Africa's rich genetic diversity and high disease burden. What remains unclear, however, are the prospects of using genomics technology for healthcare in Africa. In this qualitative study, we explored the views of 17 genomics researchers in Africa on the prospects and challenges of genomics medicine in Africa. Interviewees were researchers in Africa who were involved in genomics research projects in Africa. Analysis of in-depth interviews suggest that genomics medicine may have an impact on disease surveillance, diagnosis, treatment and prevention. However, Africa's capacity for genomics medicine, current research priorities in genomics and the translation of research findings will be key defining factors impacting on the ability of genomics medicine to improve healthcare in Africa.

Splenomegaly with Hypersplenism in Sickle Cell Anemia Treated by Radiation—Case Report

PEDIATRICS ◽  
1971 ◽  
Vol 48 (3) ◽  
pp. 457-458
Author(s):  
Annemarie Sommer ◽  
Stella B. Kontras
Keyword(s):  
Cell Survival ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Marked Improvement ◽  
Costal Margin ◽  
Red Cell ◽  
Older Children ◽  
Before And After ◽  
Red Cell Survival ◽  
Survival Studies

The incidence of splenomegaly in sickle cell anemia (defined as a spleen easily palpated below the costal margin in quiet respiration) appears to be around 10% after 10 years of age. Persistent splenomegaly in older children is rare and frequently is associated with hypersplenism. Splenectomy has been the treatment of choice in several reported cases based on red cell survival studies before and after splenectomy.1-3 Removal of the spleen has been found to be associated with marked improvement of previously very shortened red cell survival. We want to report the case of a 12-year-old boy with sickle cell anemia, splenomegaly, and sickle cell heart disease who was treated by radiation therapy for his enlarged spleen because of hypersplenism.

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