MEDIA

1. World Meningitis Day highlights need for vaccination and greater awareness

Saturday, April 24th marked the second annual World Meningitis Day, an international initiative to raise awareness about meningitis prevention and treatment. In the Philippines, organizers educated parents and the media about meningitis as well as arranged free vaccination clinics. In the UK, prominent meningitis charities highlighted the toll of the disease in the country, and in the U.S., the Meningitis Angels held events in Tulsa, Oklahoma where a recent meningitis outbreak led to five hospitalizations and two deaths. Dr. Orin Levine also commented on his blog about the common characteristics of meningitis and malaria, pointing out that both diseases represent missed opportunities for disease prevention and treatment, especially in Africa.

2. ONE sponsors guest blog series on the next 10 years of vaccines

The ONE International blog is featuring a series titled "Vaccines: The Next 10 Years" with guest posts from individuals in the international vaccine community. David Lane introduced the series calling vaccines a "critical part of our push for improved maternal and child health." Julian Lob-Levyt, CEO of the GAVI Alliance pointed out the "power of immunization," looking back on the accomplishments of the past decade to vaccinate 250 million children and save 5.4 million lives. Jean Stéphenne, Chairman and President of GlaxoSmithKline Biologicals, outlined three critical conditions for success across the next 10 years: research and development, manufacturing capacity, and expanded global access.

3. Faith-based partnerships leveraged in child mortality reductions in the DRC

This month UNICEF announced a cooperative initiative with five major religious organizations to reduce child mortality in the Democratic Republic of Congo. The coalition hopes to leverage the networks of the Christian, Muslim, and traditional religious groups in order to better involve families and promote healthy behavior change throughout the country. The partnership is part of efforts to implement the Accelerated Strategy for Child Survival and Development in Africa, and a video featuring the initiative can also be viewed on UNICEF's website.

RESEARCH

4. Special issue of the International Journal of Epidemiology focuses on the Lives Saved Tool

A special edition of the International Journal of Epidemiology highlighted the development and use of the Lives Saved Tool (LiST) for projecting child mortality reductions. Victora introduced the edition by highlighting LiST’s strengths and opportunities for improvement. Bryce et al. described how LiST was used in Malawi, Burkina Faso, and Ghana for child health program planning and improvement. Hazel and Gilroy et al. reported on evaluation data from the Accelerated Child Survival Program in West Africa. The researchers compared results from LiST with actual reductions in mortality as reported by demographic health surveys (DHS). In Ghana, the LiST projections were within the 95% confidence interval of the reductions reported in DHS, while in Mali LiST projections significantly underestimated reductions compared to observed rates. In a related study, Amouzou et al. analyzed LiST's ability to predict mortality changes by wealth quintile, finding that the tools estimated neonatal and post-neonatal mortality within 95% confidence intervals of measured mortality.

In order to populate LiST with updated data, Theodoratou et al. conducted a meta-analysis of Hib and PCV impact on child pneumonia incidence, morbidity, and mortality. Using radiologically confirmed pneumonia as a proxy for pneumonia mortality, researchers inferred that the Hib and PCVs provided a protective effect of 18 and 26 percent respectively. Theodoratou et al. also conducted a review of community and hospital case management for pneumonia, finding that community case management can lead to 70% reductions in pneumonia mortality.

5. Results of IPD surveillance among Navajo Indians 1995 to 2006

This month in Clinical Infectious Diseases, Weatherholtz et al. from the Center for American Indian Health at the Johns Hopkins University reported on the results of 12 years of IPD surveillance among Navajo Indians in the US, reviewing data from 1995 to 2006. Rates of IPD due to vaccine serotypes among children aged <1 year, 1 to <2 years, and 2 to <5 years decreased from 210, 263, and 51 cases per 100,000 population, respectively in 1995-1997 (before PCV7 introduction) to 0 cases in 2004-2006 (p<0.001) following the introduction of PCV7. Among adults over 65 years of age, vaccine type IPD rates decreased 81% (p=.02). Vaccine-serotype IPD has been virtually eliminated in the PCV7 era among Navajo of all ages. Overall rates of non-vaccine serotype IPD did not increase in any age group, though some serotype-specific increases were recorded for non-vaccine type disease caused by 1, 3, 7F, and 19A types. Rates of all-serotype IPD among Navajo children remain 3-5 fold greater than in the general U.S. population.

6. Meta-analysis shows odds of sickle-cell disease are 36 times higher among IPD patients

In an advance issue of The Lancet Infectious Diseases, Ramakrishnan et al. report on a systemic review demonstrating an increased risk of bacterial infections among those with sickle cell disease in Africa. Seven studies from Africa were included in the final analysis. Inclusion criteria for this analysis included a case-control or case-cohort design as well as sufficient information on laboratory-confirmation methods used. The odds of sickle-cell disease among patients with all-cause invasive bacterial disease, pneumococcal disease, and Hib disease were 19, 36, and 13 times higher, respectively, compared to controls who did not have invasive bacterial disease. These data suggest a significant increased risk of bacterial infections, especially pneumococcal infections, among people with sickle cell disease, a condition with which nearly a quarter of a million African children are born each year. a condition with which nearly a quarter of a million African children are born each year. Researchers highlighted the need for better data collection comparing children with and without sickle cell disease as well as targeted prevention programs for children with sickle-cell disease given their heightened risk of bacterial – especially pneumococcal – infections.

