Effectiveness of the seven- and thirteen valent pneumococcal conjugate vaccines against vaccine-serotype otitis media

2021 ◽  
Author(s):  
Ron Dagan ◽  
Bart Adriaan van der Beek ◽  
Shalom Ben-Shimol ◽  
Tamara Pilishvili ◽  
Noga Givon-Lavi
Keyword(s):  
Otitis Media ◽  
Real Life ◽  
Geographic Location ◽  
Population Based ◽  
Age Group ◽  
Unconditional Logistic Regression ◽  
Conjugate Vaccines ◽  
Middle Ear Fluid ◽  
Ethnic Distribution ◽  
Culture Positive

Abstract Background Despite the demonstrated impact of pneumococcal vaccine (PCV) implementation on otitis media (OM), demonstration of real-life serotype-specific effectiveness of the 7- and 13-valent PCVs (PCV7 and PCV13) is lacking due to the paucity of culture-positive cases. . Furthermore, pre-licensure PCV13 efficacy against OM was not studied. Methods The study was conducted from October 2009 to July 2013. Cases were children aged 5-35 months-old with OM (mostly complex OM [recurrent/non-responsive, spontaneously draining, chronic with effusion) from whom middle-ear fluid (MEF) culture was obtained; controls were contemporary children with rotavirus-negative gastroenteritis in a prospective population-based rotavirus surveillance, from the same age group with similar ethnic distribution and geographic location. Vaccine effectiveness (VE, 95% CI) was estimated as one minus odds ratio using unconditional logistic regression, adjusting for time since PCV implementation, age and ethnicity. Results 223 cases and 1,370 controls were studied. Serotypes 19F and 19A together caused 56.1% of all vaccine-serotype OM. VE of ≥2 PCV doses in children 5-35m was demonstrated as follows: PCV7 against OM due to PCV7 serotypes (VT7-OM), 57.2% (6.0-80.5); PCV13 against VT13-OM, 77.4% (53.3-92.1), PCV13 against OM due to the 6 additional non-VT7 serotypes 67.4%, (17.6-87.1), PCV13 against 19F-OM, 91.3% (1.4-99.2); and PCV13 against serotype 3-OM, 85.2% (23.9-98.4%). PCV7 and PCV13 VE against serotype 19A-OM in children 12-35m was 72.4 (6.2-91.9) and 94.6% (33.9-99.6), respectively. Conclusions PCV7 and PCV13 were effective against complex OM caused by the targeted serotypes.

Substantial reduction of antibiotic-non-susceptible pneumococcal otitis media following PCV7/PCV13 sequential introduction

2020 ◽  
Vol 75 (10) ◽  
pp. 3038-3045
Author(s):  
Shalom Ben-Shimol ◽  
Noga Givon-Lavi ◽  
David Greenberg ◽  
Bart Adriaan van der Beek ◽  
Eugene Leibovitz ◽  
...  
Keyword(s):  
Young Children ◽  
Otitis Media ◽  
Active Surveillance ◽  
Middle Ear ◽  
Substantial Reduction ◽  
Population Based ◽  
Vaccine Serotypes ◽  
Middle Ear Fluid ◽  
Fluid Culture

Abstract Background In the pre-pneumococcal conjugated vaccines (PCVs) era, serotypes included in the 7/13-valent PCVs (PCV7/PCV13) caused most pneumococcal otitis media (OM) and antibiotic-non-susceptible pneumococcal OM (ANSP-OM) episodes. In southern Israel, sequential PCV7/PCV13 introduction resulted in >90% reduction of vaccine-serotype OM. Objectives We assessed the dynamics of ANSP-OM necessitating middle ear fluid culture following PCV7/PCV13 sequential introduction in young children. Methods This was a prospective, population-based, active surveillance. All episodes in children <3 years old, during 2004–16, were included. Two subperiods were defined: (i) pre-PCV: 2004–08; and (ii) PCV13: 2014–16. ANSP was defined for the following antibiotics: penicillin (MIC ≥0.1 mg/L and ≥1.0 mg/L), macrolide, tetracycline, clindamycin, ceftriaxone, trimethoprim/sulfamethoxazole and chloramphenicol. MDR was defined as ANSP for ≥3 classes. Results Overall, 2270 pneumococcal OM episodes were identified. Annual overall pneumococcal, PCV13 and non-PCV13 serotype OM incidence declined by 86%, 97% and 33%, respectively, comparing pre-PCV with the PCV13 period. During 2004–08, 95% of ANSP was observed in vaccine serotypes. Incidence of penicillin (MIC ≥0.1 mg/L and ≥1.0 mg/L), macrolide, tetracycline, clindamycin, ceftriaxone and multidrug ANSP-OM declined by >90% in the PCV13 period. Rates of trimethoprim/sulfamethoxazole and chloramphenicol ANSP-OM declined by 85% and 79%, respectively. The proportions of ANSP of all pneumococcal isolates declined by ∼70% for penicillin, ceftriaxone and erythromycin; 53% for tetracycline; and 55% for MDR, versus no significant reductions observed for chloramphenicol, trimethoprim/sulfamethoxazole and clindamycin. Conclusions PCV7/PCV13 sequential introduction resulted in rapid and substantial ANSP-OM reduction, in parallel with the near disappearance of PCV13-serotype OM and no increase in replacement disease.

