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Sample records for achieving polio eradication

  1. Strengthening the partnership between routine immunization and the global polio eradication initiative to achieve eradication and assure sustainability.

    Abdelwahab, Jalaa; Dietz, Vance; Eggers, Rudolf; Maher, Christopher; Olaniran, Marianne; Sandhu, Hardeep; Vandelaer, Jos

    2014-11-01

    Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, the number of polio endemic countries has declined from 125 to 3 in 2013. Despite this remarkable achievement, ongoing circulation of wild poliovirus in polio-endemic countries and the increase in the number of circulating vaccine-derived poliovirus cases, especially those caused by type 2, is a cause for concern. The Polio Eradication and Endgame Strategic Plan 2013-2018 (PEESP) was developed and includes 4 objectives: detection and interruption of poliovirus transmission, containment and certification, legacy planning, and a renewed emphasis on strengthening routine immunization (RI) programs. This is critical for the phased withdrawal of oral poliovirus vaccine, beginning with the type 2 component, and the introduction of a single dose of inactivated polio vaccine into RI programs. This objective has inspired renewed consideration of how the GPEI and RI programs can mutually benefit one another, how the infrastructure from the GPEI can be used to strengthen RI, and how a strengthened RI can facilitate polio eradication. The PEESP is the first GPEI strategic plan that places strong and clear emphasis on the necessity of improving RI to achieve and sustain global polio eradication.

  2. [Polio vaccines, eradication and posterradication].

    Salmerón García, Francisco; Portela Moreira, Agustín; Soler Soneira, Marta; López Hernández, Susana; Chamorro Somoza Díaz-Sarmiento, María; Pérez González, Isabel; Rubio Gómez, María Isabel; Pérez González, Alicia; Sagredo Rodríguez, Ana; Ruiz Antúnez, Sol; Timón Jiménez, Marcos; Frutos Cabanillas, Gloria

    2013-01-01

    Vaccination against polio generates herd immunity (both with the attenuated (OPV) and inactivated (IPV) vaccines) and this will allow the eradication of the disease. The OPV vaccine produces 2-4 polio cases per cohort of one million children and therefore IPV is used in countries that can afford its cost (about 15 times more expensive than OPV). In 1988 the World Health Assembly established the polio eradication goal as "interruption of wild poliovirus transmission". If the elimination of wild poliovirus were achieved, the use of OPV will produce annually between 250 and 500 cases of polio in the world. From 1999, it was clear that eradication would require ending of immunization with OPV. On the 25th of January, 2013 it is approved the plan for the eradication and containment of all polioviruses, wild or not, so that no child suffers paralytic poliomyelitis. The most important landmarks include the lack of wild polio cases after 2014, the introduction of at least one dose of IPV in all immunization programs and to cease the type 2 OPV vaccination by the end of 2016 and to stop the use of the oral bivalent vaccine in 2019. To achieve all this, a complex scientific work and economic solidarity will be required.

  3. Achieving polio eradication: a review of health communication evidence and lessons learned in India and Pakistan.

    Obregón, Rafael; Chitnis, Ketan; Morry, Chris; Feek, Warren; Bates, Jeffrey; Galway, Michael; Ogden, Ellyn

    2009-08-01

    Since 1988, the world has come very close to eradicating polio through the Global Polio Eradication Initiative, in which communication interventions have played a consistently central role. Mass media and information dissemination approaches used in immunization efforts worldwide have contributed to this success. However, reaching the hardest-to-reach, the poorest, the most marginalized and those without access to health services has been challenging. In the last push to eradicate polio, Polio Eradication Initiative communication strategies have become increasingly research-driven and innovative, particularly through the introduction of sustained interpersonal communication and social mobilization approaches to reach unreached populations. This review examines polio communication efforts in India and Pakistan between the years 2000 and 2007. It shows how epidemiological, social and behavioural data guide communication strategies that have contributed to increased levels of polio immunity, particularly among underserved and hard-to-reach populations. It illustrates how evidence-based and planned communication strategies - such as sustained media campaigns, intensive community and social mobilization, interpersonal communication and political and national advocacy combined - have contributed to reducing polio incidence in these countries. Findings show that communication strategies have contributed on several levels by: mobilizing social networks and leaders; creating political will; increasing knowledge; ensuring individual and community-level demand; overcoming gender barriers and resistance to vaccination; and reaching out to the poorest and marginalized populations. The review concludes with observations about the added value of communication strategies in polio eradication efforts and implications for global and local public health communication interventions.

  4. So close: remaining challenges to eradicating polio.

    Toole, Michael J

    2016-03-14

    The Global Polio Eradication Initiative, launched in 1988, is close to achieving its goal. In 2015, reported cases of wild poliovirus were limited to just two countries - Afghanistan and Pakistan. Africa has been polio-free for more than 18 months. Remaining barriers to global eradication include insecurity in areas such as Northwest Pakistan and Eastern and Southern Afghanistan, where polio cases continue to be reported. Hostility to vaccination is either based on extreme ideologies, such as in Pakistan, vaccination fatigue by parents whose children have received more than 15 doses, and misunderstandings about the vaccine's safety and effectiveness such as in Ukraine. A further challenge is continued circulation of vaccine-derived poliovirus in populations with low immunity, with 28 cases reported in 2015 in countries as diverse as Madagascar, Ukraine, Laos, and Myanmar. This paper summarizes the current epidemiology of wild and vaccine-derived poliovirus, and describes the remaining challenges to eradication and innovative approaches being taken to overcome them.

  5. What needs to be done for polio eradication in India?

    Paul, Yash

    2007-08-29

    Even if wild poliovirus persists in one country only, global polio eradication cannot be achieved, because of the risk of exportation of wild virus to other countries. Among the countries where polio cases are still occurring, India happens to be the largest country. India cannot become polio free unless Uttar Pradesh and Bihar become polio free. There was a quick decline in polio incidence in some states in India, while other states reported decline slowly, but, Uttar Pradesh and Bihar have never been polio free since the polio eradication programme was launched in 1995. Despite increase in number of pulse polio immunization (PPI) rounds since year 2000 and introduction of monovalent polio vaccine type 1 (mOPV1) and type 3 (mOPV3) in Uttar Pradesh in 2005, there has been no respite in polio incidence in Uttar Pradesh and Bihar. Lately, majority of polio cases being reported from other states are occurring in migrant population from Uttar Pradesh and Bihar, and also molecular study shows that polioviruses being detected in other states have origin in Uttar Pradesh or Bihar. Thus, there is an urgent need to develop a new vaccine or strategy specifically for Uttar Pradesh and Bihar.

  6. Progress toward polio eradication--Somalia, 1998-2013.

    Mbaeyi, Chukwuma; Kamadjeu, Raoul; Mahamud, Abdirahman; Webeck, Jenna; Ehrhardt, Derek; Mulugeta, Abraham

    2014-11-01

    Since the 1988 resolution of the World Health Assembly to eradicate polio, significant progress has been made toward achieving this goal, with the result that only Afghanistan, Nigeria, and Pakistan have never successfully interrupted endemic transmission of wild poliovirus. However, one of the greatest challenges of the Global Polio Eradication Initiative has been that of maintaining the polio-free status of countries in unstable regions with weak healthcare infrastructure, a challenge exemplified by Somalia, a country in the Horn of Africa region. Somalia interrupted indigenous transmission of wild poliovirus in 2002, 4 years after the country established its national polio eradication program. But political instability and protracted armed conflict, with significant disruption of the healthcare system, have left Somalia vulnerable to 2 imported outbreaks of wild poliovirus. The first occurred during 2005-2007, resulting in >200 cases of paralytic polio, whereas the second, which began in 2013, is currently ongoing. Despite immense challenges, the country has a sensitive surveillance system that has facilitated prompt detection of outbreaks, but its weak routine immunization system means that supplementary immunization activities constitute the primary strategy for reaching children with polio vaccines. Conducting vaccination campaigns in a setting of conflict has been at times hazardous, but the country's polio program has demonstrated resilience in overcoming many obstacles to ensure that children receive lifesaving polio vaccines. Regaining and maintaining Somalia's polio-free status will depend on finding innovative and lasting solutions to the challenge of administering vaccines in a setting of ongoing conflict and instability.

  7. The Global Polio Eradication Initiative: Progress, Lessons Learned, And Polio Legacy Transition Planning.

    Cochi, Stephen L; Hegg, Lea; Kaur, Anjali; Pandak, Carol; Jafari, Hamid

    2016-02-01

    The world is closer than ever to achieving global polio eradication, with record-low polio cases in 2015 and the impending prospect of a polio-free Africa. Tens of millions of volunteers, social mobilizers, and health workers have participated in the Global Polio Eradication Initiative. The program contributes to efforts to deliver other health benefits, including health systems strengthening. As the initiative nears completion after more than twenty-five years, it becomes critical to document and transition the knowledge, lessons learned, assets, and infrastructure accumulated by the initiative to address other health goals and priorities. The primary goals of this process, known as polio legacy transition planning, are both to protect a polio-free world and to ensure that investments in polio eradication will contribute to other health goals after polio is completely eradicated. The initiative is engaged in an extensive transition process of consultations and planning at the global, regional, and country levels. A successful completion of this process will result in a well-planned and -managed conclusion of the initiative that will secure the global public good gained by ending one of the world's most devastating diseases and ensure that these investments provide public health benefits for years to come.

  8. Global Polio Eradication,The Journey So Far.

    Thacker, Naveen; Yewale, Vijay N; Pathak, Ashish

    2016-08-07

    The Global Polio Eradication Initiative (GPE I), since its launch in 1988 has achieved more than 99% reduction in polio cases globally, using oral polio vaccine (OPV). Currently only two countries (Pakistan and Afghanistan) have not been able to stop transmission of wild poliovirus (wPV). In this article, we discuss some of the challenges faced by these two countries. The lessons learnt from the tremendous public health success stories of India and Nigeria are also highlighted. Reintroduction of wPV in the polio-free areas remains a valid risk globally and some recent examples are discussed. Inactivated polio vaccine (IPV) is the most accepted risk-mitigation strategy to secure a polio-free world from both wPV and circulating vaccine derived poliomyelitis (VDPV). The challenges related to switch from trivalent to bivalent OPV and introduction of IPV in 156 countries using trivalent OPV, are also highlighted.

  9. Global polio eradication initiative: lessons learned and legacy.

    Cochi, Stephen L; Freeman, Andrew; Guirguis, Sherine; Jafari, Hamid; Aylward, Bruce

    2014-11-01

    The world is on the verge of achieving global polio eradication. During >25 years of operations, the Global Polio Eradication Initiative (GPEI) has mobilized and trained millions of volunteers, social mobilizers, and health workers; accessed households untouched by other health initiatives; mapped and brought health interventions to chronically neglected and underserved communities; and established a standardized, real-time global surveillance and response capacity. It is important to document the lessons learned from polio eradication, especially because it is one of the largest ever global health initiatives. The health community has an obligation to ensure that these lessons and the knowledge generated are shared and contribute to real, sustained changes in our approach to global health. We have summarized what we believe are 10 leading lessons learned from the polio eradication initiative. We have the opportunity and obligation to build a better future by applying the lessons learned from GPEI and its infrastructure and unique functions to other global health priorities and initiatives. In so doing, we can extend the global public good gained by ending for all time one of the world's most devastating diseases by also ensuring that these investments provide public health dividends and benefits for years to come.

  10. Progress toward polio eradication--Worldwide, 2013-2014.

    Moturi, Edna K; Porter, Kimberly A; Wassilak, Steven G F; Tangermann, Rudolf H; Diop, Ousmane M; Burns, Cara C; Jafari, Hamid

    2014-05-30

    In 1988, the World Health Assembly of the World Health Organization (WHO) resolved to interrupt wild poliovirus (WPV) transmission worldwide, and in 2012, the World Health Assembly declared the completion of global polio eradication a programmatic emergency for public health. By 2013, the annual number of WPV cases had decreased by >99% since 1988, and only three countries remained that had never interrupted WPV transmission: Afghanistan, Nigeria, and Pakistan. This report summarizes global progress toward polio eradication during 2013-2014 and updates previous reports. In 2013, a total of 416 WPV cases were reported globally from eight countries, an 86% increase from the 223 WPV cases reported from five countries in 2012. This upsurge in 2013 was caused by a 60% increase in WPV cases detected in Pakistan, and by outbreaks in five previously polio-free countries resulting from international spread of WPV. In 2014, as of May 20, a total of 82 WPV cases had been reported worldwide, compared with 34 cases during the same period in 2013. Polio cases caused by circulating vaccine-derived poliovirus (cVDPV) were detected in eight countries in 2013 and in two countries so far in 2014. To achieve polio eradication in the near future, further efforts are needed to 1) address health worker safety concerns in areas of armed conflict in priority countries, 2) to prevent further spread of WPV and new outbreaks after importation into polio-free countries, and 3) to strengthen surveillance globally. Based on the international spread of WPV to date in 2014, the WHO Director General has issued temporary recommendations to reduce further international exportation of WPV through vaccination of persons traveling from currently polio-affected countries.

  11. Next Generation Inactivated Polio Vaccine Manufacturing to Support Post Polio-Eradication Biosafety Goals

    Thomassen, Y.E.; Oever, van 't A.G.; Oijen, van M.G.C.T.; Wijffels, R.H.; Pol, van der L.A.; Bakker, W.A.M.

    2013-01-01

    Worldwide efforts to eradicate polio caused a tipping point in polio vaccination strategies. A switch from the oral polio vaccine, which can cause circulating and virulent vaccine derived polioviruses, to inactivated polio vaccines (IPV) is scheduled. Moreover, a manufacturing process, using attenua

  12. China’s Polio Eradication Campaign

    JANE; SHAW

    1995-01-01

    DECEMBER 5. 1993 was the first Intensive Immunization Day for eradicating poliomyelitis in China. On this day. Chinese President Jiang Zemin and other state leaders went to hospitals to help give children under the age of 4 the oral polio vaccine. Jiang Zemin gave the inscription: "Popularize Children’s Immunization, Dedicate a Loving Heart to Children." December 5, 1994 was the second Intensive Immunization Day. On this day,

  13. Global Polio Eradication: So Close, yet so Far

    Samad EJ Golzari

    2014-07-01

    Full Text Available Launched in 1988, the Global Polio Eradication Initiative (GPEI never seemed as close to its sole target as by 2012; polio cases decreased by over 99% thanks to the global efforts restricting endemic areas into three countries, i.e. Afghanistan, Pakistan and Nigeria. However, the enchantment did not last long as WPV1 and confirmed new polio cases were reported in Syria (1. Re-emergence of the virus, related to the WPV1 still endemic in Pakistan, had already been identified in some of the Middle Eastern countries and caused an outbreak in China (2. In previous experiences, for instance in Egypt, international outbreak response guidelines issued by the World Health Assembly (WHA in Resolution WHA59 were implemented comprehensively and supplementary immunization activities (SIAs were conducted carefully. Such global measures should immediately be taken in order to halt the risk of transmission and spread of WPV as a public health threat (2.Thanks to the continuing support of WHO and Iranian health ministry, Iran is the only country which has achieved the goal of polio eradication yet neighbouring two of the three polio endemic countries. However, the on-going challenge has become even more daunting as the threat has the potential of exacerbation due to the imported cases or carriers. Although Iran has been successful in eradication of some infectious diseases, imported cases contribute immensely to the failure in realizing the eradication aim for some other infectious diseases (3,4. Bordering Pakistan (909 km (565 mi and Afghanistan (936 km (582 mi to the east is one of the few major obstacles to be perceived as important. In some parts of Pakistan, immunization activities were suspended since June 2012 (2. It is pivotal to the polio eradication goals that immunization is restarted in the halted areas and reinforced in neighboring high-risk areas in order to prevent further spread of this outbreak.Surveillance for cases of acute flaccid

  14. The polio eradication campaign: time to shift the goal.

    Baron, Emmanuel; Magone, Claire

    2014-03-01

    The social rejection of the polio eradication campaign in endemic countries challenges an assumption underlying the goal itself: the full compliance of an entire population to a public health programme. The polio campaign, which has been an extraordinary public health enterprise, is at risk of becoming irremediably unpopular if the eradication goal is pursued at all costs. The Global Polio Eradication Initiative (GPEI) should not be driven by the fear of failure, because the greatest benefit of the polio campaign is that it has demonstrated how simple, community-wide actions can contribute to a dramatic decrease in the incidence of a disease.

  15. [The lost decade of global polio eradication and moving forward].

    Shimizu, Hiroyuki

    2010-06-01

    The Global Polio Eradication Initiative was aimed to eradicate poliomyelitis by the year 2000, however, polio eradication is still not in sight even in 2010, over 10 years after the initial target date. In 2010, indigenous transmission of wild polioviruses has been interrupted throughout the world except four countries, Afghanistan, Pakistan, India, and Nigeria. Despite the intense use of monovalent oral polio vaccines, type 1 and type 3 wild polioviruses still circulate in the four remaining polio-endemic countries, and multiple importations of wild polioviruses have also occurred extensively from Nigeria and India to a number of previously polio-free countries in Africa, Asia, and Europe. Furthermore, the emergence of type 2 vaccine-derived polioviruses has raised concerns about low level of immunity against type 2 poliovirus in some polio-endemic areas like Nigeria and India. On the other hand, operational improvements in 2009 were reported in high-risk states in northern Nigeria and transmission of type 1 and type 3 polioviruses in Nigeria is markedly declining from 2009 to 2010. Moreover, bivalent oral polio vaccine containing Sabin 1 and Sabin 3 strains has been introduced in 2010 as a promising tool to improve and simplify the supplemental immunization activities in high-risk areas. Although there was no apparent decline in the annual number of polio cases in 2000-2009 globally, it would be critical to review our experience during "the lost decade of global polio eradication" to move forward into the final stage of global polio eradication.

  16. Endgame for polio eradication? Options for overcoming social and political factors in the progress to eradicating polio.

    Ganapathiraju, Pavan V; Morssink, Christiaan B; Plumb, James

    2015-01-01

    In 1988, the Global Polio Eradication Initiative (GPEI) was launched with the goal of eradicating polio by the year 2000. After 25 years, several dynamics still challenge this large public health campaign with new cases of polio being reported annually. We examine the roots of this initiative to eradicate polio, its scope, the successes and setbacks during the last 25 years and reflect on the current state of affairs. We examine the social and political factors that are barriers to polio eradication. Options are discussed for solving the current impasse of polio eradication: using force, respecting individual freedoms and gaining support from those vulnerable to fundamentalist 'propaganda'. The travails of the GPEI indicate the need for expanding the Convention on the Rights of the Child to address situations of war and civic strife. Such a cultural and structural reference will provide the basis for global stakeholders to engage belligerent local actors whose local political conflicts are barriers to the eradication of polio. Disregard for these actors will result in stagnation of polio eradication policy, delaying eradication beyond 2018.

  17. Successes and shortcomings of polio eradication: a transmission modeling analysis.

    Mayer, Bryan T; Eisenberg, Joseph N S; Henry, Christopher J; Gomes, M Gabriela M; Ionides, Edward L; Koopman, James S

    2013-06-01

    Polio eradication is on the cusp of success, with only a few regions still maintaining transmission. Improving our understanding of why some regions have been successful and others have not will help with both global eradication of polio and development of more effective vaccination strategies for other pathogens. To examine the past 25 years of eradication efforts, we constructed a transmission model for wild poliovirus that incorporates waning immunity (which affects both infection risk and transmissibility of any resulting infection), age-mediated vaccination rates, and transmission of oral polio vaccine. The model produces results consistent with the 4 country categories defined by the Global Polio Eradication Program: elimination with no subsequent outbreaks; elimination with subsequent transient outbreaks; elimination with subsequent outbreaks and transmission detected for more than 12 months; and endemic polio transmission. Analysis of waning immunity rates and oral polio vaccine transmissibility reveals that higher waning immunity rates make eradication more difficult because of increasing numbers of infectious adults, and that higher oral polio vaccine transmission rates make eradication easier as adults become reimmunized. Given these dynamic properties, attention should be given to intervention strategies that complement childhood vaccination. For example, improvement in sanitation can reduce the reproduction number in problematic regions, and adult vaccination can lower adult transmission.

  18. Polio Eradication and Endgame Plan - Victory within Grasp.

    Patel, Manish; Menning, Lisa; Bhatnagar, Pankaj

    2016-08-07

    Since the launch of the Global Polio Eradication Initiative (GPEI) by the World Health Assembly (WHA) in 1988, the number of polio-endemic countries has decreased from 125 to 2 (Afghanistan and Pakistan). To secure the gains and to address the remaining challenges, the GPEI developed the Polio Eradication and Endgame Strategic Plan, 2013-2018 (the Plan), endorsed by all Member States at the WHA in May 2013. One of the major elements that distinguishes this Plan from previous GPEI strategies is the approach to ending all polioviruses, both wild and vaccine-derived. Overall, the Plan outlines four main objectives: (1) to stop all wild poliovirus (WPV) transmission; (2) to introduce inactivated polio vaccine (IPV), withdraw all oral polio vaccines (OPV), and strengthen immunization systems in countries with weak immunization systems and strong polio infrastructure; (3) to certify all regions as polio-free and safely contain all poliovirus stocks; (4) and to mainstream the investment in polio eradication to benefit other priority public health initiatives for years to come. Implementing the Plan and meeting the milestones in a timely manner will help to ensure that that the world remains permanently polio-free.

  19. Polio eradication in the Netherlands: a proposal for surveillance

    van Loon AM; Rumke HC; Conyn-van Spaendonck MAE; CIE

    1998-01-01

    Voor de certificatie als polio-vrij in het kader van het wereld polio eradicatie programma is een actiever en uitgebreider surveillancesysteem vereist De 'Global Commission for the Certification of the Eradication of Poliomyelitis' en de Europese Commissie hebben de principes, criteria en

  20. India's Research Contributions Towards Polio Eradication (1965-2015).

    John, T Jacob

    2016-08-07

    Pioneering research has been conducted in India during the past five decades, comprehensively covering epidemiology of poliovirus infection and of polio, efficacy and effectiveness of oral and inactivated polio vaccines (OPV, IPV) as well as pathogenesis of wild and vaccine polioviruses. It was estimated, based on epidemiology data, that India had a very heavy burden of polio, with average 500-1000 cases per day. Prevention was an urgent need, but OPV showed unacceptably low vaccine efficacy (VE) for poliovirus types 1 and 3. Having learned that response to sequential doses followed arithmetic pattern and not prime-boost principle, multiple doses were tested and found to be a simple intervention to increase VE. Eventually this knowledge became critical for polio eradication. Indian research demonstrated that monovalent OPV (mOPV) had nearly three timed higher VE than trivalent OPV (tOPV). Eventually, mOPV type 1 became essential to interrupt wild type 1 infection in many locations where the VE of tOPV was very low. Indian research pointed to the epidemiologic importance of direct person-to-person spread of wild polio viruses and the need and potential of IPV to prevent and control polio. Research on vaccine responses led to the understanding that OPV would become wild-like through back mutations and to the definition of eradication as interrupting transmission of both wild and vaccine-derived polioviruses. By asking and answering the right questions insequence, Indian polio research presaged and guided polio eradication.

  1. Regression in polio eradication in Pakistan: A national tragedy.

    Kanwal, Sumaira; Hussain, Abrar; Mannan, Shazia; Perveen, Shazia

    2016-03-01

    Polio is one out of 200 infections results to lasting paralysis, usually in the legs. The year 2014 has been the saddest year for the Pakistan when the World was about to eliminate Polio from all over the World. In year 1994 Pakistan took the initiative to eliminate Polio from the country. The efforts were going well until 2005, when Pakistan was on the wedge to overcome the Disease. The hopes were high that soon Pakistan will become a polio-virus-free country, but the drone strikes in FATA and the rise of different militant groups as a reaction of the drone attacks in FATA made it difficult for the health workers to continue their vaccination campaigns in these areas. However various factors ruined the efforts made to eradicate Polio. In Pakistan, polio is widespread to three sections. These are Karachi, Quetta block (Quetta, Pishin and Killah Abdullah district) and FATA and Peshawar district. Numerous things are accountable for polio flourishing in these regions. These comprise near to the ground socioeconomic rank of the families, not having the knowledge concerning hazard caused by polio and disinformation by limited significant people concerning how polio vaccines fabricate damage. In 2014, only 3 countries in the world remain polio-endemic: Nigeria, Pakistan and Afghanistan. From year 2012-2014 the number of registered Polio cases is on rise contrary to rest of the other two Polio-endemic countries. In spite of the extensive work done by Polio workers the number of Polio cases has broken the 16 year record. The situation is getting worse because it can also be threatening to the rest of the World.

  2. Post-polio eradication: vaccination strategies and options for India

    Jayakrishnan Thayyil

    2014-11-01

    Full Text Available In 1988, the World Health Organization (WHO resolved to eradicate poliomyelitis globally. Since then, the initiative has reported dramatic progress in decreasing the incidence of poliomyelitis and limiting the geographical extent of transmission. 2013 is recorded as the second consecutive year not reporting wild poliovirus (WPV from India. If the country can retain this position for one more year India will be declared as polio eradicated. What should be the future vaccination strategies? We searched and reviewed the full text of the available published literature on polio eradication via PubMed and examined Internet sources and websites of major international health agencies. The oral polio vaccine (OPV has been the main tool in the polio eradication program. Once WPV transmission is interrupted, the poliomyelitis will be caused only by OPV. India could expect 1 vaccine-associated paralytic polio per 4.2-4.6 million doses of OPV. Considering the threat of vaccine-derived viruses to polio eradication, WHO urged to develop a strategy to safely discontinue OPV after certification. The ultimate aim is to stop OPV safely and effectively, and eventually substitute with inactivated polio vaccine (IPV. The argument against the use of IPV is its cost. From India, field based data were available on the efficacy of IPV, which was better than OPV. IPV given intradermally resulted in seroconversion rates similar to full-dose intramuscular vaccine. The incremental cost of adopting IPV to replace OPV is relatively low, about US $1 per child per year, and most countries should be able to afford this additional cost.

  3. Progress toward polio eradication - worldwide, 2014-2015.

    Hagan, José E; Wassilak, Steven G F; Craig, Allen S; Tangermann, Rudolf H; Diop, Ousmane M; Burns, Cara C; Quddus, Arshad

    2015-05-22

    In 1988, the World Health Assembly of the World Health Organization (WHO) resolved to eradicate polio worldwide. Wild poliovirus (WPV) transmission has been interrupted in all but three countries (Afghanistan, Nigeria, and Pakistan). No WPV type 2 cases have been detected worldwide since 1999, and the last WPV type 3 case was detected in Nigeria in November 2012; since 2012, only WPV type 1 has been detected. Circulating vaccine-derived poliovirus (cVDPV), usually type 2, continues to cause cases of paralytic polio in communities with low population immunity. In 2012, the World Health Assembly declared global polio eradication "a programmatic emergency for global public health", and in 2014, WHO declared the international spread of WPV to previously polio-free countries to be "a public health emergency of international concern". This report summarizes global progress toward polio eradication during 2014-2015 and updates previous reports. In 2014, a total of 359 WPV cases were reported in nine countries worldwide. Although reported WPV cases increased in Pakistan and Afghanistan, cases in Nigeria decreased substantially in 2014, and encouraging progress toward global WPV transmission interruption has occurred. Overcoming ongoing challenges to interruption of WPV transmission globally will require sustained programmatic enhancements, including improving the quality of supplementary immunization activities (SIAs) to interrupt transmission in Afghanistan and Pakistan and to prevent WPV exportation to polio-free countries.

  4. Impact of inactivated poliovirus vaccine on mucosal immunity: implications for the polio eradication endgame.

    Parker, Edward Pk; Molodecky, Natalie A; Pons-Salort, Margarita; O'Reilly, Kathleen M; Grassly, Nicholas C

    2015-01-01

    The polio eradication endgame aims to bring transmission of all polioviruses to a halt. To achieve this aim, it is essential to block viral replication in individuals via induction of a robust mucosal immune response. Although it has long been recognized that inactivated poliovirus vaccine (IPV) is incapable of inducing a strong mucosal response on its own, it has recently become clear that IPV may boost immunity in the intestinal mucosa among individuals previously immunized with oral poliovirus vaccine. Indeed, mucosal protection appears to be stronger following a booster dose of IPV than oral poliovirus vaccine, especially in older children. Here, we review the available evidence regarding the impact of IPV on mucosal immunity, and consider the implications of this evidence for the polio eradication endgame. We conclude that the implementation of IPV in both routine and supplementary immunization activities has the potential to play a key role in halting poliovirus transmission, and thereby hasten the eradication of polio.

  5. The new polio eradication end game: rationale and supporting evidence.

    Sutter, Roland W; Platt, Lauren; Mach, Ondrej; Jafari, Hamid; Aylward, R Bruce

    2014-11-01

    Polio eradication requires the removal of all polioviruses from human populations, whether wild poliovirus or those emanating from the oral poliovirus vaccine (OPV). The Polio Eradication & Endgame Strategic Plan 2013-2018 provides a framework for interruption of wild poliovirus transmission in remaining endemic foci and lays out a plan for the new polio end game, which includes the withdrawal of Sabin strains, starting with type 2, and the introduction of inactivated poliovirus vaccine, for risk mitigation purposes. This report summarizes the rationale and evidence that supports the policy decision to switch from trivalent OPV to bivalent OPV and to introduce 1 dose of inactivated poliovirus vaccine into routine immunization schedules, and it describes the proposed implementation of this policy in countries using trivalent OPV.

  6. Eradicating polio: how the world's pediatricians can help stop this crippling illness forever.

    Orenstein, Walter A

    2015-01-01

    The American Academy of Pediatrics strongly supports the Polio Eradication and Endgame Strategic Plan of the Global Polio Eradication Initiative. This plan was endorsed in November 2012 by the Strategic Advisory Group of Experts on Immunization of the World Health Organization and published by the World Health Organization in April 2013. As a key component of the plan, it will be necessary to stop oral polio vaccine (OPV) use globally to achieve eradication, because the attenuated viruses in the vaccine rarely can cause polio. The plan includes procedures for elimination of vaccine-associated paralytic polio and circulating vaccine-derived polioviruses (cVDPVs). cVDPVs can proliferate when vaccine viruses are transmitted among susceptible people, resulting in mutations conferring both the neurovirulence and transmissibility characteristics of wild polioviruses. Although there are 3 different types of wild poliovirus strains, the polio eradication effort has already resulted in the global elimination of type 2 poliovirus for more than a decade. Type 3 poliovirus may be eliminated because the wild type 3 poliovirus was last detected in 2012. Thus, of the 3 wild types, only wild type 1 poliovirus is still known to be circulating and causing disease. OPV remains the key vaccine for eradicating wild polioviruses in polio-infected countries because it induces high levels of systemic immunity to prevent paralysis and intestinal immunity to reduce transmission. However, OPV is a rare cause of paralysis and the substantial decrease in wild-type disease has resulted in estimates that the vaccine is causing more polio-related paralysis annually in recent years than the wild virus. The new endgame strategic plan calls for stepwise removal of the type 2 poliovirus component from trivalent oral vaccines, because type 2 wild poliovirus appears to have been eradicated (since 1999) and yet is the main cause of cVDPV outbreaks and approximately 40% of vaccine-associated paralytic

  7. Role of Social Mobilization (Network) in Polio Eradication in India.

    Siddique, Anisur Rahman; Singh, Prem; Trivedi, Geetali

    2016-08-07

    In 2009, India contributed to over half the global cases of poliomyelitis. Many believed that India would be the last country to be polio free. India proved them wrong and was certified polio free in 2014. In January 2016, India celebrated 5 years of being polio free. One of the major reasons behind the interruption of polio transmission in the Polio endemic states of Uttar Pradesh and Bihar was the deployment of Social Mobilization Network (SMNet). A three tiered structure, the 7300 strong SMNet is now the gold standard in public health communication. It mobilizes communities by spearheading civil society participation; and works at district, block and community levels. The SMNet's social mobilization has evolved into an accelerated approach for achieving results with principles of mobilization at its core. The SMNet targets resistance to polio immunization through a multipronged approach by using local religious leaders, community influencers, interpersonal communication, counseling, mothers meetings, announcements from religious institutions and rallies. The success of the SMNet has been its ability to identify and convert resistant families into advocates for polio immunization. Deeply respected in the community, the SMNet mobilizers (98 percent of whom are women) are themselves models for gender empowerment. The SMNet model shows how mobilization techniques can be harnessed for short term and long term goals and can be replicated in other health programs to achieve the same results as were achieved for Polio.

  8. "Endgame" issues for the global polio eradication initiative.

    2002-01-01

    The polio eradication initiative, created after the World Health Assembly resolved, in 1988, to eradicate poliomyelitis globally by 2000, has made remarkable progress. From 1988 through 2000, the number of countries where polio was endemic decreased from >125 to 20, and the estimated number of polio cases decreased from 350,000 to 99%. Wild-type 2 poliovirus has not been detected worldwide since October 1999, despite improving surveillance. The major focus of the eradication effort is to complete the task of stopping wild-type poliovirus transmission. Given the rapid progress made toward this goal, planning for the posteradication era has begun in earnest (1) to minimize the risk of reintroduction of virus into the population from laboratory stocks or long-term carriers, and (2) to prevent vaccine-derived polioviruses from circulating and causing outbreaks. This report summarizes the current thinking about these "endgame" issues, as put forth by the World Health Organization's technical advisory body for the initiative, the Technical Consultative Group on the Global Eradication of Poliomyelitis.

  9. Progress Toward Polio Eradication - Worldwide, 2015-2016.

    Morales, Michelle; Tangermann, Rudolf H; Wassilak, Steven G F

    2016-05-13

    In 1988, the World Health Assembly resolved to eradicate poliomyelitis. Wild poliovirus (WPV) transmission persists in only two countries (Afghanistan and Pakistan) after the removal of Nigeria from the list of countries with endemic polio in September 2015.* Indigenous WPV type 2 has not been detected since 1999 and was declared eradicated by the Global Commission for the Certification of Poliomyelitis Eradication in September 2015.(†) Since November 2012, when the last case of WPV type 3 was detected in Nigeria, WPV type 1 has been the sole circulating type of WPV (1). This report summarizes global progress toward polio eradication during 2015-2016 and updates previous reports (2). In 2015, 74 WPV cases were reported in two countries (Afghanistan and Pakistan), a decrease of 79% from the 359 WPV cases reported in 2014 in nine countries; 12 WPV cases have been reported in 2016 (to date), compared with 23 during the same period in 2015 (3). Paralytic polio caused by circulating vaccine-derived poliovirus (cVDPV) remains a risk in areas with low oral poliovirus vaccine (OPV) coverage. Seven countries, including Pakistan, reported 32 cVDPV cases in 2015 (4). In four of these countries, ≥6 months have passed since the most recent case or isolate. One country (Laos) with VDPV transmission in 2015 has reported three additional cVDPV cases in 2016 to date. Encouraging progress toward polio eradication has been made over the last year; however, interruption of WPV transmission will require focus on reaching and vaccinating every missed child through high quality supplementary immunization activities (SIAs) and cross-border coordination between Afghanistan and Pakistan (5,6).

  10. Next generation inactivated polio vaccine manufacturing to support post polio-eradication biosafety goals.

    Yvonne E Thomassen

    Full Text Available Worldwide efforts to eradicate polio caused a tipping point in polio vaccination strategies. A switch from the oral polio vaccine, which can cause circulating and virulent vaccine derived polioviruses, to inactivated polio vaccines (IPV is scheduled. Moreover, a manufacturing process, using attenuated virus strains instead of wild-type polioviruses, is demanded to enhance worldwide production of IPV, especially in low- and middle income countries. Therefore, development of an IPV from attenuated (Sabin poliovirus strains (sIPV was pursued. Starting from the current IPV production process based on wild type Salk strains, adaptations, such as lower virus cultivation temperature, were implemented. sIPV was produced at industrial scale followed by formulation of both plain and aluminium adjuvanted sIPV. The final products met the quality criteria, were immunogenic in rats, showed no toxicity in rabbits and could be released for testing in the clinic. Concluding, sIPV was developed to manufacturing scale. The technology can be transferred worldwide to support post polio-eradication biosafety goals.

