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Journal of Environmental and Public... 2023Polio supplementary immunization activities (SIAs) are one of the polio eradication pillars in the Global Polio Eradication Initiative (GPEI) that increased the... (Review)
Review
BACKGROUND
Polio supplementary immunization activities (SIAs) are one of the polio eradication pillars in the Global Polio Eradication Initiative (GPEI) that increased the immunization coverage and made progress towards polio eradication. However, socioecological challenges faced during SIAs contribute to suboptimal campaign quality. The aim of this review is to identify the reported challenges during polio supplementary immunization activities (SIAs) and associated improvement strategies based on the socioecological model (SEM).
METHODS
Articles were searched from three databases which were WOS, Scopus, and PubMed. The systemic review identified the primary articles related to SIA that focused on the impact of immunization coverage, challenges, and improvement strategies. The inclusion criteria were open access English articles that were published between 2012 and 2021 and conducted in the Asia region.
RESULTS
There are nine articles described and explained regarding some form of supplementary immunization activities (SIAs) in their findings across Asia region. The majority of studies selected reported on post vaccination coverage and revealed a multifaceted challenge faced during SIAs which are widely diverse range from the microlevel of interpersonal aspects up to the macrolevel of government policy. Upon further analysis, the intervention at community level was the most dominant strategies reported during the SIA program.
CONCLUSIONS
An effective SIAs program provides the opportunity to increase the national capacity of the polio immunization program, reducing inequities in service delivery and offering additional public health benefits in controlling polio outbreaks in both endemic and nonendemic countries. Strengthening routine immunization (RI) programmes is also important for the sustainability of SIA's programs. Despite the challenges and hurdles, many Asian countries exhibited great political willingness to boost polio immunization coverage through SIA efforts.
Topics: Humans; Disease Eradication; Vaccination; Immunization; Asia; Poliomyelitis
PubMed: 36747498
DOI: 10.1155/2023/4801424 -
Molecular Psychiatry Sep 2021Pandemics have become more frequent and more complex during the twenty-first century. Posttraumatic stress disorder (PTSD) following pandemics is a significant public... (Meta-Analysis)
Meta-Analysis
Pandemics have become more frequent and more complex during the twenty-first century. Posttraumatic stress disorder (PTSD) following pandemics is a significant public health concern. We sought to provide a reliable estimate of the worldwide prevalence of PTSD after large-scale pandemics as well as associated risk factors, by a systematic review and meta-analysis. We systematically searched the MedLine, Embase, PsycINFO, Web of Science, CNKI, WanFang, medRxiv, and bioRxiv databases to identify studies that were published from the inception up to August 23, 2020, and reported the prevalence of PTSD after pandemics including sudden acute respiratory syndrome (SARS), H1N1, Poliomyelitis, Ebola, Zika, Nipah, Middle Eastern respiratory syndrome coronavirus (MERS-CoV), H5N1, and coronavirus disease 2019 (COVID-19). A total of 88 studies were included in the analysis, with 77 having prevalence information and 70 having risk factors information. The overall pooled prevalence of post-pandemic PTSD across all populations was 22.6% (95% confidence interval (CI): 19.9-25.4%, I: 99.7%). Healthcare workers had the highest prevalence of PTSD (26.9%; 95% CI: 20.3-33.6%), followed by infected cases (23.8%: 16.6-31.0%), and the general public (19.3%: 15.3-23.2%). However, the heterogeneity of study findings indicates that results should be interpreted cautiously. Risk factors including individual, family, and societal factors, pandemic-related factors, and specific factors in healthcare workers and patients for post-pandemic PTSD were summarized and discussed in this systematic review. Long-term monitoring and early interventions should be implemented to improve post-pandemic mental health and long-term recovery.
Topics: COVID-19; Communicable Diseases; Humans; Influenza A Virus, H1N1 Subtype; Influenza A Virus, H5N1 Subtype; Pandemics; Prevalence; SARS-CoV-2; Stress Disorders, Post-Traumatic; Zika Virus; Zika Virus Infection
PubMed: 33542468
DOI: 10.1038/s41380-021-01036-x -
Annals of Physical and Rehabilitation... Nov 2020Sleep disturbances, especially sleep disordered breathing and sleep movement disorders, seem to be highly prevalent among aging polio survivors. They could contribute to...
