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Molecular diagnosis of Chagas disease: a systematic review and meta-analysis. Chagas病的分子诊断:系统综述和荟萃分析。
IF 8.1 1区 医学 Pub Date : 2023-10-16 DOI: 10.1186/s40249-023-01143-7
Guillermo Pascual-Vázquez, Montserrat Alonso-Sardón, Beatriz Rodríguez-Alonso, Javier Pardo-Lledías, Angela Romero Alegría, Pedro Fernández-Soto, Juan Luis Muñoz Bellido, Antonio Muro, Moncef Belhassen-García

Background: The complexity of the Chagas disease and its phases is impossible to have a unique test for both phases and a lot of different epidemiological scenarios. Currently, serology is the reference standard technique; occasionally, results are inconclusive, and a different diagnostic technique is needed. Some guidelines recommend molecular testing. A systematic review and meta-analysis of available molecular tools/techniques for the diagnosis of Chagas disease was performed to measure their heterogeneity and efficacy in detecting Trypanosoma cruzi infection in blood samples.

Methods: A systematic review was conducted up to July 27, 2022, including studies published in international databases. Inclusion and exclusion criteria were defined to select eligible studies. Data were extracted and presented according to PRISMA 2020 guidelines. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). A random-effects model was used to calculate pooled sensitivity, specificity, and diagnostic odds ratio (DOR). Forest plots and a summary of the receiving operating characteristics (SROC) curves displayed the outcomes. Heterogeneity was determined by I2 and Tau2 statistics and P values. Funnel plots and Deek's test were used to assess publication bias. A quantitative meta-analysis of the different outcomes in the two different clinical phases was performed.

Results: We identified 858 records and selected 32 papers. Studies pertained to endemic countries and nonendemic areas with adult and paediatric populations. The sample sizes ranged from 17 to 708 patients. There were no concerns regarding the risk of bias and applicability of all included studies. A positive and nonsignificant correlation coefficient (S = 0.020; P = 0.992) was obtained in the set of studies that evaluated diagnostic tests in the acute phase population (ACD). A positive and significant correlation coefficient (S = 0.597; P < 0.000) was obtained in the case of studies performed in the chronic phase population (CCD). This resulted in high heterogeneity between studies, with the master mix origin and guanidine addition representing significant sources.

Interpretation/conclusions and relevance: The results described in this meta-analysis (qualitative and quantitative analyses) do not allow the selection of the optimal protocol of molecular method for the study of Trypanosoma cruzi infection in any of its phases, among other reasons due to the complexity of this infection. Continuous analysis and optimization of the different molecular techniques is crucial to implement this efficient diagnosis in endemic areas.

背景:由于恰加斯病及其阶段的复杂性,不可能对这两个阶段和许多不同的流行病学场景进行独特的检测。目前,血清学是参考标准技术;有时,结果是不确定的,需要不同的诊断技术。一些指南建议进行分子检测。对用于诊断Chagas病的可用分子工具/技术进行了系统综述和荟萃分析,以测量其在检测血液样本中克鲁兹锥虫感染方面的异质性和有效性。方法:截至2022年7月27日进行系统综述,包括发表在国际数据库中的研究。定义了纳入和排除标准,以选择符合条件的研究。数据是根据PRISMA 2020指南提取和呈现的。使用诊断准确性研究质量评估-2(QUADAS-2)评估研究质量。随机效应模型用于计算合并的敏感性、特异性和诊断优势比(DOR)。森林图和接收操作特性(SROC)曲线摘要显示了结果。通过I2和Tau2统计和P值确定异质性。漏斗图和Deek检验用于评估发表偏倚。对两个不同临床阶段的不同结果进行了定量荟萃分析。结果:我们共鉴定了858篇记录,筛选出32篇论文。研究涉及有成人和儿科人口的流行国家和非流行地区。样本量在17至708名患者之间。对所有纳入研究的偏倚风险和适用性没有任何顾虑。正相关系数(S = 0.020;P = 0.992)在评估急性期人群(ACD)诊断测试的一组研究中获得。正相关系数(S = 0.597;P 解释/结论和相关性:本荟萃分析(定性和定量分析)中描述的结果不允许选择研究克氏锥虫感染任何阶段的最佳分子方法方案,除其他原因外,由于这种感染的复杂性。对不同分子技术的持续分析和优化对于在流行地区实施这种有效的诊断至关重要。
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引用次数: 0
Accelerating into Immunization Agenda 2030 with momentum from China's successful COVID-19 vaccination campaign during dynamic COVID Zero. 随着中国在动态清零期间成功开展新冠肺炎疫苗接种活动的势头,加快进入2030年免疫议程。
IF 8.1 1区 医学 Pub Date : 2023-10-16 DOI: 10.1186/s40249-023-01151-7
Lance E Rodewald

China's immunization programs conducted a unified, tightly coordinated COVID-19 vaccination campaign during the dynamic COVID Zero period that reached well over 90% of the population with vaccines having > 90% effectiveness against serious-to-fatal COVID-19. The campaign was eight times the size of the annual routine national immunization program, administering 3.4 billion doses of vaccines while monitoring vaccine coverage, acceptability, safety, and effectiveness. Every asset of the routine immunization program had to be strengthened and expanded to attain high coverage and reach hundreds of millions of adults who had not been vaccinated since childhood. Program strengthening and expansion were in directions aligned with the World Health Organization's Immunization Agenda 2030, which has a vision that "everyone, everywhere, at every age fully benefits from vaccines for good health and well-being" and requires reaching all children, adolescents, and adults with lifesaving vaccines. Momentum from this campaign should not be lost but should be invested into achieving what is possible with a properly resourced national immunization program that is now proven to be capable of reaching everyone in the world's largest country throughout the life course, and to do so with all vaccines recommended by the World Health Organization.