  11. Resistance of polio to its eradication in Pakistan

    Sher Zunaira

    2011-10-01

    Full Text Available Abstract Background This study is based on EPI (Expanded Program on Immunization immunization surveys and surveillance of polio, its challenges in immunization and the way forward to overcome these challenges. Methods Several Government documents, survey reports and unpublished program documents were studied and online search was made to find information on EPI Pakistan. SPSS 16 and Microsoft Excel 2007 were used for the statistical analysis. Results Immunization against polio is higher in urban areas as compared to rural areas. Marked variation in vaccination has been observed in different provinces of Pakistan in the last decade. Secondly 10-20% of the children who have received their first dose of trivalent polio vaccine were deprived of their 2nd and 3rd dose because of poor performance of EPI and Lack of information about immunization. Conclusion In spite of numerous successes, such as the addition of new vaccines and raising immunization to over 100% in some areas, EPI is still struggling to reach its polio eradication goals. Inadequate service delivery, lack of information about immunization and limited number of vaccinators were found to be the key reason for poor performance of immunization and for large number of cases reported each year due to the deficiency of second and third booster dose.

  12. [Towards the eradication of poliomyelitis: Mexico's achievements and challenges].

    Esteve-Jaramillo, Alejandra; Richardson López-Collada, Vesta L

    2012-10-01

    Since the strategies to eradicate polio were implemented, the incidence of paralytic polio has dropped dramatically. Four main strategies have greatly contributed: a) High immunization coverage rate with oral polio vaccine (OPV), b) Supplementary immunization activities during the National Immunizations Days c) An effective epidemiological surveillance system for acute flaccid paralysis (AFP) and d) Intensified immunization activities in high risk areas. Three countries remain polio endemic, nevertheless, any country has a potential risk of the virus importation from one of these endemic areas; an accidental release of poliovirus from a research or clinical laboratory, or from having a circulating vaccine-derived poliovirus in the environment. The present document aims to provide an historical background that made possible the disease elimination in Mexico. Moreover, we discuss the challenges that every country needs to face in order to achieve a polio-free world.

  13. Faster Detection of Poliomyelitis Outbreaks to Support Polio Eradication.

    Blake, Isobel M; Chenoweth, Paul; Okayasu, Hiro; Donnelly, Christl A; Aylward, R Bruce; Grassly, Nicholas C

    2016-03-01

    As the global eradication of poliomyelitis approaches the final stages, prompt detection of new outbreaks is critical to enable a fast and effective outbreak response. Surveillance relies on reporting of acute flaccid paralysis (AFP) cases and laboratory confirmation through isolation of poliovirus from stool. However, delayed sample collection and testing can delay outbreak detection. We investigated whether weekly testing for clusters of AFP by location and time, using the Kulldorff scan statistic, could provide an early warning for outbreaks in 20 countries. A mixed-effects regression model was used to predict background rates of nonpolio AFP at the district level. In Tajikistan and Congo, testing for AFP clusters would have resulted in an outbreak warning 39 and 11 days, respectively, before official confirmation of large outbreaks. This method has relatively high specificity and could be integrated into the current polio information system to support rapid outbreak response activities.

  14. Quantifying the impact of expanded age group campaigns for polio eradication.

    Wagner, Bradley G; Behrend, Matthew R; Klein, Daniel J; Upfill-Brown, Alexander M; Eckhoff, Philip A; Hu, Hao

    2014-01-01

    A priority of the Global Polio Eradication Initiative (GPEI) 2013-2018 strategic plan is to evaluate the potential impact on polio eradication resulting from expanding one or more Supplementary Immunization Activities (SIAs) to children beyond age five-years in polio endemic countries. It has been hypothesized that such expanded age group (EAG) campaigns could accelerate polio eradication by eliminating immunity gaps in older children that may have resulted from past periods of low vaccination coverage. Using an individual-based mathematical model, we quantified the impact of EAG campaigns in terms of probability of elimination, reduction in polio transmission and age stratified immunity levels. The model was specifically calibrated to seroprevalence data from a polio-endemic region: Zaria, Nigeria. We compared the impact of EAG campaigns, which depend only on age, to more targeted interventions which focus on reaching missed populations. We found that EAG campaigns would not significantly improve prospects for polio eradication; the probability of elimination increased by 8% (from 24% at baseline to 32%) when expanding three annual SIAs to 5-14 year old children and by 18% when expanding all six annual SIAs. In contrast, expanding only two of the annual SIAs to target hard-to-reach populations at modest vaccination coverage-representing less than one tenth of additional vaccinations required for the six SIA EAG scenario-increased the probability of elimination by 55%. Implementation of EAG campaigns in polio endemic regions would not improve prospects for eradication. In endemic areas, vaccination campaigns which do not target missed populations will not benefit polio eradication efforts.

  15. Polio eradication in Nigeria and the role of the National Stop Transmission of Polio program, 2012-2013.

    Waziri, Ndadilnasiya E; Ohuabunwo, Chima J; Nguku, Patrick M; Ogbuanu, Ikechukwu U; Gidado, Saheed; Biya, Oladayo; Wiesen, Eric S; Vertefeuille, John; Townes, Debra; Oyemakinde, Akin; Nwanyanwu, Okey; Gassasira, Alex; Mkanda, Pascal; Muhammad, Ado J G; Elmousaad, Hashim A; Nasidi, Abdulsalami; Mahoney, Frank J

    2014-11-01

    To strengthen the Nigeria polio eradication program at the operational level, the National Stop Transmission of Polio (N-STOP) program was established in July 2012 as a collaborative effort of the National Primary Health Care Development Agency, the Nigerian Field Epidemiology and Laboratory Training Program, and the US Centers for Disease Control and Prevention. Since its inception, N-STOP has recruited and trained 125 full-time staff, 50 residents in training, and 50 ad hoc officers. N-STOP officers, working at national, state, and district levels, have conducted enumeration outreaches in 46,437 nomadic and hard-to-reach settlements in 253 districts of 19 states, supported supplementary immunization activities in 236 districts, and strengthened routine immunization in 100 districts. Officers have also conducted surveillance assessments, outbreak response, and applied research as needs evolved. The N-STOP program has successfully enhanced Global Polio Eradication Initiative partnerships and outreach in Nigeria, providing an accessible, flexible, and culturally competent technical workforce at the front lines of public health. N-STOP will continue to respond to polio eradication program needs and remain a model for other healthcare initiatives in Nigeria and elsewhere.

  16. Update on polio eradication in the World Health Organization South-East Asia Region, 2013.

    O'Connor, Patrick Michael; Allison, Robert; Thapa, Arun; Bahl, Sunil; Chunsuittiwat, Supamit; Hasan, Mainul; Khan, Zainul; Sedai, Tika

    2014-11-01

    There has been a tremendous amount of progress toward polio eradication in the World Health Organization South-East Asia Region particularly over the past 4 years. In 1988, there were >25,000 reported cases of wild poliovirus infection in the South-East Asia Region, and because of substantial underreporting the estimated polio burden was probably 10-fold higher. Following the initiation of mass polio immunization campaigns in the mid-1990s and years of intense effort, the 11 countries of the South-East Asia Region reported no cases of wild poliovirus infection in 2012. With India reporting the last wild poliovirus case in the region, on 13 January 2011, and its subsequent removal from the list of polio-endemic countries, in February 2012, the South-East Asia Region is firmly on track for polio-free certification in early 2014.

  17. Oversight role of the Independent Monitoring Board of the Global Polio Eradication Initiative.

    Rutter, Paul D; Donaldson, Liam J

    2014-11-01

    The Global Polio Eradication Initiative (GPEI) established its Independent Monitoring Board (IMB) in 2010 to monitor and guide its progress toward stopping polio transmission globally. The concept of an IMB is innovative, with no clear analogue in the history of the GPEI or in any other global health program. The IMB meets with senior program officials every 3-6 months. Its reports provide analysis and recommendations about individual polio-affected countries. The IMB also examines issues affecting the global program as a whole. Its areas of focus have included escalating the level of priority afforded to polio eradication (particularly by recommending a World Health Assembly resolution to declare polio eradication a programmatic emergency, which was enacted in May 2012), placing greater emphasis on people factors in the delivery of the program, encouraging innovation, strengthening focus on the small number of so-called sanctuaries where polio persists, and continuous quality improvement to reach every missed child with vaccination. The IMB's true independence from the agencies and countries delivering the program has enabled it to raise difficult issues that others cannot. Other global health programs might benefit from establishing similar independent monitoring mechanisms.

  18. Polio eradication in the African Region on course despite public health emergencies.

    Okeibunor, Joseph C; Ota, Martin C; Akanmori, Bartholomew D; Gumede, Nicksy; Shaba, Keith; Kouadio, Koffi I; Poy, Alain; Mihigo, Richard; Salla, Mbaye; Moeti, Matshidiso R

    2017-03-01

    The World Health Organization, African Region is heading toward eradication of the three types of wild polio virus, from the Region. Cases of wild poliovirus (WPV) types 2 and 3 (WPV2 and WPV3) were last reported in 1998 and 2012, respectively, and WPV1 reported in Nigeria since July 2014 has been the last in the entire Region. This scenario in Nigeria, the only endemic country, marks a remarkable progress. This significant progress is as a result of commitment of key partners in providing the much needed resources, better implementation of strategies, accountability, and innovative approaches. This is taking place in the face of public emergencies and challenges, which overburden health systems of countries and threaten sustainability of health programmes. Outbreak of Ebola and other diseases, insecurity, civil strife and political instability led to displacement of populations and severely affected health service delivery. The goal of eradication is now within reach more than ever before and countries of the region should not relent in their efforts on polio eradication. WHO and partners will redouble their efforts and introduce better approaches to sustain the current momentum and to complete the job. The carefully planned withdrawal of oral polio vaccine type II (OPV2) with an earlier introduction of one dose of inactivated poliovirus vaccine (IPV), in routine immunization, will boost immunity of populations and stop cVDPVs. Environmental surveillance for polio viruses will supplement surveillance for AFP and improve sensitivity of detection of polio viruses.

  19. Polio

    ... prevent the disease is with polio vaccine. Polio vaccine Currently, most children in the United States receive four doses of ... get medical help immediately. Fewer shots for your child Polio vaccine is normally given in conjunction with vaccinations against ...

  20. The polio eradication effort has been a great success--let's finish it and replace it with something even better.

    Kimman, Tjeerd G; Boot, Hein J

    2006-01-01

    The polio eradication campaign has greatly reduced the effects of this disease, but many new challenges have emerged. These challenges include the occurrence of polio outbreaks caused by wild-type polioviruses or circulating vaccine-derived polioviruses (cVDPVs) in areas where vaccination coverage i

  1. World Health Organization Guidelines for Containment of Poliovirus Following Type-Specific Polio Eradication - Worldwide, 2015.

    Previsani, Nicoletta; Tangermann, Rudolph H; Tallis, Graham; Jafari, Hamid S

    2015-08-28

    In 1988, the World Health Assembly of the World Health Organization (WHO) resolved to eradicate polio worldwide. Among the three wild poliovirus (WPV) types (type 1, type 2, and type 3), WPV type 2 (WPV2) has been eliminated in the wild since 1999, and WPV type 3 (WPV3) has not been reported since 2012. In 2015, only Afghanistan and Pakistan have reported WPV transmission. On May 25, 2015, all WHO Member States endorsed World Health Assembly resolution 68.3 on full implementation of the Polio Eradication and Endgame Strategic Plan 2013-2018 (the Endgame Plan), and with it, the third Global Action Plan to minimize poliovirus facility-associated risk (GAPIII). All WHO Member States have committed to implementing appropriate containment of WPV2 in essential laboratory and vaccine production facilities* by the end of 2015 and of type 2 oral poliovirus vaccine (OPV2) within 3 months of global withdrawal of OPV2, which is planned for April 2016. This report summarizes critical steps for essential laboratory and vaccine production facilities that intend to retain materials confirmed to contain or potentially containing type-specific WPV, vaccine-derived poliovirus (VDPV), or OPV/Sabin viruses, and steps for nonessential facilities† that process specimens that contain or might contain polioviruses. National authorities will need to certify that the essential facilities they host meet the containment requirements described in GAPIII. After certification of WPV eradication, the use of all OPV will cease; final containment of all polioviruses after polio eradication and OPV cessation will minimize the risk for reintroduction of poliovirus into a polio-free world.

  2. Media and interpersonal persuasions in the polio eradication campaign in northern Nigeria.

    Ozohu-Suleiman, Yakubu

    2010-09-01

    This study is premised on the increasing global concerns over the widespread resistance to polio eradication campaign in northern Nigeria. It aims to determine the level of campaign acceptance and compare the influences of mass media and interpersonal communication sources in Zaria local government area, being one of the high-risk (WPV-endemic) areas in northern Nigeria, where campaign resistance is known to be high. By way of quantitative survey, the study utilized 10% sample of the populations of eight out of the thirteen Wards in Zaria local government area, with a response rate of 78.6%. Findings reveal close ranks between campaign acceptance and resistance in the local government area, thus further confirming the difficulties still faced in polio eradication campaign in the region. This study also indicates higher performance of Interpersonal than Mass Media sources in influencing campaign acceptance and resistance in the local communities. Contact with friends and relations was rated the most influential interpersonal sources in the acceptance and resistance decision of individuals, while newspapers and magazines were rated most influential media sources that influenced campaign resistance in the local communities. The study concludes that a polio eradication campaign, backed with competent and sufficient communication expertise that utilizes knowledge-based indigenous interpersonal communication strategies will likely result in greater community acceptance in northern Nigeria.

  3. Partition and poliomyelitis: an investigation of the polio disparity affecting Muslims during India's eradication program.

    Rashid S Hussain

    Full Text Available Significant disparities in the incidence of polio existed during its eradication campaign in India. In 2006, Muslims, who comprise 16% of the population in affected states, comprised 70% of paralytic polio cases. This disparity was initially blamed on the Muslims and a rumor that the vaccination program was a plot to sterilize their children. Using the framework of structural violence, this paper describes how the socio-political and historical context of Muslim populations in India shaped the polio disparity.A qualitative study utilizing methods of rapid ethnography was conducted from May-August 2009 in Aligarh, Uttar Pradesh, India. Field methods included participant observation of vaccination teams, historical document research, and 107 interviews with both Global Polio Eradication Initiative (GPEI stakeholders and families with vaccine-eligible children. Almost all respondents agreed that Aligarh was a highly segregated city, mostly due to riots after Partition and during the 1990s. Since the formation of segregated neighborhoods, most respondents described that "Muslim areas" had been underdeveloped compared to "Hindu areas," facilitating the physical transmission of poliovirus. Distrust of the government and resistance to vaccination were linked to this disparate development and fears of sterilization influenced by the "Family Planning Program" from 1976-1977.Ethnic violence and social marginalization since the Partition and during the rise of Hindu nationalism led to distrust of the government, the formation of segregated slums, and has made Muslims victims of structural violence. This led to the creation of disease-spreading physical environments, lowered vaccine efficacy, and disproportionately higher levels of resistance to vaccination. The causes of the polio disparity found in this study elucidate the nature of possible other health disparities affecting minorities in India.This study is limited by the manual coding of the

  4. Eradicating poliomyelitis: India's journey from hyperendemic to polio-free status.

    John, T Jacob; Vashishtha, Vipin M

    2013-05-01

    India's success in eliminating wild polioviruses (WPVs) has been acclaimed globally. Since the last case on January 13, 2011 success has been sustained for two years. By early 2014 India could be certified free of WPV transmission, if no indigenous transmission occurs, the chances of which is considered zero. Until early 1990s India was hyperendemic for polio, with an average of 500 to 1000 children getting paralysed daily. In spite of introducing trivalent oral poliovirus vaccine (tOPV) in the Expanded Programme on Immunization (EPI) in 1979, the burden of polio did not fall below that of the pre-EPI era for a decade. One of the main reasons was the low vaccine efficacy (VE) of tOPV against WPV types 1 and 3. The VE of tOPV was highest for type 2 and WPV type 2 was eliminated in 1999 itself as the average per-capita vaccine coverage reached 6. The VE against types 1 and 3 was the lowest in Uttar Pradesh and Bihar, where the force of transmission of WPVs was maximum on account of the highest infant-population density. Transmission was finally interrupted with sustained and extraordinary efforts. During the years since 2004 annual pulse polio vaccination campaigns were conducted 10 times each year, virtually every child was tracked and vaccinated - including in all transit points and transport vehicles, monovalent OPV types 1 and 3 were licensed and applied in titrated campaigns according to WPV epidemiology and bivalent OPV (bOPV, with both types 1 and 3) was developed and judiciously deployed. Elimination of WPVs with OPV is only phase 1 of polio eradication. India is poised to progress to phase 2, with introduction of inactivated poliovirus vaccine (IPV), switch from tOPV to bOPV and final elimination of all vaccine-related and vaccine-derived polioviruses. True polio eradication demands zero incidence of poliovirus infection, wild and vaccine.

  5. Polio eradication initiative in Africa: influence on other infectious disease surveillance development

    Cochi Stephen

    2002-12-01

    Full Text Available Abstract Background The World Health Organization (WHO and partners are collaborating to eradicate poliomyelitis. To monitor progress, countries perform surveillance for acute flaccid paralysis (AFP. The WHO African Regional Office (WHO-AFRO and the U.S Centers for Disease Control and Prevention are also involved in strengthening infectious disease surveillance and response in Africa. We assessed whether polio-eradication initiative resources are used in the surveillance for and response to other infectious diseases in Africa. Methods During October 1999-March 2000, we developed and administered a survey questionnaire to at least one key informant from the 38 countries that regularly report on polio activities to WHO. The key informants included WHO-AFRO staff assigned to the countries and Ministry of Health personnel. Results We obtained responses from 32 (84% of the 38 countries. Thirty-one (97% of the 32 countries had designated surveillance officers for AFP surveillance, and 25 (78% used the AFP resources for the surveillance and response to other infectious diseases. In 28 (87% countries, AFP program staff combined detection for AFP and other infectious diseases. Fourteen countries (44% had used the AFP laboratory specimen transportation system to transport specimens to confirm other infectious disease outbreaks. The majority of the countries that performed AFP surveillance adequately (i.e., non polio AFP rate = 1/100,000 children aged Conclusions Despite concerns regarding the targeted nature of AFP surveillance, it is partially integrated into existing surveillance and response systems in multiple African countries. Resources provided for polio eradication should be used to improve surveillance for and response to other priority infectious diseases in Africa.

  6. Using Models to Inform Policy: Insights from Modeling the Complexities of Global Polio Eradication

    Thompson, Kimberly M.

    Drawing on over 20 years of experience modeling risks in complex systems, this talk will challenge SBP participants to develop models that provide timely and useful answers to critical policy questions when decision makers need them. The talk will include reflections on the opportunities and challenges associated with developing integrated models for complex problems and communicating their results effectively. Dr. Thompson will focus the talk largely on collaborative modeling related to global polio eradication and the application of system dynamics tools. After successful global eradication of wild polioviruses, live polioviruses will still present risks that could potentially lead to paralytic polio cases. This talk will present the insights of efforts to use integrated dynamic, probabilistic risk, decision, and economic models to address critical policy questions related to managing global polio risks. Using a dynamic disease transmission model combined with probabilistic model inputs that characterize uncertainty for a stratified world to account for variability, we find that global health leaders will face some difficult choices, but that they can take actions that will manage the risks effectively. The talk will emphasize the need for true collaboration between modelers and subject matter experts, and the importance of working with decision makers as partners to ensure the development of useful models that actually get used.

  7. [POLIOMYELITIS ERADICATION--ONE STEP TO ACHIEVE THE GOAL].

    Ljubin-Sternak, Sunčanica; Kaić, Bernard; Vilibić-Čavlek, Tatjana; Mlinarić-Galinović, Gordana

    2014-12-01

    Poliomyelitis is a very old disease of humans, caused by poliovirus. With appearance of the epidemics in the 20th century, poliomyelitis became a global public health issue. In 1988, the World Health Organization started a campaign for global eradication of poliomyelitis and till now poliomyelitis cases have been reduced by more than 99%. In Croatia, the introduction of vaccination in 1961 resulted in dramatic reduction of paralytic disease. The European region, including Croatia was certified polio free in 2002. However, the final goal of the "polio-free world" has not yet been reached. To reinforce the campaign, the global polio eradication initiative has come up with the Polio Eradication & Endgame Strategic Plan 2013-2018 with detailed program how to resolve the main challenges: (a) continued transmission of wild polioviruses in endemic reservoirs; (b) reinfection of polio-free areas; and (c) outbreaks due to the circulating vaccine-derived polioviruses (cVDPV). Global oral polio vaccine cessation will follow, with the introduction of universal use of inactivated polio vaccine.

  8. Optimal vaccine stockpile design for an eradicated disease: application to polio.

    Tebbens, Radboud J Duintjer; Pallansch, Mark A; Alexander, James P; Thompson, Kimberly M

    2010-06-11

    Eradication of a disease promises significant health and financial benefits. Preserving those benefits, hopefully in perpetuity, requires preparing for the possibility that the causal agent could re-emerge (unintentionally or intentionally). In the case of a vaccine-preventable disease, creation and planning for the use of a vaccine stockpile becomes a primary concern. Doing so requires consideration of the dynamics at different levels, including the stockpile supply chain and transmission of the causal agent. This paper develops a mathematical framework for determining the optimal management of a vaccine stockpile over time. We apply the framework to the polio vaccine stockpile for the post-eradication era and present examples of solutions to one possible framing of the optimization problem. We use the framework to discuss issues relevant to the development and use of the polio vaccine stockpile, including capacity constraints, production and filling delays, risks associated with the stockpile, dynamics and uncertainty of vaccine needs, issues of funding, location, and serotype dependent behavior, and the implications of likely changes over time that might occur. This framework serves as a helpful context for discussions and analyses related to the process of designing and maintaining a stockpile for an eradicated disease.

  9. Polio vaccination: past, present and future.

    Bandyopadhyay, Ananda S; Garon, Julie; Seib, Katherine; Orenstein, Walter A

    2015-01-01

    Live attenuated oral polio vaccine (OPV) and inactivated polio vaccine (IPV) are the tools being used to achieve eradication of wild polio virus. Because OPV can rarely cause paralysis and generate revertant polio strains, IPV will have to replace OPV after eradication of wild polio virus is certified to sustain eradication of all polioviruses. However, uncertainties remain related to IPV's ability to induce intestinal immunity in populations where fecal-oral transmission is predominant. Although substantial effectiveness and safety data exist on the use and delivery of OPV and IPV, several new research initiatives are currently underway to fill specific knowledge gaps to inform future vaccination policies that would assure polio is eradicated and eradication is maintained.

  10. Are we doing enough? Evaluation of the Polio Eradication Initiative in a district of Pakistan's Punjab province: a LQAS study

    Waqas Muhammad

    2010-02-01

    Full Text Available Abstract Background The success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. The aim of the study was to establish valid and reliable estimate for: routine oral polio vaccine (OPV coverage, logistics management and the quality of monitoring systems in health facilities, NIDs OPV coverage, the quality of NIDs service delivery in static centers and mobile teams, and to ultimately provide scientific evidence for tailoring future interventions. Methods A cross-sectional study using lot quality assessment sampling was conducted in the District Nankana Sahib of Pakistan's Punjab province. Twenty primary health centers and their catchment areas were selected randomly as 'lots'. The study involved the evaluation of 1080 children aged 12-23 months for routine OPV coverage, 20 health centers for logistics management and quality of monitoring systems, 420 households for NIDs OPV coverage, 20 static centers and 20 mobile teams for quality of NIDs service delivery. Study instruments were designed according to WHO guidelines. Results Five out of twenty lots were rejected for unacceptably low routine immunization coverage. The validity of coverage was questionable to extent that all lots were rejected. Among the 54.1% who were able to present immunization cards, only 74.0% had valid immunization. Routine coverage was significantly associated with card availability and socioeconomic factors. The main reasons for routine immunization failure were absence of a vaccinator and unawareness of need for immunization. Health workers (96.9% were a major source of information. All of the 20 lots were rejected for poor compliance in logistics management and quality of monitoring systems. Mean compliance score and compliance percentage for logistics management were 5.4 ± 2

  11. Intensified Local Resource Mobilization for the Polio Eradication Initiative: The Experience of World Health Organization in Nigeria During 2008–2015

    Yehualashet, Yared G.; Horton, Janet; Mkanda, Pascal; Vaz, Rui G.; Afolabi, Oluwole; Gashu, Sisay G.; Banda, Richard; O'Malley, Helena; Nsubuga, Peter

    2016-01-01

    Country Office team produced and submitted 102 grant reports and facilitated >20 joint project assessment exercises. Discussion. The polio program in Nigeria has achieved unprecedented gains, despite prevailing security and operational challenges, with no case of wild poliovirus infection since July 2014. Through rigorous, transparent, and accountable funds management practice, the WHO country office in Nigeria gained donors' confidence. The locally mobilized funds have made a remarkable contribution to the successful implementation of the strategies set out in the polio emergency plan. We face the challenges of a narrow donor-base, donor fatigue, and competition among other emerging agencies joining the polio eradication initiative efforts over the last few years. We actively engage the national authorities and partners for effective coordination of the polio eradication initiative program and harmonization of resources, using the existing platforms at national, state, and local levels. We recommend strengthening the local resource mobilization machinery and broadening the donor base, to support the polio endgame strategy. Such efforts should also be adopted to support routine immunization, introduction of new vaccines, and strengthening of health systems in the country as part of polio legacy planning. PMID:26912380

  12. Transmissibility and persistence of oral polio vaccine viruses: implications for the global poliomyelitis eradication initiative.

    Fine, P E; Carneiro, I A

    1999-11-15

    The global poliomyelitis eradication initiative has been a tremendous success, with current evidence suggesting that wild poliovirus will cease to circulate anywhere in the world soon after the year 2000. As the goal of wild poliovirus eradication is approached, concern has been raised about the potential for persistent transmission of oral polio vaccine (OPV) viruses, as these viruses are known to revert toward wild-type neurovirulence. This paper has been extracted from a document prepared for the World Health Organization on the implications of OPV transmissibility for the strategy of stopping OPV vaccination after global eradication of wild polioviruses. The authors review the empirical evidence on OPV transmissibility available from household and community transmission studies and from mass-vaccination experiences. They then consider theoretical measures of transmissibility and persistence for wild and OPV viruses (secondary attack rate, basic reproduction number, and critical populations' size), to assess whether transmissibility of OPV viruses is sufficient to allow persistence of these viruses after cessation of vaccination. The findings indicate that OPV viruses could persist under various plausible circumstances, and that this potential should be a major consideration when planning the cessation of OPV vaccination.

  13. New Strains Intended for the Production of Inactivated Polio Vaccine at Low-Containment After Eradication.

    Sarah Knowlson

    2015-12-01

    Full Text Available Poliomyelitis has nearly been eradicated through the efforts of the World Health Organization's Global Eradication Initiative raising questions on containment of the virus after it has been eliminated in the wild. Most manufacture of inactivated polio vaccines currently requires the growth of large amounts of highly virulent poliovirus, and release from a production facility after eradication could be disastrous; WHO have therefore recommended the use of the attenuated Sabin strains for production as a safer option although it is recognised that they can revert to a transmissible paralytic form. We have exploited the understanding of the molecular virology of the Sabin vaccine strains to design viruses that are extremely genetically stable and hyperattenuated. The viruses are based on the type 3 Sabin vaccine strain and have been genetically modified in domain V of the 5' non-coding region by changing base pairs to produce a cassette into which capsid regions of other serotypes have been introduced. The viruses give satisfactory yields of antigenically and immunogenically correct viruses in culture, are without measurable neurovirulence and fail to infect non-human primates under conditions where the Sabin strains will do so.

  14. Polio Crisis in Costa Rica: Lessons Learned and Achievements

    Gioconda Vargas-Morúa

    2015-05-01

    Full Text Available This presentation shows some of the consequences of the polio crisis in Costa Rica during the 1950’s, in order to preserve certain attitudes of Costa Ricans back then that are worth remembering: simplicity, solidarity and gratefulness. Hand in hand with highly service-oriented men and women, the country overcame the crisis and built one of the most iconic hospitals in Costa Rica: the National Children’s Hospital. It is worth rescuing the lessons learned and applying them to current times. This historical text was created based on the stories told by people who lived during the times of the crisis, on a 1956 notebook, on documents from the National Archive and the National Health and Social Security Library (BINASSS, for its name in Spanish, the Costa Rican Social Security System (CCSS, for its name in Spanish, Dr. Rodolfo Álvaro Murillo, and San Juan de Dios Hospital.  National and international newspapers were also reviewed. The consulted material confirms how the work of Costa Ricans, led by committed and service-oriented individuals, allowed for the construction of the National Children’s Hospital to take place -an institution that has served the Costa Rican people for fifty years. Costa Ricans also succeeded in eradicating polio long before several other countries around the world. The reactions of people in the 1950’s are lessons of solidarity and humanity that should not be forgotten; they should be remembered in order to value team work over individual work and make sure, no matter what our role in society is, to always stand by common well-being, as mid-century Costa Ricans did by overcoming their personal limitations and acting for the benefit of society.

  15. Environmental Surveillance of Polioviruses in Rio de Janeiro, Brazil, in Support to the Activities of Global Polio Eradication Initiative.

    de Oliveira Pereira, Joseane Simone; da Silva, Lidiane Rodrigues; de Meireles Nunes, Amanda; de Souza Oliveira, Silas; da Costa, Eliane Veiga; da Silva, Edson Elias

    2016-03-01

    Wild polioviruses still remain endemic in three countries (Afghanistan, Pakistan, and Nigeria) and re-emergency of wild polio has been reported in previously polio-free countries. Environmental surveillance has been used as a supplementary tool in monitoring the circulation of wild poliovirus (PVs) and/or vaccine-derived PVs even in the absence of acute flaccid paralysis cases. This study aimed to monitor the presence of polioviruses in wastewater samples collected at one wastewater treatment plant located in the municipality of Rio de Janeiro, Brazil. From December 2011 to June 2012 and from September to December 2012, 31 samples were collected and processed. RD and L20B cell cultures were able to isolate PVs and non-polio enteroviruses in 27/31 samples. Polioviruses were isolated in eight samples (type 1 Sabin = 1, type 2 Sabin = 5, and type 3 Sabin = 2). Vaccine-derived polioviruses were not detected nor evidence of recombination with other PVs or non-polio enterovirus serotypes were observed among the isolates. The Sabin-related serotypes 2 and 3 presented nucleotide substitutions in positions associated with the neurovirulent phenotype at the 5'-UTR. Changes in important Amino acid residues at VP1 were also observed in the serotypes 2 and 3. Environmental surveillance has been used successfully in monitoring the circulation of PVs and non-polio enteroviruses and it is of crucial importance in the final stages of the WHO global polio eradication initiative. Our results show the continuous circulation of Sabin-like PVs and non-polio enteroviruses in the analyzed area during the study period.

  16. World witnesses a tumultuous year while India reports an eventful decade in the long story of polio eradication

    Sanjay Chaturvedi

    2014-01-01

    Full Text Available With recent outbreaks in Syria and Horn of Africa, silent circulation of wild poliovirus type 1 (WPV1 in Israel, West Bank, and Gaza, and fresh spate of violence against vaccinators and their security personnel in Pakistan, the world is facing a turbulent final ascent to the summit of polio eradication. On the positive side, we may also be witnessing the end of wild poliovirus type 3 (WPV3 and defused programmatic crisis caused by funding gaps, while India registers third consecutive polio-free year. Having a cogent endgame plan 2013-2018, informed by some cardinal lessons learned from an eventful decade in India, is also a very significant development. Now, there is a parallel pursuit against WPV and vaccine-derived poliovirus (VDPV. Endgame would also involve integration of at least one dose of affordable inactivated polio vaccine (IPV to up-scaled routine immunization (RI, switch from trivalent oral polio vaccine (tOPV to bivalent oral polio vaccine (bOPV in 144 countries before 2018, stockpiling of mOPV, and simultaneous global cessation of bOPV before 2020. Role of antivirals in post-eradication era is still unclear. Some specific threats emerging at this stage are as follows: Global buildup of new birth cohorts in non-endemic countries with weak RI and downscaled supplementary immunization activities (SIAs, tremendous pressure on peripheral health workers, and fatigued systems. Cultural resistance to transnational programs is taking a violent shape in some areas. Differential interpretations of ′right to say no′, on both sides of the divide, are damaging a global cause. Amidst all these concerns, let us not forget to underline the sacrifice made by frontline vaccinators working in some of the most challenging circumstances.

  17. ERADIKASI POLIO DAN IPV (INACTIVATED POLIO VACCINE

    Gendrowahyuhono Gendrowahyuhono

    2012-09-01

    Full Text Available In the year 1988, World Health Organization (WHO claims that polio viruses should be eradicated after year 2000. However, until year 2010 the world have not been free from polio viruses circulation. So many effort had been achieved and it is estimated that the world will be free from polio virus after the year 2013. Control of poliomyelitis in Indonesia has been commenced since 1982 with routine immunization of polio program and the National Immunization Days (NID has been commenced since 1995,1996,2005 and 2006. When the world is free from polio virus, WHO suggests several alternative effort to maintain the world free from polio viruses : I stop the OPV (Oral Polio Vaccine and no polio immunization, 2 stop OPV and stock pile mOPV (monovalent OPV, 3 use OPV and IPV (Inactivated Polio Vaccine in a certain times, 4 use IPV only in a certain times. IPV has been used routinely in develop countries but has not been used in the developing countries. Several studies in development countries has been conducted, but had not been done in the developing countries. Indonesia collaboration with WHO has conducted the study of IPV in Yogyakarta Province since year 2002 until year 2010. The overall aim of the study is to compile the necessary data that will inform global and national decision-making regarding future polio immunization policies for the OPV cessation era. The data generated from the study will be particularly important to make decisions regarding optimal IPV use in developing tropical countries. It is unlikely that this data can be assembled through other means than through this study. The tentative result of the study shows that OPV immunization coverage in the year 2004 is 99% in four district and 93 % in the Yogyakarta city. Environment surveillance shows that there are 65.7% polio virus detected from 137 sewage samples pre IPV swich, and 4.8% polio virus detected from 83 sewage samples post IPV swich. Survey polio antibody serologis shows

  18. Pakistan's expanded programme on immunization: an overview in the context of polio eradication and strategies for improving coverage.

    Owais, Aatekah; Khowaja, Asif Raza; Ali, Syed Asad; Zaidi, Anita K M

    2013-07-18

    Since its inception in 1978, Pakistan's Expanded Programme on Immunization (EPI) has contributed significantly towards child health and survival in Pakistan. However, the WHO-estimated immunization coverage of 88% for 3 doses of Diptheria-Tetanus-Pertussis vaccine in Pakistan is likely an over-estimate. Many goals, such as polio, measles and neonatal tetanus elimination have not been met. Pakistan reported more cases of poliomyelits in 2011 than any other country globally, threatening the Global Polio Eradication Initiative. Although the number of polio cases decreased to 58 in 2012 through better organized supplementary immunization campaigns, country-wide measles outbreaks with over 15,000 cases and several hundred deaths in 2012-13 underscore sub-optimal EPI performance in delivering routine immunizations. There are striking inequities in immunization coverage between different parts of the country. Barriers to universal immunization coverage include programmatic dysfunction at lower tiers of the program, socioeconomic inequities in access to services, low population demand, poor security, and social resistance to vaccines among population sub-groups. Recent conflicts and large-scale natural disasters have severely stressed the already constrained resources of the national EPI. Immunization programs remain low priority for provincial and many district governments in the country. The recent decision to devolve the national health ministry to the provinces has had immediate adverse consequences. Mitigation strategies aimed at rapidly improving routine immunization coverage should include improving the infrastructure and management capacity for vaccine delivery at district levels and increasing the demand for vaccines at the population level. Accurate vaccine coverage estimates at district/sub-district level and local accountability of district government officials are critical to improving performance and eradicating polio in Pakistan.