BACKGROUND
Sleep disturbances, especially sleep disordered breathing and sleep movement disorders, seem to be highly prevalent among aging polio survivors. They could contribute to late functional deterioration, fatigue, poor quality of life and negative health outcomes, thereby increasing cardiovascular risk.
OBJECTIVES
This review focused on current knowledge of the prevalence of sleep disorders in polio survivors, their features, predictive factors and management.
DATA SOURCES
Articles were searched in PubMed and the Cochrane Library up to March 2018.
STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS
Articles needed to 1) be written in English; 2) include only participants with previous poliomyelitis or post-polio syndrome diagnosis; and 3) involve any form of sleep disorders. Articles about isolated fatigue or non-specific sleep complaints as well as non-polio specific articles (neuromuscular disorders) were not included in the qualitative analysis.
RESULTS
Among 166 studies identified, 41 were included in this review. The prevalence of sleep apnea syndrome, nocturnal alveolar hypoventilation and restless legs syndrome seemed higher than in the general population (from 7.3% to 65%, 15% to 20% and 28% to 63%, respectively). This review highlights the lack of randomised studies assessing sleep disorder management in this specific population.
LIMITATIONS
Because of the small number of eligible publications, none was excluded for methodological limitations, and only a qualitative analysis was provided.
CONCLUSIONS AND IMPLICATIONS
Follow-up of polio survivors should include systematic screening for sleep disorders because they are associated with adverse consequences. Sleep disorder evaluation and management should improve the long-term survival and quality of life of polio survivors. Methodologically robust clinical trials are needed, but the decreasing prevalence and large clinical spectrum of the disease may complicate the creation of comparable groups.
Topics: Aged; Aging; Fatigue; Female; Heart Disease Risk Factors; Humans; Male; Middle Aged; Movement Disorders; Poliomyelitis; Poliovirus; Postpoliomyelitis Syndrome; Prevalence; Quality of Life; Restless Legs Syndrome; Sleep Apnea Syndromes; Sleep Wake Disorders; Survivors
PubMed: 31794858
DOI: 10.1016/j.rehab.2019.10.007 -
The Lancet. Infectious Diseases Aug 2021Since WHO recommended introduction of at least a single dose of inactivated poliovirus vaccine (IPV) in routine immunisation schedules, there have been global IPV... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Since WHO recommended introduction of at least a single dose of inactivated poliovirus vaccine (IPV) in routine immunisation schedules, there have been global IPV shortages. Fractional-dose IPV (fIPV) administration is one of the strategies to ensure IPV availability. We reviewed studies comparing the effects of fractional with full-dose IPV vaccination to determine when seroconversion proportions with each strategy become similar in children aged 5 years and younger.
METHOD
In this systematic review and meta-analysis, we searched 16 databases in July, 2019, for trials and observational studies, including ongoing studies that compare immunogenicity and adverse events of fractional-dose (0·1 mL) to full-dose (0·5 mL) IPV in healthy children aged 5 years or younger regardless of study design, number of doses, and route of administration. Screening, selection of articles, data extraction, and risk of bias assessment were done in duplicate, and conflicts were resolved by discussion or arbitration by a third author. We assessed immunogenicity, the main outcome, as proportion of seroconverted participants and changes in geometric mean titres of anti-poliovirus antibodies. Timepoints were eligible for analysis if measurements were done at least 4 weeks after vaccination. Summary estimates were pooled by use of random-effects meta-analysis. Analysis was stratified by study design, type of outcome measure, type of poliovirus, and number of doses given. We assessed heterogeneity using the χ test of homogeneity and quantified it using the I statistic. We assessed risk of bias using the Cochrane risk of bias tool, and the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. The study is registered with PROSPERO, CRD42018092647.