Bacterial Spectrum of Acute Otitis Media in Bulgarian Children during the 10-Valent Pneumococcal Conjugate Vaccine Era

2020 ◽  
Vol 15 (03) ◽  
pp. 135-143
Author(s):  
Lena Setchanova ◽  
Iglika Stancheva ◽  
Diana Popova ◽  
Alexandra Alexandrova ◽  
Ivan Mitov
Keyword(s):  
Streptococcus Pneumoniae ◽  
Otitis Media ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Acute Otitis Media ◽  
Childhood Vaccination ◽  
Middle Ear Fluid ◽  
High Prevalence ◽  
Culture Positive ◽  
Prevalent Pathogen

Abstract Objective The 10-valent pneumococcal conjugate vaccine (PCV10) was introduced in Bulgaria for universal childhood vaccination in 2010. The objective of this study was to describe bacterial pathogens responsible for acute otitis media (AOM) in children in the era of routine PCV10 immunization. Materials and Methods Middle ear fluid (MEF)/otorrhea or nasopharyngeal specimens were collected between May 2012 and April 2017 from 425 children aged < 12 years diagnosed with AOM; 71.5% of them were vaccinated. Capsular types of Streptococcus pneumoniae and Haemophilus influenzae and antimicrobial nonsusceptibility were determined. Results Among 240 children with “severe” AOM, the studied specimens were MEF/otorrhea, and a total of 132 (55.0%) children were culture-positive. The most frequently identified bacteria were S. pyоgenes (31.1%), followed by Staphylococcus aureus (21.2%), S. pneumoniae (20.4%), and nontypeable H. influenzae (12.1%). Among 185 nasopharyngeal specimens obtained from children at the onset of a “mild” AOM episode, 67.0% were culture-positive for otopathogens. The most common pathogens were S. pneumoniae (41.9%), followed by H. influenzae (25.8%), Moraxella catarrhalis (23.4%), and S. pyоgenes (14.5%), alone or in combinations. Among children with pneumococcal AOM (79), PCV10 serotypes (VTs) were 21.5%. A high prevalence (50%) of nonvaccine serotypes 3 (14), 19A (11), and 6C (7) was found among vaccinated children. Rates of nonsusceptibility of S. pneumoniae to penicillin, amoxicillin and erythromycin, and of multidrug resistance, were 51.2, 10.1, 51.2, and 51.2, respectively. The rate of ampicillin-non-susceptibility in H. influenzae was 25%. All M. catarrhalis isolates were β-lactamase producers, and 32.2% of S. pyogenes were erythromycin-resistant. Conclusion Following implementation of PCV10, S. pyogenes was the most prevalent pathogen in children with “severe” AOM. Numbers of S. pneumoniae recovered from MEF/otorrhea significantly decreased, as did the overall proportion of VTs among AOM patients. Streptococcus pneumoniae, H. influenzae, and M. catarrhalis were the most commonly found pathogens in the nasopharynx of children with less severe AOM episodes.

scholarly journals Multi-GPU approach to global induction of classification trees for large-scale data mining

2021 ◽  
Author(s):  
Krzysztof Jurczuk ◽  
Marcin Czajkowski ◽  
Marek Kretowski
Keyword(s):  
Data Mining ◽  
Large Scale ◽  
Real Life ◽  
Population Based ◽  
Tree Structure ◽  
Global Approach ◽  
Data Parallel ◽  
Large Scale Data ◽  
The Impact ◽  
Scale Data