  19. The Challenge of Global Poliomyelitis Eradication.

    Garon, Julie R; Cochi, Stephen L; Orenstein, Walter A

    2015-12-01

    In the United States during the 1950's, polio was on the forefront of every provider and caregiver's mind. Today, most providers in the United States have never seen a case. The Global Polio Eradication Initiative (GPEI), which began in 1988 has reduced the number of cases by over 99%. The world is closer to achieving global eradication of polio than ever before but as long as poliovirus circulates anywhere in the world, every country is vulnerable. The global community can support the polio eradication effort through continued vaccination, surveillance, enforcing travel regulations and contributing financial support, partnerships and advocacy.

  20. Twenty-Eight Years of Poliovirus Replication in an Immunodeficient Individual: Impact on the Global Polio Eradication Initiative.

    Dunn, Glynis; Klapsa, Dimitra; Wilton, Thomas; Stone, Lindsay; Minor, Philip D; Martin, Javier

    2015-08-01

    There are currently huge efforts by the World Health Organization and partners to complete global polio eradication. With the significant decline in poliomyelitis cases due to wild poliovirus in recent years, rare cases related to the use of live-attenuated oral polio vaccine assume greater importance. Poliovirus strains in the oral vaccine are known to quickly revert to neurovirulent phenotype following replication in humans after immunisation. These strains can transmit from person to person leading to poliomyelitis outbreaks and can replicate for long periods of time in immunodeficient individuals leading to paralysis or chronic infection, with currently no effective treatment to stop excretion from these patients. Here, we describe an individual who has been excreting type 2 vaccine-derived poliovirus for twenty eight years as estimated by the molecular clock established with VP1 capsid gene nucleotide sequences of serial isolates. This represents by far the longest period of excretion described from such a patient who is the only identified individual known to be excreting highly evolved vaccine-derived poliovirus at present. Using a range of in vivo and in vitro assays we show that the viruses are very virulent, antigenically drifted and excreted at high titre suggesting that such chronic excreters pose an obvious risk to the eradication programme. Our results in virus neutralization assays with human sera and immunisation-challenge experiments using transgenic mice expressing the human poliovirus receptor indicate that while maintaining high immunisation coverage will likely confer protection against paralytic disease caused by these viruses, significant changes in immunisation strategies might be required to effectively stop their occurrence and potential widespread transmission. Eventually, new stable live-attenuated polio vaccines with no risk of reversion might be required to respond to any poliovirus isolation in the post-eradication era.

  1. Twenty-Eight Years of Poliovirus Replication in an Immunodeficient Individual: Impact on the Global Polio Eradication Initiative.

    Glynis Dunn

    2015-08-01

    Full Text Available There are currently huge efforts by the World Health Organization and partners to complete global polio eradication. With the significant decline in poliomyelitis cases due to wild poliovirus in recent years, rare cases related to the use of live-attenuated oral polio vaccine assume greater importance. Poliovirus strains in the oral vaccine are known to quickly revert to neurovirulent phenotype following replication in humans after immunisation. These strains can transmit from person to person leading to poliomyelitis outbreaks and can replicate for long periods of time in immunodeficient individuals leading to paralysis or chronic infection, with currently no effective treatment to stop excretion from these patients. Here, we describe an individual who has been excreting type 2 vaccine-derived poliovirus for twenty eight years as estimated by the molecular clock established with VP1 capsid gene nucleotide sequences of serial isolates. This represents by far the longest period of excretion described from such a patient who is the only identified individual known to be excreting highly evolved vaccine-derived poliovirus at present. Using a range of in vivo and in vitro assays we show that the viruses are very virulent, antigenically drifted and excreted at high titre suggesting that such chronic excreters pose an obvious risk to the eradication programme. Our results in virus neutralization assays with human sera and immunisation-challenge experiments using transgenic mice expressing the human poliovirus receptor indicate that while maintaining high immunisation coverage will likely confer protection against paralytic disease caused by these viruses, significant changes in immunisation strategies might be required to effectively stop their occurrence and potential widespread transmission. Eventually, new stable live-attenuated polio vaccines with no risk of reversion might be required to respond to any poliovirus isolation in the post-eradication

  2. Support for children identified with acute flaccid paralysis under the global polio eradication programme in Uttar Pradesh, India: a qualitative study

    Yotsu Rie R

    2012-03-01

    Full Text Available Abstract Background Cases of polio in India declined after the implementation of the polio eradication programme especially in these recent years. The programme includes surveillance of acute flaccid paralysis (AFP to detect and diagnose cases of polio at early stage. Under this surveillance, over 40,000 cases of AFP are reported annually since 2007 regardless of the number of actual polio cases. Yet, not much is known about these children. We conducted a qualitative research to explore care and support for children with AFP after their diagnosis. Methods The research was conducted in a district of western Uttar Pradesh classified as high-risk area for polio. In-depth interviews with parents of children with polio (17, with non-polio AFP (9, healthcare providers (40, and key informants from community including international and government officers, religious leaders, community leaders, journalists, and academics (21 were performed. Results Minimal medicine and attention were provided at government hospitals. Therefore, most parents preferred private-practice doctors for their children with AFP. Many were visited at homes to have stool samples collected by authorities. Some were visited repetitively following the sample collection, but had difficulty in understanding the reasons for these visits that pertained no treatment. Financial burden was a common concern among all families. Many parents expressed resentment for their children's disease, notably have been affected despite receiving multiple doses of polio vaccine. Both parents and healthcare providers lacked information and knowledge, furthermore poverty minimised the access to available healthcare services. Medicines, education, and transportation means were identified as foremost needs for children with AFP and residual paralysis. Conclusions Despite the high number of children diagnosed with AFP as part of the global polio eradication programme, we found they were not provided with

  3. Poliomyelitis eradication: Rhetoric or reality

    Bhatnagar, Nidhi; Grover, Manoj; Sinha, Smita; Kaur, Ravneet

    2013-01-01

    Since the launch of Global Polio Eradication Initiative in 1988, disease burden has been reduced by more than 99% globally. Lately, India has witnessed a year without a case of poliomyelitis. It no longer stands endemic and is being regarded as a model for polio eradication efforts in other low income endemic countries: Pakistan, Nigeria and Afghanistan. The near elimination of wild polio virus in India has set forth new challenges of vaccine derived polio virus and need for newer strategies in oral poliomyelitis vaccine cessation preparatory phase. Stricter surveillance measures are needed to check for importations, any spread of virus in migratory populations and rapid containment of newly found virus. No stone should be left unturned in this last ditch effort for extermination of polio virus form environmental circulation. India's battle against polio will be cited as the biggest public health achievement or the most expensive public health failure.

  4. Review of Australia's polio surveillance.

    Paterson, Beverley J; Durrheim, David N

    2013-06-30

    With eradication almost within reach, the importance of detecting every poliomyelitis case has taken on additional significance. The selected surveillance strategy must be effective and efficient. A review of polio surveillance in Australia was conducted to consider whether current strategies were optimal. Document review and semi-structured key informant interviews were used to conduct the review. Interviews were recorded, transcribed and thematically analysed. The review was an iterative process with feedback on the findings sought from interviewees. Since Western Pacific Regional polio-elimination status was certified, one imported adult case was detected in 2007 in Australia, with no evidence of further transmission, and no Australian paediatric cases identified. Respondents reported that: it was not possible to prevent importations; paediatric cases were more likely to be identified than adult cases; and there may be a low level of suspicion among clinicians. Case detection and outbreak mitigation were considered key reasons to undertake polio surveillance. While Australia has not achieved one of the key World Health Organization (WHO) surveillance targets, this did not compromise Australias polio-free status. Identified issues with polio surveillance were the potential for an importation with high attendant investigation and containment costs, low stool sample collection rates, and the opportunity to improve safeguards around the importation and laboratory storage of biological samples containing poliovirus. The review found strong support for ongoing polio surveillance, particularly to detect imported cases and to demonstrate commitment to maintaining a polio-free region. Existing polio surveillance strategies were considered appropriate for Australia.

  5. Outcomes of polio eradication activities in Uttar Pradesh, India: the Social Mobilization Network (SM Net and Core Group Polio Project (CGPP

    Singh Vibha

    2011-05-01

    Full Text Available Abstract Background The primary strategy to interrupt transmission of wild poliovirus in India is to improve supplemental immunization activities and routine immunization coverage in priority districts with a focus on 107 high-risk blocks of western Uttar Pradesh and central Bihar. Villages or urban areas with a history of wild poliovirus transmission, or hard-to-reach or resistant populations are categorized as high-risk areas within blocks. The Social Mobilization Network (SM Net was formed in Uttar Pradesh in 2003 to support polio eradication efforts through improved planning, implementation and monitoring of social mobilization activities in those high-risk areas. In this paper, we examine the vaccination outcomes in districts of SM Net where the CORE Group works. Methods We carried out a secondary data analysis of routine monitoring information collected by the SM Net and the Government of India. These data include information about vaccination outcomes in SM Net areas and non-SM Net areas within the districts where the CORE Group operates. Statistical analysis was used to compare, between SM Net and non-SM Net areas, vaccination outcomes considered sensitive to social mobilization efforts of the SM Net. We employed Generalized Estimating Equations (GEE statistical method to account for Intra-cluster Correlation (ICC, and used 'Quasi-likelihood under the independence model criterion (QIC' as the model selection method. Results Vaccination outcomes in SM Net areas were as high as or higher than in non-SM Net areas. There was considerable variation in vaccination outcomes between districts. Conclusions While not conclusive, the results suggest that the social mobilization efforts of the SM Net and the CORE Group are helping to increase vaccination levels in high-risk areas of Uttar Pradesh. Vaccination outcomes in CORE Group areas were equal or higher than in non-CORE, non-SM Net areas. This occurred even though SM Net areas are those with

  6. Alternative administration routes and delivery technologies for polio vaccines.

    Kraan, H.; Stel, van der W.; Kersten, G.F.A.; Amorij, J.P.

    2016-01-01

    Global polio eradication is closer than ever. Replacement of the live attenuated oral poliovirus vaccine (OPV) by inactivated poliovirus vaccine (IPV) is recommended to achieve complete eradication. Limited global production capacity and relatively high IPV costs compared to OPV spur the need for im

  7. Introduction of sequential inactivated polio vaccine-oral polio vaccine schedule for routine infant immunization in Brazil's National Immunization Program.

    Domingues, Carla Magda Allan S; de Fátima Pereira, Sirlene; Cunha Marreiros, Ana Carolina; Menezes, Nair; Flannery, Brendan

    2014-11-01

    In August 2012, the Brazilian Ministry of Health introduced inactivated polio vaccine (IPV) as part of sequential polio vaccination schedule for all infants beginning their primary vaccination series. The revised childhood immunization schedule included 2 doses of IPV at 2 and 4 months of age followed by 2 doses of oral polio vaccine (OPV) at 6 and 15 months of age. One annual national polio immunization day was maintained to provide OPV to all children aged 6 to 59 months. The decision to introduce IPV was based on preventing rare cases of vaccine-associated paralytic polio, financially sustaining IPV introduction, ensuring equitable access to IPV, and preparing for future OPV cessation following global eradication. Introducing IPV during a national multivaccination campaign led to rapid uptake, despite challenges with local vaccine supply due to high wastage rates. Continuous monitoring is required to achieve high coverage with the sequential polio vaccine schedule.

  8. Review and Prospects on the 25th Anniversary of the Global Polio Eradication Initiative(GPEI):the Last 1℅%全球消灭脊髓灰质炎行动25周年的回顾与展望:消灭最后的千分之一

    张志将; 雷正龙; 谢铮; 尹慧; 郭岩

    2014-01-01

    Ithasbeen25yearssincetheWorldHealthAssemblylaunchedtheGlobalPolioEradicationInitiative (GPEI)in 1988. This article summarized the significant achievements,major obstacles and prospects for a successful endgame stage for polio eradication in the national and global context.%自1988年的第41届世界卫生大会发起“全球消灭脊髓灰质炎行动”,至2013年第66届世界卫生大会已经25周年。本文总结了这25年间全球和中国在消灭脊髓灰质炎行动中所取得的成果及目前存在的主要障碍,并展望下一阶段的目标。

  9. Prospects of eradicating poliomyelitis by 2007: compulsory vaccination may be a strategy.

    Lahariya, Chandrakant; Pradhan, S K

    2007-01-01

    The polio eradication has reached at a critical juncture. The progress was good until year 2000, and since then no major success has been achieved. The year 2006 can easily be termed as 'nightmare period' as there was sudden increase of polio cases in the affected countries this year. The threats of re-emergence and importation continued. The apprehensions became stronger, while the target elusive. This situation requires an immediate decisive action, by the international health community, to eradicate polio at the earliest possible. This article draws some lessons from polio eradication program in last two decades, along with analyzing the concept, feasibility and applicability of compulsory vaccination for achieving the goal of polio eradication by the end of the year 2007.

  10. The polio endgame.

    Minor, Philip

    2014-01-01

    Paralytic poliomyelitis is a disease that became a public health issue at the beginning of the twentieth century and was more or less eliminated in developed countries by the early 1970s. The Global Polio Eradication Initiative of WHO has now eradicated endemic polio from all but three countries although re-introductions occur. The progress in polio eradication is striking and has accelerated over the last few years. It is likely that it will be finally eradicated from the world soon, the looming issue will then be how to stop vaccinating or modify immunization programs safely so that poliomyelitis does not re-emerge. This review article discusses the history and pathogenesis of poliomyelitis. The progress made, and challenges in sustaining the eradication of this debilitating infectious disease are considered.

  11. India's poliomyelitis eradication: a milestone in public health.

    Grover, Manoj; Bhatnagar, Nidhi; Sinha, Smita; Kaur, Ravneet

    2013-12-01

    India has recently completed 2 years without single case of poliomyelitis on 13 January 2013. This has brought South East Asian Region closer to eradication. Recently, India is being regarded as a role model for polio eradication efforts in other low-income endemic countries-Pakistan, Nigeria and Afghanistan. However, the near elimination of wild polio virus in India has set forth newer challenges. Stricter surveillance measures are now needed to check for importations spread of virus in migratory populations and rapid containment of newly found virus. India's battle against polio will soon be cited as biggest public health achievement or most expensive public health failure.

  12. Can post-eradication laboratory containment of wild polioviruses be achieved?

    Dowdle, WR; Gary, HE; Sanders, R; van Loon, AM

    2002-01-01

    The purpose of containment is to prevent reintroduction of wild polioviruses from laboratories into polio-free communities. In order to achieve global commitment to laboratory containment the rationale should be clear and compelling; the biosafety levels should be justified by the risks; and the obj

  13. Polio Vaccine

    ... Health Resources Share Polio Vaccine What is polio?Poliomyelitis (polio, for short) is a serious illness that can cause paralysis (when you can't move your arms and legs) or even death. Polio is caused by a virus. The virus can be spread by drinking water ...

  14. A Brief History of Vaccines Against Polio.

    Vashishtha, Vipin M; Kamath, Sachidanand

    2016-08-07

    Poliomyelitis, a dreaded disease of the last century that had already crippled millions of people across the globe, is now on the verge of eradication thanks mainly to two polio vaccines, inactivated polio vaccine (IPV) and oral polio vaccine (OPV). Ever since their development in late 1950s and early 1960s, the journey of their early development process, clinical trials, licensure and ultimately widespread clinical use in different countries provide a fascinating tale of events. Oral polio vaccine has been the mainstay of global polio eradication initiative (GPEI) in most of the countries. With the advent of 'polio endgame', the focus has now shifted back to IPV. However, there are certain issues associated with global cessation of OPV use and universal implementation of IPV in routine immunization schedules across the globe that need to be dealt with some urgency, before proclaiming the global victory over polio.

  15. Unraveling the Transmission Ecology of Polio.

    Micaela Martinez-Bakker

    2015-06-01

    Full Text Available Sustained and coordinated vaccination efforts have brought polio eradication within reach. Anticipating the eradication of wild poliovirus (WPV and the subsequent challenges in preventing its re-emergence, we look to the past to identify why polio rose to epidemic levels in the mid-20th century, and how WPV persisted over large geographic scales. We analyzed an extensive epidemiological dataset, spanning the 1930s to the 1950s and spatially replicated across each state in the United States, to glean insight into the drivers of polio's historical expansion and the ecological mode of its persistence prior to vaccine introduction. We document a latitudinal gradient in polio's seasonality. Additionally, we fitted and validated mechanistic transmission models to data from each US state independently. The fitted models revealed that: (1 polio persistence was the product of a dynamic mosaic of source and sink populations; (2 geographic heterogeneity of seasonal transmission conditions account for the latitudinal structure of polio epidemics; (3 contrary to the prevailing "disease of development" hypothesis, our analyses demonstrate that polio's historical expansion was straightforwardly explained by demographic trends rather than improvements in sanitation and hygiene; and (4 the absence of clinical disease is not a reliable indicator of polio transmission, because widespread polio transmission was likely in the multiyear absence of clinical disease. As the world edges closer to global polio eradication and continues the strategic withdrawal of the Oral Polio Vaccine (OPV, the regular identification of, and rapid response to, these silent chains of transmission is of the utmost importance.

  16. Unraveling the Transmission Ecology of Polio.

    Martinez-Bakker, Micaela; King, Aaron A; Rohani, Pejman

    2015-06-01

    Sustained and coordinated vaccination efforts have brought polio eradication within reach. Anticipating the eradication of wild poliovirus (WPV) and the subsequent challenges in preventing its re-emergence, we look to the past to identify why polio rose to epidemic levels in the mid-20th century, and how WPV persisted over large geographic scales. We analyzed an extensive epidemiological dataset, spanning the 1930s to the 1950s and spatially replicated across each state in the United States, to glean insight into the drivers of polio's historical expansion and the ecological mode of its persistence prior to vaccine introduction. We document a latitudinal gradient in polio's seasonality. Additionally, we fitted and validated mechanistic transmission models to data from each US state independently. The fitted models revealed that: (1) polio persistence was the product of a dynamic mosaic of source and sink populations; (2) geographic heterogeneity of seasonal transmission conditions account for the latitudinal structure of polio epidemics; (3) contrary to the prevailing "disease of development" hypothesis, our analyses demonstrate that polio's historical expansion was straightforwardly explained by demographic trends rather than improvements in sanitation and hygiene; and (4) the absence of clinical disease is not a reliable indicator of polio transmission, because widespread polio transmission was likely in the multiyear absence of clinical disease. As the world edges closer to global polio eradication and continues the strategic withdrawal of the Oral Polio Vaccine (OPV), the regular identification of, and rapid response to, these silent chains of transmission is of the utmost importance.

  17. Surviving polio in a post-polio world.

    Groce, Nora Ellen; Banks, Lena Morgon; Stein, Michael Ashley

    2014-04-01

    Excitement mounts as the global health and international development communities anticipate a polio-free world. Despite substantial political and logistical hurdles, only 223 cases of wild poliovirus in three countries were reported in 2012. Down 99% from the estimated 350,000 annual cases in 125 countries in 1988-this decline signals the imminent global eradication of polio. However, elimination of new polio cases should not also signal an end to worldwide engagement with polio. As many as 20 million continue to live with the disabling consequences of the disease. In developed countries where polio immunization became universal after dissemination of the polio vaccine in the 1950s, almost all individuals who have had polio are now above age 50. But in many developing countries where polio vaccination campaigns reached large segments of the population only after 1988, millions disabled by polio are still children or young adults. Demographically, this group is also different. After three decades of immunization efforts, those children unvaccinated in the late 1980s were more likely to be from poorer rural and slum communities and to be girls-groups not only harder to reach than more affluent members of the population but also individuals who, if they contract polio, are less likely to have access to medical and rehabilitation programs or education, job training, employment and social support services. The commitment to eradicate polio should not be considered complete while those living with the disabling sequelae of polio continue to live in poor health, poverty and social isolation. This paper reviews what is currently known about disabled survivors of polio and highlights areas of need in public health research, policy and programming. Based on a literature review, discussion and field observations, we identify continuing challenges posed by polio and argue that the attention, funding and commitment now being directed towards eradication be shifted to provide

  18. Australia's polio risk.

    Martin, Nicolee; Paterson, Beverley J; Durrheim, David N

    2014-06-30

    Australia, like all polio-free countries and regions, remains at risk of a wild poliovirus importation until polio is eradicated globally. The most probable route of importation will be through a traveller arriving in Australia either by air or sea from a polio-endemic or re-infected country. While the overall risk of an imported wild poliovirus infection leading to transmission within Australia is assessed as being low, some areas of the country have been identified as at increased risk. Local areas with relatively high arrivals from polio endemic countries, areas of low vaccination coverage and the potential for transmission to occur when these 2 factors are combined, were identified by this review as Australia's main polio risk. The risk of an importation event leading to locally acquired cases is mitigated by generally high polio vaccination coverage in Australia. This high coverage extends to residents of the Torres Strait Islands who are in close proximity to Papua New Guinea, a country identified as at high risk of poliovirus transmission should an importation occur. In 2012, all states and territories had vaccination coverage of greater than 90% at 1 year of age and all exceeded 93% at 2 years of age. Population immunity to wild poliovirus type 1, which remains the major cause of paralysis globally, has been estimated at 82%. This is sufficient to prevent outbreaks of this type in Australia. Of the 211 eligible non-polio acute flaccid paralysis (AFP) cases classified between 2008 and 2011, 91% (193) were vaccinated against polio at least once. High quality surveillance for AFP, which is supplemented by sentinel enterovirus and environmental surveillance activities, gives confidence that an imported case would be detected and appropriate public health action would ensue.

  19. Progress toward poliomyelitis eradication - Nigeria, January 2011-September 2012.

    2012-11-09

    In 1988, the World Health Assembly launched the Global Polio Eradication Initiative (GPEI) and, in 2012, declared the completion of polio eradication a programmatic emergency for global public health. To date, wild poliovirus (WPV) cases reported worldwide in 2012 are at historically low levels. Nigeria is one of only three countries with uninterrupted WPV transmission (in addition to Pakistan and Afghanistan) and has been the origin of WPV imported into 25 previously polio-free countries since 2003. This report updates previous reports and describes polio eradication activities and progress in Nigeria during January 2011-September 2012, as of October 30, 2012. The number of reported WPV cases increased from 21 in 2010 to 62 in 2011. During January-September 2012, a total of 99 WPV cases were reported, more than doubling from the 42 cases reported during the same period in 2011. During 2011, a total of 32 circulating vaccine-derived polio virus type 2 (cVDPV2) cases were confirmed; six cVDPV2 cases were confirmed during January-September 2012, compared with 18 cVDPV2 cases during the same period in 2011. Nigeria's 2012 Polio Eradication Emergency Plan includes senior government leadership oversight, new program management and strategic initiatives, an accountability framework, and a surge in human resources to address chronically missed children during supplemental immunization activities (SIAs).* In 2012, indicators of immunization campaign quality show modest improvements; available data indicate gaps in surveillance. Continuing WPV transmission in Nigeria poses an ongoing risk for WPV reintroduction and outbreaks in polio-free countries and is a major obstacle to achieving global eradication.

  20. Overview of the Application on Environmental Surveillance in the Process of the Polio Eradication%环境监测在消灭脊髓灰质炎过程的作用

    吴照; 温宁; 梁晓峰

    2011-01-01

    随着全球消灭脊髓灰质炎(脊灰)活动进入最后阶段,世界各地仍然面临脊灰病毒输入的风险,环境监测将为消灭脊灰监测提供技术支撑.%In the final stage of Global Polio Eradication Initiative (GPEI), global still faces the imported risk of poliovirus. Environmental surveillance will provide comprehensive technical support for GPEI.

  1. Scale down of the inactivated polio vaccine production process

    Thomassen, Y.E.; Oever, van 't R.; Vinke, C.M.; Spiekstra, A.; Wijffels, R.H.; Pol, van der L.A.; Bakker, W.A.M.

    2013-01-01

    The anticipated increase in the demand for inactivated polio vaccines resulting from the success in the polio eradication program requires an increase in production capacity and cost price reduction of the current inactivated polio vaccine production processes. Improvement of existing production pro

  2. Polio and Post-Polio Syndrome

    ... who've had polio develop post-polio syndrome (PPS) years later. Symptoms include tiredness, new muscle weakness, ... There is no way to prevent or cure PPS. The polio vaccine has wiped out polio in ...

  3. The discussion of inactivated poliovirus vaccine immunization strategy in China during the global polio eradication stage%全球消灭脊髓灰质炎最后阶段我国脊髓灰质炎疫苗免疫策略的探讨

    伊赫亚; 王芃; 辛美哲; 李黎; 杨维中

    2015-01-01

    Since its launching at the World Health Assembly (WHA) in 1988,the Global Polio Eradication Initiative (GPEI) has reduced the global incidence of polio by over 99 %,from an estimated 350 000 cases then to 406 reported cases in 2013,and the number of countries with endemic polio from 125 to 3.The reduction is the result of the global effort to eradicate the disease.In 2012,the World Health Assembly declared ending polio a "programmatic emergency for global public health" and developed the Polio Eradication & Endgame Strategic Plan 2013-2018.In the plan,all countries are recommended to introduce at least 1 dose of IPV into their routine immunization programs to reduce the consequences of a subsequent circulating poliovirus after OPV2 cessation.Under certain conditions,how should at least one dose of IPV be introduced into Chinese routine immunization programs,what problems might be met during the process and what lessons we could learn from abroad are of great interest to us.During the meeting,experts shared the experiences of introducing IPV into their routine immunization programs and provided suggestions to us.Proper communication strategy and maintaining the high coverage of vaccination are the primary factors during the vaccine policy changing period.

  4. Progress Toward Poliomyelitis Eradication--Pakistan, January 2014-September 2015.

    Farag, Noha H; Wadood, Mufti Zubair; Safdar, Rana Muhammad; Ahmed, Nabil; Hamdi, Sabrine; Tangermann, Rudolph H; Ehrhardt, Derek

    2015-11-20

    Since Nigeria reported its last case of wild poliovirus type 1 (WPV1) in July 2014, Pakistan and Afghanistan remain the only two countries where WPV transmission has never been interrupted. This report describes actions taken and progress achieved toward polio eradication in Pakistan during January 2014-September 2015 and updates previous reports. A total of 38 WPV1 cases were reported in Pakistan during January-September 2015, compared with 243 during the same period in 2014 (an 84% decline). Among WPV1 cases reported in 2015, 32 (84%) occurred in children aged <36 months, nine (32%) of whom had never received oral poliovirus vaccine (OPV). Twenty-six (68%) of the 38 reported cases occurred in the Federally Administered Tribal Areas (FATA) and Khyber Pakhtunkhwa (KPK) Province. During January-September 2015, WPV1 was detected in 20% (64 of 325) of environmental samples collected, compared with 34% (98 of 294) of samples collected during the same period in 2014. The quality and scope of polio eradication activities improved considerably following the establishment of a national Emergency Operations Center, which coordinated polio eradication partners' activities. All activities are following a National Polio Eradication Emergency Action Plan that includes a rigorous action plan for the polio low transmission season (January-April). The presence of WPV1 in environmental samples in areas where no polio cases are detected highlights the need to improve surveillance for acute flaccid paralysis (AFP). Focused efforts to close remaining immunity gaps by locating, tracking, and vaccinating continually missed children and improving coverage with OPV through the routine vaccination program are needed to stop WPV transmission in Pakistan.

  5. Non-Polio Enterovirus

    ... Disease Viral Meningitis What is Polio? About Non-Polio Enteroviruses Recommend on Facebook Tweet Share Compartir Symptoms Lists symptoms of non-polio enterovirus infection… Transmission Explains how non-polio enteroviruses ...

  6. A public health achievement under adversity: the eradication of poliomyelitis from Peru, 1991.

    Sobti, Deepak; Cueto, Marcos; He, Yuan

    2014-12-01

    The fight to achieve global eradication of poliomyelitis continues. Although native transmission of poliovirus was halted in the Western Hemisphere by the early 1990s, and only a few cases have been imported in the past few years, much of Latin America's story remains to be told. Peru conducted a successful flexible, or flattened, vertical campaign in 1991. The initial disease-oriented programs began to collaborate with community-oriented primary health care systems, thus strengthening public-private partnerships and enabling the common goal of poliomyelitis eradication to prevail despite rampant terrorism, economic instability, and political turmoil. Committed leaders in Peru's Ministry of Health, the Pan American Health Organization, and Rotary International, as well as dedicated health workers who acted with missionary zeal, facilitated acquisition of adequate technologies, coordinated work at the local level, and increased community engagement, despite sometimes being unable to institutionalize public health improvements.

  7. Progress Toward Poliomyelitis Eradication--Afghanistan, January 2014‒August 2015.

    Mbaeyi, Chukwuma; Saatcioglu, Akif; Tangermann, Rudolf H; Hadler, Stephen; Ehrhardt, Derek

    2015-10-23

    Despite recent progress toward global polio eradication, endemic transmission of wild poliovirus (WPV) continues to be reported in Afghanistan and Pakistan. The Afghanistan program must overcome many challenges to remain on track toward achieving the objectives set in the 2013–2018 strategic plan of the Global Polio Eradication Initiative (GPEI). Cross-border transmission of WPV type 1 (WPV1) continues to occur among children traveling to and from Pakistan. The country's routine immunization system remains weak and unable to reach recommended benchmarks in most regions; hence, the national Polio Eradication Initiative (PEI) relies mainly on providing children aged <5 years with oral poliovirus vaccine (OPV), administered during supplementary immunization activities (SIAs). Because of ongoing conflict and insecurity, some children continue to be missed during SIAs in areas not under government control; however, the majority of missed children live in accessible areas and are often unreached because of a failure to plan, implement, and supervise SIAs efficiently. This report describes polio eradication activities and progress in Afghanistan during January 2014‒August 2015 and updates previous reports. During 2014, a total of 28 WPV1 cases were reported in Afghanistan, compared with 14 cases in 2013; nine cases were reported during January‒August 2015, the same number as during the same period in 2014. To eliminate poliovirus transmission in Afghanistan, emergency operations centers (EOCs) need to be established at the national level and in critical regions without delay to improve overall coordination and oversight of polio eradication activities. The recently revised National Emergency Action Plan for polio eradication needs to be fully implemented, including detailed microplanning and enhanced monitoring and supervision of SIAs, as well as improved cross-border coordination with Pakistan.

  8. Following in the footsteps of smallpox: can we achieve the global eradication of measles?

    Morgan Oliver WC

    2004-03-01

    Full Text Available Abstract Background Although an effective measles vaccine has been available for almost 40 years, in 2000 there were about 30 million measles infections worldwide and 777,000 measles-related deaths. The history of smallpox suggests that achieving measles eradication depends on several factors; the biological characteristics of the organism; vaccine technology; surveillance and laboratory identification; effective delivery of vaccination programmes and international commitment to eradication. Discussion Like smallpox, measles virus has several biological characteristics that favour eradication. Humans are the only reservoir for the virus, which causes a visible illness and infection leading to life-long immunity. As the measles virus has only one genetic serotype which is relatively stable over time, the same basic vaccine can be used world-wide. Vaccination provides protection against measles infection for at least 15 years, although efficacy may be reduced due to host factors such as nutritional status. Measles vaccination may also confer other non-specific health benefits leading to reduced mortality. Accurate laboratory identification of measles cases enables enhanced surveillance to support elimination programmes. The "catch-up, keep-up, follow-up" vaccination programme implemented in the Americas has shown that measles elimination is possible using existing technologies. On 17th October 2003 the "Cape Town Measles Declaration" by the World Health Organisation and the United Nations Childrens Fund called on governments to intensify efforts to reduce measles mortality by supporting universal vaccination coverage and the development of more effective vaccination. Summary Although more difficult than for smallpox, recent experience in the Americas suggests that measles eradication is technically feasible. Growing international support to deliver these programmes means that measles, like smallpox, may very well become a curiosity of history.

  9. Polio endgame: the global introduction of inactivated polio vaccine.

    Patel, Manish; Zipursky, Simona; Orenstein, Walt; Garon, Julie; Zaffran, Michel

    2015-05-01

    In 2013, the World Health Assembly endorsed a plan that calls for the ultimate withdrawal of oral polio vaccines (OPV) from all immunization programs globally. The withdrawal would begin in a phased manner with removal of the type 2 component of OPV in 2016 through a global switch from trivalent OPV to bivalent OPV (containing only types 1 and 3). To mitigate risks associated with immunity gaps after OPV type 2 withdrawal, the WHO Strategic Advisory Group of Experts has recommended that all 126 OPV-only using countries introduce at least one dose of inactivated polio vaccine into routine immunization programs by end-2015, before the trivalent OPV-bivalent OPV switch. The introduction of inactivated polio vaccine would reduce risks of reintroduction of type 2 poliovirus by providing some level of seroprotection, facilitating interruption of transmission if outbreaks occur, and accelerating eradication by boosting immunity to types 1 and 3 polioviruses.

  10. Role Of Polio Sena And Awareness Of Pulse Polio Immunization

    Taneja D.K

    1997-01-01

    Full Text Available Research: 1. Can the student volunteers from schools be an important resource in IEC and social mobilisation for pulse polio programme? 2. What is the level of awareness regarding pulse polio among the households? Objectives: 1. To assess awareness among households about PPI. 2. To evaluate role of Polio Sena, besides other sources in IEC for PPI campaign. Study design: Intervention Setting: National Capital Territory of Delhi. Intervention: For the purpose of IEC and social mobilisation, an innovative scheme of involving school children from class 6th to 12th was launched in the Pulse Polio Immunization (PPI campaign of 1995 â€" 96 held in Delhi. This student volunteer force was named ‘Polio Sena’ and the volunteers were assigned specific tasks. Participants: Households with a child under the age of three years. Statistical analysis: Proportions. Results: High level of awareness about PPI campaign was found. Majority were aware about the age group of eligible children, the dates and number of PPI doses to be given. Achievements of ‘Polio Sena’ were significant. 24.9% of house - holds had received information about PPI from school children, which was maximum among interpersonal sources of communication. Television was the commonest medium of information. Conclusion: Polio sena was an important source of IEC and social mobilisation for PPI.

  11. The final stages of the global eradication of poliomyelitis.

    Grassly, Nicholas C

    2013-08-05

    The global incidence of poliomyelitis has dropped by more than 99 per cent since the governments of the world committed to eradication in 1988. One of the three serotypes of wild poliovirus has been eradicated and the remaining two serotypes are limited to just a small number of endemic regions. However, the Global Polio Eradication Initiative (GPEI) has faced a number of challenges in eradicating the last 1 per cent of wild-virus transmission. The polio endgame has also been complicated by the recognition that vaccination with the oral poliovirus vaccine (OPV) must eventually cease because of the risk of outbreaks of vaccine-derived polioviruses. I describe the major challenges to wild poliovirus eradication, focusing on the poor immunogenicity of OPV in lower-income countries, the inherent limitations to the sensitivity and specificity of surveillance, the international spread of poliovirus and resulting outbreaks, and the potential significance of waning intestinal immunity induced by OPV. I then focus on the challenges to eradicating all polioviruses, the problem of vaccine-derived polioviruses and the risk of wild-type or vaccine-derived poliovirus re-emergence after the cessation of oral vaccination. I document the role of research in the GPEI's response to these challenges and ultimately the feasibility of achieving a world without poliomyelitis.