FINDINGS
860 records were screened for eligibility, of which 36 potentially eligible full-text articles were assessed and 14 articles were included in the final analysis: two ongoing trials and 12 articles reporting on ten completed studies. For poliovirus type 2, there were no significant differences in the proportions of seroconversions between fractional and full doses of IPV for two or three doses: the risk ratio for serconversion at one dose was 0·61 (95% CI 0·51-0·72), at two doses was 0·90 (0·82-1·00), and at three doses was 0·95 (0·91-1·00). Geometric mean titres (GMTs) for poliovirus type 2 were lower for fIPV than for full-dose IPV: -0·51 (95% CI -0·87 to -0·14) at one dose, -0·49 (-0·70 to -0·28) at two doses, and -0·98 (-1·46 to -0·51) at three doses. The seroconversion meta-analysis for the three-dose comparison was homogeneous (p=0·45; I=0%), whereas heterogeneity was observed in the two-dose (p<0·00001; I=88%) and one-dose (p=0·0004; I=74%) comparisons. Heterogeneity was observed in meta-analyses of GMTs for one-dose (p<0·00001; I=92%), two-dose (p=0·002; I=80%), and three-dose (p<0·00001; I=93%) comparisons. Findings for types 1 and 3 were similar to those for type 2. The certainty of the evidence was high for the three-dose comparisons and moderate for the rest of the comparisons.
INTERPRETATION
There is no substantial difference in seroconversion between three doses of fIPV and three doses of full-dose IPV, although the full dose gives higher titres of antibodies for poliovirus type 1, 2, and 3. Use of fractional IPV instead of the full dose can stretch supplies and possibly lower the cost of vaccination.
FUNDING
South African Medical Research Council and the National Research Foundation of South Africa.
Topics: Administration, Oral; Antibodies, Viral; Child, Preschool; Dose-Response Relationship, Immunologic; Humans; Immunization Schedule; Immunogenicity, Vaccine; Injections, Intradermal; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Inactivated; Randomized Controlled Trials as Topic; Seroconversion
PubMed: 33939958
DOI: 10.1016/S1473-3099(20)30693-9 -
The Journal of Arthroplasty Jun 2021Patients with postpolio residual paralysis can develop disabling hip arthritis in paralytic as well as a nonparalytic limb, warranting total hip arthroplasty (THA)....
BACKGROUND
Patients with postpolio residual paralysis can develop disabling hip arthritis in paralytic as well as a nonparalytic limb, warranting total hip arthroplasty (THA). Limited literature is available on the results of THA among these patients in the form of small series or case reports. We have undertaken a systematic review to evaluate the clinical outcome of THA in patients with poliomyelitis with hip pathologies.
METHODS
A systematic search of electronic databases of PubMed, Scopus, and Web of Science pertaining to English literature was undertaken from 1945 to August 2020 to assess the results of THA in patients with poliomyelitis. Information was gathered about demographics, indication, clinical course, complications, functional outcome, survival, and need for any revision surgery in these patients.
RESULTS
The literature search revealed 81 articles. Finally, after deduplication and manual selection, 16 relevant articles (128 hips) were included for evaluation. There is a paucity of literature evaluating THA in patients with poliomyelitis over the last 2 decades. The principal reason for arthroplasty was osteoarthritis of the hip in the ipsilateral (paralyzed) limb. A combination of cemented, uncemented, and hybrid implant fixation system was found to be used by surgeons. Addressing instability and perioperative management of limb length discrepancy were found to be challenging propositions.
CONCLUSION
THA remains an effective intervention to relieve pain and improve quality of life in patients of poliomyelitis afflicted with either primary or secondary arthritis of the hip. The use of uncemented nonconstrained hip implant designs appears to demonstrate better results than constrained implants.
Topics: Arthroplasty, Replacement, Hip; Hip Prosthesis; Humans; Paralysis; Quality of Life; Reoperation; Treatment Outcome
PubMed: 33593623
DOI: 10.1016/j.arth.2021.01.046 -
Future Microbiology Nov 2020An overview of recent epidemiology and disease burden, independent of patient age, of diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis and invasive disease...
An overview of recent epidemiology and disease burden, independent of patient age, of diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis and invasive disease in the UK. A systematic review was undertaken. Outcomes included incidence, prevalence, risk factors and cost burden. 39 publications were included. Hepatitis B prevalence is high among certain risk groups. A small pertussis risk remains in pregnancy and for infants, which led to the introduction of maternal vaccination. invasive disease cases are limited to rare serotypes. Polio, tetanus and diphtheria are well controlled. The evaluated diseases are currently well controlled, thanks to a comprehensive vaccination program, with a generally low clinical and cost burden.