在新冠疫情动态清零期间,中国免疫规划开展了统一、密切协调的新冠肺炎疫苗接种活动,接种疫苗的人口超过90% > 对严重到致命的新冠肺炎有90%的有效性。这场运动的规模是年度常规国家免疫计划的八倍,接种了34亿剂疫苗,同时监测疫苗的覆盖率、可接受性、安全性和有效性。必须加强和扩大常规免疫计划的每一项资产,以实现高覆盖率,并惠及数亿从小就没有接种疫苗的成年人。加强和扩大计划的方向与世界卫生组织的《2030年免疫议程》一致,该议程的愿景是“每个人、每个地方、每个年龄段都能充分受益于疫苗,以实现良好的健康和福祉”,并要求为所有儿童、青少年和成年人接种救命疫苗。这场运动的势头不应丧失,而应投资于通过一个资源充足的国家免疫计划实现可能的目标,该计划目前已被证明能够在世界最大国家的每个人的整个生命过程中惠及他们,并通过世界卫生组织推荐的所有疫苗实现这一目标。
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引用次数: 0
Immunization coverage, knowledge, satisfaction, and associated factors of non-National Immunization Program vaccines among migrant and left-behind families in China: evidence from Zhejiang and Henan provinces. 中国流动人口和留守家庭非国家免疫规划疫苗的免疫覆盖率、知识、满意度及相关因素:来自浙江和河南省的证据。
IF 8.1 1区 医学 Pub Date : 2023-10-13 DOI: 10.1186/s40249-023-01145-5
Yaguan Zhou, Duanhui Li, Yuan Cao, Fenhua Lai, Yu Wang, Qian Long, Zifan Zhang, Chuanbo An, Xiaolin Xu
<p><strong>Background: </strong>Migrant and left-behind families are vulnerable in health services utilization, but little is known about their disparities in immunization of non-National Immunization Program (NIP) vaccines. This study aims to evaluate the immunization coverage, knowledge, satisfaction, and associated factors of non-NIP vaccines among local and migrant families in the urban areas and non-left-behind and left-behind families in the rural areas of China.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted in urban areas of Zhejiang and rural areas of Henan in China. A total of 1648 caregivers of children aged 1-6 years were interviewed face-to-face by a pre-designed online questionnaire, and their families were grouped into four types: local urban, migrant, non-left-behind, and left-behind. Non-NIP vaccines included Hemophilus influenza b (Hib) vaccine, varicella vaccine, rotavirus vaccine, enterovirus 71 vaccine (EV71) and 13-valent pneumonia vaccine (PCV13). Log-binomial regression models were used to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the difference on immunization coverage of children, and knowledge and satisfaction of caregivers among families. The network models were conducted to explore the interplay of immunization coverage, knowledge, and satisfaction. Logistic regression models with odds ratios (ORs) and 95% CIs were used to estimate the associated factors of non-NIP vaccination.</p><p><strong>Results: </strong>The immunization coverage of all non-NIP vaccines and knowledge of all items of local urban families was the highest, followed by migrant, non-left-behind and left-behind families. Compared with local urban children, the PRs (95% CIs) for getting all vaccinated were 0.65 (0.52-0.81), 0.29 (0.22-0.37) and 0.14 (0.09-0.21) among migrant children, non-left-behind children and left-behind children, respectively. The coverage-knowledge-satisfaction network model showed the core node was the satisfaction of vaccination schedule. Non-NIP vaccination was associated with characteristics of both children and caregivers, including age of children (> 2 years-OR: 1.69, 95% CI: 1.07-2.68 for local urban children; 2.67, 1.39-5.13 for migrant children; 3.09, 1.23-7.76 for non-left-behind children); and below caregivers' characteristics: family role (parents: 0.37, 0.14-0.99 for non-left-behind children), age (≤ 35 years: 7.27, 1.39-37.94 for non-left-behind children), sex (female: 0.49, 0.30-0.81 for local urban children; 0.31, 0.15-0.62 for non-left-behind children), physical health (more than average: 1.58, 1.07-2.35 for local urban children) and non-NIP vaccines knowledge (good: 0.45, 0.30-0.68 for local urban children; 7.54, 2.64-21.50 for left-behind children).</p><p><strong>Conclusions: </strong>There were immunization disparities in non-NIP vaccines among migrant and left-behind families compared with their local counterparts. Non-NIP vaccination promotion strategies,
背景:移民和留守家庭在卫生服务利用方面很脆弱,但人们对他们在非国家免疫计划(NIP)疫苗免疫方面的差异知之甚少。本研究旨在评估中国城市本地和流动家庭以及农村非留守和留守家庭非NIP疫苗的免疫覆盖率、知识、满意度及其相关因素。方法:在浙江城市和河南农村进行横断面调查。通过预先设计的在线问卷,共有1648名1-6岁儿童的照顾者接受了面对面的采访,他们的家庭被分为四类:本地城市、流动、非留守和留守。非NIP疫苗包括乙型流感嗜血杆菌疫苗、水痘疫苗、轮状病毒疫苗、肠道病毒71型疫苗和13价肺炎疫苗。对数二项回归模型用于计算儿童免疫覆盖率以及家庭护理人员知识和满意度差异的患病率(PR)和95%置信区间(CI)。进行网络模型是为了探索免疫覆盖率、知识和满意度之间的相互作用。使用具有比值比(OR)和95%CI的Logistic回归模型来估计非NIP疫苗接种的相关因素。结果:所有非NIP疫苗的免疫覆盖率和当地城市家庭所有项目的知识水平最高,其次是流动、非留守和留守家庭。与当地城市儿童相比,流动儿童、非留守儿童和留守儿童全部接种疫苗的概率比(95%CI)分别为0.65(0.52-0.81)、0.29(0.22-0.37)和0.14(0.09-0.21)。覆盖知识满意度网络模型表明,核心节点是疫苗接种进度的满意度。非NIP疫苗接种与儿童和照顾者的特征相关,包括儿童的年龄(> 2岁OR:1.69,95%CI:1.07-2.68为当地城市儿童;移民儿童2.67、1.39-5.13;非留守儿童为3.09、1.23-7.76);及以下照顾者的特征:家庭角色(父母:非留守儿童0.370.14-0.99)、年龄(≤ 35岁:非留守儿童7.27,1.39-37.94)、性别(女性:当地城市儿童0.49,0.30-0.81;非留守儿童0.31,0.15-0.62),身体健康(高于平均水平:1.58,1.07-2.35,当地城市儿童)和非NIP疫苗知识(良好:0.45,0.30-0.68,当地留守儿童7.54,2.64-21.50)。应特别在留守和移民家庭中实施非NIP疫苗接种促进战略,包括对护理人员的教育和免疫信息系统的优化。
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引用次数: 0
Cost-effectiveness of seasonal influenza vaccination of children in China: a modeling analysis. 中国儿童季节性流感疫苗接种的成本-效果:模型分析。
IF 8.1 1区 医学 Pub Date : 2023-10-11 DOI: 10.1186/s40249-023-01144-6
Qiang Wang, Huajie Jin, Liuqing Yang, Hui Jin, Leesa Lin

Background: China has a high burden of influenza-associated illness among children. We aimed to evaluate the cost-effectiveness of introducing government-funded influenza vaccination to children in China (fully-funded policy) compared with the status quo (self-paid policy).