AbstractThis paper concerns the evolutionary induction of decision trees (DT) for large-scale data. Such a global approach is one of the alternatives to the top-down inducers. It searches for the tree structure and tests simultaneously and thus gives improvements in the prediction and size of resulting classifiers in many situations. However, it is the population-based and iterative approach that can be too computationally demanding to apply for big data mining directly. The paper demonstrates that this barrier can be overcome by smart distributed/parallel processing. Moreover, we ask the question whether the global approach can truly compete with the greedy systems for large-scale data. For this purpose, we propose a novel multi-GPU approach. It incorporates the knowledge of global DT induction and evolutionary algorithm parallelization together with efficient utilization of memory and computing GPU’s resources. The searches for the tree structure and tests are performed simultaneously on a CPU, while the fitness calculations are delegated to GPUs. Data-parallel decomposition strategy and CUDA framework are applied. Experimental validation is performed on both artificial and real-life datasets. In both cases, the obtained acceleration is very satisfactory. The solution is able to process even billions of instances in a few hours on a single workstation equipped with 4 GPUs. The impact of data characteristics (size and dimension) on convergence and speedup of the evolutionary search is also shown. When the number of GPUs grows, nearly linear scalability is observed what suggests that data size boundaries for evolutionary DT mining are fading.

scholarly journals SARS-CoV-2 infection is at herd immunity in the majority segment of the population of Qatar

2021 ◽  
Author(s):  
Mohamed H Al-Thani ◽  
Elmoubasher Farag ◽  
Roberto Bertollini ◽  
Hamad Eid Al Romaihi ◽  
Sami Abdeen ◽  
...  
Keyword(s):  
Total Population ◽  
Herd Immunity ◽  
Geographic Location ◽  
Population Based ◽  
Infection Prevalence ◽  
Cross Sectional ◽  
Previous Infection ◽  
Current Infection ◽  
Polymerase Chain ◽  
Population Based Survey

Abstract Background Qatar experienced a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic that disproportionately affected the craft and manual worker (CMW) population who comprise 60% of the total population. This study aimed to assess ever and/or current infection prevalence in this population. Methods A cross-sectional population-based survey was conducted during July 26-September 09, 2020 to assess both anti-SARS-CoV-2 positivity through serological testing and current infection positivity through polymerase chain reaction (PCR) testing. Associations with antibody and PCR positivity were identified through regression analyses. Results Study included 2,641 participants, 69.3% of whom were &lt;40 years of age. Anti-SARS-CoV-2 positivity was 55.3% (95% CI: 53.3-57.3%) and was significantly associated with nationality, geographic location, educational attainment, occupation, and previous infection diagnosis. PCR positivity was 11.3% (95% CI: 9.9-12.8%) and was significantly associated with nationality, geographic location, occupation, contact with an infected person, and reporting two or more symptoms. Infection positivity (antibody and/or PCR positive) was 60.6% (95% CI: 58.6-62.5%). The proportion of antibody-positive CMWs that had a prior SARS-CoV-2 diagnosis was 9.3% (95% CI: 7.9-11.0%). Only seven infections were ever severe and one was ever critical—an infection severity rate of 0.5% (95% CI: 0.2-1.0%). Conclusions Six in every 10 CMWs have been infected, suggestive of reaching the herd immunity threshold. Infection severity was low with only one in every 200 infections progressing to be severe or critical. Only one in every 10 infections had been previously diagnosed suggestive of mostly asymptomatic or mild infections.

scholarly journals Sociodemographic Predictors of Physical Functioning in the Elderly: A National Health Survey

2018 ◽  
Vol 16 (1) ◽  
pp. 37
Author(s):  
Milena Kostadinovic ◽  
Dejan Nikolic ◽  
Ivana Petronic ◽  
Dragana Cirovic ◽  
Mirko Grajic ◽  
...  
Keyword(s):  
Marital Status ◽  
Educational Level ◽  
Well Being ◽  
Population Based ◽  
Age Group ◽  
Place Of Residence ◽  
Gender Group ◽  
Group 2 ◽  
Level Group ◽  
Group 1

