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BMC Public Health Nov 2023The resurgence of poliovirus infection in previously polio free regions and countries calls for renewed commitment to the global polio eradication efforts including...
BACKGROUND
The resurgence of poliovirus infection in previously polio free regions and countries calls for renewed commitment to the global polio eradication efforts including strengthening of Acute Flaccid Paralysis (AFP) surveillance systems. Zambia is one of the countries substantially at risk for the importation of poliovirus infection from neighbouring countries including Malawi, Mozambique, and Democratic Republic of the Congo (DRC). This study describes a seven-year AFP surveillance, assesses the surveillance indicators, and highlights areas for improvement.
METHODS
We conducted retrospective analysis of the routinely collected AFP surveillance data from January 2015 to December 2022. The AFP surveillance indicators performance was assessed using the World Health Organisation's recommended minimum AFP surveillance indicators performance.
RESULTS
Cumulatively, a total of 1715 AFP cases were reported over the study period. More than half, 891 (52%) of reported cases were aged < 5 years with 917 (53.5%) of males. More than half, 1186 (69.2%) had fever at onset, 718 (41.9%) had asymmetric paralysis and 1164 (67.9%) had their paralysis progressed within 3 days of onset. The non-polio AFP rate ranges from 3.4 to 6.4 per 100,000 children < 15 years old and stool adequacy ranging from 70.9% to 90.2% indicating sensitive surveillance with late detection of cases. The percentage of cases with early stool collection, timely transportation was above the World Health Organisation (WHO) minimum of 80% but with declining proportion of stools arriving in the laboratory in optimal condition. Completeness of 60-days follow-up evaluation was suboptimal ranging from 0.9% to 28.2%.
CONCLUSION
The AFP surveillance system in Zambia is doing well. However, additional efforts are needed to improve early detection of cases; stool sample collection, transportation and monitoring to ensure arrival in good condition in the laboratory; and improve 60-days follow-up evaluation for evidenced-based classification of inadequate AFP cases and proper care.
Topics: Child; Male; Humans; Adolescent; Poliomyelitis; Zambia; Retrospective Studies; alpha-Fetoproteins; Population Surveillance; Poliovirus; Paralysis
PubMed: 37951902
DOI: 10.1186/s12889-023-17141-1 -
Acta Ortopedica Brasileira 2023The genu recurvatum is characterized by a hyperextension deformity of the knee in the sagittal plane. Among its causes are conditions such as arthrogryposis, cerebral...
INTRODUCTION
The genu recurvatum is characterized by a hyperextension deformity of the knee in the sagittal plane. Among its causes are conditions such as arthrogryposis, cerebral palsy, poliomyelitis, sequelae of tibial tuberosity fracture and some syndromes with generalized joint hypermobility. Treatment of this deformity can be challenging and, to date, aggressive methods such as femur or tibial osteotomies are the most used for its correction.
OBJECTIVE
This study aimed to describe a new surgical technique for correcting genu recurvatum.
METHODS
This is a prospective clinical study of children who underwent posterior hemiepiphysiodesis of the distal femur with transphyseal screws.
RESULTS
The approach proved to be safe and useful for genu recurvatum deformities, with femoral or articular apex.
CONCLUSION
This approach shows great potential for correcting genu recurvatum in the developing skeleton, being an excellent alternative to the more aggressive methods currently used to treat this deformity.
PubMed: 38115875
DOI: 10.1590/1413-785220233105e268307 -
Current Opinion in Immunology Oct 2023The eradication of polio during the latter half of the 20th century can be considered one of the greatest medical triumphs in history. This achievement can be attributed... (Review)
Review
The eradication of polio during the latter half of the 20th century can be considered one of the greatest medical triumphs in history. This achievement can be attributed to the development of vaccines that received the public's almost unwavering acceptance of them, especially by parents who had been waiting/hoping for a medical breakthrough that would ensure that their children would not succumb to the devastating effects of infantile paralysis. Sixty years later, the worldwide population was now confronted with an equally devastating disease - Covid-19 - which by the 2020-2021 time period had reached pandemic levels not seen since the flu outbreak of 1918. Unlike polio, however, several vaccines against Covid-19 were rapidly developed and deployed due to advances in microbiologic and immunologic technology. But also, unlike the polio vaccine experience, there was not universal acceptance of the Covid-19 vaccines and this has led to continuation of the pandemic into 2023 (albeit at a reduced level). In addition, acceptance of the Covid-19 vaccines has been confronted with the uncertainty that they do not apparently prevent transmission in asymptomatic people, and the mutation rate of the virus requires periodic re-evaluation and possible upgrading of the vaccines. This review will focus on the various factors that have led to these contrasting attitudes toward these two different vaccines and how resistance and hesitancy to vaccine use can be overcome by implementing various measures, after introducing the key roles that the sciences of microbiology and immunology have played in vaccine development over the past 250+ years.