Methods: A decision tree model was developed to calculate the economic and health outcomes, from a societal perspective, using national- and provincial-level data. The incremental cost-effectiveness ratio (ICER) [incremental costs per quality-adjusted life year (QALY) gained] was used to compare the fully-funded policy with the self-paid policy under the willingness-to-pay threshold equivalent to national and provincial GDP per capita. Sensitivity analyses were performed and various scenarios were explored based on real-world conditions, including incorporating indirect effect into the analysis.

Results: Compared to the self-paid policy, implementation of a fully-funded policy could prevent 1,444,768 [95% uncertainty range (UR): 1,203,446-1,719,761] symptomatic cases, 92,110 (95% UR: 66,953-122,226) influenza-related hospitalizations, and 6494 (95% UR: 4590-8962) influenza-related death per season. The fully-funded policy was cost-effective nationally (7964 USD per QALY gained) and provincially for 13 of 31 provincial-level administrative divisions (PLADs). The probability of a funded vaccination policy being cost-effective was 56.5% nationally, and the probability in 9 of 31 PLADs was above 75%. The result was most sensitive to the symptomatic influenza rate among children under 5 years [ICER ranging from - 25,612 (cost-saving) to 14,532 USD per QALY gained]. The ICER of the fully-funded policy was substantially lower (becoming cost-saving) if the indirect effects of vaccination were considered.

Conclusions: Introducing a government-funded influenza policy for children is cost-effective in China nationally and in many PLADs. PLADs with high symptomatic influenza rate and influenza-associated mortality would benefit the most from a government-funded influenza vaccination program.

背景:中国儿童患流感相关疾病的负担很高。我们旨在评估中国儿童接种政府资助流感疫苗(全额资助政策)与现状(自费政策)的成本效益。方法:利用国家和省级数据,从社会角度建立决策树模型,计算经济和健康结果。增量成本效益比(ICER)[获得的每个质量调整生命年的增量成本(QALY)]用于在相当于国家和省级人均GDP的支付意愿阈值下比较全额资助政策和自费政策。进行了敏感性分析,并根据真实世界的条件探索了各种场景,包括将间接影响纳入分析。结果:与自费政策相比,实施全额资助政策可以预防1444768例[95%不确定性范围(UR):1203446-1719761]有症状病例、92110例(95%UR:66953-122226)流感相关住院和6494例(95%UR:4590-8962)流感相关死亡。全额资助的政策在全国范围内具有成本效益(每个QALY获得7964美元),在31个省级行政区中的13个省级行政区划中具有成本效益。资助的疫苗接种政策在全国范围内具有成本效益的概率为56.5%,31种PLAD中有9种的概率高于75%。这一结果对5岁以下儿童的症状性流感发病率最为敏感[每增加一个QALY,ICER从-25612美元(节省成本)到14532美元不等]。如果考虑到疫苗接种的间接影响,全额资助政策的ICER要低得多(节省成本)。结论:在中国和许多PLAD中,引入政府资助的儿童流感政策具有成本效益。具有高症状性流感发病率和流感相关死亡率的PLAD将从政府资助的流感疫苗接种计划中受益最大。
{"title":"Cost-effectiveness of seasonal influenza vaccination of children in China: a modeling analysis.","authors":"Qiang Wang, Huajie Jin, Liuqing Yang, Hui Jin, Leesa Lin","doi":"10.1186/s40249-023-01144-6","DOIUrl":"10.1186/s40249-023-01144-6","url":null,"abstract":"<p><strong>Background: </strong>China has a high burden of influenza-associated illness among children. We aimed to evaluate the cost-effectiveness of introducing government-funded influenza vaccination to children in China (fully-funded policy) compared with the status quo (self-paid policy).</p><p><strong>Methods: </strong>A decision tree model was developed to calculate the economic and health outcomes, from a societal perspective, using national- and provincial-level data. The incremental cost-effectiveness ratio (ICER) [incremental costs per quality-adjusted life year (QALY) gained] was used to compare the fully-funded policy with the self-paid policy under the willingness-to-pay threshold equivalent to national and provincial GDP per capita. Sensitivity analyses were performed and various scenarios were explored based on real-world conditions, including incorporating indirect effect into the analysis.</p><p><strong>Results: </strong>Compared to the self-paid policy, implementation of a fully-funded policy could prevent 1,444,768 [95% uncertainty range (UR): 1,203,446-1,719,761] symptomatic cases, 92,110 (95% UR: 66,953-122,226) influenza-related hospitalizations, and 6494 (95% UR: 4590-8962) influenza-related death per season. The fully-funded policy was cost-effective nationally (7964 USD per QALY gained) and provincially for 13 of 31 provincial-level administrative divisions (PLADs). The probability of a funded vaccination policy being cost-effective was 56.5% nationally, and the probability in 9 of 31 PLADs was above 75%. The result was most sensitive to the symptomatic influenza rate among children under 5 years [ICER ranging from - 25,612 (cost-saving) to 14,532 USD per QALY gained]. The ICER of the fully-funded policy was substantially lower (becoming cost-saving) if the indirect effects of vaccination were considered.</p><p><strong>Conclusions: </strong>Introducing a government-funded influenza policy for children is cost-effective in China nationally and in many PLADs. PLADs with high symptomatic influenza rate and influenza-associated mortality would benefit the most from a government-funded influenza vaccination program.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"12 1","pages":"92"},"PeriodicalIF":8.1,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41216892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors associated with recommendation behaviors of four non-National Immunization Program vaccines: a cross-sectional survey among public health workers in China. 四种非国家免疫规划疫苗推荐行为的相关因素:中国公共卫生工作者的横断面调查。
IF 8.1 1区 医学 Pub Date : 2023-10-07 DOI: 10.1186/s40249-023-01142-8
Yun Lyu, Xiaozhen Lai, Yidi Ma, Hai Fang

Background: Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases. In China, the coverage rate of non-National Immunization Program (non-NIP) vaccines can be improved by leveraging the recommendation from public health workers. Hence, understanding the influencing factors of recommendation behaviors assume paramount importance. This study aims to investigate influencing factors of public health workers' recommendation behaviors towards non-NIP vaccines, with a particular emphasis on financial incentives.