  12. Eradicating and eliminating infectious diseases: Past, Present and Future

    Jai P Narain

    2011-01-01

    Full Text Available During the past 60 years, a number of infectious diseases have been targeted for eradication or elimination, with mixed results. While smallpox is the only one successfully eradicated so far, campaigns on yaws and malaria brought about a dramatic reduction in the incidence in the beginning of the campaign but ultimately could not achieve the desired goal. There is again a renewed interest in disease eradication. The World Health assembly in May 2010 passed a resolution calling for eradication of measles by 2015; the target of polio eradication still remains elusive. In view of these developments, it is appropriate time to revisit the concept of disease eradication and elimination, the achievements and failures of past eradication programmes and reasons thereof, and possibly apply these lessons while planning for the future activities. This paper based on the Dr. A.L.Saha Memorial Oration describes various infectious diseases that have been targeted for eradication or elimination since 1950s, the potential direct and indirect benefits from disease eradication, and the issues and opportunities for the future.

  13. Polio in Pakistan: Social constraints and travel implications.

    Mushtaq, Asim; Mehmood, Sajid; Rehman, Muhammad Ateeq Ur; Younas, Asma; Rehman, Muhammad Saif Ur; Malik, Muhamamd Faheem; Hyder, Muhammad Zeeshan

    2015-01-01

    The Global Polio Eradication Initiative (GPEI) in Pakistan has faced failure despite being implemented successfully. Polio cases were successfully reduced by 99% until 2005. However, thereafter, new polio cases were registered, which continue to rise annually. This repeat polio outbreak has placed the country on watch by the World Health Organization (WHO) due to travelers, and Hajj and Umrah pilgrims. The present report reviews the published literature for determining the social constraints to the polio eradication initiative in Pakistan. Religion, politics, awareness, insecurity, inequity, governance, and social responsibility have been identified as key social factors in the failure of any vaccination campaign. Possible interventions have been proposed, which include effectively using modern mass media and educating vaccinators on the social and cultural background of the target community.

  14. Eradication of poliomyelitis in countries affected by conflict.

    Tangermann, R H; Hull, H F; Jafari, H; Nkowane, B; Everts, H; Aylward, R B

    2000-01-01

    The global initiative to eradicate poliomyelitis is focusing on a small number of countries in Africa (Angola, Democratic Republic of the Congo, Liberia, Sierra Leone, Somalia, Sudan) and Asia (Afghanistan, Tajikistan), where progress has been hindered by armed conflict. In these countries the disintegration of health systems and difficulties of access are major obstacles to the immunization and surveillance strategies necessary for polio eradication. In such circumstances, eradication requires special endeavours, such as the negotiation of ceasefires and truces and the winning of increased direct involvement by communities. Transmission of poliovirus was interrupted during conflicts in Cambodia, Colombia, El Salvador, Peru, the Philippines, and Sri Lanka. Efforts to achieve eradication in areas of conflict have led to extra health benefits: equity in access to immunization, brought about because every child has to be reached; the revitalization and strengthening of routine immunization services through additional externally provided resources; and the establishment of disease surveillance systems. The goal of polio eradication by the end of 2000 remains attainable if supplementary immunization and surveillance can be accelerated in countries affected by conflict.

  15. The role of Sabin inactivated poliovirus vaccine in the final phase of global polio eradication%Sabin株脊髓灰质炎灭活疫苗在全球消灭脊髓灰质炎最后阶段的作用

    董少忠; 朱文兵

    2016-01-01

    Global polio eradication has entered its final phase, but still faces enormous challenges. The Polio Eradication and Endgame Strategic Plan (2013-2018) set the target for making the world polio-free by 2018. Meanwhile, the World Heath Organization Global Action Plan (GAP Ⅲ) recommended that polioviruses be stored under strict conditions after eradication of the wild poliovirus. At least one dose of inactivated poliovirus vaccine (IPV) would be required for each newborn baby in the world to ensure successful completion of the final strategy and GAPⅢ. The Sabin IPV has a high production safety and low production cost, compared with the wild-virus IPV and, therefore, can play an important role in the final stage of global polio eradication.%全球消灭脊髓灰质炎已经进入最终阶段,但依然面临巨大的挑战。《全球消灭脊髓灰质炎最后阶段战略规划(2013—2018)》(尾声战略)设定了至2018年世界无脊髓灰质炎的目标。同时,《世界卫生组织全球行动计划》(GAPⅢ)要求在消灭野生脊髓灰质炎病毒后,需严格封存脊髓灰质炎病毒。为保证尾声战略和GAPⅢ顺利实施,目前,全球每个新生儿需引入至少一剂次脊髓灰质炎灭活疫苗(IPV)。相对于野病毒生产的IPV,Sabin IPV具有生成过程安全性高,生产成本低的特点,可在全球消灭脊髓灰质炎的最后阶段中发挥重要作用。

  16. Current Status and Future Prospects to Achieve Foot-and-Mouth Disease Eradication in South America.

    Clavijo, A; Sanchez-Vazquez, M J; Buzanovsky, L P; Martini, M; Pompei, J C; Cosivi, O

    2017-02-01

    South America has a favourable position with respect to foot-and-mouth disease (FMD) compared with other FMD-affected regions due to the elimination of endemic clinical presentation of the disease. South America has reached the final stage of control and aims to eradicate the disease in the region under the provisions of the Hemispheric Program for the Eradication of FMD 2011-2020 (PHEFA). This programme aims at bringing eradication to completion, thereby eliminating the pool of foot-and-mouth disease genotypes active in South America. This plan includes a regional political agreement that provides strategies and technical guidelines for the eradication of foot-and-mouth disease from South America. It incorporates knowledge and experience regarding the disease's history and its connection with the different production systems, animal movement and trade. The Pan American Foot and Mouth Disease Center has led the control and eradication programmes, providing the framework for designing national and subregional programmes that have led to significant progress in controlling the disease in South America. The current situation is the result of several factors, including the proper implementation of a national control programmes, good veterinary infrastructure in most countries and public-private participation in the process of eradicating the disease. Notwithstanding the favourable health status, there are significant challenges for the goal of eradication. At this stage, South American countries should enhance their surveillance strategies particularly through the use of target or risk-based surveys that contribute to increase the degree of sensitivity in the search for viral circulation in the context of absence of clinical occurrence of FMD.

  17. Polio Endgame, Information Gaps Related to Vaccines and Immunity.

    Ahmad, Mohammad; Bahl, Sunil; Kunwar, Abhishek

    2016-08-07

    Evidence generated through research studies has guided programmatic actions and fine-tuned strategies for the Global Polio Eradication Initiative (GPEI). However, many gaps still persist in the understanding of a risk-free implementation of the polio endgame. Immediate concerns relate to the introduction of inactivated polio vaccine (IPV) and switch from trivalent oral polio vaccine (tOPV) to bivalent oral polio vaccine (bOPV) in routine immunization schedule. A comprehensive understanding of mucosal immunity in populations and best response options against circulating vaccine derived poliovirus (cVDPV) outbreaks in post tOPV-bOPV switch is essential to mitigate the risks of wild and vaccine-derived poliovirus importations and emergence of cVDPVs in polio-free countries. A clearer picture is also needed on few operational issues, interference between polio vaccines and other EPI vaccines and products related to polio endgame. It is also extremely important to develop mechanisms to identify and manage long-term poliovirus excretors who may pose a risk of reintroduction into the population after global eradication of poliovirus.

  18. The Journalists Initiatives on Immunisation Against Polio and Improved Acceptance of the Polio Vaccine in Northern Nigeria 2007–2015

    Warigon, Charity; Mkanda, Pascal; Banda, Richard; Zakari, Furera; Damisa, Eunice; Idowu, Audu; Bawa, Samuel; Gali, Emmanuel; Tegegne, Sisay G.; Hammanyero, Kulchumi; Nsubuga, Peter; Korir, Charles; Vaz, Rui G.

    2016-01-01

    Background. The polio eradication initiative had major setbacks in 2003 and 2007 due to media campaigns in which renowned scholars and Islamic clerics criticized polio vaccines. The World Health Organization (WHO) partnered with journalists in 2007 to form the Journalists Initiatives on Immunisation Against Polio (JAP), to develop communication initiatives aimed at highlighting polio eradication activities and the importance of immunization in northern Nigeria. Methods. We evaluated the impact of JAP activities in Kaduna State by determining the total number of media materials produced and the number of newspaper clips and bulletins published in support of polio eradication. We also determined the number of households in noncompliant communities that became compliant with vaccination during 2015 supplementary immunization activities (SIAs) after JAP interventions and compared caregivers’ sources of information about SIAs in 2007 before and after the JAP was formed. Results. Since creation of the JAP, >500 reports have been published and aired, with most portraying polio vaccine positively. During June 2015 SIAs in high-risk wards of Kaduna STATE, JAP interventions resulted in vaccination of 5122 of 5991 children (85.5%) from noncompliant households. During early 2007, the number of caregivers who had heard about SIA rounds from the media increased from 26% in January, before the JAP was formed, to 33% in March, after the initiation of JAP activities. Conclusions. The formation of the JAP resulted in measurable improvement in the acceptance of polio vaccine in northern Nigeria. PMID:26721745

  19. Estimating the risk of re-emergence after stopping polio vaccination

    Akira eSasaki

    2012-05-01

    Full Text Available Live vaccination against polio has effectively prevented outbreaks in most developed countries for more than 40 years, and there remain only a few countries where outbreaks of poliomyelitis by the wild strain still threaten the community. It is expected that worldwide eradication will be eventually achieved through careful surveillance and a well-managed immunization program. The present paper argues, however, that based on a simple stochastic model the risk of outbreak by a vaccine-derived strain after the cessation of vaccination is quite high, even if many years have passed since the last confirmed case. As vaccinated hosts are natural reservoirs for virulent poliovirus, the source of the risk is the vaccination itself, employed to prevent the outbreaks. The crisis after stopping vaccination will emerge when the following two conditions are met: the susceptible host density exceeds the threshold for epidemics and the vaccinated host density remains large enough to ensure the occurrence of virulent mutants in the population. Our estimates for transmission, recovery, and mutation rates, show that the probability of an outbreak of vaccine-derived virulent viruses easily exceeds 90%. Moreover, if a small fraction of hosts have a longer infectious period, as observed in individuals with innate immunodeficiency, the risk of an outbreak rises significantly. Under such conditions, successful global eradication of polio is restricted to a certain range of parameters even if inactive polio vaccine (IPV is extensively used after the termination of live vaccination.

  20. Living with polio and postpolio syndrome in the United Kingdom.

    Atwal, Anita; Giles, Amy; Spiliotopoulou, Georgia; Plastow, Nicola; Wilson, Lesley

    2013-06-01

    The term Postpolio Syndrome (PPS) is used to describe new and late manifestations of poliomyelitis that occur later in life in polio survivors. Polio had been eradicated in the United Kingdom (UK) and most of Europe, although this is not the case in all countries. Research in this area has tended to focus upon the impact of polio and PPS on health status and functional health rather than its overall effect on people's lives. This study's two main aims were to explore the ways in which polio and PPS in the UK has affected the respondents' lives and to ascertain their views about how the quality of life could be improved. The two questions were as follows: (1) How has the health of people with polio and PPS affected their quality of life? (2) What would people with polio and PPS change to improve their quality of life? Deductive content analysis using existing qualitative data from a cross-sectional survey of 336 returned questionnaires from persons with polio and PPS was carried out. The average age of the participants was 54 years. Our research found that polio survivors valued social occupations and participation in family life. Our research has also shown that healthcare professionals still do not understand polio and PPS and this lack of understanding influences their clients' quality of life. Finances and accessibility of environments also influence participation in chosen occupations. Rehabilitation programmes for people with polio and PPS need to be targeted towards maintaining and improving accessible environments and participation in chosen occupations, and healthcare professionals need to ensure that persons with polio and PPS are referred to persons with specific expertise in this area.

  1. Information about the Late Effects of Polio

    ... not included. Contact info@post-polio.org. Remember POLIO? Polio (poliomyelitis or infantile paralysis) triggers memories of ... Have you heard about the LATE EFFECTS OF POLIO? In the late 1970s, survivors of polio reported ...

  2. Risk management in a polio-free world.

    Bruce Aylward, R; Sutter, Roland W; Cochi, Steve L; Thompson, Kimberly M; Jafari, Hamid; Heymann, David

    2006-12-01

    Inherent in the decision to launch the Global Polio Eradication Initiative in 1988 was the expectation for many people that immunization against poliomyelitis would eventually simply stop, as had been the case with smallpox following its eradication in 1977. However, the strategies for managing the risks associated with a "polio-free" world must be continuously refined to reflect new developments, particularly in our understanding of the live polioviruses in the oral poliovirus vaccine (OPV) and in the international approach to managing potential biohazards. The most important of these developments has been the confirmation in 2000 that vaccine-derived polioviruses (VDPVs) can circulate and cause polio outbreaks, making the use of OPV after interruption of wild poliovirus transmission incompatible with a polio-free world. A comprehensive strategy has been developed to minimize the risks associated with eventual OPV cessation, centered on appropriate long-term biocontainment of poliovirus stocks (whether for vaccine production, diagnosis, or research), the controlled reintroduction of any live poliovirus vaccine (i.e., from an OPV stockpile), and appropriate use of the inactivated poliovirus vaccine (IPV). Although some aspects of this risk management strategy are still debated, there is wide agreement that no strategy would entirely eliminate the potential risks to a polio-free world. The current strategy for risk management in a polio-free world will continue to evolve with better characterization of these risks and the development of more effective approaches both to reduce those risks and to limit their consequences should they occur.

  3. Post-Polio Syndrome

    ... or fatigue, this may overwork already stressed-out motor neurons and increase your risk of post-polio syndrome. Generally, post-polio syndrome is rarely life-threatening, but severe muscle weakness can lead to complications: Falls. Weakness in your leg muscles makes it ...

  4. Reducing resistance to polio immunisation with free health camps and Bluetooth messaging: An update from Kaduna, Northern, Nigeria.

    Birukila, Gerida; Babale, Sufiyan M; Epstein, Helen; Gugong, Victor; Anger, Robert; Corkum, Melissa; Jehoshaphat Nebanat, Albarka; Musoke, Fredrick; Alabi, Olaniran

    2017-01-01

    Since 1997, the Global Polio Eradication Initiative has sponsored regular door-to-door polio immunisation campaigns in northern Nigeria. On 30 July 2015, the country was finally declared poliofree, a hard won success. At various times, polio eradication has been threatened by rumours and community tensions. For example, in 2003, local Imams, traditional leaders and politicians declared a polio campaign boycott, due to the concerns about the safety of the polio vaccine. Although the campaigns resumed in 2004, many parents continued to refuse vaccination because of the persistence of rumours of vaccine contamination, and anger about the poor state of health services for conditions other than polio. To address this, UNICEF and Nigerian Government partners piloted two interventions: (1) mobile 'health camps' to provide ambulatory care for conditions other than polio and (2) an audiovisual clip about vaccine safety and other health issues, shareable on multimedia mobile phones via Bluetooth pairing. The mobile phone survey found that Bluetooth compatible messages could rapidly spread behavioural health messages in low-literacy communities. The health camps roughly doubled polio vaccine uptake in the urban ward where it was piloted. This suggests that polio eradication would have been accelerated by improving primary health care services.

  5. Post-Polio Syndrome

    ... fibers it activates. The polio virus attacks specific neurons in the brain stem and spinal cord. In an effort to ... Understanding Sleep The Life and Death of a Neuron Order Publications Brain for Life Support Resources Patient Organizations Professional Societies ...

  6. Polio field census and vaccination of underserved populations--northern Nigeria, 2012-2013.

    2013-08-23

    In 2012, the World Health Assembly declared completion of polio eradication a public health emergency. However, wild poliovirus (WPV) transmission remains endemic in three countries (Afghanistan, Nigeria, and Pakistan). In Nigeria, the National Stop Transmission of Polio (N-STOP) program, under the umbrella of the Nigerian Field Epidemiology and Laboratory Training Program (FELTP), has been developed to implement innovative strategies that address the remaining polio eradication challenges in Nigeria. One N-STOP initiative focuses on locating and vaccinating children agedpolio vaccination coverage likely contributes to ongoing WPV transmission. During August 2012-April 2013, N-STOP conducted field outreach activities that enumerated 40,212 remote settlements, including 4,613 (11.5%) settlements never visited by vaccination teams during previous polio supplemental immunization activities (SIAs). Enumeration resulted in documentation of 906,201 children agedpolio vaccination, and in detection of 211 unreported cases of acute flaccid paralysis (AFP) with onset of illness in the 6 months before enumeration. Sustaining access to underserved populations in remote settlements in future SIAs will increase overall population immunity and should decrease WPV transmission. By providing a flexible and capable workforce consisting of Nigerian citizens, N-STOP is able to support evaluation and implementation of innovative polio eradication strategies in Nigeria while building local public health capacity with a potential to address other public health problems following the eradication of polio from Nigeria.

  7. Mobile Technology based Polio-Vaccination System (PVS – First Step Towards Polio-Free Pakistan

    Nukhba Afzal

    2017-02-01

    Full Text Available Health information technology revolutionized the world with its great expansion and widespread in the domain of health care system. Most of the developed countries adopted advanced technology in their vaccination systems. Vaccination systems of many developing countries still lack the use of technology eventually causing mismanagement and corruption to occur in vaccination campaigns. Issues like mismanagement and corruption not only affect vaccination campaigns but also cause further diffusion of a disease. Pakistan is also one of such countries where vaccination system is prone to these and many other issues and hence it does not help in disease eradication. For example, polio remains alive in Pakistan because Pakistan’s Polio vaccination system is faced with many problems and the biggest one is security of vaccination teams. Corruption, mismanagement, unawareness among public and life-threat to vaccination teams are the main problems of current polio vaccination system of Pakistan. To overcome these flaws and to make an idyllic system with the new advanced technology, we propose technology oriented secure polio vaccination system. The proposed system is more secure and removes flaws in the current system. We model our proposed system using Colored Petri Nets (CPNs which is a state-of-the-art tool for formal modeling.

  8. RAPID COMMUNICATION-- POLIO VACCINE COVERAGE IN THE ACUTE FLACCID PARALYSIS (AFP) CASES IN ROMANIA.

    Băicuş, Anda

    2015-01-01

    Poliovirus (PV), a member of the Enterovirus genus, is the etiological agent of poliomyelitis. A study carried out between 2013-2014 on 30 serum samples from acute flaccid paralysis (AFP) cases, showed a protective antibody level of 90% against poliovirus Sabin strains type 1 and type 2 and of 88% against type 3. No PV strains were isolated from 2009 to 2015 in Romania. Maintaining a high vaccine coverage level against polio is mandatory until global polio eradication, especially as the risk of polio importation remains elevated in Romania.

  9. Response to a Large Polio Outbreak in a Setting of Conflict - Middle East, 2013-2015.

    Mbaeyi, Chukwuma; Ryan, Michael J; Smith, Philip; Mahamud, Abdirahman; Farag, Noha; Haithami, Salah; Sharaf, Magdi; Jorba, Jaume C; Ehrhardt, Derek

    2017-03-03

    As the world advances toward the eradication of polio, outbreaks of wild poliovirus (WPV) in polio-free regions pose a substantial risk to the timeline for global eradication. Countries and regions experiencing active conflict, chronic insecurity, and large-scale displacement of persons are particularly vulnerable to outbreaks because of the disruption of health care and immunization services (1). A polio outbreak occurred in the Middle East, beginning in Syria in 2013 with subsequent spread to Iraq (2). The outbreak occurred 2 years after the onset of the Syrian civil war, resulted in 38 cases, and was the first time WPV was detected in Syria in approximately a decade (3,4). The national governments of eight countries designated the outbreak a public health emergency and collaborated with partners in the Global Polio Eradication Initiative (GPEI) to develop a multiphase outbreak response plan focused on improving the quality of acute flaccid paralysis (AFP) surveillance* and administering polio vaccines to >27 million children during multiple rounds of supplementary immunization activities (SIAs).(†) Successful implementation of the response plan led to containment and interruption of the outbreak within 6 months of its identification. The concerted approach adopted in response to this outbreak could serve as a model for responding to polio outbreaks in settings of conflict and political instability.

  10. The Politics of Polio.

    Gallagher, Hugh

    1996-01-01

    Profiles the elaborate attempts by the Roosevelt White House to hide his disability from the public. Early in his career, polio resulted in Franklin Roosevelt being paralyzed from the waist down. Although never officially denied, the White House went to extraordinary lengths to keep this knowledge from the public. (MJP)

  11. Attitudes and practices of auxiliary nurse midwives and accredited social health activists in Uttar Pradesh and Bihar regarding polio immunization in India.

    Thacker, Naveen; Choudhury, Panna; Gargano, Lisa M; Weiss, Paul S; Pazol, Karen; Vashishtha, Vipin M; Bahl, Sunil; Jafari, Hamid S; Kumar, Amod; Arora, Manisha; Venczel, Linda; Orenstein, Walter A; Omer, Saad B; Hughes, James M

    2013-08-01

    Although India was removed from the list of polio endemic countries in January 2012, maintaining the focus on polio vaccination is critically important to prevent reintroduction of the virus. In 2009-2010, we conducted a study to assess the attitudes and practices of frontline health workers in India regarding polio immunization in Uttar Pradesh and Bihar. More than 95% of auxiliary nurse midwives (ANMs) and accredited social health activists (ASHAs) agreed that polio supplementary immunization campaigns helped in increasing acceptance of all vaccines. The majority of ANMs (60-70%) and ASHAs (56-71%) believed that polio immunization activities benefitted or greatly benefitted other activities they were carrying out. Less than 5% of ANMs and ASHAs felt they were very likely to face resistance when promoting or administering polio vaccine. This study provides information that may be useful for programs in other countries for polio eradication and in India for measles elimination.

  12. Progress toward poliomyelitis eradication--Afghanistan and Pakistan, January 2010-September 2011.

    2011-11-11

    Indigenous transmission of wild poliovirus (WPV) has never been interrupted in Afghanistan, Pakistan, India, and Nigeria. Among those countries, Afghanistan and Pakistan represent a common epidemiologic reservoir. This report updates previous reports (1,4) and describes polio eradication activities and progress in Afghanistan and Pakistan during January 2010--September 2011, as of October 31, 2011, and planned activities during 2011--2012 to address challenges to polio eradication. In Afghanistan, WPV transmission during 2010--2011 predominantly occurred in the conflict-affected South Region and the adjacent Farah Province of the West Region. During 2010, 25 WPV cases were confirmed in Afghanistan, compared with 38 in 2009; 42 WPV cases were confirmed during January--September 2011, compared with 19 for the same period in 2010. In Pakistan, WPV transmission during 2010--2011occurred both in conflict-affected, inaccessible areas along the common border with Afghanistan and in accessible areas; 144 WPV cases were confirmed in 2010, compared with 89 in 2009, and 120 WPV cases were confirmed during January--September 2011, compared with 93 during the same period in 2010. In Pakistan, the president launched a National Emergency Action Plan for polio eradication in January 2011, emphasizing the key role and responsibility of political and health-care leaders at the district and subdistrict (union council) levels. Enhanced commitment, management, and oversight by provincial and district authorities will be needed to achieve further progress toward interruption of WPV transmission in Pakistan. Continued efforts also will be needed to enhance the safety of vaccination teams within insecure areas of both countries.

  13. Determinants of health disparities: The perennial struggle against polio in Nigeria

    Nosayaba Osazuwa-Peters

    2011-01-01

    Full Text Available Polio remains a global public health issue, and even though it has been eradicated from most countries of the world, countries like Nigeria, the largest black nation on earth, threatens the dream of total eradication of polio from the surface of the earth. Transmission of wild polio virus has never been eliminated in Nigeria, but even worse is the number of countries, both in Sub-Saharan Africa and all over the world that has become re-infected by polio virus strains from Northern Nigeria in recent past. Although a lot has been documented about the Nigerian polio struggle, one aspect that has received little attention on this issue is ethnic and geographic disparities between the Southern and the Northern parts of Nigeria. Understanding these disparities involved in polio virus transmission in Nigeria, as well as the social determinants of health prevalent in Northern Nigeria will help government and other stakeholders and policy makers to synergize their efforts in the fight against this perennial scourge.

  14. Progress Toward Poliomyelitis Eradication - Afghanistan, January 2015‒August 2016.

    Mbaeyi, Chukwuma; Shukla, Hemant; Smith, Philip; Tangermann, Rudolf H; Martinez, Maureen; Jorba, Jaume C; Hadler, Stephen; Ehrhardt, Derek

    2016-11-04

    Only 74 cases of wild poliovirus (WPV) were reported globally in 2015, the lowest number of cases ever reported worldwide (1,2). All of the reported cases were WPV type 1 (WPV1), the only known WPV type still circulating; WPV type 2 has been eradicated, and WPV type 3 has not been detected since November 2012 (1). In 2015 in Afghanistan, WPV detection also declined from 2014, and trends observed in 2016 suggest that circulation of the virus is limited to a few localized areas. Despite the progress, there are concerns about the ability of the country's Polio Eradication Initiative (PEI) to meet the goal of interrupting endemic WPV transmission by the end of 2016 (3). The deteriorating security situation in the Eastern and Northeastern regions of the country considerably limits the ability to reach and vaccinate children in these regions. Furthermore, because of frequent population movements to and from Pakistan, cross-border transmission of WPV1 continues (4). Although the national PEI has taken steps to improve the quality of supplementary immunization activities (SIAs),* significant numbers of children living in accessible areas are still being missed during SIAs, and routine immunization services remain suboptimal in many parts of the country. This report describes polio eradication activities and progress in Afghanistan during January 2015‒August 2016 and updates previous reports (5,6). During 2015, a total of 20 WPV1 cases were reported in Afghanistan, compared with 28 cases in 2014; eight cases were reported during January‒August 2016, compared with nine cases reported during the same period in 2015. To achieve interruption of poliovirus transmission in Afghanistan, it is important that the 2016-2017 National Emergency Action Plan(†) for polio eradication be systematically implemented, including 1) improving the quality of SIAs and routine immunization services, 2) ensuring ongoing dialogue between PEI leaders and local authorities, 3) adopting

  15. Between East and West: polio vaccination across the Iron Curtain in Cold War Hungary.

    Vargha, Dora

    2014-01-01

    In 1950s Hungary, with an economy and infrastructure still devastated from World War II and facing further hardships, thousands of children became permanently disabled and many died in the severe polio epidemic that shook the globe. The relatively new communist regime invested significantly in solving the public health crisis, initially importing a vaccine from the West and later turning to the East for a new solution. Through the history of polio vaccination in Hungary, this article shows how Cold War politics shaped vaccine evaluation and implementation in the 1950s. On the one hand, the threat of polio created a safe place for hitherto unprecedented, open cooperation among governments and scientific communities on the two sides of the Iron Curtain. On the other hand, Cold War rhetoric influenced scientific evaluation of vaccines, choices of disease prevention, and ultimately the eradication of polio.

  16. Polio, terror and the immunological worldview.

    Peckham, Robert

    2016-07-22

    This paper adopts a socio-historical perspective to explore when, how and why the eradication of poliomyelitis has become politicised to the extent that health workers and security personnel are targeted in drive-by shootings. Discussions of the polio crisis in Afghanistan and Pakistan have tended to focus on Taliban suspicions of a US-led public health intervention and the denunciation of 'modernity' by Islamic 'extremists'. In contrast, this paper considers a broader history of indigenous hostility and resistance to colonial immunisation on the subcontinent, suggesting how interconnected public health and political crises today have reactivated the past and created a continuity between events. The paper explores how the biomedical threat posed by polio has become intertwined with military and governmental discourses premised on the 'preemptive strike'. Here, the paper tracks the connections between biological immunity and a postcolonial politics that posits an immunological rationale for politico-military interventions. The paper concludes by reflecting on the consequences for global public health of this entanglement of infectious disease with terror.

  17. Applying the Concept of Peptide Uniqueness to Anti-Polio Vaccination

    Darja Kanduc

    2015-01-01

    Full Text Available Background. Although rare, adverse events may associate with anti-poliovirus vaccination thus possibly hampering global polio eradication worldwide. Objective. To design peptide-based anti-polio vaccines exempt from potential cross-reactivity risks and possibly able to reduce rare potential adverse events such as the postvaccine paralytic poliomyelitis due to the tendency of the poliovirus genome to mutate. Methods. Proteins from poliovirus type 1, strain Mahoney, were analyzed for amino acid sequence identity to the human proteome at the pentapeptide level, searching for sequences that (1 have zero percent of identity to human proteins, (2 are potentially endowed with an immunologic potential, and (3 are highly conserved among poliovirus strains. Results. Sequence analyses produced a set of consensus epitopic peptides potentially able to generate specific anti-polio immune responses exempt from cross-reactivity with the human host. Conclusion. Peptide sequences unique to poliovirus proteins and conserved among polio strains might help formulate a specific and universal anti-polio vaccine able to react with multiple viral strains and exempt from the burden of possible cross-reactions with human proteins. As an additional advantage, using a peptide-based vaccine instead of current anti-polio DNA vaccines would eliminate the rare post-polio poliomyelitis cases and other disabling symptoms that may appear following vaccination.

  18. Eradication and Current Status of Poliomyelitis in Pakistan: Ground Realities

    Shazia Ghafoor

    2016-01-01

    Full Text Available Pakistan is among the last three countries along with Afghanistan and Nigeria, where polio virus is still endemic. More or less, with some fluctuations, numbers of reported cases in the past few years have shown a rising trend. Year 2014 pushed the country into the deep sea of difficulties, as number of cases rose to red alert level of 328. Security situation has adversely affected the whole immunization coverage campaign. In a country where 40 polio vaccinators have been killed since 2012, such a big number of cases is not a surprising outcome. Worse perception of parents about polio vaccine as in Karachi and FATA, the high risk zones, makes 100% coverage a dream. Minor and perhaps delayed payments to polio workers make them frustrated, resulting in decline of trained manpower for vaccination. Strong implementation of policies is required and those found guilty of attack on polio workers need to be punished. Targeted community awareness programme, strong surveillance network, and involvement of influential religious entities can help to root out polio disease from country. Present review is aimed at analyzing all barriers on the road to success in eradication of polio from Pakistan.

  19. Eradication and Current Status of Poliomyelitis in Pakistan: Ground Realities.

    Ghafoor, Shazia; Sheikh, Nadeem

    2016-01-01

    Pakistan is among the last three countries along with Afghanistan and Nigeria, where polio virus is still endemic. More or less, with some fluctuations, numbers of reported cases in the past few years have shown a rising trend. Year 2014 pushed the country into the deep sea of difficulties, as number of cases rose to red alert level of 328. Security situation has adversely affected the whole immunization coverage campaign. In a country where 40 polio vaccinators have been killed since 2012, such a big number of cases is not a surprising outcome. Worse perception of parents about polio vaccine as in Karachi and FATA, the high risk zones, makes 100% coverage a dream. Minor and perhaps delayed payments to polio workers make them frustrated, resulting in decline of trained manpower for vaccination. Strong implementation of policies is required and those found guilty of attack on polio workers need to be punished. Targeted community awareness programme, strong surveillance network, and involvement of influential religious entities can help to root out polio disease from country. Present review is aimed at analyzing all barriers on the road to success in eradication of polio from Pakistan.

  20. Eradication and Current Status of Poliomyelitis in Pakistan: Ground Realities

    Ghafoor, Shazia

    2016-01-01

    Pakistan is among the last three countries along with Afghanistan and Nigeria, where polio virus is still endemic. More or less, with some fluctuations, numbers of reported cases in the past few years have shown a rising trend. Year 2014 pushed the country into the deep sea of difficulties, as number of cases rose to red alert level of 328. Security situation has adversely affected the whole immunization coverage campaign. In a country where 40 polio vaccinators have been killed since 2012, such a big number of cases is not a surprising outcome. Worse perception of parents about polio vaccine as in Karachi and FATA, the high risk zones, makes 100% coverage a dream. Minor and perhaps delayed payments to polio workers make them frustrated, resulting in decline of trained manpower for vaccination. Strong implementation of policies is required and those found guilty of attack on polio workers need to be punished. Targeted community awareness programme, strong surveillance network, and involvement of influential religious entities can help to root out polio disease from country. Present review is aimed at analyzing all barriers on the road to success in eradication of polio from Pakistan. PMID:27517055

  1. Progress Toward Poliomyelitis Eradication--Nigeria, January 2014-July 2015.

    Etsano, Andrew; Gunnala, Rajni; Shuaib, Faisal; Damisa, Eunice; Mkanda, Pascal; Ticha, Johnson M; Banda, Richard; Korir, Charles; Chevez, Ana Elena; Enemaku, Ogu; Corkum, Melissa; Davis, Lora B; Nganda, Gatei-Wa; Burns, Cara C; Wassilak, Steven G F; Vertefeuille, John F

    2015-08-21

    Since the 1988 launch of global poliomyelitis eradication efforts, four of the six World Health Organization (WHO) regions have been certified polio-free. Nigeria is one of only three countries, along with Afghanistan and Pakistan, where transmission of wild poliovirus (WPV) has never been interrupted. During 2003-2013, northern Nigeria served as a reservoir for WPV reintroduction into 26 previously polio-free countries. In 2012, the Nigerian government launched a national polio eradication emergency plan to intensify efforts to interrupt WPV transmission. This report describes polio eradication activities and progress in Nigeria during January 2014-July 2015 and updates previous reports. No WPV cases have been reported to date in 2015, compared with a total of six cases reported during 2014. Onset of paralysis in the latest reported WPV type 1 (WPV1) case was July 24, 2014. Only one case of circulating vaccine-derived poliovirus type 2 (cVDPV2) has been reported to date in 2015, compared with 20 cVDPV2 cases during the same period in 2014. Pending final laboratory testing of 218 remaining specimens of 16,617 specimens collected since January 2015, Nigeria could be removed from the WHO list of polio-endemic countries in September 2015. Major remaining challenges to the national polio eradication program include sustaining political support and program funding in the absence of active WPV transmission, maintaining high levels of population immunity in hard-to-reach areas, and accessing children in security-compromised areas of the northeastern states.

  2. [Poliomyelitis eradication is a visible unsolved problem in the coming years].

    Seĭbil', V B; Malyshkina, L P

    2011-01-01

    The WHO global polio eradication initiative launched in 1988, by eradicating wild polio viruses, was to be completed in 2000. The initiative had not been implemented. Enormous work has resulted in a reduction in the number of poliomyelitis cases worldwide from 350,000 to 1,500-2,000 a year. However, the incidence of poliomyelitis does not and is unlikely to stop by the newly fix date--2013. The reason is that vaccine-derived polio viruses that are pathogenic in nature remain and long circulate in the earth. The circulation in human beings leads to the restoration of their neurovirulence and ability to induce severe paralytic diseases. In 1999 the WHO reported the global eradication of wild polio virus type 2 and therefore there should not be diseases caused by polio virus of this type. Nevertheless, the virus-induced diseases continue to emerge. About 300 cases of diseases induced by vaccine-derived poliovirus type 2 had been notified by July 2009. At present, there is no way to eradicate all polio viruses worldwide so the case in point may be only to stop their transmission or minimize morbidity with on-going vaccination.

  3. Polio eradication. Efficacy of inactivated poliovirus vaccine in India.

    Jafari, Hamid; Deshpande, Jagadish M; Sutter, Roland W; Bahl, Sunil; Verma, Harish; Ahmad, Mohammad; Kunwar, Abhishek; Vishwakarma, Rakesh; Agarwal, Ashutosh; Jain, Shilpi; Estivariz, Concepcion; Sethi, Raman; Molodecky, Natalie A; Grassly, Nicholas C; Pallansch, Mark A; Chatterjee, Arani; Aylward, R Bruce

    2014-08-22

    Inactivated poliovirus vaccine (IPV) is efficacious against paralytic disease, but its effect on mucosal immunity is debated. We assessed the efficacy of IPV in boosting mucosal immunity. Participants received IPV, bivalent 1 and 3 oral poliovirus vaccine (bOPV), or no vaccine. A bOPV challenge was administered 4 weeks later, and excretion was assessed 3, 7, and 14 days later. Nine hundred and fifty-four participants completed the study. Any fecal shedding of poliovirus type 1 was 8.8, 9.1, and 13.5% in the IPV group and 14.4, 24.1, and 52.4% in the control group by 6- to 11-month, 5-year, and 10-year groups, respectively (IPV versus control: Fisher's exact test P poliovirus types 1 and 3 between 38.9 and 74.2% and 52.8 and 75.7%, respectively. Thus, IPV in OPV-vaccinated individuals boosts intestinal mucosal immunity.