Topics: Adolescent; Bacterial Vaccines; Child; Child Health; Child, Preschool; Communicable Disease Control; Communicable Diseases; Female; Humans; Infant; Male; United Kingdom; Vaccination; Viral Vaccines
PubMed: 33207948
DOI: 10.2217/fmb-2020-0170 -
BMJ Global Health Nov 2021The Global Polio Eradication Initiative uses polio supplementary immunisation activities (SIAs) as a strategy to increase vaccine coverage and cease poliovirus...
INTRODUCTION
The Global Polio Eradication Initiative uses polio supplementary immunisation activities (SIAs) as a strategy to increase vaccine coverage and cease poliovirus transmission. Impact of polio SIAs on immunisation systems is frequently debated. We reviewed the impact of polio SIAs on routine immunisation and health systems during the modern era of polio eradication.
METHODS
We searched nine databases for studies reporting on polio SIAs and immunisation coverage, financial investment, workforce and health services delivery. We conducted a narrative synthesis of evidence. Records prior to 1994, animal, modelling or case studies data were excluded.
RESULTS
20/1637 unique records were included. Data on vaccine coverage were included in 70% (14/20) studies, workforce in 65% (13/20) and health services delivery in 85% (17/20). SIAs positively contributed to vaccination uptake of non-polio vaccines in seven studies, neutral in three and negative in one. Some polio SIAs contributed to workforce strengthening through training and capacity building. Polio SIAs were accompanied with increased social mobilisation and community awareness building confidence in vaccination programmes. Included studies were programmatic in nature and contained variable data, thus could not be justly critically appraised.
CONCLUSION
Polio SIAs are successful at increasing polio vaccine coverage, but the resources and infrastructures were not always utilised for delivery of non-polio vaccines and integration into routine service delivery. We found a gap in standardised tools to evaluate SIAs, which can then inform service integration. Our study provides data to inform SIAs evaluations, and provides important considerations for COVID-19 vaccine roll-out to strengthen health systems.
PROSPERO REGISTRATION NUMBER
CRD42020152195.
Topics: COVID-19; COVID-19 Vaccines; Humans; Immunization; Immunization Programs; Poliomyelitis; SARS-CoV-2; Vaccination
PubMed: 34776411
DOI: 10.1136/bmjgh-2021-006568 -
Vaccine Jun 2023The introduction of anti-poliomyelitis vaccines has driven progress toward the global eradication of wild polioviruses, a millennium goal of the World Health... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The introduction of anti-poliomyelitis vaccines has driven progress toward the global eradication of wild polioviruses, a millennium goal of the World Health Organization. With the vaccination campaigns carried out since 1964, in 2002 Italy was certified polio-free, considering that no cases had been recorded since 1983. Nevertheless, it is crucial to guarantee high level of immunization coverage also in low-endemicity countries, considering that sporadic polio cases can be recorded. To evaluate the presence of susceptible subjects in the population, seroepidemiological studies are key actions.
METHODS
We conducted a systematic review of the relevant literature to evaluate the prevalence of anti-PV neutralizing antibodies in Italian population. Seven studies, selected among scientific articles available in MEDLINE/PubMed, ISI Web of Knowledge and Scopus and published from January 1, 2012, to November 15, 2022, were included.
RESULTS
The pooled prevalence of subjects without PV1 neutralizing antibodies was 6.4% (95%CI = 0.5-16.9), for PV2 it was 5.3% (95%CI = 0.4-14.2), and for PV3 it was 13.0% (95%CI = 4.0-25.7; I2 = 98.5%). Levels of neutralizing antibodies appears to decrease with increasing age; this decline is a proxy for the real risk factor, which is the time since the last vaccine dose.
CONCLUSIONS
Public health institutions must be aware of the risk of reintroduction of wild PV in polio-free countries and therefore they must keep high level of immunization in population and reinforce the active surveillance systems.
Topics: Humans; Poliovirus; Prevalence; Antibodies, Viral; Poliomyelitis; Poliovirus Vaccines; Antibodies, Neutralizing; Italy; Poliovirus Vaccine, Oral
PubMed: 37121798
DOI: 10.1016/j.vaccine.2023.04.047 -
Expert Review of Vaccines Sep 2019: In Asia Pacific, most countries recommend a monovalent hepatitis B virus (HBV) vaccine dose at birth followed by primary vaccination series including three or four...