We aimed to evaluate the prevalence of sociodemographic factors with the presence and different degrees of walking difficulties in elderly above 65 years, and to analyze association between evaluated variables and the presence and degree of waking difficulties. In the population based study, 3540 individuals age above 65 years from Serbia were recruited. Further predictors were analyzed: gender, age, level of education, marital status, body mass index (BMI), index of well-being and place of residence. We assessed difficulty in walking half a km on level ground without the use of any aid (Group-1); and difficulty in walking up or down 12 steps (Group-2). Walking difficulties were categorized as no difficulty, some difficulty, a lot of difficulty and cannot do at all. For present difficulty significant predictors were: age (Group-1 (OR-3.022)/Group-2 (OR-3.825)), gender (Group-1 (OR-0.337)/Group-2 (OR-0.311)), educational level (Group-1 (OR-0.689)/Group-2 (OR-0.556)) and place of residence (Group-2 (OR-1.523)) while for non-performing the task, significant predictors were: age (Group-1 (OR-1.998)/Group-2 (OR-2.096)), gender (Group-1 (OR-0.629)/Group-2 (OR-0.495)), BMI (Group-1 (OR-1.219)/Group-2 (OR-1.305)), marital status (Group-1 (OR 0.764)/Group-2 (OR-0.769)), educational level (Group-1 (OR-0.679)/Group-2 (OR-0.719)) and index of well-being (Group-2 (OR-0.764)). Understanding of predictors, and their role on functional decline in elderly is of great importance for the development of specific population-based health programs to prevent further functional loss and preserve achieved functional gains.

scholarly journals Medication Prescribed Within 1 Year Preceding Fall-Related Injuries in Older Adults in Ontario, Canada

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 236-236
Author(s):  
Yu Ming ◽  
Aleksandra Zecevic ◽  
Richard Booth ◽  
Susan Hunter ◽  
Andrew Johnson ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Anatomical Therapeutic Chemical ◽  
Group Discussion ◽  
Head Injuries ◽  
Prescription Medication ◽  
Population Based ◽  
Age Group ◽  
Secondary Health Care ◽  
One Year

Abstract Background: The consequences of fall-related injuries are becoming more significant due to ageing societies worldwide. This study aims to provide information on medications prescribed to older adults within one year before they experienced fall-related injury in Ontario, Canada. Methods: A population-based descriptive study of older adults (66 years and older) who experienced fall-related injury was conducted using administrative secondary health care data of Ontario. The percentages of patients prescribed each Anatomical Therapeutic Chemical 4th level medication class and fall-risk increasing drugs one year before their fall-related injuries was summarized. Results: From 2010 to 2014, 288,251 older adults (63.2% females) were admitted to Emergency Department due to fall-related injury, 39.9% were fall-related fractures, 12.6% were head injuries. One year prior to their injury, 48.46% of older adults were prescribed with statins; 35.23% were prescribed with diuretics; 26.84% were prescribed with antidepressants; 25.90% were prescribed with opioids and 16.61% were prescribed with anxiolytics. A higher percentage of females were prescribed with diuretics, antidepressants, and anxiolytics than males. 85 years and older people had higher percentage of prescription of diuretics, antidepressants and antipsychotics than other age group. Discussion: In general, older adults diagnosed with fall-related injuries were prescribed with more opioids, benzodiazepines and antidepressants than other general older adults. There were distinct patterns of prescription medication within each sex and age group (66-74 group, 75-84 group and 85 years and older group). Further association between medications and fall-related injuries need to be established using well-defined cohort studies.

scholarly journals OP0248 PREMATURE MORTALITY BURDEN FOR SYSTEMIC SCLEROSIS: NATIONWIDE POPULATION-BASED STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 156.1-156
Author(s):  
E. Yen ◽  
D. Singh ◽  
M. Wu ◽  
R. Singh
Keyword(s):  
Rheumatoid Arthritis ◽  
United States ◽  
Disease Burden ◽  
Age Groups ◽  
Premature Mortality ◽  
Population Based ◽  
Age Group ◽  
Population Based Study ◽  
Mortality Burden ◽  
Over Time