  4. Environmental Surveillance of Polio and Non-Polio Enterovi¬ruses in Sistan and Balouchestan Province

    S Hamed Khodaei

    2008-09-01

    Full Text Available "nBackground: Enteroviruses can easily circulate in the population through sewage and they are suitable indicators for environ­mental surveillance. On the other hand, in some countries there are evidences of silent circulation of viruses in sew­age specimens despite no virus isolation from clinical specimens. Therefore, WHO has suggested environmental surveil­lance using surface water and sewage specimens for final confirmation of Poliovirus eradication. In this research, according to wild Poliovirus circulation in Afghanistan and Pakistan and probability of virus entrance to Iran, and also to assure wild Poliovi­rus eradication, the environmental surveillance was performed in Sistan and Balouchestan Province of Iran."nMethods: From March 2004 to February 2005, 86 specimens from 2 sewage disposal systems, 5 hospitals and surface water from several villages were collected by Grab Sample method and tested for Enteroviruses directly and using 2 concentration meth­ods: Pellet and Two-phase. Then Poliovirus and Non-Polio Enteroviruses (NPEV were serotyped by microneutraliza­tion method and Polioviruses were intratypically differentiated using ELISA and Probe Hybridization techniques."nResults: From a total of 86 specimens, Enteroviruses and Non-Polio Enteroviruses were isolated from 49(56.98% and 46(53.49% of specimens respectively. Polioviruses were isolated from 18(20.93% specimens and none of them was wild Poliovi­rus fortunately. 13(17.81%, 39(53.42% and 57(78.08% of enteroviruses were isolated using Direct, Pellet and Two-phase methods, respectively."nConclusions: The results of this research confirm the validity of environmental surveillance and Polio eradication in Sistan and Balouchestan Province. "n 

  5. Eradication of Poliomyelitis in Iran, a Historical Perspective

    SM Zahraei

    2009-03-01

    Full Text Available "nPoliomyelitis is a highly infectious disease caused by a virus. It invades the nervous system, and can cause total paralysis in a matter of hours. After initiation of polio eradication programme in 1988 by WHO, number of polio cases abruptly de­creased. In 1988, polio paralyzed nearly 350000 children annually worldwide while in 2007 just 1360 cases reported. The programme has been started in Iran since 1991 and based on high routine immunization coverage, robust Acute Flaccid Pa­ralysis surveillance system and very qualified supplementary immunization activities which has been established and im­plemented in all the country, number of reported cases decreased from 50 to zero in 2001 and Iran has been polio free since 2001. However due to endemicity of poliomyelitis in Afghanistan and Pakistan (two neighboring countries of Iran and high level of international traveling between these countries, risk of polio importation and re-emergence of wild polio virus is very high.

  6. Polio and Post-Polio Syndrome - Multiple Languages: MedlinePlus

    ... Are Here: Home → Multiple Languages → All Health Topics → Polio and Post-Polio Syndrome URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Polio and Post-Polio Syndrome - Multiple Languages To use ...

  7. Polio vaccine - what you need to know

    ... is taken in its entirety from the CDC Polio Vaccine Information Statement (VIS): www.cdc.gov/vaccines/ ... statements/ipv.html CDC review information for the Polio VIS: Page last reviewed: July 20, 2016 Page ...

  8. From emergence to eradication: the epidemiology of poliomyelitis deconstructed.

    Nathanson, Neal; Kew, Olen M

    2010-12-01

    Poliomyelitis has appeared in epidemic form, become endemic on a global scale, and been reduced to near-elimination, all within the span of documented medical history. Epidemics of the disease appeared in the late 19th century in many European countries and North America, following which polio became a global disease with annual epidemics. During the period of its epidemicity, 1900-1950, the age distribution of poliomyelitis cases increased gradually. Beginning in 1955, the creation of poliovirus vaccines led to a stepwise reduction in poliomyelitis, culminating in the unpredicted elimination of wild polioviruses in the United States by 1972. Global expansion of polio immunization resulted in a reduction of paralytic disease from an estimated annual prevaccine level of at least 600,000 cases to fewer than 1,000 cases in 2000. Indigenous wild type 2 poliovirus was eradicated in 1999, but unbroken localized circulation of poliovirus types 1 and 3 continues in 4 countries in Asia and Africa. Current challenges to the final eradication of paralytic poliomyelitis include the continued transmission of wild polioviruses in endemic reservoirs, reinfection of polio-free areas, outbreaks due to circulating vaccine-derived polioviruses, and persistent excretion of vaccine-derived poliovirus by a few vaccinees with B-cell immunodeficiencies. Beyond the current efforts to eradicate the last remaining wild polioviruses, global eradication efforts must safely navigate through an unprecedented series of endgame challenges to assure the permanent cessation of all human poliovirus infections.

  9. Paralytic poliomyelitis associated with Sabin monovalent and bivalent oral polio vaccines in Hungary.

    Estívariz, Concepción F; Molnár, Zsuzsanna; Venczel, Linda; Kapusinszky, Beatrix; Zingeser, James A; Lipskaya, Galina Y; Kew, Olen M; Berencsi, György; Csohán, Agnes

    2011-08-01

    Historical records of patients with vaccine-associated paralytic poliomyelitis (VAPP) in Hungary during 1961-1981 were reviewed to assess the risk of VAPP after oral polio vaccine (OPV) administration. A confirmed VAPP case was defined as a diagnosis of paralytic poliomyelitis and residual paralysis at 60 days in a patient with an epidemiologic link to the vaccine. Archived poliovirus isolates were retested using polymerase chain reaction and sequencing of the viral protein 1 capsid region. This review confirmed 46 of 47 cases previously reported as VAPP. Three cases originally linked to monovalent OPV (mOPV) 3 and one case linked to mOPV1 presented after administration of bivalent OPV 1 + 3 (bOPV). The adjusted VAPP risk per million doses administered was 0.18 for mOPV1 (2 cases/11.13 million doses), 2.96 for mOPV3 (32 cases/10.81 million doses), and 12.82 for bOPV (5 cases/390,000 doses). Absence of protection from immunization with inactivated poliovirus vaccine or exposure to OPV virus from routine immunization and recent injections could explain the higher relative risk of VAPP in Hungarian children. In polio-endemic areas in which mOPV3 and bOPV are needed to achieve eradication, the higher risk of VAPP would be offset by the high risk of paralysis due to wild poliovirus and higher per-dose efficacy of mOPV3 and bOPV compared with trivalent OPV.

  10. Progress toward poliomyelitis eradication - Nigeria, January 2012-September 2013.

    2013-12-13

    Transmission of wild poliovirus (WPV) has never been interrupted in Afghanistan, Pakistan, and Nigeria, and since 2003, Nigeria has been a reservoir for WPV reintroduction to 25 polio-free countries. In 2012, the Nigerian government activated an emergency operations center and implemented a national emergency action plan to eradicate polio. The 2013 revision of this plan prioritized 1) improving quality of supplemental immunization activities (SIAs), 2) implementing strategies to reach underserved populations, 3) adopting special approaches in security-compromised areas, 4) improving outbreak response, 5) enhancing routine immunization and activities implemented between SIAs, and 6) strengthening surveillance. This report summarizes polio eradication activities in Nigeria during January 2012-September 2013 and updates previous reports. During January-September 2013, 49 polio cases were reported from 26 local government areas (LGAs) in nine states in Nigeria, compared with 101 cases reported from 70 LGAs in 13 states during the same period in 2012. For all of 2012, a total of 122 cases were reported. No WPV type 3 (WPV3) cases have been reported since November 2012. For the first time ever, in 2013, no polio cases of any type have been detected in the northwest of Nigeria; however, transmission continues in Kano and states in the northeast. Despite considerable progress, 24 LGAs in 2012 and seven LGAs in 2013 reported two or more cases; WPV continues to circulate in eight LGAs that had cases in 2012. Efforts to interrupt transmission remain impeded by insecurity, anti-polio-vaccine sentiment, and chronically poor SIA implementation in selected areas. Improvement of SIA quality and effective outbreak response will be needed to interrupt WPV transmission in 2014.

  11. A study of the knowledge and attitude towards pulse polio immunization in semi urban areas of South India

    Joseph N

    2011-02-01

    Full Text Available BackgroundThe government of India launched the pulse polioimmunization (PPI programme in 1995 with the aim oferadicating poliomyelitis by the end of 2000. Despite this,733 children with polio were reported in 2009 alone.Therefore, there is a need to understand the reasonunderlying such high numbers of cases after so many yearsof programme implementation. This study was performedto assess the knowledge of the general population aboutpoliomyelitis and PPI and their attitude and practicetowards PPI.MethodThis cross-sectional study was undertaken in two semiurbanareas of Mangalore city. Only houses in whichchildren under five lived were included in the study. Datawas collected by interviewing any adult member of thehousehold using a pretested questionnaire.ResultsThe literacy rate of study participants was 99%. Only35(10.9% participants knew the correct mode oftransmission of polio. More than one quarter of the studypopulation were under the misconception that polio is acurable disease. The primary source of information aboutPPI in majority of participants was the television (n = 192;60%. Two-hundred and eighty eight (90% participantsknew that the purpose of PPI was to eradicate polio. Only128 (40% participants knew that polio drops can be givento children with mild illnesses and an identical number ofparticipants knew that hot food stuff should not be givenfor at least half an hour following vaccinationadministration. Misconceptions such as PPI causing vaccineoverdose was identified among 7 (2.2% participants, it is asubstitute for routine immunization was believed among 30(9.4% participants and that oral polio vaccine preventsother diseases was seen among 76 (23.7% participants. Theeducational status of the participants was significantlyassociated with their awareness level (χ2 =13.668, DF=6,P=0.033.ConclusionThis study identified a few important misconceptionsassociated with polio and PPI which need to be addressedby large scale awareness

  12. PERAN LABORATORIUM DALAM MENUNJANG ERADIKASI POLIO

    Gendro Wahyuhono

    2012-09-01

    Full Text Available Pada sidang tanggal 28 Mei 1988 telah diadopsi resolusi WHA (World Health Assembly dan menugaskan WHO untuk melaksanakan pemberantasan virus polio dari dunia menjelang tahun 2000. Keberhasilan dari rencana tersebut di atas akan sangat bergantung pada banyak faktor dari Pengembangan Program Imunisasi (PPI yang ada. Hal yang paling penting adalah peningkatan cakupan imunisasi dan peningkatan surveillons. Khusus penyakit polio, kegiatan surveillons sangat bergantung pada pelayanan laboratorium. Ketergantungan ini makin meningkat dengan makin berkurangnya kasus poliomyelitis. Di suatu daerah, di mana kasus polio sudah sangat jarang ditemukan maka setiap kasus lumpuh layuh pada anak balita harus diperiksa laboratorium secara lengkap dan sempurna. Tulisan ini memuat beberapa bahasan tentang virus polio, patogenesis, cara penularan, imunitas, dan pencegahannya dengan imunisasi. Jaringan laboratorium mengenai tingkat eradikasi polio, peran dan fungsi laboratorium. Cara pengumpulan spesimen, cara penyimpanan dan pengirimannya.   Kata kunci: Polio, Laboratorium, Eradikasi

  13. The role of research in viral disease eradication and elimination programs: lessons for malaria eradication.

    Joel G Breman

    Full Text Available By examining the role research has played in eradication or regional elimination initiatives for three viral diseases--smallpox, poliomyelitis, and measles--we derive nine cross-cutting lessons applicable to malaria eradication. In these initiatives, some types of research commenced as the programs began and proceeded in parallel. Basic laboratory, clinical, and field research all contributed notably to progress made in the viral programs. For each program, vaccine was the lynchpin intervention, but as the programs progressed, research was required to improve vaccine formulations, delivery methods, and immunization schedules. Surveillance was fundamental to all three programs, whilst polio eradication also required improved diagnostic methods to identify asymptomatic infections. Molecular characterization of pathogen isolates strengthened surveillance and allowed insights into the geographic source of infections and their spread. Anthropologic, sociologic, and behavioural research were needed to address cultural and religious beliefs to expand community acceptance. The last phases of elimination and eradication became increasingly difficult, as a nil incidence was approached. Any eradication initiative for malaria must incorporate flexible research agendas that can adapt to changing epidemiologic contingencies and allow planning for posteradication scenarios.

  14. Frequency of isolation of polioviruses and non polio enteroviruses from patients with acute flaccid paralysis, enterovirus infection and children from groups at risk

    N. I. Romanenkova

    2012-01-01

    Full Text Available The article describes the frequency of isolation of polioviruses and non polio enteroviruses from different categories of the investigated children. The percentage of detection of polioviruses from the patients with acute flaccid paralysis was lower than that from the children from groups at risk. Among the patients with the enterovirus infection the polioviruses were rarely revealed. The frequency of isolation of non polio enteroviruses from these patients was significantly higher than that from the other categories of investigated persons. The improvement of poliomyelitis surveillance and the reinforcement of virological surveillance of children from groups at risk and those with enterovirus infection will provide the important data for Global Polio Eradication Initiative and the maintenance of polio free status of the Russian Federation.

  15. Upaya Eradikasi Polio Di Indonesia

    Rina R., Oke; Ritarwan, Kiking

    2010-01-01

    Poliomyelitis is an acute infectious disease involve motor neuron of the spinal cord and brain and results in an asymmetric flaccid paralysis of the voluntary muscles. Although poliomyelitis caused by wild virus has been eradicated from the western since 1994, its remains a problem in developing countries.With widespread immunization, poliomyelitis has become preventable, and recurrent major epidemics are no longer encountered. Wisdom background and eradicate poliomyelitis strategy ...

  16. Assessing the effectiveness of house-to-house visits on routine oral polio immunization completion and tracking of defaulters.

    Curry, Dora Ward; Perry, Henry B; Tirmizi, Syed N; Goldstein, Allison L; Lynch, Meg C

    2014-06-01

    Strengthening routine immunization is one of the four prongs of the Global Polio Eradication Initiative. Using data collected through 30-cluster sample household surveys of caretakers of children aged 12-23 months, this paper assessed the effectiveness of house-to-house visits on routine oral polio immunization completion, using simple frequency tables, bivariate and multivariate logistic regression analyses. Logistic regression results demonstrated that children in households where the caregivers reported receiving a household visit by health workers were more likely to be fully immunized for polio through routine immunization than other children, although results were significant only after correcting for confounders. In Ethiopia and India, children of caregivers who remembered a house-to-house visit were significantly and positively associated with routine polio vaccination completion (OR = 2.2 and OR = 2.2 respectively). In Angola, the association was positive, though not significant (OR = 1.3). The evidence suggests that targeting high-risk areas for house-to-house visits played a role in increasing routine polio vaccination.

  17. Polio: another cause for global concern?

    Phillips, Jennan A

    2015-02-01

    Polio was declared an international public health emergency in May 2014. International travel and migration raises the threat for widespread outbreak. Promoting and protecting worker's health requires increased vigilance over international public health concerns.

  18. Political epidemiology: strengthening socio-political analysis for mass immunisation - lessons from the smallpox and polio programmes.

    Taylor, S

    2009-01-01

    Control and reduction of infectious diseases is a key to attaining the Millennium Development Goals. An important element of this work is the successful immunisation, especially in resource-poor countries. Mass immunisation, most intensively in the case of eradication, depends on a combination of reliable demand (e.g. public willingness to comply with the vaccine protocol) and effective supply (e.g. robust, generally state-led, vaccine delivery). This balance of compliance and enforceability is, quintessentially, socio-political in nature - conditioned by popular perceptions of disease and risk, wider conditions of economic development and poverty, technical aspects of vaccine delivery, and the prevailing international norms regarding power relations between states and peoples. In the past 100 years, three out of six disease eradication programmes have failed. The explanations for failure have focused on biotechnical and managerial or financial issues. Less attention is paid to socio-political aspects. Yet socio-political explanations are key. Eradication is neither inherently prone to failure, nor necessarily doomed in the case of polio. However, eradication, and similar mass immunisation initiatives, which fail to address social and political realities of intervention may be. A comparison of the smallpox and polio eradication programmes illustrates the importance of disease-specific socio-political analysis in programme conceptualisation, design, and management.

  19. Post-Polio Directory 2014: Post-Polio Clinics, Health Professionals, Support Groups

    ... 0332 260.517 fax antonio.toniolo@uninsubria.it ITALY–Support Groups Associazione Nazionale Polio e Sindrome Postpolio Louise Read, ... Allen San Rafael FrancineAllen@comcast.net Post-Polio Group/California North ... PT Advanced Spine Physical Therapy Drake Professional Park 343 W Drake Rd Ste ...

  20. [Poliomyelitis--Challenges for the Last Mile of the Eradication Programme].

    Müller, O; Jahn, A; Razum, O

    2016-04-01

    The World Health Organisation initiated the Global Polio Eradication Initiative in the year 1988. With the large-scale application of routine and mass vaccinations in children under the age of 5 years, polio disease has become restricted to only 3 endemic countries (Afghanistan, Pakistan and Nigeria) by today. However, since the beginning of the 21st century, increasing numbers of secondary polio epidemics have been observed which were triggered through migration, political turmoil and weak health systems. In addition, there emerged serious technical (e. g., back-mutations of oral vaccine virus to wild virus) and socio-political (refusal of vaccinations in Muslim populations of Nigeria and Pakistan) problems with the vaccination in the remaining endemic countries. It thus appears questionable if the current eradiation initiative will reach its goal in the foreseeable future.

  1. Post-Polio Health International including International Ventilator Users Network

    ... Place Explore the past, the present and help build a promising future for the world’s polio survivors. ... Polio Health International (PHI) Including International Ventilator Users Network 4207 Lindell Blvd., #110, Saint Louis, MO 63108- ...

  2. Falls in Korean Polio Survivors: Incidence, Consequences, and Risk Factors

    Nam, Kiyeun; Lee, Seungyeol; Yang, Eun Joo; Kim, Keewon; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho; Lim, Jae-Young

    2016-01-01

    Falls and fall-related injuries are important issue among polio survivors. The purpose of this study was to determine the incidence of, and consequences and factors associated with falls among Korean polio survivors. A total of 317 polio survivors participated in this study. All participants completed a questionnaire including fall history, symptoms related to post-polio syndrome and other information through a telephone interview. Among them, 80 participants visited our clinic for additional...

  3. Psychometric Properties of the Fatigue Severity Scale in Polio Survivors

    Burger, Helena; Franchignoni, Franco; Puzic, Natasa; Giordano, Andrea

    2010-01-01

    The objective of this study was to evaluate by means of classical test theory and Rasch analysis the scaling characteristics and psychometric properties of the Fatigue Severity Scale (FSS) in polio survivors. A questionnaire, consisting of five general questions (sex, age, age at time of acute polio, sequelae of polio, and new symptoms), the FSS,…

  4. A national reference for inactivated polio vaccine derived from Sabin strains in Japan.

    Shirato, Haruko; Someya, Yuichi; Ochiai, Masaki; Horiuchi, Yoshinobu; Takahashi, Motohide; Takeda, Naokazu; Wakabayashi, Kengo; Ouchi, Yasumitsu; Ota, Yoshihiro; Tano, Yoshio; Abe, Shinobu; Yamazaki, Shudo; Wakita, Takaji

    2014-09-08

    As one aspect of its campaign to eradicate poliomyelitis, the World Health Organization (WHO) has encouraged development of the inactivated polio vaccine (IPV) derived from the Sabin strains (sIPV) as an option for an affordable polio vaccine, especially in low-income countries. The Japan Poliomyelitis Research Institute (JPRI) inactivated three serotypes of the Sabin strains and made sIPV preparations, including serotypes 1, 2 and 3 D-antigens in the ratio of 3:100:100. The National Institute of Infectious Diseases, Japan, assessed the immunogenic stability of these sIPV preparations in a rat potency test, according to an evaluation method recommended by the WHO. The immunogenicity of the three serotypes was maintained for at least 4 years when properly stored under -70°C. Based on these data, the sIPV preparations made by JPRI have been approved as national reference vaccines by the Japanese national control authority and used for the quality control of the tetracomponent sIPV-containing diphtheria-tetanus-acellular pertussis combination vaccines that were licensed for a routine polio immunization in Japan.

  5. [The eradication of the poliomyelitis in the European Region of the World Health Organization].

    Limia Sánchez, Aurora

    2013-01-01

    Poliomyelitis was considered an important event for the public health since the end of XIX century when this disease became epidemic. As soon as vaccines were available member states of the World Health Organization (WHO) in the European Region started to implement vaccination programmes against polio with an important impact in the incidence in this disease. In May 1988, the World Health Assembly resolution for the global eradication of poliomyelitis was adopted and the mechanisms to oversee the progress in the different WHO Regions were established. This article briefly reviews the history of polio in the WHO European Region, the process for certification and maintenance, the strategies for eradication and the current situation in the European Region and globally. The European Region was certified polio-free in 2002. Nevertheless, there are still three endemic countries in the world, some others use live attenuated vaccines as well as countries in the Horn of Africa are recently suffering the reintroduction of wild poliovirus. Considering these circumstances, the risk of reintroduction of poliovirus and the generation of outbreaks in the European Region exists, therefore high vaccination coverage against polio and good quality surveillance systems are needed to be guaranteed in every member state.

  6. Progress towards the eradication of poliomyelitis globally and in Africa, January 2000.

    Tangermann, R H; Aylward, B R; Hull, H F; Nkowane, B; Everts, H; Olive, J M

    1999-01-01

    Led by an international partnership including Rotary International, the WHO, UNICEF and the Centers for Disease Control and Prevention in the USA, the global initiative to eradicate poliomyelitis has made remarkable progress since its beginning in 1988. The number of polio cases has decreased from an estimated 350,000 cases in 1988 to just over 5,000 reported cases in 1999. Following successful eradication from the WHO Region of the America's, certified as polio-free in 1994, wild poliovirus was last reported from the Western Pacific Region (including China) in 1997, and from the European Region (including all countries of the former Soviet Union) in November 1998. Large parts of Southern and Northern Africa and the Middle East are also polio-free. This success is related to the implementation of annual nationwide supplemental oral poliovaccine (OPV) campaigns in all recently or currently polio-endemic countries, targeting all children under 5 years with two doses of OPV. Progress of the initiative is monitored by special surveillance systems for all cases of acute flaccid paralysis (AFP) in children under 15 years, including virological testing to rule out wild poliovirus infection. The initiative currently focuses on a limited number of remaining endemic countries in South Asia and Africa, including India, Pakistan, Bangladesh, and Nigeria. The initiative is also beginning to be successful in several countries affected by conflict situations, such as Afghanistan, Sudan (South), Somalia, Democratic Republic of the Congo and Angola.

  7. Hormesis and the salk polio vaccine.

    Calabrese, Edward J

    2012-01-01

    The production of the Salk vaccine polio virus by monkey kidney cells was generated using the synthetic tissue culture medium, Mixture 199. In this paper's retrospective assessment of this process, it was discovered that Mixture 199 was modified by the addition of ethanol to optimize animal cell survival based on experimentation that revealed a hormetic-like biphasic response relationship. This hormesis-based optimization procedure was then applied to all uses of Mixture 199 and modifications of it, including its application to the Salk polio vaccine during preliminary testing and in its subsequent major societal treatment programs.

  8. An Introduction to Poliovirus: Pathogenesis, Vaccination, and the Endgame for Global Eradication.

    Minor, Philip D

    2016-01-01

    Poliomyelitis is caused by poliovirus, which is a positive strand non-enveloped virus that occurs in three distinct serotypes (1, 2, and 3). Infection is mainly by the fecal-oral route and can be confined to the gut by antibodies induced either by vaccine, previous infection or maternally acquired. Vaccines include the live attenuated strains developed by Sabin and the inactivated vaccines developed by Salk; the live attenuated vaccine (Oral Polio Vaccine or OPV) has been the main tool in the Global Program of Polio eradication of the World Health Organisation. Wild type 2 virus has not caused a case since 1999 and type 3 since 2012 and eradication seems near. However most infections are entirely silent so that sophisticated environmental surveillance may be needed to ensure that the virus has been eradicated, and the live vaccine can sometimes revert to virulent circulating forms under conditions that are not wholly understood. Cessation of vaccination is therefore an increasingly important issue and inactivated polio vaccine (IPV) is playing a larger part in the end game.

  9. Risks associated with the use of live-attenuated vaccine poliovirus strains and the strategies for control and eradication of paralytic poliomyelitis.

    Pliaka, Vaia; Kyriakopoulou, Zaharoula; Markoulatos, Panayotis

    2012-05-01

    The Global Polio Eradication Initiative was launched in 1988 with the aim to eliminate paralytic poliomyelitis. Two effective vaccines are available: inactivated polio vaccine (IPV) and oral polio vaccine (OPV). Since 1964, OPV has been used instead of IPV in most countries due to several economic and biological advantages. However, in rare cases, the live-attenuated Sabin strains of OPV revert to neurovirulence and cause vaccine-associated paralytic poliomyelitis in vaccinees or lead to emergence of vaccine-derived poliovirus strains. Attenuating mutations and recombination events have been associated with the reversion of vaccine strains to neurovirulence. The substitution of OPV with an improved new-generation IPV and the availability of new specific drugs against polioviruses are considered as future strategies for outbreak control and the eradication of paralytic poliomyelitis worldwide.

  10. Survey of young patients with polio and a foreign background at a Swedish post-polio outpatient clinic.

    Werhagen, Lars; Borg, Kristian

    2016-10-01

    Nowadays, polio survivors aged under 60 years are non-native Swedes which pose new aspects and challenges to a post-polio outpatient clinic. To analyze the medical data, walking aids, occupational, and family situation in non-native polio survivors aged less than 60 years at a Swedish post-polio outpatient clinic. Retrospective data analysis. Data were retrieved from medical records at the post-polio outpatient clinic. Actual age, age at acute polio infection, walking capacity, pain, concomitant diseases, working and family situation, and ethnical origin were analyzed. Data are presented in numbers and percentage. 153 patients were included. Mean age was 45 (17-60) years, and mean age at acute polio infection was 2 (0-12) years. Paresis of the lower extremities was the most common disability. 10 % were wheelchair dependent. Pain occurred in 70 % with a mean intensity of 55 measured with the visual analog scale. Hypertension was the most common concomitant disease. Half of the polio survivors were working at least part time, and roughly half were singles. Data were comparable with data earlier published in Swedish native polio survivors. Non-native polio survivors aged under 60 years showed similarities in age at acute polio infection, paresis, prevalence, and intensity of pain when compared with native Swedish polio survivors. They were, however, younger, and were less often working and married/cohabitants than native Swedish polio survivors. The results of this study underline the importance of social and vocational rehabilitation tailoring rehabilitation suitable for polio survivors with a foreign background.

  11. Crippling Violence: Conflict and Incident Polio in Afghanistan.

    Alison Norris

    Full Text Available Designing effective public health campaigns in areas of armed conflict requires a nuanced understanding of how violence impacts the epidemiology of the disease in question.We examine the geographical relationship between violence (represented by the location of detonated Improvised Explosive Devices and polio incidence by generating maps of IEDs and polio incidence during 2010, and by comparing the mean number of IED detonations in polio high-risk districts with non polio high-risk districts during 2004-2009.We demonstrate a geographic relationship between IED violence and incident polio. Districts that have high-risk for polio have highly statistically significantly greater mean numbers of IEDs than non polio high-risk districts (p-values 0.0010-0.0404.The geographic relationship between armed conflict and polio incidence provides valuable insights as to how to plan a vaccination campaign in violent contexts, and allows us to anticipate incident polio in the regions of armed conflict. Such information permits vaccination planners to engage interested armed combatants to co-develop strategies to mitigate the effects of violence on polio.

  12. Willapa - Spartina Eradication 2013

    US Fish and Wildlife Service, Department of the Interior — Willapa NWR and its partners continue the ongoing and successful program aimed at eradication of the nonnative cordgrass, Spartina alterniflora (Spartina) in Willapa...

  13. 江苏省消灭脊髓灰质炎工作的回顾及策略%Review of the Works for Poliomyelitis Eradication and Its Strategies in Jiangsu Province

    刁连东

    2001-01-01

    routine polio vaccination, still we carried out supplementary vaccination to establish an effective immune barrier among the population; (2) To strengthen the AFP surveillance. The AFP surveillance system had been established in 1991 in Jiangsu Province, the various surveillance indexes now has reached every requirements for proving no polio virus exists. In the course of surveillance, we pursued a case-reporting encouragement system and an active AFP searching at regular intervals to strengthen AFP case reporting and surveillance. Since 1993, there was no wild-type polio virus found. To summarize and evaluate the strategies for poliomyelitis eradication not only can consolidate the achievements of the work but also can provide reference in controlling other viral diseases.

  14. Oral Polio Vaccination and Hospital Admissions With Non-Polio Infections in Denmark

    Sørup, Signe; Stensballe, Lone G; Krause, Tyra Grove;

    2015-01-01

    Background.  Live vaccines may have nonspecific beneficial effects on morbidity and mortality. This study examines whether children who had the live-attenuated oral polio vaccine (OPV) as the most recent vaccine had a different rate of admissions for infectious diseases than children with inactiv......Background.  Live vaccines may have nonspecific beneficial effects on morbidity and mortality. This study examines whether children who had the live-attenuated oral polio vaccine (OPV) as the most recent vaccine had a different rate of admissions for infectious diseases than children...... with inactivated diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b vaccine (DTaP-IPV-Hib) or live measles-mumps-rubella vaccine (MMR) as their most recent vaccine. Methods.  A nationwide, register-based, retrospective cohort study of 137 403 Danish children born 1997-1999, who had received 3 doses...... of DTaP-IPV-Hib, were observed from 24 months (first OPV dose) to 36 months of age. Results.  Oral polio vaccine was associated with a lower rate of admissions with any type of non-polio infection compared with DTaP-IPV-Hib as most recent vaccine (adjusted incidence rate ratio [IRR], 0.85; 95% confidence...

  15. A Study Of Polio Disease In Pakistan Using Gis Approach

    Usman Ahmad

    2015-06-01

    Full Text Available Abstract Pakistan is one of the countries in the world who is affected with polio virus. The main objective of this present study was applying spatial statistics to examine the spatiotemporal patterns and areas of hotspot detection for describing the pattern of polio disease in Pakistan. In this study statistical data smoothing process was used to decrease noise in polio records which is registered at a district level from 2011 to 2014. Morans I Spatial analysis method was applied to measure spatial association in polio disease distribution in study area and examined how districts were spread or clustered. Getis-Ord Gi d statistics was utilized for the identification of cold spot and hotspot within study area and IDW technique applied for Interpolation. This predicts the trend of polio disease distribution around the study area. The incidence rate of polio disease through mapping depicted uneven distribution of poliovirus in affected districts of Pakistan. Spatial statistics are used to perform Morans I test and it measured considerable positive spatial autocorrelation of polio disease incidences for previous four successive years. The results depicted spatially clustered and spatial pattern of polio disease in study area. The research concluded that the polio cases were increased in northwestern side of KPK province and southern part of the Sindh province of Pakistan over the past two years 20132014.

  16. Survey of post polio syndrome in Tehran

    Talebian S; Olyaei GR; Moosavi Ghomi S

    2009-01-01

    "nBackground: The long-term effects of poliomyelitis are known in many of countries. In despite of one accrue title for these signs and symptoms; there are similarity aspects in patients' problems. In the signs of explained, absence of strength and endurance, musculoskeletal difficulties, respiratory dysfunction, sleep disorders are more generalized. Prevalence of post polio syndrome (PPS) is aim of this study. "nMethods: 150 subjects with history of poliomyelitis (80 male and ...

  17. Survey of post polio syndrome in Tehran

    Talebian S

    2009-04-01

    Full Text Available "nBackground: The long-term effects of poliomyelitis are known in many of countries. In despite of one accrue title for these signs and symptoms; there are similarity aspects in patients' problems. In the signs of explained, absence of strength and endurance, musculoskeletal difficulties, respiratory dysfunction, sleep disorders are more generalized. Prevalence of post polio syndrome (PPS is aim of this study. "nMethods: 150 subjects with history of poliomyelitis (80 male and 70 female in Tehran city contributes in this study and complete question forms. "nResults: Muscle pain was reported in 88% of subjects. Thigh muscle weakness was at 42/28%, also muscle spasm indicated at 66%. Recurrent falling of subjects appeared in 74/7%. Early fatigue reported 86%. Above five signs selected for PPS. In this study 85 subjects had four signs of above criteria or 56.66% of subjects had PPS. "nConclusion:  Depended of evaluation and observation there is post polio syndrome in Tehran. Recommended for physical therapy of post polio syndrome attend to stages of progression of this syndrome. In aim to this procedure, physical treatment of these patients must limit to muscle fatigue and also severe physical and exercise activities must be reduce, also some mild aerobic activities without fatigue can be useful.

  18. A Polio Immunization Pamphlet with Increased Appeal and Simplified Language Does Not Improve Comprehension to an Acceptable Level.

    Davis, Terry C.; Fredrickson, Doren D.; Arnold, Connie; Murphy, Peggy W.; Herbst, Melissa; Bocchini, Joseph A.

    1998-01-01

    Two polio-vaccine pamphlets written on a sixth-grade level were compared for readability, comprehension, and preference among a broad range of parents. The easy-to-read version was widely preferred, and comprehension was significantly higher. However, the use of instructional graphics was required to achieve an acceptable level of comprehension.…

  19. Polio endgame: the global switch from tOPV to bOPV.

    Garon, Julie; Seib, Katherine; Orenstein, Walter A; Ramirez Gonzalez, Alejandro; Chang Blanc, Diana; Zaffran, Michel; Patel, Manish

    2016-06-01

    Globally, polio cases have reached an all-time low, and type 2 poliovirus (one of three) is eradicated. Oral polio vaccine (OPV) has been the primary tool, however, in rare cases, OPV induces paralysis. In 2013, the World Health Assembly endorsed the phased withdrawal of OPV and introduction of inactivated poliovirus vaccine (IPV) into childhood routine immunization schedules. Type 2 OPV will be withdrawn through a globally synchronized "switch" from trivalent OPV (all three types) to bivalent OPV (types 1 and 3). The switch will happen in 155 OPV-using countries between April 17(th) and May 1(st), 2016. Planned activities to reduce type 2 outbreak risks post-switch include the following: tOPV campaigns to increase type 2 immunity prior to the switch, monovalent OPV2 stockpiling to respond to outbreaks should they occur, containment of both wild and vaccine type 2 viruses, enhanced acute flaccid paralysis (AFP) and environmental surveillance, outbreak response protocols, and ensured access to IPV and bivalent OPV.

  20. Oral Polio Vaccination and Hospital Admissions With Non-Polio Infections in Denmark

    Sørup, Signe; Stensballe, Lone G; Krause, Tyra G;

    2016-01-01

    with inactivated diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b vaccine (DTaP-IPV-Hib) or live measles-mumps-rubella vaccine (MMR) as their most recent vaccine. Methods.  A nationwide, register-based, retrospective cohort study of 137 403 Danish children born 1997-1999, who had received 3 doses...

  1. Detection of polioviruses and non-polio enteroviruses by acute flaccid paralysis and environmental surveillances in Sistan and Balouchestan Province

    Saeideh alsadat Razavi

    2006-09-01

    Full Text Available Background: In some countries, though wild poliovirus isolation from clinical specimens has not been done, evidences of silent circulation of wild virus in sewage system have been reported. On the other hand, based on WHO recommendations, if there is any probability of wild virus entrance from endemic countries, environmental surveillance is advised as a completion to Acute Flaccid Paralysis (AFP surveillance. Methods: AFP and environmental surveillance were performed simultaneously in Sistan and Balouchestan province to confirm wild poliovirus eradication. To perform AFP surveillance, 21 stool specimens of AFP suspected cases were collected in a one year period and evaluated using L20B, RD and Hep-2 cell lines. To perform environmental surveillance, 86 samples from urban and hospital sewage disposal systems were collected. Using direct, Pellet and Two-phase methods for virus concentration, Enterovirus existence was investigated in above-mentioned cell lines. Results: Non-polio enteroviruses and polioviruses were isolated from 53.49% and 20.93% of sewage specimens, respectively. Sabin-Like polioviruses were isolated from 9.52% of AFP cases, and non-polio enteroviruses from 14.28% of them. Poliovirus type 2 was not isolated form stool specimens and there was no Poliovirus type 1 isolation from sewage specimens, either. Conclusion: The environmental surveillance as a completion to AFP in Sistan and Balouchestan Province in Iran confirms poliovirus eradication.