7. Community-acquired pneumonia in HIV-infected children: a global perspective

This month in Current Opinions in Pulmonary Medicine, Gray and Zar from the University of Capetown, South Africa reviewed pneumonia etiology, treatment, and vaccination in HIV-positive children. Researchers highlighted past findings: among HIV-positive children S. pneumoniae is the most common cause of bacteremic pneumonia; IPD incidence rates are 9 to 43 times greater than among HIV-negative children; and PCV is immunogenic though it results in lower antibody responses and waning immunity following vaccination. Nevertheless, due to high incidence rates in the HIV-positive population, the overall impact of PCV is greater in that population compared to HIV negative individuals; reductions in pneumonia are 15 times greater and the vaccine-attributable reduction in IPD is nearly 60 times greater than in the HIV-negative population. The paper also reviewed treatment and nutritional considerations specific to pneumonia in HIV-positive children.

8. Household study in Vietnam reveals high resistance to oral antibiotics for pneumonia

In a recent edition of BMC Infectious Diseases, Hoa et al. analyzed resistance to antibiotics commonly used against S. pneumoniae among children under five in rural Vietnam. Through a household survey of 818 children, researchers found that 421 (52%) carried S. pneumoniae and 477 (58%) reported antibiotic use in the three weeks prior to the survey. Nearly all (95%) samples of S. pneumoniae collected in the survey showed resistance to at least one antibiotic, and more than half (60%) of the samples showed resistance to multiple drugs. The highest rates of resistance were to co-trimoxazole (78%), tetracycline (75%), phenoxymethylpenicillin (75%), erythromycin (70%) and ciprofloxacin (28%). Full resistance to amoxicillin was low (4%) but intermediate resistance was prevalent (32%), and researchers noted that high-dose amoxicillin would be the only effective oral antibiotic against S. pneumoniae in this population. The authors called for better prescription and dispensing practices of antibiotics as well as expanded PCV coverage.

9. Serotype-specific immune hypo-responsiveness to PCV7 demonstrated among infant carriers of S. pneumoniae

Dagan et al.presented findings this month in the Journal of Infectious Diseases regarding serotype-specific hyporesponsiveness among infant carriers of S. pneumoniae prior to receiving PCV. Researchers collected naso or oro-pharyngeal specimens from 545 children prior to immunizing them with PCV7 on a two- or three-dose schedule. Antibody responses were measured by looking at serotype-specific immunoglobulin (Ig) G levels at multiple time points. Among children who were pneumococcal carriers before receiving PCV7, IgG responses to carried serotypes were significantly lower than among children who were not carriers before vaccination, while IgG response to non-carried serotypes was the same amongst the two groups. The effect was partially overcome when a booster dose was administered at an older age.

10. China's progress in reaching MDG4, pneumonia remains leading cause of child mortality

Rudan et al.from the Centre for Population Health Science at the University of Edinburgh Medical School highlighted pneumonia as a leading cause of under-five mortality in China, as reported in the Lancet. Using information from publicly-available Chinese databases as well as longitudinal studies, researchers tracked mortality trends from 1990 to 2008, identifying a 71% reduction in child mortality (from 64.6 to 18.5 per 1000 live births) during the time period. In 2008, pneumonia deaths comprised 15 to 17% of total child mortality with congenital and neonatal causes also accounting for significant portions of the deaths. Dr. Orin Levine also highlighted these findings in his blog, recognizing the progress made against child mortality in the past three decades and offering next steps for continued mortality reduction as well as more equitable coverage of life-saving interventions among different income strata. In a related study featured in the Chinese Journal of Contemporary Pediatrics, Wang et al. from the Kunming Maternal and Child Health Hospital in China analyzed the etiology of community-acquired pneumonia among over 1,100 children, finding that 35.1% of bacterial pneumonia cases stemmed from S. pneumoniae infection.

UPCOMING EVENTS

The 28th Annual Meeting of the European Society for Paediatric Infectious Diseases will take place in Nice, France on May 4 to 8, 2010. This year's themes are immunization in special circumstances and better diagnosis of paediatric infectious diseases. Visit http://www2.kenes.com/espid2010/Pages/Home.aspx for more information.

The Partnering for Global Health Forum will take place on May 4 to 6, 2010 in Chicago, Illinois. The session will bring together representatives from research and academia, pharmaceuticals and biotechnology, and government and donor agencies. For more information, please visit: http://pgh.bio.org/opencms/pgh/2010/.

The World Economic Forum on Africa will be held in Dar es Salaam, Tanzania from May 5 to 7, 2010. The session's title is Rethinking Africa's Growth Strategy, and more information can be found at: http://www.weforum.org/en/events/WorldEconomicForumonAfrica2010/index.htm.

The Global Health Council's 37th Annual International Conference on Global Health, Dateline 2010: Global Health Goals & Metrics, will take place in Washington D.C. June 10 to 14, 2010. Additional information on this conference, which will examine metrics, progress and challenges on global health goals, is available at http://www.globalhealth.org/conference_2010/.


On July 11 to 14, 2010, the International Conference on Emerging Infectious Diseases will be held in Atlanta, Georgia. Visit http://www.iceid.org/ for additional information about the conference.

The 26th International Pediatric Association Congress of Pediatrics will be held in Johannesburg, South Africa from August 4 to 9, 2010. The session will include a focus on child survival and associated progress towards MDGs, health determinants, issues in neonatal health, and emerging infections. Registration instructions and more information can be found at: http://www2.kenes.com/ipa/pages/home.aspx.