Methods: A cross-sectional survey was conducted using a multi-stage sampling method in 2019 from August to October. 627 public health workers were recruited from 148 community healthcare centers in ten provincial-level administrative divisions in China. An anonymous questionnaire was used to collect demographic information, attitudes towards vaccination, and recommendation behaviors towards non-NIP vaccines, including Haemophilus influenzae type b (Hib) vaccine, pneumococcal conjugate vaccine, varicella vaccine, and rotavirus vaccine. Descriptive analysis and multivariate logistic regression analysis were adopted in this study.

Results: Of the 610 public health workers with complete survey data, 53.8%, 57.4%, 84.1%, and 54.1% often recommended Hib vaccine, pneumococcal pneumonia vaccine (PCV), varicella vaccine, and rotavirus vaccine, respectively. Logistic regression revealed that gender (Hib vaccine: OR = 0.4, 95% CI: 0.2-0.8; PCV: OR = 0.4, 95% CI: 0.2-0.8; rotavirus vaccine: OR = 0.3, 95% CI: 0.2-0.6), financial incentives for non-NIP vaccination (Hib vaccine: OR = 1.9, 95% CI: 1.1-3.6; PCV: OR = 2.1, 95% CI: 1.1-3.9; rotavirus vaccine: OR = 2.0, 95% CI: 1.1-3.8) and perception of vaccine safety (Hib vaccine: OR = 2.7, 95% CI: 1.1-7.0; PCV: OR = 3.2, 95% CI: 1.2-8.0; rotavirus vaccine: OR = 3.0, 95% CI: 1.2-7.7) were associated with public health workers' recommendation towards Hib vaccine, PCV and rotavirus vaccine.

Conclusions: The findings highlighted public health workers' recommendation behaviors of non-NIP vaccines in China and revealed strong association between vaccine recommendation and financial incentives. This highlights the importance of financial incentives in public health workers' recommendation toward non-NIP vaccines in China. Proper incentives are recommended for public health workers to encourage effective health promotion in immunization practices.

背景:免疫接种是保护五岁以下儿童免受一系列疾病侵害的重要预防措施。在中国,可以利用公共卫生工作者的建议来提高非国家免疫计划疫苗的覆盖率。因此,了解推荐行为的影响因素至关重要。本研究旨在调查公共卫生工作者对非NIP疫苗推荐行为的影响因素,特别是经济激励。方法:2019年8月至10月采用多阶段抽样方法进行横断面调查。627名公共卫生工作者来自中国10个省级行政区划的148个社区卫生中心。使用匿名问卷收集人口统计信息、对疫苗接种的态度和对非NIP疫苗的推荐行为,包括乙型流感嗜血杆菌疫苗、肺炎球菌结合疫苗、水痘疫苗和轮状病毒疫苗。本研究采用描述性分析和多元逻辑回归分析。结果:在610名有完整调查数据的公共卫生工作者中,分别有53.8%、57.4%、84.1%和54.1%的人经常推荐接种Hib疫苗、肺炎球菌肺炎疫苗、水痘疫苗和轮状病毒疫苗。Logistic回归显示性别(Hib疫苗:OR = 0.4,95%置信区间:0.2-0.8;PCV:或 = 0.4,95%置信区间:0.2-0.8;轮状病毒疫苗:OR = 0.3,95%置信区间:0.2-0.6),非NIP疫苗接种的经济激励(Hib疫苗:OR = 1.9,95%置信区间:1.1-3.6;PCV:或 = 2.1,95%置信区间:1.1-3.9;轮状病毒疫苗:OR = 2.0,95%CI:1.1-3.8)和疫苗安全性感知(Hib疫苗:OR = 2.7,95%置信区间:1.1-7.0;PCV:或 = 3.2,95%置信区间:1.2-8.0;轮状病毒疫苗:OR = 3.0,95%CI:1.2-7.7)与公共卫生工作者对Hib疫苗、PCV和轮状病毒疫苗的推荐有关。结论:研究结果突出了中国公共卫生工作者对非NIP疫苗的推荐行为,并揭示了疫苗推荐与经济激励之间的强烈关联。这突出了财政激励在中国公共卫生工作者推荐非NIP疫苗方面的重要性。建议对公共卫生工作者采取适当的激励措施,鼓励在免疫实践中有效促进健康。
{"title":"Factors associated with recommendation behaviors of four non-National Immunization Program vaccines: a cross-sectional survey among public health workers in China.","authors":"Yun Lyu, Xiaozhen Lai, Yidi Ma, Hai Fang","doi":"10.1186/s40249-023-01142-8","DOIUrl":"10.1186/s40249-023-01142-8","url":null,"abstract":"<p><strong>Background: </strong>Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases. In China, the coverage rate of non-National Immunization Program (non-NIP) vaccines can be improved by leveraging the recommendation from public health workers. Hence, understanding the influencing factors of recommendation behaviors assume paramount importance. This study aims to investigate influencing factors of public health workers' recommendation behaviors towards non-NIP vaccines, with a particular emphasis on financial incentives.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted using a multi-stage sampling method in 2019 from August to October. 627 public health workers were recruited from 148 community healthcare centers in ten provincial-level administrative divisions in China. An anonymous questionnaire was used to collect demographic information, attitudes towards vaccination, and recommendation behaviors towards non-NIP vaccines, including Haemophilus influenzae type b (Hib) vaccine, pneumococcal conjugate vaccine, varicella vaccine, and rotavirus vaccine. Descriptive analysis and multivariate logistic regression analysis were adopted in this study.</p><p><strong>Results: </strong>Of the 610 public health workers with complete survey data, 53.8%, 57.4%, 84.1%, and 54.1% often recommended Hib vaccine, pneumococcal pneumonia vaccine (PCV), varicella vaccine, and rotavirus vaccine, respectively. Logistic regression revealed that gender (Hib vaccine: OR = 0.4, 95% CI: 0.2-0.8; PCV: OR = 0.4, 95% CI: 0.2-0.8; rotavirus vaccine: OR = 0.3, 95% CI: 0.2-0.6), financial incentives for non-NIP vaccination (Hib vaccine: OR = 1.9, 95% CI: 1.1-3.6; PCV: OR = 2.1, 95% CI: 1.1-3.9; rotavirus vaccine: OR = 2.0, 95% CI: 1.1-3.8) and perception of vaccine safety (Hib vaccine: OR = 2.7, 95% CI: 1.1-7.0; PCV: OR = 3.2, 95% CI: 1.2-8.0; rotavirus vaccine: OR = 3.0, 95% CI: 1.2-7.7) were associated with public health workers' recommendation towards Hib vaccine, PCV and rotavirus vaccine.</p><p><strong>Conclusions: </strong>The findings highlighted public health workers' recommendation behaviors of non-NIP vaccines in China and revealed strong association between vaccine recommendation and financial incentives. This highlights the importance of financial incentives in public health workers' recommendation toward non-NIP vaccines in China. Proper incentives are recommended for public health workers to encourage effective health promotion in immunization practices.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"12 1","pages":"91"},"PeriodicalIF":8.1,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10559509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41162201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of remote radiologist-interpreted point-of-care ultrasound for suspected dengue patients in a primary health care facility in Colombia. 对哥伦比亚初级卫生保健机构中疑似登革热患者的远程放射科医生解读护理点超声的评估。
IF 8.1 1区 医学 Pub Date : 2023-09-28 DOI: 10.1186/s40249-023-01141-9
Lyda Osorio, Iñigo Prieto, Daniela Zuluaga, Deliana Ropero, Neelesh Dewan, Jonathan D Kirsch