  2. HIV/AIDS eradication

    Marsden, Matthew D.; Zack, Jerome A.

    2013-01-01

    Antiretroviral therapy can inhibit HIV replication in patients and prevent progression to AIDS. However, it is not curative. Here we provide an overview of what antiretroviral drugs do and how the virus persists during therapy in rare reservoirs, such as latently infected CD4+ T cells. We also outline several innovative methods that are currently under development to eradicate HIV from infected individuals. These strategies include gene therapy approaches intended to create an HIV-resistant i...

  3. Pylera for the eradication of Helicobacter pylori infection.

    Saleem, Aamir

    2012-02-01

    An ideal antibiotic regimen for Helicobacter pylori should achieve eradication rates of approximately 90%. Current 7-day triple therapy is successful in about two-thirds of patients. A novel treatment is required to achieve higher eradication with minimal induction of bacterial resistance. The aim of this article is to evaluate the safety and efficacy of a single triple capsule (Pylera) containing bismuth, metronidazole and tetracycline, given with omeprazole for the eradication of H. pylori infection. Extensive literature searches were conducted using PubMed data from 1982 to 2007. This search included headings of H. pylori, bismuth and eradication therapy. The triple capsule Pylera, when given with omeprazole, achieved eradication rates ranging between 84 and 97%. Eradication rates were similar for clarithromycin- and metronidazole-resistant strains. Eradication rates with an omeprazole, bismuth, metronidazole and tetracycline regimen appeared comparable for metronidazole-resistant and -sensitive strains. This effect is not seen with the use of triple therapy in cases of clarithromycin resistance. Clinical trials did not report any serious side effects from bismuth-based regimens and compliance was similar to standard triple therapy. Bismuth-based triple therapy using Pylera is a simplified, effective and well-tolerated regimen achieving cure rates of above 90%.

  4. Polio and the Vaccine (Shot) to Prevent It

    ... Immunizations Polio and the Vaccine (Shot) to Prevent It Language: English Español (Spanish) Format: Select one PDF [ ... paralysis or weakness can last a lifetime. Is it serious? The risk of lifelong paralysis is very ...

  5. Post-polio syndrome and rehabilitation.

    Tiffreau, V; Rapin, A; Serafi, R; Percebois-Macadré, L; Supper, C; Jolly, D; Boyer, F-C

    2010-02-01

    Post-polio syndrome (PPS) is the commonly affected term to describe the symptoms that may develop many years after acute paralytic poliomyelitis. The etiology of PPS is still unclear. An overuse of enlarged motor units is suspected causing denervation again due to distal degeneration of axons. Metabolic and functional changes has been described in muscle fibers of partially denervated muscles. Nevertheless, submaximal aerobic training and low intensity muscular strengthening have shown positive effects on muscular strength and cardiorespiratory system in patients affected by PPS. Aquatic therapy has a positive impact on pain and muscle function. In patients with severe fatigue, it is recommended to adapt the daily exercise routine to their specific case.

  6. Is EU/EEA population protected from polio?

    Nijsten, Dre; Carrillo-Santisteve, P; Miglietta, A; Ruitenberg, J; Lopalco, P L

    2015-01-01

    The WHO European Region has been declared polio-free since 2002. By 2010, inactivated polio vaccine (IPV) was the only polio vaccine in use in the EU/EEA for the primary vaccination of children. A systematic review of the literature on polio seroprevalence studies, complemented by the analysis of available vaccine coverage data, has been carried out with the aim of assessing the level of protection against polio in the European population. A total of 52 studies, with data from 14 out of the 31 EU/EEA countries, were included in the analysis. This systematic review shows that, overall, seroprevalence for PV1 and PV3 is high in most countries, although seroimmunity gaps have been detected in several birth cohorts. In particular, relatively low immunity status was found in some countries for individuals born in the 60's and 70's. Discrepancies between reported vaccination coverage and immunity levels have been also highlighted. Countries should make sure that their population is being vaccinated for polio to reduce the risk of local poliovirus transmission in case of importation. Moreover, assessing immunity status should be priority for those traveling to areas where wild polioviruses are still circulating.

  7. The novel adjuvant dmLT promotes dose sparing, mucosal immunity and longevity of antibody responses to the inactivated polio vaccine in a murine model.

    Norton, Elizabeth B; Bauer, David L; Weldon, William C; Oberste, M Steven; Lawson, Louise B; Clements, John D

    2015-04-15

    One option for achieving global polio eradication is to replace the oral poliovirus vaccine (OPV), which has the risk of reversion to wild-type virulence, with the inactivated poliovirus vaccine (IPV) vaccine. Adjuvants and alternate routes of immunization are promising options that may reduce antigen dose in IPV vaccinations, potentially allowing dose sparing and cost savings. Use of adjuvants and alternate routes of immunization could also help promote mucosal immunity, potentially mimicking the protection against intestinal virus shedding seen with OPV. In the current study, we examined the impact of combining the novel adjuvant dmLT with trivalent IPV for dose sparing, induction of mucosal immunity and increasing longevity of anti-poliovirus (PV) responses in a mouse model following either intradermal (ID) or intramuscular (IM) delivery. We found that non-adjuvanted ID delivery was not superior to IM delivery for fractional dose sparing, but was associated with development of mucosal immunity. Vaccination with IPV+dmLT promoted serum anti-PV neutralizing antibodies with fractional IPV doses by either IM or ID delivery, achieving at least five-fold dose sparing above non-adjuvanted fractional doses. These responses were most noticeable with the PV1 component of the trivalent vaccine. dmLT also promoted germinal center formation and longevity of serum anti-PV neutralizing titers. Lastly, dmLT enhanced mucosal immunity, as defined by fecal and intestinal anti-PV IgA secretion, when included in IPV immunization by ID or IM delivery. These studies demonstrate that dmLT is an effective adjuvant for either IM or ID delivery of IPV. Inclusion of dmLT in IPV immunizations allows antigen dose sparing and enhances mucosal immunity and longevity of anti-PV responses.

  8. Peste des petits ruminants: a suitable candidate for eradication?

    Baron, M D; Parida, S; Oura, C A L

    2011-07-02

    This year will see the final announcement, accompanied by much justifiable celebration, of the eradication from the wild of rinderpest, the 'cattle plague' that has been with us for so many centuries. The only known rinderpest virus (RPV) remaining is in a relatively small number of laboratories around the world, and in the stockpiles of vaccine held on a precautionary basis. As we mark this achievement, only the second virus ever eradicated through human intervention, it seems a good time to look at rinderpest's less famous cousin, peste des petits ruminants ('the plague of small ruminants') and assess if it should, and could, also be targeted for global eradication.

  9. Polio inactivated vaccine costs into routine childhood immunization in Brazil.

    Sartori, Ana Marli Christovam; Vicentine, Margarete Paganotti; Gryninger, Lígia Castelloni Figueiredo; Soárez, Patricia Coelho de; Novaes, Hillegonda Maria Dutilh

    2015-01-01

    OBJECTIVE To analyze the costs of vaccination regimens for introducing inactivated polio vaccine in routine immunization in Brazil. METHODS A cost analysis was conducted for vaccines in five vaccination regimens, including inactivated polio vaccine, compared with the oral polio vaccine-only regimen. The costs of the vaccines were estimated for routine use and for the "National Immunization Days", during when the oral polio vaccine is administered to children aged less than five years, independent of their vaccine status, and the strategic stock of inactivated polio vaccine. The presented estimated costs are of 2011. RESULTS The annual costs of the oral vaccine-only program (routine and two National Immunization Days) were estimated at US$19,873,170. The incremental costs of inclusion of the inactivated vaccine depended on the number of vaccine doses, presentation of the vaccine (bottles with single dose or ten doses), and number of "National Immunization Days" carried out. The cost of the regimen adopted with two doses of inactivated vaccine followed by three doses of oral vaccine and one "National Immunization Day" was estimated at US$29,653,539. The concomitant replacement of the DTPw/Hib and HepB vaccines with the pentavalent vaccine enabled the introduction of the inactivated polio without increasing the number of injections or number of visits needed to complete the vaccination. CONCLUSIONS The introduction of the inactivated vaccine increased the annual costs of the polio vaccines by 49.2% compared with the oral vaccine-only regimen. This increase represented 1.13% of the expenditure of the National Immunization Program on the purchase of vaccines in 2011.

  10. Quinolone-containing therapies in the eradication of Helicobacter pylori.

    Chuah, Seng-Kee; Tai, Wei-Chen; Lee, Chen-Hsiang; Liang, Chih-Ming; Hu, Tsung-Hui

    2014-01-01

    Fluoroquinolones, especially levofloxacin, are used in the eradication of Helicobacter pylori worldwide. Many consensus guidelines recommend that the second-line rescue therapy for H. pylori eradication consists of a proton pump inhibitor, a quinolone, and amoxicillin as an option. Unfortunately, quinolone is well associated with a risk of developing bacterial resistance. In this paper, we review quinolone-containing H. pylori eradication regimens and the challenges that influence the efficacy of eradication. It is generally suggested that the use of levofloxacin should be confined to "rescue" therapy only, in order to avoid a further rapid increase in the resistance of H. pylori to quinolone. The impact of quinolone-containing H. pylori eradication regimens on public health issues such as tuberculosis treatment must always be taken into account. Exposure to quinolone is relevant to delays in diagnosing tuberculosis and the development of drug resistance. Extending the duration of treatment to 14 days improves eradication rates by >90%. Tailored therapy to detect fluoroquinolone-resistant strains can be done by culture-based and molecular methods to provide better eradication rates. Molecular methods are achieved by using a real-time polymerase chain reaction to detect the presence of a gyrA mutation, which is predictive of treatment failure with quinolones-containing triple therapy.

  11. Progress Toward Poliomyelitis Eradication - Pakistan, January 2015-September 2016.

    Hsu, Christopher H; Mahamud, Abdirahman; Safdar, Rana Muhammad; Ahmed, Jamal; Jorba, Jaume; Sharif, Salmaan; Farag, Noha; Martinez, Maureen; Tangermann, Rudolph H; Ehrhardt, Derek

    2016-11-25

    Pakistan, Afghanistan, and Nigeria remain the only countries where endemic wild poliovirus type 1 (WPV1) transmission continues. This report describes the activities, challenges, and progress toward polio eradication in Pakistan during January 2015-September 2016 and updates previous reports (1,2). In 2015, a total of 54 WPV1 cases were reported in Pakistan, an 82% decrease from 2014. In 2016, 15 WPV1 cases had been reported as of November 1, representing a 61% decrease compared with the 38 cases reported during the same period in 2015 (Figure 1). Among the 15 WPV1 cases reported in 2016, children aged <36 months accounted for 13 cases; four of those children had received only a single dose of oral poliovirus vaccine (OPV). Seven of the 15 WPV1 cases occurred in the province of Khyber Pakhtunkhwa (KP), five in Sindh, two in the Federally Administered Tribal Areas (FATA), and one in Balochistan (3). During January-September 2016, WPV1 was detected in 9% (36 of 384) of environmental samples collected, compared with 19% (69 of 354) of samples collected during the same period in 2015. Rigorous implementation of the 2015-2016 National Emergency Action Plan (NEAP) (4), coordinated by the National Emergency Operations Center (EOC), has resulted in a substantial decrease in overall WPV1 circulation compared with the previous year. However, detection of WPV1 cases in high-risk areas and the detection of WPV1 in environmental samples from geographic areas where no polio cases are identified highlight the need to continue to improve the quality of supplemental immunization activities (SIAs),* immunization campaigns focused on vaccinating children with OPV outside of routine immunization services, and surveillance for acute flaccid paralysis (AFP). Continuation and refinement of successful program strategies, as outlined in the new 2016-2017 NEAP (5), with particular focus on identifying children missed by vaccination, community-based vaccination, and rapid response to virus

  12. Mathematical Modeling of Programmatic Requirements for Yaws Eradication

    Mitjà, Oriol; Fitzpatrick, Christopher; Asiedu, Kingsley; Solomon, Anthony W.; Mabey, David C.W.; Funk, Sebastian

    2017-01-01

    Yaws is targeted for eradication by 2020. The mainstay of the eradication strategy is mass treatment followed by case finding. Modeling has been used to inform programmatic requirements for other neglected tropical diseases and could provide insights into yaws eradication. We developed a model of yaws transmission varying the coverage and number of rounds of treatment. The estimated number of cases arising from an index case (basic reproduction number [R0]) ranged from 1.08 to 3.32. To have 80% probability of achieving eradication, 8 rounds of treatment with 80% coverage were required at low estimates of R0 (1.45). This requirement increased to 95% at high estimates of R0 (2.47). Extending the treatment interval to 12 months increased requirements at all estimates of R0. At high estimates of R0 with 12 monthly rounds of treatment, no combination of variables achieved eradication. Models should be used to guide the scale-up of yaws eradication. PMID:27983500

  13. Non-polio enteroviruses associated with acute flaccid paralysis (AFP) and facial paralysis (FP) cases in Romania, 2001-2008.

    Persu, Ana; Băicuş, Anda; Stavri, Simona; Combiescu, Mariana

    2009-01-01

    Acute flaccid paralysis is a complex clinical syndrome, with a wide variety of possible etiologies and with clinical manifestations that can vary according to age or geographical region. Enteroviruses (polioviruses and non-polio enteroviruses) are among the viral agents that can cause AFP. AFP surveillance is important for public health through its use in monitoring poliomyelitis, in the context of the Global Initiative to eradicate this disease. The current paper aims to assess the non-polio enteroviruses (NPEV) association with AFP and FP cases registered in Romania in the period 2001-2008 and to identify prevalent serotypes. Within the framework of Surveillance of AFP Cases Program, were collected samples from 579 children with AFP or FP (3.069 samples). The samples were processed and inoculated onto two types of cell culture (RD and L20B), according to WHO protocol. The identification of isolated viruses has been done by the reaction of seroneutralization with pools of specific antiserum and then with monospecific antiserum for confirmation. NPEV were isolated from 58 cases (123 positive samples). During the analyzed period, 23 NPEV serotypes have circulated (15 Echo serotypes and 8 coxsackie serotypes). The most frequently identified were the Echoviruses 13 and 11 and the coxsackie A viruses. 88% of positive cases have occurred in children between 1 and 5 years. As seasonal distribution, the peak of NPEV circulation was in the months August-September (36.2%). The paper provides information about NPEV circulation in Romania in the past 8 years, about its association with the AFP and FP and it indicates the need for monitoring NPEV circulation even after the eradication of poliomyelitis.

  14. A research agenda for malaria eradication: vaccines.

    2011-01-25

    Vaccines could be a crucial component of efforts to eradicate malaria. Current attempts to develop malaria vaccines are primarily focused on Plasmodium falciparum and are directed towards reducing morbidity and mortality. Continued support for these efforts is essential, but if malaria vaccines are to be used as part of a repertoire of tools for elimination or eradication of malaria, they will need to have an impact on malaria transmission. We introduce the concept of "vaccines that interrupt malaria transmission" (VIMT), which includes not only "classical" transmission-blocking vaccines that target the sexual and mosquito stages but also pre-erythrocytic and asexual stage vaccines that have an effect on transmission. VIMT may also include vaccines that target the vector to disrupt parasite development in the mosquito. Importantly, if eradication is to be achieved, malaria vaccine development efforts will need to target other malaria parasite species, especially Plasmodium vivax, where novel therapeutic vaccines against hypnozoites or preventive vaccines with effect against multiple stages could have enormous impact. A target product profile (TPP) for VIMT is proposed and a research agenda to address current knowledge gaps and develop tools necessary for design and development of VIMT is presented.

  15. Inactivated polio vaccine development for technology transfer using attenuated Sabin poliovirus strains to shift from Salk-IPV to Sabin-IPV.

    Bakker, Wilfried A M; Thomassen, Yvonne E; van't Oever, Aart G; Westdijk, Janny; van Oijen, Monique G C T; Sundermann, Lars C; van't Veld, Peter; Sleeman, Eelco; van Nimwegen, Fred W; Hamidi, Ahd; Kersten, Gideon F A; van den Heuvel, Nico; Hendriks, Jan T; van der Pol, Leo A

    2011-09-22

    Industrial-scale inactivated polio vaccine (IPV) production dates back to the 1960s when at the Rijks Instituut voor de Volksgezondheid (RIV) in Bilthoven a process was developed based on micro-carrier technology and primary monkey kidney cells. This technology was freely shared with several pharmaceutical companies and institutes worldwide. In this contribution, the history of one of the first cell-culture based large-scale biological production processes is summarized. Also, recent developments and the anticipated upcoming shift from regular IPV to Sabin-IPV are presented. Responding to a call by the World Health Organization (WHO) for new polio vaccines, the development of Sabin-IPV was continued, after demonstrating proof of principle in the 1990s, at the Netherlands Vaccine Institute (NVI). Development of Sabin-IPV plays an important role in the WHO polio eradication strategy as biocontainment will be critical in the post-OPV cessation period. The use of attenuated Sabin strains instead of wild-type Salk polio strains will provide additional safety during vaccine production. Initially, the Sabin-IPV production process will be based on the scale-down model of the current, and well-established, Salk-IPV process. In parallel to clinical trial material production, process development, optimization and formulation research is being carried out to further optimize the process and reduce cost per dose. Also, results will be shown from large-scale (to prepare for future technology transfer) generation of Master- and Working virus seedlots, and clinical trial material (for phase I studies) production. Finally, the planned technology transfer to vaccine manufacturers in low and middle-income countries is discussed.

  16. Aerobic exercise capacity in post-polio syndrome

    Voorn, E.L.

    2015-01-01

    The aim of this thesis was to expand the body of knowledge on the diminished aerobic capacity of individuals with post-polio syndrome (PPS). The studies described in this thesis were based on the assumption that, besides a reduced muscle mass, deconditioning contributes to the severely diminished ae

  17. Production and potential use of monoclonal antibodies against polio viruses.

    A.D.M.E. Osterhaus (Albert); A.L. van Wezel; G. van Steenis (Bert); A.G. Hazendonk

    1982-01-01

    textabstractLymphocyte hybridomas secreting monoclonal antibodies against different strains of polio virus type 1, 2, or 3 have been produced. For this purpose Balb/C mice were immunized with purified and inactivated virus suspensions and their splenocytes were fused with P3X63Ag8 mouse myeloma cell

  18. Patients with post-polio syndrome are more likely to have subclinical involvement as compared to polio survivors without new symptoms

    Arzu Yagiz On

    2016-01-01

    Full Text Available Background: Post-polio syndrome (PPS is a condition that affects polio survivors decades after recovery from an initial acute attack. It is a well-known entity that limbs thought to be nonaffected by polio survivors commonly demonstrate electromyography (EMG evidence of prior polio. Although the diagnosis of PPS requires a remote history of acute paralytic polio, clinically unapparent damage caused by poliovirus can be associated with PPS later in life. Objective: To evaluate EMG abnormalities and late progressive symptoms in limbs thought to be nonaffected by polio survivors, in order to determine the prevalence of subclinical motor neuron involvement in those fulfilling criteria for PPS comparing to those without such symptoms. Materials and Methods: Clinical and EMG findings of 464 limbs in 116 polio survivors who had been admitted to our clinic were analyzed. Affection of the limbs by polio was classified based on the patient′s self-report on remote weakness during the acute phase of poliomyelitis, muscle strength measured by manual muscle testing, and four-limb needle EMG. Results: Seventy-six of the patients (65.5% met the criteria of PPS. Needle EMG studies revealed subclinical involvement in 122 out of 293 (42% limbs with no history of remote weakness during the acute phase of poliomyelitis. Prevalence of subclinical involvement was found 47% in polio survivors who met the criteria of PPS compared to 33% in those without PPS (P = 0.013. Among the limbs that had developed new weakness in PPS patients, 33.5% had subclinical involvement. Discussion and Conclusion: Subclinical involvement is common in limbs thought to be nonaffected by polio survivors, and this is especially present in those fulfilling criteria for PPS. New muscle weakness may develop in apparently nonaffected, subclinically involved muscles. Thus we believe that four-limb EMG studies should be performed in all polio survivors, especially in those with the symptoms of PPS.

  19. Progress toward poliomyelitis eradication - Afghanistan and Pakistan, 2009.

    2010-03-12

    Afghanistan, Pakistan, India, and Nigeria are the four remaining countries where indigenous wild poliovirus (WPV) transmission has never been interrupted. This report updates previous reports and describes polio eradication activities in Afghanistan and Pakistan during January-December 2009 and proposed activities in 2010 to address challenges. During 2009, both countries continued to conduct coordinated supplemental immunization activities (SIAs) and used multiple strategies to reach previously unreached children. These strategies included 1) use of short interval additional dose (SIAD) SIAs to administer a dose of oral poliovirus vaccine (OPV) within 1-2 weeks after a prior dose during negotiated periods of security; 2) systematic engagement of local leaders; 3) negotiations with conflict parties; and 4) increased engagement of nongovernmental organizations delivering basic health services. However, security problems continued to limit access by vaccination teams to large numbers of children. In Afghanistan, poliovirus transmission during 2009 predominantly occurred in 12 high-risk districts in the conflict-affected South Region; 38 WPV cases were confirmed in 2009, compared with 31 in 2008. In Pakistan, 89 WPV cases were confirmed in 2009, compared with 118 in 2008, but transmission persisted both in security-compromised areas and in accessible areas, where managerial and operational problems continued to affect immunization coverage. Continued efforts to enhance safe access of vaccination teams in insecure areas will be required for further progress toward interruption of WPV transmission in Afghanistan and Pakistan. In addition, substantial improvements in subnational accountability and oversight are needed to improve immunization activities in Pakistan.

  20. Randomized trial: The effect of oral polio vaccine at birth on polio antibody titers at 6 weeks and 6 months of age

    Anna Sofie Hansen

    2014-01-01

    Conclusions: OPV0 may contribute to early polio protection, particularly in children of mothers with low antibody levels. However, OPV0 did not contribute to overall polio immunity after subsequent doses of OPV were given, and was associated with significantly lower antibody titers in children of mothers with high antibody levels. However, it did not negatively affect the proportion of seropositive children.

  1. University students perspective on polio vaccination--ruse or realistic need for Pakistani children?

    Shaikh, Masood Ali; Kamal, Anila; Naqvi, Irum

    2014-06-01

    Polio vaccinators and law enforcement officials protecting them, have been killed in the line of duty since 2012 in Pakistan. This study was conducted to determine the opinions of university students in Islamabad and Rawalpindi, regarding the importance of polio vaccination, and the role of international donor agencies. Nine hundred forty-six students participated in this study; 833 (88.1%) students thought that polio is a public health problem in the country, and 815 (86.2%) thought that polio vaccination prevents polio in children. About a quarter of respondents thought that Pakistanis as well as non-Pakistanis working for either international nongovernmental organizations or United Nations agencies are spies working for the Western governments or their spy agencies. An appalling 300 (31.7%) respondents replied as either affirmatively or 'don't know' to the question whether killing of polio vaccinators is justified.

  2. Eradication of measles: remaining challenges.

    Holzmann, Heidemarie; Hengel, Hartmut; Tenbusch, Matthias; Doerr, H W

    2016-06-01

    Measles virus (MeV) is an aerosol-borne and one of the most contagious pathogenic viruses known. Almost every MeV infection becomes clinically manifest and can lead to serious and even fatal complications, especially under conditions of malnutrition in developing countries, where still 115,000 to 160,000 patients die from measles every year. There is no specific antiviral treatment. In addition, MeV infections cause long-lasting memory B and T cell impairment, predisposing people susceptible to opportunistic infections for years. A rare, but fatal long-term consequence of measles is subacute sclerosing panencephalitis. Fifteen years ago (2001), WHO has launched a programme to eliminate measles by a worldwide vaccination strategy. This is promising, because MeV is a human-specific morbillivirus (i.e. without relevant animal reservoir), safe and potent vaccine viruses are sufficiently produced since decades for common application, and millions of vaccine doses have been used globally without any indications of safety and efficacy issues. Though the prevalence of wild-type MeV infection has decreased by >90 % in Europe, measles is still not eliminated and has even re-emerged with recurrent outbreaks in developed countries, in which effective vaccination programmes had been installed for decades. Here, we discuss the crucial factors for a worldwide elimination of MeV: (1) efficacy of current vaccines, (2) the extremely high contagiosity of MeV demanding a >95 % vaccination rate based on two doses to avoid primary vaccine failure as well as the installation of catch-up vaccination programmes to fill immunity gaps and to achieve herd immunity, (3) the implications of sporadic cases of secondary vaccine failure, (4) organisation, acceptance and drawbacks of modern vaccination campaigns, (5) waning public attention to measles, but increasing concerns from vaccine-associated adverse reactions in societies with high socio-economic standards and (6) clinical

  3. Challenges and key research questions for yaws eradication.

    Marks, Michael; Mitjà, Oriol; Vestergaard, Lasse S; Pillay, Allan; Knauf, Sascha; Chen, Cheng-Yen; Bassat, Quique; Martin, Diana L; Fegan, David; Taleo, Fasihah; Kool, Jacob; Lukehart, Sheila; Emerson, Paul M; Solomon, Anthony W; Ye, Tun; Ballard, Ronald C; Mabey, David C W; Asiedu, Kingsley B

    2015-10-01

    Yaws is endemic in west Africa, southeast Asia, and the Pacific region. To eradicate yaws by 2020, WHO has launched a campaign of mass treatment with azithromycin. Progress has been made towards achievement of this ambitious goal, including the validation of point-of-care and molecular diagnostic tests and piloting of the strategy in several countries, including Ghana, Vanuatu, and Papua New Guinea. Gaps in knowledge need to be addressed to allow refinement of the eradication strategy. Studies exploring determinants of the spatial distribution of yaws are needed to help with the completion of baseline mapping. The finding that Haemophilus ducreyi causes lesions similar to yaws is particularly important and further work is needed to assess the effect of azithromycin on these lesions. The integration of diagnostic tests into different stages of the eradication campaign needs investigation. Finally, studies must be done to inform the optimum mass-treatment strategy for sustainable interruption of transmission.

  4. Undiagnosed Hoffa fracture of medial femoral condyle presenting as chronic pain in a post-polio limb

    Aditya Krishna Mootha; Priyanka Majety; Vishal Kumar

    2014-01-01

    Isolated coronal fracture of medial femoral condyle with intact lateral femoral condyle is extremely rare.A high index of suspicion is necessary for early diagnosis especially in cases of undisplaced fractures.Here we report a case of medial Hoffa fracture in a post-polio limb presenting as chronic pain.Management of such fractures in limbs affected by late sequelae of poliomyelitis is particularly problematic in view ofosteoporosis and osseous hypoplasia.The fracture was approached through medial parapatellar arthrotomy and fixation was done with cannulated cancellous screws in anteroposterior direction.Union was achieved at 16 weeks.

  5. Pathophysiology of muscular changes in post-polio syndrome and consequences for physical mobility

    Bickerstaffe, A.

    2016-01-01

    A large proportion of the estimated 10-20 million polio survivors worldwide can be expected to experience symptoms of further neuromuscular decline for many decades to come as they develop post-polio syndrome (PPS). Chapter 1 in Section A contains an overview of the insights into PPS as they stood a

  6. Childhood mortality after oral polio immunisation campaign in Guinea-Bissau

    Aaby, Peter; Hedegaard, Kathryn; Sodemann, Morten

    2005-01-01

    Though previous studies have suggested a non-specific beneficial effect of oral polio vaccine (OPV), there has been no evaluation of the mortality impact of national polio immunization days. On the other hand, studies examining the effect of OPV and diphtheria-tetanus-pertussis (DTP) vaccines, wh...

  7. The March of Dimes and Polio: Lessons in Vaccine Advocacy for Health Educators

    Larsen, Dawn

    2012-01-01

    The polio vaccine became available in 1955, due almost entirely to the efforts of the March of Dimes. In 1921, Franklin Roosevelt gave a public face to polio and mounted a campaign to prevent it, establishing the National Foundation for Infantile Paralysis in 1938. During the Depression, U.S. citizens were asked to contribute one dime. Entertainer…

  8. Psoriasis sparing the polio-affected limb: Is it merely the koebner phenomenon?

    B C Ravikumar

    2014-01-01

    Full Text Available Psoriasis being a common skin condition, atypical forms and unusual localizations of this disease are quite frequently seen. However, psoriasis sparing a polio-affected limb is extremely rare. We report a case of an adult male, who presented with psoriasis distributed all over the body but with almost complete sparing of the polio-affected left lower limb.

  9. Tracking the polio virus down the Congo River: a case study on the use of Google Earth™ in public health planning and mapping

    Kamadjeu Raoul

    2009-01-01

    Full Text Available Abstract Background The use of GIS in public health is growing, a consequence of a rapidly evolving technology and increasing accessibility to a wider audience. Google Earth™ (GE is becoming an important mapping infrastructure for public health. However, generating traditional public health maps for GE is still beyond the reach of most public health professionals. In this paper, we explain, through the example of polio eradication activities in the Democratic Republic of Congo, how we used GE Earth as a planning tool and we share the methods used to generate public health maps. Results The use of GE improved field operations and resulted in better dispatch of vaccination teams and allocation of resources. It also allowed the creation of maps of high quality for advocacy, training and to help understand the spatiotemporal relationship between all the entities involved in the polio outbreak and response. Conclusion GE has the potential of making mapping available to a new set of public health users in developing countries. High quality and free satellite imagery, rich features including Keyhole Markup Language or image overlay provide a flexible but yet powerful platform that set it apart from traditional GIS tools and this power is still to be fully harnessed by public health professionals.

  10. Lessons learnt to keep Europe polio-free: a review of outbreaks in the European Union, European Economic Area, and candidate countries, 1973 to 2013.

    Derrough, Tarik; Salekeen, Alexandra

    2016-04-21

    Between 1973 and 2013, 12 outbreaks of paralytic poliomyelitis with a cumulative total of 660 cases were reported in the European Union, European Economic Area and candidate countries. Outbreaks lasted seven to 90 weeks (median: 24 weeks) and were identified through the diagnosis of cases of acute flaccid paralysis, for which infection with wild poliovirus was subsequently identified. In two countries, environmental surveillance was in place before the outbreaks, but did not detect any wild strain before the occurrence of clinical cases. This surveillance nonetheless provided useful information to monitor the outbreaks and their geographical spread. Outbreaks were predominantly caused by poliovirus type 1 and typically involved unvaccinated or inadequately vaccinated groups within highly immunised communities. Oral polio vaccine was primarily used to respond to the outbreaks with catch-up campaigns implemented either nationwide or in restricted geographical areas or age groups. The introduction of supplementary immunisation contained the outbreaks. In 2002, the European region of the World Health Organization was declared polio-free and it has maintained this status since. However, as long as there are non-vaccinated or under-vaccinated groups in European countries and poliomyelitis is not eradicated, countries remain continuously at risk of reintroduction and establishment of the virus. Continued efforts to reach these groups are needed in order to ensure a uniform and high vaccination coverage.

  11. Eradication of Helicobacter pylori infection.

    Wu, Tzung-Shiun; Hu, Huang-Ming; Kuo, Fu-Chen; Kuo, Chao-Hung

    2014-04-01

    Eradication of Helicobacter pylori infection has become an important issue recently, because this bacterial species cluster can cause many gastrointestinal diseases. Elevated antibiotic resistance is related to an increasing failure rate of H. pylori eradication. Standard triple therapy is still the first-line therapy; however, according to the Maastricht IV Consensus Report, it should be abandoned in areas of high clarithromycin resistance. Alternative first-line therapies include bismuth-containing quadruple therapy, sequential, concomitant, and hybrid therapies. Quinolone-based triple therapy may be considered as first-line therapy in areas of clarithromycin resistance >15-20% and quinolone resistance <10%. Unique second-line therapy is still unclear, and bismuth-containing quadruple therapy or levofloxacin-based triple therapy can be used as rescue treatment. Third-line therapy should be under culture guidance to select the most effective regimens (such as levofloxacin-based, rifabutin-based, or furazolidone-based therapies). Antibiotics resistance, patient compliance, and CYP 2C19 genotypes could influence the outcome. Clinicians should use antibiotics according to local reports.

  12. Environmental surveillance of non-polio enteroviruses in Iran

    Kargar, Mohammad; Sadeghipour, Sara; Nategh, Rakhshandeh

    2009-01-01

    Background Enteroviruses can shed in feces for several weeks, so many excrete viruses can remain infectious for a long time in environment. Therefore, by detecting enteroviruses in environmental specimens and sewage, we can understand this virus circulation, the approximate ratio of contaminated persons in society and they are suitable indicators for environmental surveillance. Methods Since March 2006 to February 2007, 86 specimens from Sistan & Balouchestan,63 specimens from Tehran and 48 samples from Fars sewage disposal systems and surface water were collected by Grab Sample method and tested for enteroviruses directly by using two concentration methods: Pellet and Two-phase. Then Non-Polio Enteroviruses (NPEV) were serotyped by microneutralization method. Results Enteroviruses were isolated from 49(56.98%) of specimens in Sistan & Baluchestan,38(60.32%) in Tehran and 11(22.92%) in Fars. Besides, the majority of Non-Polio Enteroviruses related to Non-typable Enteroviruses (N.T.E.V), E11 (31.52%), COX-B (27.58%), E7 (17.73%) and E4 (21.67%). Conclusion Environmental surveillance has been used successfully in monitoring enteric virus circulation and assessing the extent or duration of epidemic non polioviruses in specific populations. The results of this research show the seasonal circulation of enteroviruses in different parts of Iran. PMID:19781063

  13. Environmental surveillance of non-polio enteroviruses in Iran

    Sadeghipour Sara

    2009-09-01

    Full Text Available Abstract Background Enteroviruses can shed in feces for several weeks, so many excrete viruses can remain infectious for a long time in environment. Therefore, by detecting enteroviruses in environmental specimens and sewage, we can understand this virus circulation, the approximate ratio of contaminated persons in society and they are suitable indicators for environmental surveillance. Methods Since March 2006 to February 2007, 86 specimens from Sistan & Balouchestan,63 specimens from Tehran and 48 samples from Fars sewage disposal systems and surface water were collected by Grab Sample method and tested for enteroviruses directly by using two concentration methods: Pellet and Two-phase. Then Non-Polio Enteroviruses (NPEV were serotyped by microneutralization method. Results Enteroviruses were isolated from 49(56.98% of specimens in Sistan & Baluchestan,38(60.32% in Tehran and 11(22.92% in Fars. Besides, the majority of Non-Polio Enteroviruses related to Non-typable Enteroviruses (N.T.E.V, E11 (31.52%, COX-B (27.58%, E7 (17.73% and E4 (21.67%. Conclusion Environmental surveillance has been used successfully in monitoring enteric virus circulation and assessing the extent or duration of epidemic non polioviruses in specific populations. The results of this research show the seasonal circulation of enteroviruses in different parts of Iran.