Background:Premature mortality is an important way to quantify disease burden. Patients with systemic sclerosis (SSc) can die prematurely of disease, however, the premature mortality burden of SSc is unknown. The years of potential life lost (YPLL), in addition to age-standardized mortality rate (ASMR) in younger ages, can be used as measures of premature death.Objectives:To evaluate the premature mortality burden of SSc by calculating: 1) the proportions of SSc deaths as compared to deaths from all other causes (non-SSc) by age groups over time, 2) ASMR for SSc relative to non-SSc-ASMR by age groups over time, and 3) the YPLL for SSc relative to other autoimmune diseases.Methods:This is a population-based study using a national mortality database of all United States residents from 1968 through 2015, with SSc recorded as the underlying cause of death in 46,798 deaths. First, we calculated the proportions of deaths for SSc and non-SSc by age groups for each of 48 years and performed joinpoint regression trend analysis1to estimate annual percent change (APC) and average APC (AAPC) in the proportion of deaths by age. Second, we calculated ASMR for SSc and non-SSc causes and ratio of SSc-ASMR to non-SSc-ASMR by age groups for each of 48 years, and performed joinpoint analysis to estimate APC and AAPC for these measures (SSc-ASMR, non-SSc-ASMR, and SSc-ASMR/non-SSc-ASMR ratio) by age. Third, to calculate YPLL, each decedent’s age at death from a specific disease was subtracted from an arbitrary age limit of 75 years for years 2000 to 2015. The years of life lost were then added together to yield the total YPLL for each of 13 preselected autoimmune diseases.Results:23.4% of all SSc deaths as compared to 13.5% of non-SSc deaths occurred at <45 years age in 1968 (p<0.001, Chi-square test). In this age group, the proportion of annual deaths decreased more for SSc than for non-SSc causes: from 23.4% in 1968 to 5.7% in 2015 at an AAPC of -2.2% (95% CI, -2.4% to -2.0%) for SSc, and from 13.5% to 6.9% at an AAPC of -1.5% (95% CI, -1.9% to -1.1%) for non-SSc. Thus, in 2015, the proportion of SSc and non-SSc deaths at <45 year age was no longer significantly different. Consistently, SSc-ASMR decreased from 1.0 (95% CI, 0.8 to 1.2) in 1968 to 0.4 (95% CI, 0.3 to 0.5) per million persons in 2015, a cumulative decrease of 60% at an AAPC of -1.9% (95% CI, -2.5% to -1.2%) in <45 years old. The ratio of SSc-ASMR to non-SSc-ASMR also decreased in this age group (cumulative -20%, AAPC -0.3%). In <45 years old, the YPLL for SSc was 65.2 thousand years as compared to 43.2 thousand years for rheumatoid arthritis, 18.1 thousand years for dermatomyositis,146.8 thousand years for myocarditis, and 241 thousand years for type 1 diabetes.Conclusion:Mortality at younger ages (<45 years) has decreased at a higher pace for SSc than from all other causes in the United States over a 48-year period. However, SSc accounted for more years of potential life lost than rheumatoid arthritis and dermatomyositis combined. These data warrant further studies on SSc disease burden, which can be used to develop and prioritize public health programs, assess performance of changes in treatment, identify high-risk populations, and set research priorities and funding.References:[1]Yen EY….Singh RR. Ann Int Med 2017;167:777-785.Disclosure of Interests:None declared

Air Conduction Thresholds and Secretory Otitis Media: A Conventional and Extra-High Frequency Audiometric Comparison

1989 ◽  
Vol 98 (10) ◽  
pp. 767-771 ◽  
Author(s):  
Iain W. S. Mair ◽  
Oddbjørn Fjermedal ◽  
Einar Laukli
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
High Frequency ◽  
Pure Tone ◽  
Low Frequency ◽  
Secretory Otitis Media ◽  
Middle Ear Fluid ◽  
Ventilation Tubes ◽  
Air Conduction

A comparison has been made of air conduction threshold changes up to 1 year after myringotomy, aspiration of middle ear fluid, and insertion of ventilation tubes in ten patients with bilateral and 12 with unilateral secretory otitis media (SOM). Pure tone air conduction thresholds have been analyzed in three frequency groups: Low frequency (LF; 0.25, 0.5, and 1 kHz), high frequency (HF; 2,4, and 8 kHz), and extra-high frequency (EHF; 10, 12, 14, and 16 kHz). In the LF and HF ranges, significant improvement came during the first 24 hours after intubation, while in the EHF range, threshold lowering occurred gradually over the following 2 months. Possible explanations for these findings are discussed.

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