Background: Early identification of plasma leakage may guide treatment decisions in dengue patients. This study evaluated the value of point-of-care ultrasound (POCUS) to detect plasma leakage and predict hospitalization or referral to a higher level of care in suspected dengue patients under routine conditions at a primary care facility in Colombia.

Methods: We conducted a cohort study between April 2019 and March 2020 in a primary care hospital in Cali, Colombia. We prospectively included and followed 178 patients who were at least 2 years old with fever of less than 10 days and clinician-suspected dengue. A trained general practitioner performed a standardized POCUS protocol. Images were quality-rated and overread by an expert radiologist, and her results and those of the general practitioner were compared using the Kappa index. Logistic regression was used to identify factors associated with plasma leakage at enrollment and explore its prognostic value regarding hospital admission or referral to a higher level of care.

Results: Half (49.6%) POCUS images were of suitable quality to be interpreted. The proportion of plasma leakage reported by the radiologist was 85.1% (95% CI: 78.6-90.2%) and 47.2% by the study physician (Kappa = 0.25, 95% CI: 0.15-0.35). The most frequent ultrasound findings were ascites (hepatorenal 87.2%, splenorenal 64%, or pelvic 21.8%) and gallbladder wall thickening (10.5%). Plasma leakage was higher in subjects with thrombocytopenia (aOR = 4, 95% CI: 1.3-12.1) and lower in patients 30-59 years old (aOR = 0.1, 95% CI: 0.0-0.4) than in those 18 years old or younger. POCUS evidence of plasma leakage (aOR = 8.2, 95% CI: 2.2-29.9), thrombocytopenia (aOR = 6.3, 95% CI: 2.4-16.0) and pulse pressure (aOR = 1.1, 95% CI: 1.07-1.2) were associated with hospital admission or referral to a higher level of care.

Conclusions: Ultrasound is useful to detect plasma leakage in primary care and, challenges remain to guarantee high-quality images and diagnostic accuracy, for which a standardized dengue POCUS protocol and training program is needed.

背景:早期发现血浆渗漏可能指导登革热患者的治疗决策。这项研究评估了护理点超声(POCUS)在哥伦比亚初级保健机构常规条件下检测血浆渗漏并预测疑似登革热患者住院或转诊到更高水平护理的价值。方法:我们于2019年4月至2020年3月在哥伦比亚卡利的一家初级保健医院进行了一项队列研究。我们前瞻性地纳入并跟踪了178名年龄至少为2岁、发烧时间小于10天且临床医生怀疑登革热的患者。经过培训的全科医生执行了标准化POCUS方案。放射科医生对图像进行了质量评级和高估,并使用Kappa指数将她的结果与全科医生的结果进行了比较。在入组时使用Logistic回归来确定与血浆渗漏相关的因素,并探讨其对入院或转诊到更高水平护理的预后价值。结果:一半(49.6%)的POCUS图像具有合适的解释质量。放射科医生报告的血浆渗漏比例为85.1%(95%置信区间:78.6-90.2%),研究医生报告的为47.2%(Kappa = 0.25,95%CI:0.15-0.35)。最常见的超声检查结果是腹水(肝肾87.2%,脾肾64%,或盆腔21.8%)和胆囊壁增厚(10.5%)。血小板减少症(aOR = 4,95%可信区间:1.3-12.1)和30-59岁患者更低(aOR = 0.1、95%可信区间:0.0-0.4)。血浆渗漏的POCUS证据(aOR = 8.2,95%可信区间:2.2-29.9)、血小板减少症(aOR = 6.3,95%CI:2.4-16.0)和脉冲压力(aOR = 1.1,95%可信区间:1.07-1.2)与入院或转诊到更高级别的护理相关。结论:超声有助于检测初级保健中的血浆渗漏,但要保证高质量的图像和诊断准确性仍然存在挑战,为此需要一个标准化的登革热POCUS方案和培训计划。
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引用次数: 0
Female genital schistosomiasis, human papilloma virus infection, and cervical cancer in rural Madagascar: a cross sectional study. 马达加斯加农村女性生殖器血吸虫病、人类乳头状瘤病毒感染和宫颈癌症:一项横断面研究。
IF 8.1 1区 医学 Pub Date : 2023-09-25 DOI: 10.1186/s40249-023-01139-3
Jean-Marc Kutz, Pia Rausche, Tahinamandranto Rasamoelina, Sonya Ratefiarisoa, Ravo Razafindrakoto, Philipp Klein, Anna Jaeger, Rivo Solotiana Rakotomalala, Zoly Rakotomalala, Bodo Sahondra Randrianasolo, Sandrine McKay-Chopin, Jürgen May, Rapahel Rakotozandrindrainy, Dewi Ismajani Puradiredja, Elisa Sicuri, Monika Hampl, Eva Lorenz, Tarik Gheit, Rivo Andry Rakotoarivelo, Daniela Fusco

Background: Women's health in resource-limited settings can benefit from the integrated management of high-burden diseases, such as female genital schistosomiasis (FGS) and human papilloma virus (HPV)-related cervical cancer. In schistosomiasis-endemic countries such as Madagascar, data on FGS and HPV prevalence are lacking as well as preventive measures for both conditions. This study aims to estimate the prevalence of FGS and HPV in rural Madagascar, and to examine associated risk factors to identify opportunities for improving women's health.