Integration of hexavalent diphtheria, tetanus, acellular pertussis, hepatitis B virus, inactivated poliomyelitis and Haemophilus influenzae type b conjugate vaccine within existing national recommendations following a birth dose of monovalent hepatitis B virus vaccine: results of a systematic...
: In Asia Pacific, most countries recommend a monovalent hepatitis B virus (HBV) vaccine dose at birth followed by primary vaccination series including three or four doses of combination vaccines against diphtheria, tetanus, and pertussis, with or without type b (Hib), HBV or poliomyelitis antigens. If hexavalent conjugate vaccines against diphtheria-tetanus-acellular pertussis-HBV-inactivated poliovirus-Hib (DTPa-HBV-IPV/Hib) replace the vaccines included in the primary vaccination series, co-administration of lower-valent vaccines would be avoided but infants would receive ≥4 doses of HBV-containing vaccines before the age of 2 years. : We searched for clinical trials conducted in the South-East Asia and Western Pacific Regions (World Health Organization geographic definition), investigating vaccination regimens with >3 doses of HBV-containing vaccines in infants, including a monovalent HBV vaccine birth dose and ≥1 dose of GSK's hexavalent DTPa-HBV-IPV/Hib vaccine. : The six clinical trials included in this review showed that infants who received the monovalent HBV vaccine at birth and three or four doses of DTPa-HBV-IPV/Hib vaccine achieved protective immunogenic titers with a clinically acceptable safety profile. Our results support the integration of hexavalent DTPa-HBV-IPV/Hib vaccine within existing national recommendations in the Asia Pacific region to reduce the number of injections during infancy.
Topics: Databases, Factual; Diphtheria; Diphtheria-Tetanus-acellular Pertussis Vaccines; Haemophilus Infections; Haemophilus influenzae type b; Hepatitis B; Hepatitis B Vaccines; Hepatitis B virus; Humans; Immunization Schedule; Poliomyelitis; Tetanus; Vaccines, Combined; Vaccines, Conjugate; Whooping Cough
PubMed: 31328999
DOI: 10.1080/14760584.2019.1646643 -
Physical Therapy Oct 2022The purpose of this study was to critically appraise and summarize the evidence for reliability of muscle strength and muscle power assessment in patients with...
OBJECTIVE
The purpose of this study was to critically appraise and summarize the evidence for reliability of muscle strength and muscle power assessment in patients with neuromuscular diseases (NMDs) using isokinetic dynamometry.
METHODS
PubMed, CINAHL, and Embase electronic databases were searched from inception to March 8, 2022. Studies designed to evaluate reliability of muscle strength and power measurements using isokinetic dynamometry were included in this review. First, the methodological quality of the studies was assessed according to the Consensus-Based Standards for the Selection of Health Measurement Instruments guidelines. Next, the quality of measurement properties was determined. Finally, the methodological quality and quality of measurement properties of the studies were combined to obtain a best-evidence synthesis.
RESULTS
A best-evidence synthesis of reliability was performed in 11 studies including postpoliomyelitis syndrome (n = 5), hereditary motor and sensory neuropathy (n = 2), motor neuron diseases (n = 1), myotonic dystrophy (n = 1), and groups of pooled NMDs (n = 2). A best-evidence synthesis on measurement error could not be performed. Quality of evidence on reliability ranged from high in postpoliomyelitis syndrome to very low in hereditary motor and sensory neuropathy, motor neuron diseases, and groups of pooled NMDs. The most frequently used outcome measure was peak torque, which was reliable in all populations (intraclass correlation coefficient >0.7).
CONCLUSION
The quality of evidence for reliability of isokinetic dynamometry was found to vary substantially among different NMDs. High quality of evidence has been obtained only in patients with postpoliomyelitis syndrome. Further research is needed in the majority of known NMDs to determine reliability and validity of isokinetic dynamometry.
IMPACT
The ability of isokinetic dynamometers to capture clinically relevant changes in muscle strength and muscle power in NMDs remains unclear. Isokinetic dynamometry results in NMDs should be interpreted with caution.
Topics: Humans; Muscle Strength Dynamometer; Reproducibility of Results; Postpoliomyelitis Syndrome; Muscle Strength; Neuromuscular Diseases; Hereditary Sensory and Motor Neuropathy; Muscles; Muscle, Skeletal
PubMed: 35899532
DOI: 10.1093/ptj/pzac099