Topics: Child; Humans; COVID-19 Vaccines; COVID-19; Vaccines; Vaccination; Poliomyelitis
PubMed: 37651977
DOI: 10.1016/j.coi.2023.102386 -
Arquivos de Neuro-psiquiatria Feb 2024
Topics: Humans; Postpoliomyelitis Syndrome; Denervation; Poliomyelitis
PubMed: 38395421
DOI: 10.1055/s-0044-1779507 -
Frontiers in Medicine 2023The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for serious respiratory infections in humans. Even in the absence of respiratory...
BACKGROUND
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for serious respiratory infections in humans. Even in the absence of respiratory symptoms, gastrointestinal (GI) signs were commonly reported in adults and children. Thus, oral-fecal transmission was suspected as a possible route of infection. The objective of this study was to describe RNA shedding in nasopharyngeal and stool samples obtained from asymptomatic and symptomatic children and to investigate virus viability.
METHODS
This study included 179 stool and 191 nasopharyngeal samples obtained from 71 children, which included symptomatic ( = 64) and asymptomatic ( = 7) ones. They were collected every 7 days from the onset of the infection until negativation. Viral RNA was detected by real-time RT-PCR, targeting the N and ORF1 genes. Whole-genome sequencing was performed for positive cases. Viral isolation was assessed on Vero cells, followed by molecular detection confirmation.
RESULTS
All cases included in this study ( = 71) were positive in their nasopharyngeal samples. SARS-CoV-2 RNA was detected in 36 stool samples obtained from 15 out of 71 (21.1%) children; 13 were symptomatic and two were asymptomatic. Excretion periods varied from 7 to 21 days and 7 to 14 days in nasopharyngeal and fecal samples, respectively. Four variants were detected: Alpha ( = 3), B.1.160 ( = 3), Delta ( = 7), and Omicron ( = 1). Inoculation of stool samples on cell culture showed no specific cytopathic effect. All cell culture supernatants were negative for RT-qPCR.
CONCLUSION
Our study demonstrated nasopharyngeal and fecal shedding of SARS-CoV-2 RNA by children up to 21 and 14 days, respectively. Fecal shedding was recorded in symptomatic and asymptomatic children. Nevertheless, SARS-CoV-2 was not isolated from positive stool samples.
PubMed: 38020093
DOI: 10.3389/fmed.2023.1226207 -
Revista Espanola de Cirugia Ortopedica... 2023Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder...
INTRODUCTION
Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder orientation, increase fracture risk and reduce implant stability. The aim of this study is to describe a series of patients with RP treated by THA.
MATERIAL AND METHODS
Retrospective descriptive study of patients with RP treated with THA between 1999 and 2021 in a tertiary hospital, with clinical and radiological follow-up and functional and complication evaluation until present or death, with a minimum of 12 months.
RESULTS
Sixteen patients underwent surgery, with 13 THA implanted in the paretic limb, 6 for fracture and 7 for osteoarthritis, while the remaining 3 were implanted in the contralateral limb. Four dual mobility cups were implanted as an antiluxation measure. At 1 year postoperatively, 11 had complete range of motion with no increase in Trendelenburg cases. The Harris hip score (HHS) improved 32.1 points, the visual analogue scale (VAS) 5.25 points, and the Merlé-d'Augbiné-Poste scale 6 points. The length discrepancy correction was 13.77mm. Median follow-up was 3.5 years (1-24). Two cases were revised for polyethylene wear and two for instability, with no infections, periprosthetic fractures, or cup or stem loosening.
CONCLUSIONS
THA in patients with RP allows improvement of the clinico-functional situation with an acceptable complication rate. The risk of dislocation could be minimised with dual mobility cups.
PubMed: 37328055
DOI: 10.1016/j.recot.2023.06.007 -
High coverage and timeliness of vaccination of children under 6 years of age in Risaralda, Colombia.Human Vaccines & Immunotherapeutics Aug 2023This study determined the coverage and timeliness of immunization in children <6 y from Risaralda, Colombia. A retrospective cross-sectional study evaluated data...
This study determined the coverage and timeliness of immunization in children <6 y from Risaralda, Colombia. A retrospective cross-sectional study evaluated data from a vaccination coverage and timeliness verification survey conducted in 2019, including 2457 children <6 y from Risaralda, Colombia. Variables included demographics, a record of vaccinations included in the Colombian Vaccination Plan, and date of immunization. Vaccination was defined as timely until 29 d after the day established by the plan. Coverage was over 95% for all vaccinations, except the boosters of diphtheria/pertussis/tetanus (DTP) and oral polio at 18 months (91.0%), influenza (85.6%), and yellow fever (49.2%). Most surveyed children demonstrated very high timeliness of vaccination, with values close to, or over, 90%, although there were exceptions for pentavalent (DTP+ type B+hepatitis B) and polio vaccines at 6 months (79.4%), influenza (85.6%), and yellow fever (49.2%). Before the COVID-19 pandemic, Colombian Vaccination Plan demonstrated high coverage and timeliness of vaccination of children <6 y of age; however, timeliness for the third dose of DTP-Hib-HBV and polio showed opportunities for improvement.