Methods: After initial community outreach activities, interested women aged 18-49 years were recruited consecutively in 2021 at three primary health care centers in the district of Marovoay. FGS was detected by colposcopy. Colposcopy images were double-blind reviewed by two independent specialists. A Luminex bead-based assay was performed on cervical vaginal lavage specimens for HPV typing. Crude (CPR) and adjusted prevalence ratios (APR) of associations between selected factors and FGS and HPV positivity were estimated using univariable and multivariable binary Poisson regression with 95% confidence intervals (CIs).

Results: Among 500 women enrolled, 302 had complete information on FGS and HPV diagnosis, and were thus eligible for analysis. Within the sample, 189 (62.6%, 95% CI: 56.9-68.1) cases of FGS were detected. A total of 129 women (42.7%, 95% CI: 37.1-48.5) tested positive for HPV. In total, 80 women (26.5%, 95% CI: 21.6-31.8]) tested positive for both conditions. No association was observed between FGS and HPV positivity, while previous pregnancy (APR = 0.65, 95% CI: 0.43-0.78) and older age (APR = 0.59, 95% CI: 0.42-0.81) are showing a negative association with HPV infection compared to no previous pregnancy and younger age groups.

Conclusions: The results of the study show that FGS and HPV are highly prevalent in rural Madagascar. The concurrent prevalence of these two conditions requires urgent adaptations of public health strategies to improve women's health, such as integrated services at primary level of care.

背景:在资源有限的环境中,妇女的健康可以受益于高负担疾病的综合管理,如女性生殖器血吸虫病(FGS)和人乳头瘤病毒(HPV)相关的宫颈癌症。在马达加斯加等血吸虫病流行国家,缺乏FGS和HPV流行率的数据,也缺乏针对这两种情况的预防措施。本研究旨在评估马达加斯加农村女性生殖器切割和人乳头状瘤病毒的患病率,并检查相关的风险因素,以确定改善妇女健康的机会。方法:在最初的社区外展活动之后,2021年,在Marovoy区的三个初级卫生保健中心连续招募了18-49岁的感兴趣的女性。阴道镜检查发现FGS。两位独立专家对阴道镜图像进行了双盲审查。对宫颈阴道灌洗标本进行基于Luminex珠的HPV分型测定。采用95%置信区间(CI)的单变量和多变量二元泊松回归估计了所选因素与FGS和HPV阳性之间关系的粗患病率(CPR)和调整患病率(APR)。在样本中,检测到189例(62.6%,95%置信区间:56.9-68.1)FGS病例。共有129名女性(42.7%,95%置信区间:37.1-48.5)的HPV检测呈阳性。总共有80名女性(26.5%,95%CI:21.6-31.8])在这两种情况下检测呈阳性。未观察到FGS与HPV阳性之间的相关性,而既往妊娠(APR = 0.65,95%可信区间:0.43-0.78)和年龄较大(APR = 0.59,95%CI:0.42-0.81)显示出与HPV感染的负相关。结论:研究结果表明,FGS和HPV在马达加斯加农村高度流行。这两种疾病同时流行,需要紧急调整公共卫生战略,以改善妇女的健康,例如初级保健的综合服务。
{"title":"Female genital schistosomiasis, human papilloma virus infection, and cervical cancer in rural Madagascar: a cross sectional study.","authors":"Jean-Marc Kutz, Pia Rausche, Tahinamandranto Rasamoelina, Sonya Ratefiarisoa, Ravo Razafindrakoto, Philipp Klein, Anna Jaeger, Rivo Solotiana Rakotomalala, Zoly Rakotomalala, Bodo Sahondra Randrianasolo, Sandrine McKay-Chopin, Jürgen May, Rapahel Rakotozandrindrainy, Dewi Ismajani Puradiredja, Elisa Sicuri, Monika Hampl, Eva Lorenz, Tarik Gheit, Rivo Andry Rakotoarivelo, Daniela Fusco","doi":"10.1186/s40249-023-01139-3","DOIUrl":"10.1186/s40249-023-01139-3","url":null,"abstract":"<p><strong>Background: </strong>Women's health in resource-limited settings can benefit from the integrated management of high-burden diseases, such as female genital schistosomiasis (FGS) and human papilloma virus (HPV)-related cervical cancer. In schistosomiasis-endemic countries such as Madagascar, data on FGS and HPV prevalence are lacking as well as preventive measures for both conditions. This study aims to estimate the prevalence of FGS and HPV in rural Madagascar, and to examine associated risk factors to identify opportunities for improving women's health.</p><p><strong>Methods: </strong>After initial community outreach activities, interested women aged 18-49 years were recruited consecutively in 2021 at three primary health care centers in the district of Marovoay. FGS was detected by colposcopy. Colposcopy images were double-blind reviewed by two independent specialists. A Luminex bead-based assay was performed on cervical vaginal lavage specimens for HPV typing. Crude (CPR) and adjusted prevalence ratios (APR) of associations between selected factors and FGS and HPV positivity were estimated using univariable and multivariable binary Poisson regression with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Among 500 women enrolled, 302 had complete information on FGS and HPV diagnosis, and were thus eligible for analysis. Within the sample, 189 (62.6%, 95% CI: 56.9-68.1) cases of FGS were detected. A total of 129 women (42.7%, 95% CI: 37.1-48.5) tested positive for HPV. In total, 80 women (26.5%, 95% CI: 21.6-31.8]) tested positive for both conditions. No association was observed between FGS and HPV positivity, while previous pregnancy (APR = 0.65, 95% CI: 0.43-0.78) and older age (APR = 0.59, 95% CI: 0.42-0.81) are showing a negative association with HPV infection compared to no previous pregnancy and younger age groups.</p><p><strong>Conclusions: </strong>The results of the study show that FGS and HPV are highly prevalent in rural Madagascar. The concurrent prevalence of these two conditions requires urgent adaptations of public health strategies to improve women's health, such as integrated services at primary level of care.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"12 1","pages":"89"},"PeriodicalIF":8.1,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10518971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41155334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing food security performance from the One Health concept: an evaluation tool based on the Global One Health Index. 从“一个健康”概念评估粮食安全绩效:基于全球一个健康指数的评估工具。
IF 8.1 1区 医学 Pub Date : 2023-09-22 DOI: 10.1186/s40249-023-01135-7
Si-Yu Gu, Fu-Min Chen, Chen-Sheng Zhang, Yi-Bin Zhou, Tian-Yun Li, Ne Qiang, Xiao-Xi Zhang, Jing-Shu Liu, Shu-Xun Wang, Xue-Chen Yang, Xiao-Kui Guo, Qin-Qin Hu, Xiao-Bei Deng, Le-Fei Han