  14. Establishment of realtime RT-PCR assay to detect polio virus in the Acute Flaccid Paralysis laboratory surveillance

    Nike Susanti

    2016-07-01

    Full Text Available AbstrakLatar belakang: Virus polio indigenous terakhir ditemukan di Indonesia tahun 1995 tetapi ancaman viruspolio impor dan mutasi virus dari Oral Polio Vaccine (OPV menjadi Vaccine Derived Poliovirus (VDPVmasih berlanjut. Tahun 1991 WHO mengembangkan Surveilans Acute Flaccid Paralysis (AFP dan tahun2014, identifikasi virus polio dengan real-time reverse transcriptase Polymerase Chain Reaction (rRTPCRmulai digunakan di Laboratorium Nasional Polio Pusat Biomedis dan Teknologi Dasar Kesehatan.Tujuan dari penggunaan rRT-PCR untuk mendapatkan metode yang cepat dan lebih baik dalam memantausirkulasi dan mutasi virus polio.Metode: Isolat polio positif diidentifikasi menggunakanan rRT PCR dengan kombinasi primer dan probeyang ditetapkan WHO. RNA virus di konversi ke cDNA menggunakan reverse transcriptase lalu diamplifikasimenggunakan taq polymerase. Produk PCR di deteksi dan diidentifikasi dengan hibridisasi menggunakanprobe spesifik. Sintesis cDNA dan reaksi PCR menggunakan primer yang dilekatkan di probe. Kombinasiprimer dan probe menghasilkan identifikasi serotipe dan intratypic differentiation (ITD dari isolat virus.Hasil: Selama tahun 2014, NPL Jakarta menerima 604 kasus AFP dari surveilans dan lima kasusterdeteksi positif mengandung virus polio. Semua spesimen positif mengandung virus polio yang berasaldari vaksin. Dua kasus positif virus polio tipe P2 (40%, satu kasus jenis virus polio P1 (20%, 1 kasusjenis virus polio P3 (20% dan satu kasus virus polio campuran jenis P1 + P2 (20%.Kesimpulan: Real-time PCR dapat digunakan di Laboratorium Polio Jakarta untuk membantu identifikasivirus Polio secara cepat. Tes ini dapat digunakan untuk memantau sirkulasi virus polio pada populasiyang rutin diimunisasi dengan OPV. (Health Science Journal of Indonesia 2016;7:27-31Kata kunci: ITD, Poliovirus, Identification, rRT-PCR AbstractBackground: The last indigenous polio was detected in 1995 but the threat of wild type polio viruses and themutation of Oral

  15. Eradicating a Disease: Lessons from Mathematical Epidemiology

    Glomski, Matthew; Ohanian, Edward

    2012-01-01

    Smallpox remains the only human disease ever eradicated. In this paper, we consider the mathematics behind control strategies used in the effort to eradicate smallpox, from the life tables of Daniel Bernoulli, to the more modern susceptible-infected-removed (SIR)-type compartmental models. In addition, we examine the mathematical feasibility of…

  16. H pylori recurrence after successful eradication

    Yaron Niv

    2008-01-01

    Recurrence of H pylori after eradication is rare in developed countries and more frequent in developing countries.Recrudescence(recolonization of the same strain within 12 mo after eradication)rather than reinfection(colonization with a new strain,more than 12 mo after eradication)is considered to be responsiblefor most of the cases.This observation was confirmed only in developed countries,while in developing countries a recent meta-analysis demonstrated a high rate of reinfection.The proportion of H pylori annual recurrence was 2.67% and 13.00% in developed and developing countries,respectively.Nested meta-analysis(only cases with a longer follow-up and a negative 13CUBT a year after eradication)revealed annual recurrence rate of 1.45%[relative risk(RR),0.54]and 12.00%(RR,0.92)in developed and developing countries,respectively.These findings support the notion that in developed countries many cases of recurrence are due to recrudescence within the first year after eradication,with a 46% drop in the recurrence rate after the first year post eradication,while in developing countries reinfection is more pronounced,and continue at the same rate since eradication.A different approach for follow-up after H pylori eradication is probably needed in patients of developing countries,since reinfection is highly prevalent.

  17. High incidence of osteoporosis and fractures in an aging post-polio population.

    Mohammad, Ausaf F

    2009-01-01

    Since the polio epidemic in Ireland in the 1950s, most polio survivors are approaching into the 6th and 7th decade of their lives. There is little data about bone density and risk of fractures in these patients. In 2006, we undertook an audit of post-polio patients attending rheumatology and neurology outpatient clinics in a university teaching hospital. Our aim was to determine the prevalence of osteoporosis (OP), falls and fractures and to evaluate the association of bone density with other potential contributing factors to OP.

  18. Routine immunization - do people know about it? A study among caretakers of children attending pulse polio immunization in east Delhi

    Sharma Rahul

    2008-01-01

    Full Text Available Research question: Do caretakers of children under five years have sufficient knowledge regarding routine immunization (RI? Objective: To assess the knowledge about RI among caretakers of young children. Settings: Pulse polio immunization centres in East Delhi. Study design: Cross-sectional study. Participants: Six hundred and eighty-two caretakers accompanying children under 5 years to pulse polio booths in November 2006. Study tool: Pre-tested semi-open-ended questionnaire. Statistical analysis: Proportions, Chi-square test. Results: The proportions of respondents who had awareness about different aspects of RI, such as weekday of RI (37.0%, age group for RI (49.1%, number of visits required in the first year of life (27.0%, were all low. When asked to name the four diseases covered under the RI program in Delhi, only 268 (39.3% could name at least three. The education level of respondents was strongly associated with their knowledge about RI. Conclusion: The need of the hour is to make RI a ′felt need′ of the community. Making caretakers more aware about RI is a vital step in achieving this goal.

  19. Prioritizing islands for the eradication of invasive vertebrates in the United Kingdom overseas territories.

    Dawson, Jeffrey; Oppel, Steffen; Cuthbert, Richard J; Holmes, Nick; Bird, Jeremy P; Butchart, Stuart H M; Spatz, Dena R; Tershy, Bernie

    2015-02-01

    Invasive alien species are one of the primary threats to native biodiversity on islands worldwide. Consequently, eradicating invasive species from islands has become a mainstream conservation practice. Deciding which islands have the highest priority for eradication is of strategic importance to allocate limited resources to achieve maximum conservation benefit. Previous island prioritizations focused either on a narrow set of native species or on a small geographic area. We devised a prioritization approach that incorporates all threatened native terrestrial vertebrates and all invasive terrestrial vertebrates occurring on 11 U.K. overseas territories, which comprise over 2000 islands ranging from the sub-Antarctic to the tropics. Our approach includes eradication feasibility and distinguishes between the potential and realistic conservation value of an eradication, which reflects the benefit that would accrue following eradication of either all invasive species or only those species for which eradication techniques currently exist. We identified the top 25 priority islands for invasive species eradication that together would benefit extant populations of 155 native species including 45 globally threatened species. The 5 most valuable islands included the 2 World Heritage islands Gough (South Atlantic) and Henderson (South Pacific) that feature unique seabird colonies, and Anegada, Little Cayman, and Guana Island in the Caribbean that feature a unique reptile fauna. This prioritization can be rapidly repeated if new information or techniques become available, and the approach could be replicated elsewhere in the world.

  20. Viral Aetiology of Acute Flaccid Paralysis Surveillance Cases, before and after Vaccine Policy Change from Oral Polio Vaccine to Inactivated Polio Vaccine

    T. S. Saraswathy Subramaniam

    2014-01-01

    Full Text Available Since 1992, surveillance for acute flaccid paralysis (AFP cases was introduced in Malaysia along with the establishment of the National Poliovirus Laboratory at the Institute for Medical Research. In 2008, the Ministry of Health, Malaysia, approved a vaccine policy change from oral polio vaccine to inactivated polio vaccine (IPV. Eight states started using IPV in the Expanded Immunization Programme, followed by the remaining states in January 2010. The objective of this study was to determine the viral aetiology of AFP cases below 15 years of age, before and after vaccine policy change from oral polio vaccine to inactivated polio vaccine. One hundred and seventy-nine enteroviruses were isolated from the 3394 stool specimens investigated between 1992 and December 2012. Fifty-six out of 107 virus isolates were polioviruses and the remaining were non-polio enteroviruses. Since 2009 after the sequential introduction of IPV in the childhood immunization programme, no Sabin polioviruses were isolated from AFP cases. In 2012, the laboratory AFP surveillance was supplemented with environmental surveillance with sewage sampling. Thirteen Sabin polioviruses were also isolated from sewage in the same year, but no vaccine-derived poliovirus was detected during this period.

  1. Logistics of Guinea worm disease eradication in South Sudan.

    Jones, Alexander H; Becknell, Steven; Withers, P Craig; Ruiz-Tiben, Ernesto; Hopkins, Donald R; Stobbelaar, David; Makoy, Samuel Yibi

    2014-03-01

    From 2006 to 2012, the South Sudan Guinea Worm Eradication Program reduced new Guinea worm disease (dracunculiasis) cases by over 90%, despite substantial programmatic challenges. Program logistics have played a key role in program achievements to date. The program uses disease surveillance and program performance data and integrated technical-logistical staffing to maintain flexible and effective logistical support for active community-based surveillance and intervention delivery in thousands of remote communities. Lessons learned from logistical design and management can resonate across similar complex surveillance and public health intervention delivery programs, such as mass drug administration for the control of neglected tropical diseases and other disease eradication programs. Logistical challenges in various public health scenarios and the pivotal contribution of logistics to Guinea worm case reductions in South Sudan underscore the need for additional inquiry into the role of logistics in public health programming in low-income countries.

  2. Dracunculiasis eradication - Finishing the job before surprises arise

    Benjamin Jelle Visser

    2012-01-01

    ABSTRACT Dracunculiasis(Guinea worm disease) is a preventable waterborne parasitic disease that affects the poorest people living in remote rural areas in sub-SaharanAfrican countries, who do not have access to safe drinking water.The Guinea Worm Eradication Program, a25-year old campaign to rid the world ofGuineaWorm disease has now reached its final stage accelerating to zero cases in all endemic countries.During the19th and20th centuries, dracunculiasis was common in much ofSouthernAsia and theAfrican continent.The overall number of cases has been reduced tremendously by≥99%, from the3.32 million cases estimated to have occurred in1986 inAfrica to only1797 cases reported in2010 reported in only five countries(Sudan,Mali,Ethiopia,Chad andGhana) andAsia free of the disease.This achievement is unique in its kind - the only previously eradicated disease is smallpox, a viral infection for which vaccination was possible - and it has been achieved through primary community-based prevention and health education programs.Most efforts need to be taken in two countries,SouthSudan(comprising94% or1698 out of1797 of the cases reported world-wide in2010) andMali because of frequent movements of nomads in a vast area inside and outsideMali’s borders.All factors favourable to dracunculiasis eradication are available including adequate financial resources, community and political support and high levels of advocacy.Thus there is no reason that this disabling parasitic disease cannot be eradicated soon before surprises arise such as new civil conflicts in currently endemic countries.

  3. Uso universal da vacina inativada contra poliomielite Universal use of inactivated polio vaccine

    Luiza Helena Falleiros Carvalho

    2006-07-01

    terms of worldwide eradication and the World Health Organization.s (WHO proposals in this transition period between global eradication and the post-eradication period. SOURCES OF DATA: Data for the period from 1955 to 2005 were searched in MEDLINE, LILACS, The Web, Doctor's Guide, WHO website and Pan American Health Organization (PAHO website and text book. SUMMARY OF THE FINDINGS: In 1988, the WHO established the goal of eradicating the disease and interrupting transmission of the wild virus globally. Since then, there has been a dramatic decline of the disease, although in 2005 there were still some countries considered endemic and others where polio returned on account of imported viruses. The vaccines used worldwide are the classical tOPV and IPV, and in this eradication process, the use of mOPV vaccines has been encouraged in places where only one type of poliovirus circulates. In addition to spreading the virus in the community, the OPV vaccines may, however, cause paralyses by reversal of the neurovirulence process. CONCLUSIONS: For a world free of poliomyelitis disease, it would be necessary to interrupt circulation of the virus, which will only be possible if the OPV virus were to be discontinued, in accordance with the WHO proposals for this transition period and the post-eradication period.

  4. Incompatibility of lyophilized inactivated polio vaccine with liquid pentavalent whole-cell-pertussis-containing vaccine

    Kraan, H.; Have, Ten R.; Maas, van der L.; Kersten, G.F.A.; Amorij, J.P.

    2016-01-01

    A hexavalent vaccine containing diphtheria toxoid, tetanus toxoid, whole cell pertussis, Haemophilius influenza type B, hepatitis B and inactivated polio vaccine (IPV) may: (i) increase the efficiency of vaccination campaigns, (ii) reduce the number of injections thereby reducing needlestick injurie

  5. Poverty eradication: a new paradigm.

    Pethe, V P

    1998-08-01

    This article offers a new paradigm for eradicating poverty in India. It was assumed incorrectly by Mahatma Gandhi that a good society without mass poverty would follow after independence. India copied Western models of development and developed giant factories, big dams, and megacities. Agriculture did not expand the number of jobs for people. The Western paradigm failed in India because of the false assumption of "trickle down" of income to the masses. The targeted programs to the poor did not directly benefit enough of the poor. Mega-industrialization led to reduced employment and higher skill needs. The model failed mainly because it was a proxy and relied on indirect ways of reaching the poor. The models failed to be adapted to conditions in India. The Swadeshi paradigm is a direct model for addressing mass poverty. Poverty is affected by immediate, intermediate, and ultimate determinants. Poverty begets social and economic problems, such as ignorance, ill health, high fertility, unemployment, and crime. In India and developing countries, mass poverty results from under use of human resources; lack of equal opportunities; and an outdated non-egalitarian social structure, an unjust global economic order, human cruelty, and erosion of ethical values. Indians are squandering their precious resources mimicking Western consumerism. Poverty leads to rapid population growth. People become productive assets with universal literacy, compulsory and free education, health services and sanitation, vocational training, and work ethics. India needs people-oriented policies with less emphasis on capital accumulation.

  6. Willapa - Spartina Mapping and Eradication 2015

    US Fish and Wildlife Service, Department of the Interior — The Willapa National Wildlife Refuge (Willapa NWR) continues to work toward the eradication of the non-native cordgrass, Spartina alterniflora (Spartina) from...

  7. Willapa - Spartina Mapping and Eradication 2014

    US Fish and Wildlife Service, Department of the Interior — The Willapa National Wildlife Refuge (Willapa NWR) continued a successful program aimed at eradicating the non-native cordgrass, Spartina alterniflora (Spartina)...

  8. A Research Agenda for Malaria Eradication: Vaccines

    ,

    2011-01-01

    Vaccines could be a crucial component of efforts to eradicate malaria. Current attempts to develop malaria vaccines are primarily focused on Plasmodium falciparum and are directed towards reducing morbidity and mortality. Continued support for these efforts is essential, but if malaria vaccines are to be used as part of a repertoire of tools for elimination or eradication of malaria, they will need to have an impact on malaria transmission. We introduce the concept of “vaccines that interrupt...

  9. Eradication of Ebola Based on Dynamic Programming

    Zhu, Jia-Ming; Wang, Lu; Liu, Jia-Bao

    2016-01-01

    This paper mainly studies the eradication of the Ebola virus, proposing a scientific system, including three modules for the eradication of Ebola virus. Firstly, we build a basic model combined with nonlinear incidence rate and maximum treatment capacity. Secondly, we use the dynamic programming method and the Dijkstra Algorithm to set up M-S (storage) and several delivery locations in West Africa. Finally, we apply the previous results to calculate the total cost, production cost, storage cost, and shortage cost. PMID:27313655

  10. Role of gastritis pattern on Helicobacter pylori eradication.

    Zullo, Angelo; Severi, Carola; Vannella, Lucy; Hassan, Cesare; Sbrozzi-Vanni, Andrea; Annibale, Bruno

    2012-12-01

    Helicobacter pylori eradication rate following standard triple therapy is decreasing. Identification of predictive factors of therapy success would be useful for H. pylori management in clinical practice. This study aimed to evaluate the role of different gastritis patterns on the efficacy of the currently suggested 14-day triple therapy regimen. One-hundred and seventeen, consecutive, non-ulcer dyspeptic patients, with H. pylori infection diagnosed at endoscopy, were enrolled. All patients received a 14-day, triple therapy with lansoprazole 30 mg, clarithromycin 500 mg and amoxicillin 1 g, all given twice daily. Bacterial eradication was assessed with (13)C-urea breath test 4-6 weeks after completion of therapy. H. pylori infection was cured in 70.1% at ITT analysis and 83.7% at PP analysis. The eradication rate tended to be lower in patients with corpus-predominant gastritis as compared to those with antral-predominant gastritis at both ITT (66.1 vs 74.5%) and PP (80.4 vs 87.2%) analyses. The multivariate analysis failed to identify factors associated with therapy success. However, 14-day triple therapy does not achieve acceptable H. pylori cure rate in Italy, and should be not recommended in clinical practice.

  11. Pulse Polio Immunization Coverage Evaluation In A Rural Area Of Agra District

    Nandan Deoki

    1996-01-01

    Full Text Available Research Question: What is the extent of PPI Coverage and what is the source of information and motivation to the community. Objective: To assess the extent of coverage of immunization carried out during pulse polio Immunization (1995-96 in rural areas of Agra District. Study Design: Cross-sectional Setting: Selected Villages of PHC Bichpuri, covered by ICDS, in Agra District Participants: Persons who took the <3 children for immunization Sample Size: 581 Persons from 987 households Study Variables: Doses of OPV received, source of information, location of immunization site, distance traveled and mode of transport. Results: The reported achievement for the first dose was 86.6% and for the second it was 87.6%. It was found that most important sources of knowledge were Anganwadi Worker (43.54% followed by ANM (26.88%. Majority of the immunization booths (67.29% were working in sunshine. More than 90% villagers reached the site walking on foot. Recommendations: Efforts should be made by the worker (HW and AWW to motivate the population for 100% coverage under the coming PPI programme. Information should be given to the worker regarding correct location of immunization site.

  12. Ridgefield - Invasive Plant Focused Eradication

    US Fish and Wildlife Service, Department of the Interior — The proposed project is a part of the Refuge invasive species management program and willhelp achieve goals and protect priority habitats identified in the Refuge...

  13. Helicobacter pylori eradication for preventing gastric cancer.

    Lu, Bin; Li, Meng

    2014-05-21

    Helicobacter pylori (H. pylori) infection is a major risk factor for gastric cancer (GC) development, which is one of the most challenging malignant diseases worldwide with limited treatments. In the multistep pathogenesis of GC, H. pylori infection slowly induces chronic active gastritis, which progresses through the premalignant stages of atrophic gastritis, intestinal metaplasia, and dysplasia, and then finally to GC. Although eradication of H. pylori is a reasonable approach for the prevention of GC, there have been some contradictory reports, with only some long-term follow-up data showing efficacy of this approach. The inconsistencies are likely due to the insufficient number of participants, relatively short follow-up periods, poor quality of study designs, and the degree and extent of preneoplastic changes at the time of H. pylori eradication. This review analyzes recent high-quality studies to resolve the discrepancies regarding the eradication of H. pylori for GC prevention. The relationship between H. pylori eradication and GC/precancerous lesions/metachronous GC is examined, and the cost-effectiveness of this strategy in the prevention of GC is assessed. Although it is assumed that eradication of H. pylori has the potential to prevent GC, the feasibility and appropriate timing of this strategy for cancer prevention remain to be determined. As a result, additional well-designed trials with longer follow-up periods are needed to clarify this issue.

  14. Helicobacter pylori eradication: Sequential therapy and Lactobacillus reuteri supplementation

    Cesare Efrati; Giorgia Nicolini; Claudio Cannaviello; Nicole Piazza O'Sed; Stefano Valabrega

    2012-01-01

    incidence of adverse effects in all groups of patients with sequential therapy,probably due to the presence of the L.reuteri supplementation.CONCLUSION:The sequential treatment regimen achieved a significantly higher eradication rate of H.pylori compared with standard 7-d regimen.L.reuteri supplementation could reduce the frequency and the intensity of antibiotic-associated side-effects.

  15. Factors Associated with Reduced Quality of Life in Polio Survivors in Korea.

    Yang, Eun Joo; Lee, Seung Yeol; Kim, Keewon; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho; Lim, Jae-Young

    2015-01-01

    The purpose of this study is to assess health-related quality of life in polio survivors (PS) compared with that in the general population in Korea. Polio survivors (n = 120) from outpatient clinics at two hospitals, healthy controls (HC, n = 121) and members of the general population with activity limitations (AL, n = 121) recruited through a proportional-allocation, systematic sampling strategy from the Fourth Korean National Health and Nutrition Examination Survey were surveyed with self-rated health-related quality of life (Euro QoL five-dimensions). The proportion of participants who reported problems in mobility, usual activity, and symptoms of anxiety/depression were higher in the PS group compared with the HC and AL groups. There was no significant difference in the self-care dimension across the groups. Polio-specific questionnaire, pain, depression, fatigue, Modified Barthel Index (K-MBI) and Short Physical Performance Battery (SPPB) were assessed in the PS group. Those with post-poliomyelitis syndrome had greater problems in mobility, usual activity, and depression/anxiety. Polio survivors, especially those with more pain and fatigue symptoms, and those who did not have access to medical services had poorer health-related quality of life. These findings afford useful information for potential intervention improving quality of life in polio survivors.

  16. Currents issues in cardiorespiratory care of patients with post-polio syndrome

    Marco Orsini

    2016-07-01

    Full Text Available ABSTRACT Post-polio syndrome (PPS is a condition that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. Most often, polio survivors experience a gradual new weakening in muscles that were previously affected by the polio infection. The actual incidence of cardiovascular diseases (CVDs in individuals suffering from PPS is not known. However, there is a reason to suspect that individuals with PPS might be at increased risk. Method A search for papers was made in the databases Bireme, Scielo and Pubmed with the following keywords: post polio syndrome, cardiorespiratory and rehabilitation in English, French and Spanish languages. Although we targeted only seek current studies on the topic in question, only the relevant (double-blind, randomized-controlled and consensus articles were considered. Results and Discussion Certain features of PPS such as generalized fatigue, generalized and specific muscle weakness, joint and/or muscle pain may result in physical inactivity deconditioning obesity and dyslipidemia. Respiratory difficulties are common and may result in hypoxemia. Conclusion Only when evaluated and treated promptly, somE patients can obtain the full benefits of the use of respiratory muscles aids as far as quality of life is concerned.

  17. Factors Associated with Reduced Quality of Life in Polio Survivors in Korea.

    Eun Joo Yang

    Full Text Available The purpose of this study is to assess health-related quality of life in polio survivors (PS compared with that in the general population in Korea. Polio survivors (n = 120 from outpatient clinics at two hospitals, healthy controls (HC, n = 121 and members of the general population with activity limitations (AL, n = 121 recruited through a proportional-allocation, systematic sampling strategy from the Fourth Korean National Health and Nutrition Examination Survey were surveyed with self-rated health-related quality of life (Euro QoL five-dimensions. The proportion of participants who reported problems in mobility, usual activity, and symptoms of anxiety/depression were higher in the PS group compared with the HC and AL groups. There was no significant difference in the self-care dimension across the groups. Polio-specific questionnaire, pain, depression, fatigue, Modified Barthel Index (K-MBI and Short Physical Performance Battery (SPPB were assessed in the PS group. Those with post-poliomyelitis syndrome had greater problems in mobility, usual activity, and depression/anxiety. Polio survivors, especially those with more pain and fatigue symptoms, and those who did not have access to medical services had poorer health-related quality of life. These findings afford useful information for potential intervention improving quality of life in polio survivors.

  18. Polio and Nobel prizes: looking back 50 years.

    Norrby, Erling; Prusiner, Stanley B

    2007-05-01

    In 1954, John Enders, Thomas Weller, and Frederick Robbins were awarded the Nobel Prize in Physiology or Medicine "for their discovery of the ability of poliomyelitis viruses to grow in cultures of various types of tissue."5370 This discovery provided for the first time opportunities to produce both inactivated and live polio vaccines. By searching previously sealed Nobel Committee archives, we were able to review the deliberations that led to the award. It appears that Sven Gard, who was Professor of Virus Research at the Karolinska Institute and an adjunct member of the Nobel Committee at the time, played a major role in the events leading to the awarding of the Prize. It appears that Gard persuaded the College of Teachers at the Institute to decide not to follow the recommendation by their Nobel Committee to give the Prize to Vincent du Vigneaud. Another peculiar feature of the 1954 Prize is that Weller and Robbins were included based on only two nominations submitted for the first time that year. In his speech at the Nobel Prize ceremony, Gard mentioned the importance of the discovery for the future production of vaccines, but emphasized the implications of this work for growing many different, medically important viruses. We can only speculate on why later nominations highlighting the contributions of scientists such as Jonas Salk, Hilary Koprowski, and Albert Sabin in the development of poliovirus vaccines have not been recognized by a Nobel Prize.

  19. Education for the Eradication of Poverty

    C.I. Oriahi

    2010-12-01

    Full Text Available This study examines the possible education for the eradication of poverty in Nigeria. It defines poverty as a state pf shortage or deficiency of meeting basic needs. Majors causes of poverty are overpopulation, illiteracy, unemployment, environmental degradation and government insensitive to the welfare of the people. Effects of poverty include homelessness, malnutrition and starvation, illness, crime, violence and antisocial behaviour like Internet Fraud (Yahoo business and Advance Fee Fraud Populace (419. Some poverty eradication strategies highlighted include: (i Organisation of international workshops on eradication of poverty, (ii Respect for human rights, (iii Quality basic education for girls (iv Meaningful contributions by NGOs, (v Provision of jobs for the people. Some recommendations are made for the way forward.

  20. Detection of non-polio enteroviruses from 17 years of virological surveillance of acute flaccid paralysis in the Philippines.

    Apostol, Lea Necitas; Suzuki, Akira; Bautista, Analisa; Galang, Hazel; Paladin, Fem Julia; Fuji, Naoko; Lupisan, Socorro; Olveda, Remigio; Oshitani, Hitoshi

    2012-04-01

    Acute flaccid paralysis (AFP) surveillance has been conducted as part of the World Health Organization (WHO) strategy on poliomyelitis eradication. Aside from poliovirus, which is the target pathogen, isolation, and identification of non-polio enteroviruses (NPEVs) is also done by neutralization test using pools of antisera which can only identify limited number of NPEVs. In the Philippines, despite the significant number of isolated NPEVs, no information is available with regard to its occurrence, diversity, and pattern of circulation. In this study, a total of 790 NPEVs isolated from stool samples submitted to the National Reference Laboratory from 1992 to 2008 were analyzed; neutralization test was able to type 55% (442) of the isolates. Of the remaining 356 isolates, which were untyped by using neutralization test, 348 isolates were analyzed further by RT-PCR targeting the VP1 gene. A total of 47 serotypes of NPEV strains were identified using neutralization test and molecular typing, including 28 serotypes of human enterovirus B (HEV-B), 12 serotypes of HEV-A, and 7 of HEV-C. The HEV-B group (625/790; 79%) constituted the largest proportion of isolates, followed by HEV-C (108/790; 13.7%), HEV-A (57/790; 7.2%), and no HEV-D. Coxsackievirus (CV) B, echovirus (E)6, E11, and E13 were the most frequent isolates. E6, E11, E13, E14, E25, E30, E33, CVA20, and CVA24 were considered as endemic strains, some NPEVs recurred and few serotypes existed only for 1-3 years during the study period. Despite some limitations in this study, plural NPEVs with multiple patterns of circulation in the Philippines for 17 years were identified.

  1. Triple therapy with clarithromycin, amoxicillin and omeprazole for Helicobacter pylori eradication in children and adolescents

    KAWAKAMI Elisabete

    2001-01-01

    Full Text Available Background - Helicobacter pylori infection presents high prevalence in developing countries, but there are few pediatric assays evaluating antimicrobial treatment. Objective - The aim of this study was to investigate Helicobacter pylori eradication rate using a short regimen (7 and 10 days of triple therapy with clarithromycin, amoxicillin and omeprazole. Patients and methods - Twenty-five Hp positive patients who presented severe epigastralgia, were submitted to antimicrobial treatment with amoxicillin (50 mg/kg/day - maximum dose 1g bid, clarithromycin (30 mg/kg/day - maximum dose 500 mg bid and omeprazole (0.6 mg/kg/day - maximum dose 20 mg bid during 7 or 10 days. After 2 months, clinical symptoms were evaluated and gastric biopsies were taken to test Hp eradication. Results - Overall eradication rate was achieved in 16/25 patients (64% - IC(95% = 45-83%, in 11/15 (73% - IC(95% = 51-95% patients who used 10 days therapy course and in 5/10 (50% - IC(95% = 19-81% who used 7 days therapy course. Eradication drugs were well accepted and adverse effects were reported in two patients (8%. Conclusions - This triple therapy regimen had moderate efficacy (64%. The data suggests that 10 days therapy course achieves better eradication rate (73% than 7 days course (50% to treat Hp infection in our population.

  2. Yaws: towards the WHO eradication target

    Marks, Michael

    2016-01-01

    In 2012 WHO declared a target to eradicate yaws by 2020. The cornerstone of this strategy is community mass treatment with azithromycin. Initial studies suggest this is a very effective tool that may be capable of interrupting transmission. Alongside this there has been progress in the development and validation of diagnostic tests for yaws. Several new challenges have also emerged, in particular, evidence that Haemophilus ducreyi can cause phenotypically similar ulcers in yaws endemic communities, and evidence for a possible non-human primate reservoir. The 2020 eradication target remains ambitious and more challenges should be expected on the journey. PMID:27268712

  3. Yaws: towards the WHO eradication target.

    Marks, Michael

    2016-06-01

    In 2012 WHO declared a target to eradicate yaws by 2020. The cornerstone of this strategy is community mass treatment with azithromycin. Initial studies suggest this is a very effective tool that may be capable of interrupting transmission. Alongside this there has been progress in the development and validation of diagnostic tests for yaws. Several new challenges have also emerged, in particular, evidence that Haemophilus ducreyi can cause phenotypically similar ulcers in yaws endemic communities, and evidence for a possible non-human primate reservoir. The 2020 eradication target remains ambitious and more challenges should be expected on the journey.

  4. [Poliovirus immunology: vaccines, problems for the prevention/eradication and future interventions].

    Fernández-Cruz Pérez, Eduardo; Rodríguez-Sainz, Carmen

    2013-01-01

    Polio is a contagious disease that is caused by the poliovirus, an enterovirus in the family Picornaviridae. The virus enters through the oral mucosa and multiplies in epithelial cells of both the oropharynx as the gastrointestinal tract, releasing virus in oropharyngeal secretions and through the stool. The mode of transmission is fecal-oral and/or oral-oral. The virus preferentially infects children under 5 years. Most infections are asymptomatic and self-limiting gastrointestinal tract. Eventually it spreads to the central nervous system and affects the anterior horn motor neurons of the spinal cord causing paralysis and even death. We will describe host-virus interaction and the natural history of infection which depends on many factors, including the type of viral inoculum (serotypes VP1, 2 and 3) and host factors, such as nutritional status, concurrent infections and the ability to induce protective immune responses, such as, humoral anti-viral antibody responses with neutralizing antibodies, mucosal immunity and systemic adaptative immune responses. We will discuss the relevant aspects of the immuno-pathogenesis of the infection by poliovirus and the problems related to the host-virus interactions in the subjects vaccinated, with the latest advances in the strategies to develop optimal protection with the different poliovirus vaccines that could allow the development of a more effective immunization with induction of the effect or mechanisms that would prevent development of the disease, transmission of the virus, out-breaks and eventually the poliovirus eradication.

  5. [Eradication of poliomyelitis and emergence of pathogenic vaccine-derived polioviruses: from Madagascar to Cameroon].

    Delpeyroux, Francis; Colbère-Garapin, Florence; Razafindratsimandresy, Richter; Sadeuh-Mba, Serge; Joffret, Marie-Line; Rousset, Dominique; Blondel, Bruno

    2013-11-01

    The oral poliovaccine, a live vaccine made of attenuated poliovirus strains, is the main tool of the vaccination campaigns organised for eradicating poliomyelitis. these campaigns had led to the decline and, thereafter, to the disappearance of wild poliovirus strains of the three serotypes (1-3) in most parts of the world. However, when the poliovaccine coverage becomes too low, vaccine polioviruses can circulate in insufficiently immunized populations and become then pathogenic by mutations and genetic recombination with other enteroviruses of the same species, in particular some coxsackievirus A. These mutated and recombinant vaccine strains have been implicated in several epidemics of paralytic poliomyelitis. Two polio outbreaks associated with these pathogenic circulating vaccine-derived poliovirus (cVDPV) occurred in 2001-2002 and 2005 in the South of Madagascar where vaccine coverage was low. These cVDPV, of serotype 2 or 3, were isolated from paralyzed children and some of their healthy contacts. Other cVDPV were isolated in the same region from healthy children in 2011, indicating that these viruses were circulating again. Vaccination campaigns could stop the outbreaks in 2002 and 2005, and most probably prevent another one in 2011. Therefore, the genetic plasticity of poliovaccine strains that threatens the benefit of vaccination campaigns is the target of an accurate surveillance and an important theme of studies in the virology laboratories of the Institut Pasteur international network.

  6. Enabling implementation of the Global Vaccine Action Plan: developing investment cases to achieve targets for measles and rubella prevention.

    Thompson, Kimberly M; Strebel, Peter M; Dabbagh, Alya; Cherian, Thomas; Cochi, Stephen L

    2013-04-18

    Global prevention and control of infectious diseases requires significant investment of financial and human resources and well-functioning leadership and management structures. The reality of competing demands for limited resources leads to trade-offs and questions about the relative value of specific investments. Developing investment cases can help to provide stakeholders with information about the benefits, costs, and risks associated with available options, including examination of social, political, governance, and ethical issues. We describe the process of developing investment cases for globally coordinated management of action plans for measles and rubella as tools for enabling the implementation of the Global Vaccine Action Plan (GVAP). We focus on considerations related to the timing of efforts to achieve measles and rubella goals independently and within the context of ongoing polio eradication efforts, other immunization priorities, and other efforts to control communicable diseases or child survival initiatives. Our analysis suggests that the interactions between the availability and sustainability of financial support, sufficient supplies of vaccines, capacity of vaccine delivery systems, and commitments at all levels will impact the feasibility and timing of achieving national, regional, and global goals. The timing of investments and achievements will determine the net financial and health benefits obtained. The methodology, framing, and assumptions used to characterize net benefits and uncertainties in the investment cases will impact estimates and perceptions about the value of prevention achieved overall by the GVAP. We suggest that appropriately valuing the benefits of investments of measles and rubella prevention will require the use of integrated dynamic disease, economic, risk, and decision analytic models in combination with consideration of qualitative factors, and that synthesizing information in the form of investment cases may help

  7. Poliovirus shedding after the first and second doses of trivalent polio vaccines in newborns

    Viramitha K. Rusmil

    2015-07-01

    Full Text Available Background The trivalent oral polio vaccine (tOPV produced by Bio Farma consists of three live, attenuated poliovirus serotypes (1, 2, and 3. The tOPV stimulates the formation of secretory IgA (sIgA on the intestinal wall and lumen. The existence of sIgA is considered giving immunity in the intestines, it could prevent the spread of viral replication and thus inhibit the transmission of the polio virus. Objective To determine the differences in shedding after each of the first two tOPV immunizations in newborns. Methods This one-way repeated measure study was conducted in newborns from three primary health centers in Bandung, West Java. After administering tOPV to newborns, we assessed the shedding of poliovirus in their stool specimens at 30 days after the first dose and 7 days after the second dose. Data was analyzed using McNemar test with 95% confidence intervals (CI to differentiate the shedding of poliovirus after the first and second doses. Results Of 150 children, 128 subjects completed the study. At 30 days after the first tOPV dose, 26 subjects (20.3% were negative for shedding of poliovirus in stool specimens. Of the 102 subjects who had poliovirus isolated from their stools, the serotypes comprised of polio 1: 10.9%, polio 2: 14.8%, polio 3: 45.3%, polio 1 and 3: 3.1%, polio 2 and 3: 4.7%, and polio 1,2, and 3: 0.8%. At 7 days after the second tOPV dose, there was a significant increase in subjects negative for shedding of poliovirus (78 subjects; 60.9%. Statistical analysis revealed significantly decreased shedding of poliovirus in stool specimens between the first and second doses of tOPV (P<0.05 . Conclusion There is a significantly decreased number of subjects with shedding of poliovirus in stool specimens 7 days after the second tOPV dose than at 30 days after the first tOPV dose

  8. Poliovirus shedding after the first and second doses of trivalent polio vaccines in newborns

    Viramitha K. Rusmil

    2015-07-01

    Full Text Available Background The trivalent oral polio vaccine (tOPV produced by Bio Farma consists of three live, attenuated poliovirus serotypes (1, 2, and 3. The tOPV stimulates the formation of secretory IgA (sIgA on the intestinal wall and lumen. The existence of sIgA is considered giving immunity in the intestines, it could prevent the spread of viral replication and thus inhibit the transmission of the polio virus.Objective To determine the differences in shedding after each of the first two tOPV immunizations in newborns.Methods This one-way repeated measure study was conducted in newborns from three primary health centers in Bandung, West Java. After administering tOPV to newborns, we assessed the shedding of poliovirus in their stool specimens at 30 days after the first dose and 7 days after the second dose. Data was analyzed using McNemar test with 95% confidence intervals (CI to differentiate the shedding of poliovirus after the first and second doses.Results Of 150 children, 128 subjects completed the study. At 30 days after the first tOPV dose, 26 subjects (20.3% were negative for shedding of poliovirus in stool specimens. Of the 102 subjects who had poliovirus isolated from their stools, the serotypes comprised of polio 1: 10.9%, polio 2: 14.8%, polio 3: 45.3%, polio 1 and 3: 3.1%, polio 2 and 3: 4.7%, and polio 1,2, and 3: 0.8%. At 7 days after the second tOPV dose, there was a significant increase in subjects negative for shedding of poliovirus (78 subjects; 60.9%. Statistical analysis revealed significantly decreased shedding of poliovirus in stool specimens between the first and second doses of tOPV (P<0.05 .Conclusion There is a significantly decreased number of subjects with shedding of poliovirus in stool specimens 7 days after the second tOPV dose than at 30 days after the first tOPV dose.