Topics: Humans; Child; Child, Preschool; Colombia; Cross-Sectional Studies; Influenza, Human; Pandemics; Retrospective Studies; Yellow Fever; COVID-19; Vaccination; Immunization, Secondary; Diphtheria-Tetanus-Pertussis Vaccine; Haemophilus influenzae type b; Influenza Vaccines; Poliomyelitis
PubMed: 37722884
DOI: 10.1080/21645515.2023.2257424 -
International Journal For Equity in... Dec 2023This study examined the perceived barriers of migrants and refugees to vaccinating their children against measles and polio in Iran.
BACKGROUND
This study examined the perceived barriers of migrants and refugees to vaccinating their children against measles and polio in Iran.
METHODS
First, an instrument was developed and validated through several steps. Next, 1,067 parents who had not vaccinated their children against polio and measles or had delayed receiving any dose of these two vaccines until the age of 15 were selected from 16 provinces and completed the instrument. Finally, the data were analyzed.
RESULTS
The results of the explanatory factor analysis showed that the perceived barriers affecting vaccination against polio and measles vaccines were categorized into five factors: low knowledge, negative attitude, communication challenges, lack of participation in vaccination programs, and problems related to migration and refugees. Additionally, the results indicated a significant difference in the mean score of perceived barriers based on participants' level of education, economic status, and nationality.
CONCLUSION
The identified barriers may provide a perspective for developing effective efforts in this area. Interventions should focus on parents with low education and poor economic status.
Topics: Child; Humans; Transients and Migrants; Refugees; Iran; Measles; Vaccination; Vaccines; Poliomyelitis
PubMed: 38057773
DOI: 10.1186/s12939-023-02075-2 -
Methods and Protocols Sep 2023The recently discovered Jingmenvirus group includes viruses with a segmented genome, RNA of a positive polarity, and several proteins with distant homology to the...
The recently discovered Jingmenvirus group includes viruses with a segmented genome, RNA of a positive polarity, and several proteins with distant homology to the proteins of the members of the genus Some Jingmenvirus group members, namely the Alongshan virus (ALSV) and Jingmen tick virus, are reported to be tick-borne human pathogens that can cause a wide variety of symptoms. The ALSV is widely distributed in Eurasia, yet no reliable assay that can detect it exists. We describe a qPCR system for ALSV detection. Our data showed that this system can detect as little as 10 copies of the ALSV in a sample. The system showed no amplification of the common tick-borne viruses circulating in Eurasia, i.e., the Yanggou tick virus-which is another Jingmenvirus group member-or some known members of the genus . The qPCR system was tested and had no nonspecific signal for the , , , and ticks. The qPCR system had no nonspecific signal for human and sheep serum as well. Overall, the qPCR system described here can be used for reliable and quantitative ALSV detection.
PubMed: 37736962
DOI: 10.3390/mps6050079 -
BMC Public Health Jul 2023Low polio vaccine coverage can result in the spread of Poliovirus to areas free from viral circulation. This study analyzed the temporal trends and spatial distribution...
BACKGROUND
Low polio vaccine coverage can result in the spread of Poliovirus to areas free from viral circulation. This study analyzed the temporal trends and spatial distribution of polio vaccine coverage in one year-old children in Brazil, between 2011 and 2021.
METHODS
This was an ecological, time-series study (2011 to 2021) with annual vaccine coverages against poliomyelitis, extracted from the Information System of the National Immunization Program from the 26 States and the Distrito Federal (DF). The percentage reductions in vaccination coverage in Brazil and in the Regions were calculated. Prais-Winsten regression models were used to analyze time series for the Regions and States, and spatial analysis identified the distribution of clusters (high-high; low-low; high-low and low-high) of vaccination coverages across Brazilian municipalities, using a 5% significance level.
RESULTS
From 2011 to 2021, the coverage of polio vaccines decreased by 29,9%. There was a progressive increase observed in clusters resulting in low vaccination coverages (140 low-low Brazilian municipalities in 2011 vs. 403 in 2021), mostly reported in the North and Northeast regions of the country. There was a downward trend in vaccination coverages in 24 of the 26 States and DF (p ≤ 0.05).
CONCLUSIONS
The reduction in polio vaccine coverage, as observed in the North and Northeast regions of Brazil, may favor the spread of Poliovirus. Therefore, vaccination strategies should be prioritized for children residing in areas with sharp and recurrent declines in vaccination coverages, including travelers, migrants, and refugees.
Topics: Humans; Child; Infant; Brazil; Poliovirus Vaccine, Inactivated; Vaccination; Poliovirus; Poliomyelitis; Poliovirus Vaccine, Oral
PubMed: 37452296
DOI: 10.1186/s12889-023-16192-8