Background: Food systems instantiate the complex interdependencies across humans, physical environments, and other organisms. Applying One Health approaches for agri-food system transformation, which adopts integrated and unifying approaches to optimize the overall health of humans, animals, plants, and environments, is crucial to enhance the sustainability of food systems. This study develops a potential assessment tool, named the global One Health index-Food Security (GOHI-FS), aiming to evaluate food security performance across countries/territories from One Health perspective and identify relevant gaps that need to be improved for sustainable food systems.

Methods: We comprehensively reviewed existing frameworks and elements of food security. The indicator framework of GOHI-FS was conceptualized following the structure-process-outcome model and confirmed by expert advisory. Publicly available data in 2020 was collected for each indicator. The weighting strategy was determined by the Fuzzy Analytical Hierarchy Process. The data for each indicator was normalized and aggregated by weighted arithmetic mean. Linear regressions were performed to evaluate the associations of GOHI-FS with health and social-economic indicators.

Results: The GOHI-FS includes 5 first-level indicators, 19 second-level indicators and 45 third-level indicators. There were 146 countries/territories enrolled for evaluation. The highest average score of first-level indicators was Nutrition (69.8) and the lowest was Government Support and Response (31.3). There was regional heterogeneity of GOHI-FS scores. Higher median scores with interquartile range (IQR) were shown in North America (median: 76.1, IQR: 75.5-76.7), followed by Europe and Central Asia (median: 66.9, IQR: 60.1-74.3), East Asia and the Pacific (median: 60.6, IQR: 55.5-68.7), Latin America and the Caribbean (median: 60.2, IQR: 57.8-65.0), Middle East and North Africa (median: 56.6, IQR: 52.0-62.8), South Asia (median: 51.1, IQR: 46.7-53.8), and sub-Saharan Africa (median: 41.4, IQR: 37.2-46.5). We also found significant associations between GOHI-FS and GDP per capita, socio-demographic index, health expenditure and life expectancy.

Conclusions: GOHI-FS is a potential assessment tool to understand the gaps in food security across countries/territories under the One Health concept. The pilot findings suggest notable gaps for sub-Saharan Africa in numerous aspects. Broad actions are needed globally to promote government support and response for food security.

背景:食物系统体现了人类、物理环境和其他生物之间复杂的相互依存关系。将“一个健康”方法应用于农业食品系统转型,该方法采用综合统一的方法来优化人类、动物、植物和环境的整体健康,对于提高食品系统的可持续性至关重要。这项研究开发了一种潜在的评估工具,名为全球单一健康指数粮食安全(GOHI-FS),旨在从单一健康的角度评估各国/地区的粮食安全绩效,并确定可持续粮食系统需要改进的相关差距。方法:我们全面审查了粮食安全的现有框架和要素。GOHI-FS的指标框架是根据结构-过程-结果模型概念化的,并得到了专家咨询的确认。收集了2020年每个指标的公开数据。加权策略由模糊层次分析法确定。对每个指标的数据进行归一化,并通过加权算术平均数进行汇总。进行线性回归来评估GOHI-FS与健康和社会经济指标的相关性。结果:GOHI-FS包括5个一级指标、19个二级指标和45个三级指标。共有146个国家/地区参加了评估。一级指标平均得分最高的是营养(69.8),最低的是政府支持和反应(31.3)。GOHI-FS得分存在区域异质性。北美(中位数:76.1,IQR:75.5-76.7)、欧洲和中亚(中位数:66.9,IQR:60.1-74.3)、东亚和太平洋(中位数:60.6,IQR:55.5-68.7)、拉丁美洲和加勒比(中位数:60.0,IQR:57.8-65.0)、中东和北非(中位数:56.6,IQR:52.0-62.8),南亚(中位数:51.1,IQR:46.7-53.8)和撒哈拉以南非洲(中位数:41.4,IQR:37.2-46.5)。我们还发现GOHI-FS与人均GDP、社会人口指数、医疗支出和预期寿命之间存在显著关联。结论:GOHI-FS是一个潜在的评估工具,可以了解“一个健康”概念下各国/地区的粮食安全差距。试点结果表明,撒哈拉以南非洲在许多方面存在显著差距。需要在全球范围内采取广泛行动,促进政府对粮食安全的支持和应对。
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引用次数: 0
Hepatitis B reactivation in cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis. 接受免疫检查点抑制剂治疗的癌症患者的乙型肝炎再激活:系统综述和荟萃分析。
IF 8.1 1区 医学 Pub Date : 2023-09-22 DOI: 10.1186/s40249-023-01128-6
Zhengzheng Xia, Jianyu Zhang, Wenjun Chen, Haiyan Zhou, Di Du, Kongcai Zhu, Hui Chen, Jun Meng, Jun Yang

Background: Immunotherapy shows promise as a treatment option for various cancers. However, there is growing concern over potential complications from hepatitis B virus (HBV) reactivation after checkpoint blockade immunotherapy. Although most of the previous clinical trials on immune checkpoint inhibitors (ICIs) excluded patients with HBV, a few case reports and retrospective studies of HBV reactivation have been published. The aim of this study is to assess the risk of hepatitis B virus reactivation (HBVr) in patients receiving ICIs for advanced cancer.

Methods: English and Chinese language literature published prior to April 30, 2023, was searched in PubMed, EMBASE, Web of Science, Cochrane, SinoMed, CNKI and Wanfang Data for studies reporting HBVr rates in cancer patients treated with ICIs. A pooled risk estimate was calculated for HBVr rates with 95% confidence intervals (CI).

Results: Data from 34 studies including 7126 patients were retrieved and analyzed. The pooled HBVr rate in cancer patients treated with ICIs was 1.3% (I2 = 90.44%, 95% CI: 0.2-2.9%, P < 0.001). Subgroup analysis revealed that patients diagnosed with hepatocellular carcinoma (HCC), HBV carriers, and patients from Asian regions or in developing countries have a higher rate of HBVr.

Conclusions: Our meta-analysis demonstrated a low risk of HBVr in patients treated with ICIs for advanced cancer. ICI treatment may be safely used in patients with existing HBV infection or chronic hepatitis B, accompanied by regular monitoring and appropriate antiviral prophylaxis if necessary.

背景:免疫疗法有望成为各种癌症的治疗选择。然而,人们越来越担心检查点阻断免疫疗法后乙型肝炎病毒(HBV)再激活的潜在并发症。尽管以前大多数关于免疫检查点抑制剂(ICIs)的临床试验都排除了HBV患者,但已经发表了一些HBV再激活的病例报告和回顾性研究。本研究的目的是评估接受ICI治疗晚期癌症患者的乙型肝炎病毒再激活(HBVr)风险。方法:在PubMed、EMBASE、Web of Science、Cochrane、SinoMed、CNKI和Wanfang Data中检索2023年4月30日之前发表的中英文文献,以了解报道ICIs治疗的癌症患者HBVr率的研究。以95%置信区间(CI)计算HBVr发病率的合并风险估计值。结果:检索并分析了34项研究的数据,包括7126名患者。接受ICIs治疗的癌症患者的合并HBVr率为1.3%(I2 = 90.44%,95%置信区间:0.2-2.9%,P 结论:我们的荟萃分析表明,接受ICIs治疗的晚期癌症患者的HBVr风险较低。ICI治疗可以安全地用于已有HBV感染或慢性乙型肝炎的患者,并在必要时进行定期监测和适当的抗病毒预防。
{"title":"Hepatitis B reactivation in cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis.","authors":"Zhengzheng Xia, Jianyu Zhang, Wenjun Chen, Haiyan Zhou, Di Du, Kongcai Zhu, Hui Chen, Jun Meng, Jun Yang","doi":"10.1186/s40249-023-01128-6","DOIUrl":"10.1186/s40249-023-01128-6","url":null,"abstract":"<p><strong>Background: </strong>Immunotherapy shows promise as a treatment option for various cancers. However, there is growing concern over potential complications from hepatitis B virus (HBV) reactivation after checkpoint blockade immunotherapy. Although most of the previous clinical trials on immune checkpoint inhibitors (ICIs) excluded patients with HBV, a few case reports and retrospective studies of HBV reactivation have been published. The aim of this study is to assess the risk of hepatitis B virus reactivation (HBVr) in patients receiving ICIs for advanced cancer.</p><p><strong>Methods: </strong>English and Chinese language literature published prior to April 30, 2023, was searched in PubMed, EMBASE, Web of Science, Cochrane, SinoMed, CNKI and Wanfang Data for studies reporting HBVr rates in cancer patients treated with ICIs. A pooled risk estimate was calculated for HBVr rates with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Data from 34 studies including 7126 patients were retrieved and analyzed. The pooled HBVr rate in cancer patients treated with ICIs was 1.3% (I<sup>2</sup> = 90.44%, 95% CI: 0.2-2.9%, P < 0.001). Subgroup analysis revealed that patients diagnosed with hepatocellular carcinoma (HCC), HBV carriers, and patients from Asian regions or in developing countries have a higher rate of HBVr.</p><p><strong>Conclusions: </strong>Our meta-analysis demonstrated a low risk of HBVr in patients treated with ICIs for advanced cancer. ICI treatment may be safely used in patients with existing HBV infection or chronic hepatitis B, accompanied by regular monitoring and appropriate antiviral prophylaxis if necessary.</p>","PeriodicalId":48820,"journal":{"name":"Infectious Diseases of Poverty","volume":"12 1","pages":"87"},"PeriodicalIF":8.1,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10515058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41149487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Tackling barriers to scale up human papillomavirus vaccination in China: progress and the way forward. 解决中国扩大人乳头瘤病毒疫苗接种的障碍:进展和前进方向。
IF 8.1 1区 医学 Pub Date : 2023-09-21 DOI: 10.1186/s40249-023-01136-6
Xue-Lian Zhao, Shang-Ying Hu, Jia-Wei Hu, Hong-Hao Wang, Tian-Meng Wen, Yu-Shu Feng, You-Lin Qiao, Fang-Hui Zhao, Yong Zhang

The human papillomavirus (HPV) vaccine is the first vaccine developed specifically targeting the prevention of cervical cancer. For more than 15 years, China has expedited a series of efforts on research and development of the domestically manufactured HPV vaccines, producing local population-based evidence, promoting free HPV vaccination from pilots, and launching action plans to tackle barriers in the scale-up of HPV vaccination. To further roll out the HPV vaccination program in China, several challenges should be addressed to support the steps forward. The availability of more locally manufactured HPV vaccines, pricing negotiation and local evidence supporting the efficacy of one-dose schedule would greatly alleviate the continued supply and financial constraints in China. Meanwhile, more attention should be paid to girls living in low-resource areas and males to ensure equal access to the HPV vaccination. Furthermore, linkage to secondary prevention and further real-world monitoring and evaluation are warranted to inform effective cervical cancer prevention strategies in the post-vaccine era.

人乳头瘤病毒(HPV)疫苗是第一种专门针对预防癌症而开发的疫苗。15年多来,中国加快了一系列国产HPV疫苗的研发工作,提供了基于当地人群的证据,推广了试点免费HPV疫苗接种,并启动了解决扩大HPV疫苗接种障碍的行动计划。为了在中国进一步推广HPV疫苗接种计划,应解决几个挑战,以支持向前迈出的步伐。更多本地生产的HPV疫苗的可用性、价格谈判和支持一剂计划有效性的本地证据将大大缓解中国持续的供应和财政限制。同时,应更多地关注生活在低资源地区的女孩和男性,以确保平等获得HPV疫苗接种。此外,有必要将二级预防与进一步的现实世界监测和评估联系起来,为后疫苗时代有效的癌症预防策略提供信息。
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引用次数: 0
期刊
Infectious Diseases of Poverty
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