  9. A research agenda for malaria eradication: vaccines.

    Abdulla, S.; Agre, P.; Alonso, P.L.; Arevalo-Herrera, M.; Bassat, Q.; Binka, F.; Chitnis, C.; Corradin, G.; Cowman, A. F.; Culpepper, J.; Portillo, H. del; Dinglasan, R.R.; Duffy, P.; Gargallo, D.; Greenwood, B.; Guinovart, C.; Hall, B.F.; Herrera, S.; Hoffman, S.; Lanzavecchia, A.; Leroy, O.; Levine, M.M.; Loucq, C.; Mendis, K.; Milman, J.; Moorthy, V.S.; Pleuschke, G.; Plowe, C.V.; Reed, S.; Sauerwein, R.W.; Saul, A.; Schofield, L.; Sinden, R.R.; Stubbs, J.; Villafana, T.; Wirth, D.; Yadav, P.; Ballou, R.; Brown, G.; Birkett, A.; Brandt, W.; Brooks, A.; Carter, T.; Golden, A.; Lee, C.; Nunes, J.; Puijalon, O.; Raphael, T.; Richards, H.; Warren, C.; Woods, C.

    2011-01-01

    Vaccines could be a crucial component of efforts to eradicate malaria. Current attempts to develop malaria vaccines are primarily focused on Plasmodium falciparum and are directed towards reducing morbidity and mortality. Continued support for these efforts is essential, but if mal

  10. Brazil : Eradicating Child Labor in Brazil

    World Bank

    2001-01-01

    The report reviews evidence of child labor in Brazil, and the Government's efforts to eradicate its worst forms, by examining background assessments of ongoing programs for its prevention. It seeks to identify promising strategies, addressing the needs of highly vulnerable children in urban areas, engaged in activities such as drug commerce, prostitution, or other dangerous activities. One...

  11. Can leprosy be eradicated with chemotherapy? An evaluation of the Malta Leprosy Eradication Project.

    Jacobson, Robert R; Gatt, Paul

    2008-12-01

    The Malta Leprosy Eradication Project (MLEP) was proposed in 1971 by Freerksen with the aim of eradicating leprosy in Malta. The project involved re-treatment of all known cases in Malta as of 1972 and all new cases thereafter with a regimen consisting of Isoprodian (a combination of dapsone, prothionamide and isoniazid) and rifampicin for varying intervals depending on the severity of their disease and their response to treatment. Overall the response to therapy was excellent with an extremely low relapse rate. During the 30 years of the project the incidence of leprosy steadily decreased continuing a decline that had started at least two decades earlier and Freerksen declared the disease eradicated from Malta in 2001. Although given the long incubation period of leprosy cases may still be occasionally detected in the future, the disease has been basically eradicated at this time and there are no patients currently receiving treatment. This work was done at the leprosy clinic, Boffa Hospital, Floriana, Malta.

  12. Clinical Outcome of Eradication Therapy for Gastric Mucosa-Associated Lymphoid Tissue Lymphoma according to H. pylori Infection Status

    Ju Seok Kim

    2016-01-01

    Full Text Available Background. To evaluate the long-term outcome of H. pylori eradication therapy for gastric MALT lymphoma according to the presence of H. pylori infection. Methods. We retrospectively reviewed the medical records of patients between January 2001 and June 2014. The clinicopathologic characteristics and clinical outcomes were compared between H. pylori-positive and H. pylori-negative gastric MALT lymphoma groups. Results. Fifty-four patients were enrolled: 12 H. pylori-negative and 42 H. pylori-positive patients. The tumor was located more frequently in both the proximal and distal parts of the stomach (P=0.001, and the percentage of multiple lesions was significantly greater in the H. pylori-negative group (P=0.046. Forty-seven patients received initial eradication therapy, and 85% (35/41 of H. pylori-positive patients and 50% (3/6 of H. pylori-negative patients achieved complete remission after eradication therapy. The presence of multiple lesions was a predictive factor for unresponsiveness to H. pylori eradication (P=0.024. The efficacy of eradication therapy (P=0.133, complete remission (CR maintenance period, and relapse after eradication therapy were not significantly different between the two groups. Conclusions. H. pylori eradication therapy could be an effective first-line treatment for localized H. pylori-negative gastric MALT lymphoma, especially for single lesions.

  13. Reflux esophagitis triggered after Helicobacter pylori eradication: a noteworthy demerit of eradication therapy among the Japanese?

    Katsunori eIijima

    2015-06-01

    Full Text Available In the February 2013 Revision of Insured Medical Treatment, bacterial eradication for all Helicobacter pylori-positive individuals in Japan was covered under the insurance scheme. However, reflux esophagitis is believed to occur in approximately 10% of Japanese patients who undergo eradication therapy. Hence, the risk of reflux esophagitis among such cases should be carefully considered, particularly in the treatment for H. pylori-positive patients who are otherwise healthy. The eradication of Helicobacter pylori in cases of H. pylori-positive gastritis markedly suppresses gastric inflammation, and inhibits gastric mucosal atrophy and its progression to intestinal metaplasia. In a long-term follow-up study (10-20 years, eradication treatment was found to reduce the risk of subsequent gastric cancer. However, the fact that eradication-induced reflux esophagitis could increase the long-term risk of Barrett’s esophagus and esophageal adenocarcinoma should also be considered in the Japanese population. Appropriate treatment with proton pump inhibitors should be taken into consideration for patients undergoing eradication therapy in clinical practice.

  14. 100 years poliovirus: from discovery to eradication. A meeting report.

    Skern, Tim

    2010-09-01

    Just over hundred years ago, Karl Landsteiner and Erwin Popper identified a virus, later termed poliovirus, as the causative agent of poliomyelitis. This groundbreaking discovery simultaneously provided the basis for the measures that today prevent the outbreaks of the terrible epidemics caused by poliovirus. In 1988, the WHO started its eradication program to eliminate the virus from the planet. The symposium celebrated the discovery of poliovirus and discussed our current state of knowledge of poliovirus biology. Prospects for the eradication program were evaluated, with particular emphasis being placed on why certain countries still have not succeeding in interrupting wild-type transmission of poliovirus. Discussion also centred on the role of inactivated poliovirus vaccines in the eradication program and the maintenance of a poliovirus-free world, whenever this goal should be achieved.

  15. Fun with maths: exploring implications of mathematical models for malaria eradication.

    Eckhoff, Philip A; Bever, Caitlin A; Gerardin, Jaline; Wenger, Edward A

    2014-12-11

    Mathematical analyses and modelling have an important role informing malaria eradication strategies. Simple mathematical approaches can answer many questions, but it is important to investigate their assumptions and to test whether simple assumptions affect the results. In this note, four examples demonstrate both the effects of model structures and assumptions and also the benefits of using a diversity of model approaches. These examples include the time to eradication, the impact of vaccine efficacy and coverage, drug programs and the effects of duration of infections and delays to treatment, and the influence of seasonality and migration coupling on disease fadeout. An excessively simple structure can miss key results, but simple mathematical approaches can still achieve key results for eradication strategy and define areas for investigation by more complex models.

  16. Commonly used disinfectants fail to eradicate Salmonella enterica biofilms from food contact surface materials.

    Corcoran, M; Morris, D; De Lappe, N; O'Connor, J; Lalor, P; Dockery, P; Cormican, M

    2014-02-01

    Salmonellosis is the second most common cause of food-borne illness worldwide. Contamination of surfaces in food processing environments may result in biofilm formation with a risk of food contamination. Effective decontamination of biofilm-contaminated surfaces is challenging. Using the CDC biofilm reactor, the activities of sodium hypochlorite, sodium hydroxide, and benzalkonium chloride were examined against an early (48-h) and relatively mature (168-h) Salmonella biofilm. All 3 agents result in reduction in viable counts of Salmonella; however, only sodium hydroxide resulted in eradication of the early biofilm. None of the agents achieved eradication of mature biofilm, even at the 90-min contact time. Studies of activity of chemical disinfection against biofilm should include assessment of activity against mature biofilm. The difficulty of eradication of established Salmonella biofilm serves to emphasize the priority of preventing access of Salmonella to postcook areas of food production facilities.

  17. Addition of cranberry to proton pump inhibitor-based triple therapy for Helicobacter pylori eradication

    Seyyedmajidi, Mohammadreza; Ahmadi, Anahita; Hajiebrahimi, Shahin; Seyedmajidi, Seyedali; Rajabikashani, Majid; Firoozabadi, Mona; Vafaeimanesh, Jamshid

    2016-01-01

    Objective: Proton pump inhibitor-based triple therapy with two antibiotics for Helicobacter pylori eradication is widely accepted, but this combination fails in a considerable number of cases. Some studies have shown that cranberry inhibits the adhesion of a wide range of microbial pathogens, including H. pylori. The aim of this study was to assess the effect of cranberry on H. pylori eradication with a standard therapy including lansoprazole, clarithromycin, and amoxicillin (LCA) in patients with peptic ulcer disease (PUD). Methods: In this study, H. pylori-positive patients with PUD were randomized into two groups: Group A: A 14-day LCA triple therapy with 30 mg lansoprazole bid, 1000 mg amoxicillin bid, and 500 mg clarithromycin bid; Group B: A 14-day 500 mg cranberry capsules bid plus LCA triple therapy. A 13C-urea breath test was performed for eradication assessment 6 weeks after the completion of the treatment. Findings: Two hundred patients (53.5% males, between 23 and 77 years, mean age ± standard deviation: 50.29 ± 17.79 years) continued treatment protocols and underwent 13C-urea breath testing. H. pylori eradication was achieved in 74% in Group A (LCA without cranberry) and 89% in Group B (LCA with cranberry) (P = 0.042). Conclusion: The addition of cranberry to LCA triple therapy for H. pylori has a higher rate of eradication than the standard regimen alone (up to 89% and significant). PMID:27843960

  18. Symptom-based tendencies of Helicobacter pylori eradication in patients with functional dyspepsia

    Ling Lan; Jing Yu; Yu-Long Chen; Ya-Li Zhong; Hao Zhang; Chang-He Jia; Yuan Yuan; Bo-Wei Liu

    2011-01-01

    AIM: To investigate whether there were symptombased tendencies in the Helicobacter pylori (H. pylori ) eradication in functional dyspepsia (FD) patients. METHODS: A randomized, single-blind, placebo-controlled study of H. pylori eradication for FD was conducted. A total of 195 FD patients with H. pylori infection were divided into two groups: 98 patients in the treatment group were treated with rabeprazole 10 mg twice daily for 2 wk, amoxicillin 1.0 g and clarithromycin 0.5 g twice daily for 1 wk; 97 patients in the placebo group were given placebos as control. Symptoms of FD, such as postprandial fullness, early satiety, nausea, belching, epigastric pain and epigastric burning, were assessed 3 mo after H. pylori eradication. RESULTS: By per-protocol analysis in patients with successful H. pylori eradication, higher effective rates of 77.2% and 82% were achieved in the patients with epigastric pain and epigastric burning than those in the placebo group (P 0.05). In 84 patients who received H. pylori eradication therapy, the effective rates for epigastric pain (73.8%) and epigastric burning (80.7%) were higher than those in the placebo group (P 0.05). By intention-to-treat analysis, patients with epigastric pain and epigastric burning in the treatment group achieved higher effective rates of 60.8% and 65.7% than the placebo group (33.3% and 31.8%) (P 0.05). CONCLUSION: The efficacy of H. pylori eradication has symptom-based tendencies in FD patients. It may be effective in the subgroup of FD patients with epigastric pain syndrome.

  19. Global eradication of lymphatic filariasis: the value of chronic disease control in parasite elimination programmes.

    Edwin Michael

    Full Text Available The ultimate goal of the global programme against lymphatic filariasis is eradication through irrevocable cessation of transmission using 4 to 6 years of annual single dose mass drug administration. The costs of eradication, managerial impediments to executing national control programmes, and scientific uncertainty about transmission endpoints, are challenges to the success of this effort, especially in areas of high endemicity where financial resources are limited. We used a combined analysis of empirical community data describing the association between infection and chronic disease prevalence, mathematical modelling, and economic analyses to identify and evaluate the feasibility of setting an infection target level at which the chronic pathology attributable to lymphatic filariasis--lymphoedema of the extremities and hydroceles--becomes negligible in the face of continuing transmission as a first stage option in achieving the elimination of this parasitic disease. The results show that microfilaria prevalences below a threshold of 3.55% at a blood sampling volume of 1 ml could constitute readily achievable and sustainable targets to control lymphatic filarial disease. They also show that as a result of the high marginal cost of curing the last few individuals to achieve elimination, maximal benefits can occur at this threshold. Indeed, a key finding from our coupled economic and epidemiological analysis is that when initial uncertainty regarding eradication occurs and prospects for resolving this uncertainty over time exist, it is economically beneficial to adopt a flexible, sequential, eradication strategy based on controlling chronic disease initially.

  20. Global eradication of lymphatic filariasis: the value of chronic disease control in parasite elimination programmes.

    Michael, Edwin; Malecela, Mwele N; Zervos, Mihail; Kazura, James W

    2008-08-13

    The ultimate goal of the global programme against lymphatic filariasis is eradication through irrevocable cessation of transmission using 4 to 6 years of annual single dose mass drug administration. The costs of eradication, managerial impediments to executing national control programmes, and scientific uncertainty about transmission endpoints, are challenges to the success of this effort, especially in areas of high endemicity where financial resources are limited. We used a combined analysis of empirical community data describing the association between infection and chronic disease prevalence, mathematical modelling, and economic analyses to identify and evaluate the feasibility of setting an infection target level at which the chronic pathology attributable to lymphatic filariasis--lymphoedema of the extremities and hydroceles--becomes negligible in the face of continuing transmission as a first stage option in achieving the elimination of this parasitic disease. The results show that microfilaria prevalences below a threshold of 3.55% at a blood sampling volume of 1 ml could constitute readily achievable and sustainable targets to control lymphatic filarial disease. They also show that as a result of the high marginal cost of curing the last few individuals to achieve elimination, maximal benefits can occur at this threshold. Indeed, a key finding from our coupled economic and epidemiological analysis is that when initial uncertainty regarding eradication occurs and prospects for resolving this uncertainty over time exist, it is economically beneficial to adopt a flexible, sequential, eradication strategy based on controlling chronic disease initially.

  1. Vacina contra poliomielite: um novo paradigma Polio vaccines: a new paradigma

    Lucia Ferro Bricks

    2007-06-01

    , from January 2000 to December 2006. DATA SYNTHESIS: Acknowledgement of vaccine-associated paralysis and oral vaccine-derived circulating viruses’ paralysis shall certainly require discontinuation of oral vaccination for poliomyelitis use in a short time. After eradication of the wild viruses, oral vaccination for poliomyelitis should be discontinued, preferably in a synchronized manner in all the countries. After termination of vaccination programs, people will become susceptible again to poliomyelitis virus and disease outbreaks caused by wild viruses may occur (accidental escape from laboratories or bioterrorism. In countries already using inactivated poliovirus vaccine, it is unlikely that vaccination will be interrupted. Countries that currently use exclusively oral poliovirus vaccine will have to rely on epidemiological surveillance and on oral vaccine inventories to control potential polio outbreaks. If the oral poliovirus vaccine is reintroduced in those populations, there will be again a risk for vaccine-associated paralysis and oral vaccine-derived circulating viruses’ that may spread rapidly to other regions and to nearby countries. CONCLUSIONS: Inactivated poliovirus vaccine introduction in the routine Brazilian vaccination calendar should be programmed as well as acquisition of technology for inactivated poliovirus vaccine production since the latter is currently insufficient to cover global demand.

  2. Oral polio vaccine influences the immune response to BCG vaccination. A natural experiment

    Sartono, Erliyani; Lisse, Ida M; Terveer, Elisabeth M;

    2010-01-01

    BACKGROUND: Oral polio vaccine (OPV) is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW) and normal-birth-weight (NBW) infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did...

  3. Associations between perceptions of environmental barriers and participation in persons with late effects of polio.

    Lund, Maria Larsson; Lexell, Jan

    2009-01-01

    The aim of this pilot study was to assess the association between perceived environmental barriers and perceived participation in everyday life situations encountered by people with late effects of polio. A sample of 45 persons with clinically verified late effects of polio answered the Swedish versions of the Impact on Participation and Autonomy Questionnaire (IPA-S) and the Craig Hospital Inventory of Environmental Factors (CHIEF-S). The relationships between the perceived occurrence of a broad range of environmental barriers and perception of participation in life situations and problems with participation were explored. The majority of the respondents perceived that they encountered environmental barriers, but their occurrence was generally infrequent and their magnitude tended to be low. The barriers identified in the physical/structural subscale were generally most strongly related to problems with participation, compared with the four other environmental subscales. A high frequency of never encountering environmental barriers in the three subscales physical/structural, work and education, and policies in CHIEF-S were significantly related to more reports of good participation in IPA-S. These associations indicate that the participation of those with late effects of polio is influenced by their perception of the barriers they encounter. Further studies of these concepts can provide a greater understanding of disabilities and help us to promote participation in life situations for people with late effects of polio.

  4. Does oral polio vaccine at birth affect the size of the thymus?

    Eriksen, Helle Brander; Lund, Najaaraq; Biering-Sørensen, Sofie;

    2014-01-01

    BACKGROUND: There is increasing evidence that vaccines have an effect on general mortality which goes beyond specific disease protection. Oral polio vaccine (OPV) is widely used in low-income countries, but in observational studies in Guinea-Bissau we observed that not receiving OPV at birth...

  5. Preventing Vaccine-Derived Poliovirus Emergence during the Polio Endgame

    Burns, Cara C.; Lyons, Hil; Blake, Isobel M.; Oberste, M. Steven; Kew, Olen M.; Grassly, Nicholas C.

    2016-01-01

    Reversion and spread of vaccine-derived poliovirus (VDPV) to cause outbreaks of poliomyelitis is a rare outcome resulting from immunisation with the live-attenuated oral poliovirus vaccines (OPVs). Global withdrawal of all three OPV serotypes is therefore a key objective of the polio endgame strategic plan, starting with serotype 2 (OPV2) in April 2016. Supplementary immunisation activities (SIAs) with trivalent OPV (tOPV) in advance of this date could mitigate the risks of OPV2 withdrawal by increasing serotype-2 immunity, but may also create new serotype-2 VDPV (VDPV2). Here, we examine the risk factors for VDPV2 emergence and implications for the strategy of tOPV SIAs prior to OPV2 withdrawal. We first developed mathematical models of VDPV2 emergence and spread. We found that in settings with low routine immunisation coverage, the implementation of a single SIA increases the risk of VDPV2 emergence. If routine coverage is 20%, at least 3 SIAs are needed to bring that risk close to zero, and if SIA coverage is low or there are persistently “missed” groups, the risk remains high despite the implementation of multiple SIAs. We then analysed data from Nigeria on the 29 VDPV2 emergences that occurred during 2004−2014. Districts reporting the first case of poliomyelitis associated with a VDPV2 emergence were compared to districts with no VDPV2 emergence in the same 6-month period using conditional logistic regression. In agreement with the model results, the odds of VDPV2 emergence decreased with higher routine immunisation coverage (odds ratio 0.67 for a 10% absolute increase in coverage [95% confidence interval 0.55−0.82]). We also found that the probability of a VDPV2 emergence resulting in poliomyelitis in >1 child was significantly higher in districts with low serotype-2 population immunity. Our results support a strategy of focused tOPV SIAs before OPV2 withdrawal in areas at risk of VDPV2 emergence and in sufficient number to raise population immunity

  6. Preventing Vaccine-Derived Poliovirus Emergence during the Polio Endgame.

    Margarita Pons-Salort

    2016-07-01

    Full Text Available Reversion and spread of vaccine-derived poliovirus (VDPV to cause outbreaks of poliomyelitis is a rare outcome resulting from immunisation with the live-attenuated oral poliovirus vaccines (OPVs. Global withdrawal of all three OPV serotypes is therefore a key objective of the polio endgame strategic plan, starting with serotype 2 (OPV2 in April 2016. Supplementary immunisation activities (SIAs with trivalent OPV (tOPV in advance of this date could mitigate the risks of OPV2 withdrawal by increasing serotype-2 immunity, but may also create new serotype-2 VDPV (VDPV2. Here, we examine the risk factors for VDPV2 emergence and implications for the strategy of tOPV SIAs prior to OPV2 withdrawal. We first developed mathematical models of VDPV2 emergence and spread. We found that in settings with low routine immunisation coverage, the implementation of a single SIA increases the risk of VDPV2 emergence. If routine coverage is 20%, at least 3 SIAs are needed to bring that risk close to zero, and if SIA coverage is low or there are persistently "missed" groups, the risk remains high despite the implementation of multiple SIAs. We then analysed data from Nigeria on the 29 VDPV2 emergences that occurred during 2004-2014. Districts reporting the first case of poliomyelitis associated with a VDPV2 emergence were compared to districts with no VDPV2 emergence in the same 6-month period using conditional logistic regression. In agreement with the model results, the odds of VDPV2 emergence decreased with higher routine immunisation coverage (odds ratio 0.67 for a 10% absolute increase in coverage [95% confidence interval 0.55-0.82]. We also found that the probability of a VDPV2 emergence resulting in poliomyelitis in >1 child was significantly higher in districts with low serotype-2 population immunity. Our results support a strategy of focused tOPV SIAs before OPV2 withdrawal in areas at risk of VDPV2 emergence and in sufficient number to raise population

  7. Eradication of malaria through genetic engineering:the current situation

    Wing-Chui Chong; Rusliza Basir; Yam Mun Fei

    2013-01-01

    Malaria is an intra-cellular parasitic protozoon responsible for millions of deaths annually.Host and parasite genetic factors are crucial in affecting susceptibility to malaria and progression of the disease.Recent increased deployment of vector controls and new artemisinin combination therapies have dramatically reduced the mortality and morbidity of malaria worldwide.However, the gradual emergence of parasite and mosquito resistance has raised alarm regarding the effectiveness of current artemisinin-based therapies.In this review, mechanisms of anti-malarial drug resistance in thePlasmodium parasite and new genetically engineered tools of research priorities are discussed.The complexity of the parasite lifecycle demands novel interventions to achieve global eradication.However, turning laboratory discovered transgenic interventions into functional products entails multiple experimental phases in addition to ethical and safety hurdles.Uncertainty over the regulatory status and public acceptance further discourage the implementation of genetically modified organisms.

  8. Managing and eradicating wildlife tuberculosis in New Zealand

    Warburton, B; Livingstone, P

    2015-01-01

    Abstract Tuberculosis (TB) due to Mycobacterium bovis infection was first identified in brushtail possums (Trichosurus vulpecula) in New Zealand in the late 1960s. Since the early 1970s, possums in New Zealand have been controlled as part of an ongoing strategy to manage the disease in livestock. The TB management authority (TBfree New Zealand) currently implements three strategic choices for disease-related possum control: firstly TB eradication in areas selected for eradication of the disease from livestock and wildlife, secondly Free Area Protection in areas in which possums are maintained at low densities, normally along a Vector Risk Area (VRA) boundary, and thirdly Infected Herd Suppression, which includes the remaining parts of VRA where possums are targeted to minimise the infection risk to livestock. Management is primarily through a range of lethal control options. The frequency and intensity of control is driven by a requirement to reduce populations to very low levels (usually to a trap-catch index below 2%), then to hold them at or below this level for 5–10 years to ensure disease eradication.Lethal possum control is implemented using aerial- and ground-based applications, under various regulatory and operational constraints. Extensive research has been undertaken aimed at improving the efficacy and efficiency of control. Aerial applications use sodium fluoroacetate (1080) bait for controlling possums over extensive and rugged areas of forest that are difficult to access by foot. Ground-based control uses a range of toxins (primarily, a potassium cyanide-based product) and traps. In the last 5 years there has been a shift from simple possum population control to the collection of spatial data on possum presence/absence and relative density, using simple possum detection devices using global positioning system-supported data collection tools, with recovery of possum carcasses for diagnostic necropsy. Such data provide information subsequently used in

  9. Use of Mobile Information Technology during Planning, Implementation and Evaluation of a Polio Campaign in South Sudan.

    John Haskew

    Full Text Available Use of mobile information technology may aid collection of real-time, standardised data to inform and improve decision-making for polio programming and response. We utilised Android-based smartphones to collect data electronically from more than 8,000 households during a national round of polio immunisation in South Sudan. The results of the household surveys are presented here, together with discussion of the application of mobile information technology for polio campaign planning, implementation and evaluation in a real-time setting.Electronic questionnaires were programmed onto Android-based smartphones for mapping, supervision and survey activities during a national round of polio immunisation. National census data were used to determine the sampling frame for each activity and select the payam (district. Individual supervisors, in consultation with the local district health team, selected villages and households within each payam. Data visualisation tools were utilised for analysis and reporting.Implementation of mobile information technology and local management was feasible during a national round of polio immunisation in South Sudan. Red Cross visits during the polio campaign were equitable according to household wealth index and households who received a Red Cross visit had significantly higher odds of being aware of the polio campaign than those who did not. Nearly 95% of children under five were reported to have received polio immunisation (according to maternal recall during the immunisation round, which varied by state, county and payam. A total of 11 payams surveyed were identified with less than 90% reported immunisation coverage and the least poor households had significantly higher odds of being vaccinated than the most poor. More than 95% of households were aware of the immunisation round and households had significantly higher odds of being vaccinated if they had prior awareness of the campaign taking place

  10. Maternal education, empowerment, economic status and child polio vaccination uptake in Pakistan: a population based cross sectional study

    Zaheer, Sidra; Shafique, Kashif

    2017-01-01

    Objectives To explore the association of maternal education and empowerment with childhood polio vaccination using nationally representative data of Pakistani mothers in a reproductive age group. Design Cross-sectional. Setting Secondary analysis of Pakistan Demographic and Health Survey (PDHS), 2012–2013 data was performed. Participants Of the 13 558 mothers included in the survey sample, 6982 mothers were able to provide information regarding polio vaccinations. Main outcome measures Polio vaccination coverage among children aged up to 5 years was categorised as complete vaccination (all four oral polio vaccine (OPV) doses), incomplete vaccination, and no vaccination (zero OPV dose received). Mothers' empowerment status was assessed using standard ‘Measure DHS’ questions regarding their involvement in decision-making related to health, household possessions and visits among family and friends. Education was categorised as no education, primary, secondary and higher education. Results of multinomial regression analyses were reported as adjusted OR with 95% CI. We adjusted for age, wealth index, urban/rural residence, place of delivery, and antenatal and postnatal visits. Results Only 56.4% (n=3936) of the children received complete polio vaccination. Women with no education had significantly higher odds of their child receiving no polio vaccination (OR 2.34, 95% CI 1.05 to 5.18; pvaccination (OR 1.40, 95% CI 1.04 to 1.87; pchild for any polio vaccination (OR 1.58, 95% CI 1.17 to 2.12; pvaccination (OR 1.18, 95% CI 1.00 to 1.41; p=0.04). Conclusions Illiteracy, socioeconomic status and empowerment of women remained significant factors linked to poorer uptake of routine polio vaccination. PMID:28283489

  11. Determinants of performance of supplemental immunization activities for polio eradication in Uttar Pradesh, India: social mobilization activities of the Social mobilization Network (SM Net and Core Group Polio Project (CGPP

    Weiss William M

    2013-01-01

    Full Text Available Abstract Background The primary strategy to interrupt transmission of wild poliovirus in India is to improve supplemental immunization activities (SIAs and routine immunization coverage in priority districts. The CORE Group, part of the Social Mobilization Network (SM Net, has been successful in improving SIA coverage in high-risk areas of Uttar Pradesh (UP. The SM Net works through community level mobilisers (from the CORE Group and UNICEF and covers more than 2 million children under the age of five. In this paper, we examine the reasons the CORE Group had been successful through exploration of which social mobilization activities of the CORE Group predicted better performance of SIAs. Methods We carried out a secondary data analysis of routine monitoring information collected by the CORE Group and the Government of India for SIAs. These data included information about vaccination outcomes of SIAs in CORE Group areas and non-CORE Group areas within the districts where the CORE Group operates, along with information about the number of various social mobilization activities carried out for each SIA. We employed Generalized Linear Latent and Mixed Model (GLLAMM statistical analysis methods to identify which social mobilization activities predicted SIA performance, and to account for the intra-class correlation (ICC between multiple observations within the same geographic areas over time. Results The number of mosque announcements carried out was the most consistent determinant of improved SIA performance across various performance measures. The number of Bullawa Tollies carried out also appeared to be an important determinant of improved SIA performance. The number of times other social mobilization activities were carried out did not appear to determine better SIA performance. Conclusions Social mobilization activities can improve the performance of mass vaccination campaigns. In the CORE Group areas, the number of mosque announcements and Bullawa Tollies carried out were important determinants of desired SIA outcomes. The CORE Group and SM Net should conduct sufficient numbers of these activities in support of each SIA. It is likely, however, that the quality of social mobilization activities (not studied here is as or more important than the quantity of activities; quality measures of social mobilization activities should be investigated in the future as to how they determine vaccination performance.

  12. Eradicating Corruption in Public Office in Nigeria

    Wada Attah Ademu

    2013-12-01

    Full Text Available This paper attempts to provide a model for dealing with the problem of corruption in Nigeria. It uses an analytical approach to explore the Singapore model of dealing with acts of corruption to serve as a model for Nigeria. Corruption is inimical to socio-economic development of any country where it is practised on any scale. This explains why all nations make efforts to minimize or eradicate corruption in their economies. Nigeria has been ranked among the most corrupt nations of the World by many international anti-corruption agencies. If other nations take measures to eradicate corruption from their economies because of its negative consequences, Nigeria cannot be an exception. Corruption has led to gross misuse of public funds in Nigeria and has caused untold hardship to her citizens via non-payments of people’s benefits and lack of provision of basic public utilities. To deal with corruption in Nigeria, various anti-corruption agencies were set up but the problem remains. This paper therefore recommends the Singapore model as a method of dealing with corruption in Nigeria. This model holds each sectional head responsible for any act of corruption in his/her unit if established. The government was strong and determined to deal with the transgressors; there was political will to tame corruption and therefore there was government support to the anti-corruption agencies. If this model is adopted and faithfully implemented, corruption could be eradicated from Nigeria. In addition, constitutional amendments that would update and clearly define acts that constitute corrupt practices as these acts manifest in various forms are necessary to facilitate interpretation and enforcement of anti-corruption laws.

  13. Hybrid Therapy Regimen for Helicobacter Pylori Eradication

    Zhi-Qiang Song; Jian Liu; Li-Ya Zhou

    2016-01-01

    Objective:Helicobacterpylori (H.pylori) eradication remains a challenge with increasing antibiotic resistance.Hybrid therapy has attracted widespread attention because of initial report with good efficacy and safety.However,many issues on hybrid therapy are still unclear such as the eradication efficacy,safety,compliance,influencing factors,correlation with antibiotic resistance,and comparison with other regimens.Therefore,a comprehensive review on the evidence of hybrid therapy for H.pylori infection was conducted.Data Sources:The data used in this review were mainly from PubMed articles published in English up to September 30,2015,searching by the terms of"Helicobacterpylori" or "H.pylori",and "hybrid".Study Selection:Clinical research articles were selected mainly according to their level of relevance to this topic.Results:Totally,1871 patients of 12 studies received hybrid therapy.The eradication rates were 77.6-97.4% in intention-to-treat and 82.6-99.1% in per-protocol analyses.Compliance was 93.3-100.0%,overall adverse effects rate was 14.5-67.5%,and discontinued medication rate due to adverse effects was 0-6.7%.H.pylori culture and sensitivity test were performed only in 13.3% patients.Pooled analysis showed that the eradication rates with dual clarithromycin and metronidazole susceptible,isolated metronidazole or clarithromycin resistance,and dual clarithromycin and metronidazole resistance were 98.5%,97.6%,92.9%,and 80.0%,respectively.Overall,the efficacy,compliance,and safety of hybrid therapy were similar with sequential or concomitant therapy.However,hybrid therapy might be superior to sequential therapy in Asians.Conclusions:Hybrid therapy showed wide differences in the efficacy but consistently good compliance and safety across different regions.Dual clarithromycin and metronidazole resistance were the key factor to efficacy.Hybrid therapy was similar to sequential or concomitant therapy in the efficacy,safety,and compliance.

  14. Measuring Poverty in order to Eradicate It

    Julien Damon

    2012-06-01

    Full Text Available In 2000, the UN established its Millennium Development Goals, with the notable aim of halving extreme poverty by 2015. That same year, the European Union launched its Lisbon strategy, containing an injunction to “make a decisive impact on the eradication of poverty by 2010”. Since 2007, France has set a national target of reducing poverty by one third over five years. These proactive policies call, in all three cases, for technical elucidation to define and describe poverty. Each of the three scales – French, European and international – has its own approaches and methods of quantification. And yet their similarities are more significant than their differences.

  15. [History of development of the live poliomyelitis vaccine from Sabin attenuated strains in 1959 and idea of poliomyelitis eradication].

    Lashkevich, V A

    2013-01-01

    against poliomyelitis. In some developing countries the vaccination data are falsified, thereby threatening the polio epidemics reappearance and the virus spreading to other countries. Methods must be developed for detection and dealing with extremely rare persistent virus carriers. Because of all these constraints the outcome of poliomyelitis eradication at present is uncertain and vaccination must be continued. The world has become poliovaccine dependent.

  16. Control and eradication of endemic infectious diseases in cattle

    Houe, Hans; Nielsen, Liza Rosenbaum; Nielsen, Søren Saxmose

    "Control and eradication of endemic infectious diseases in cattle" provides the key elements that should be addressed in the establishment of bovine disease control and eradication programmes. The book aims to reach a broad group of readers, including: students; professionals in veterinary practi......, industry and governmental institutions; researchers; and others involved in control and eradication of endemic diseases in livestock. Key elements range from socioeconomic aspects such as motivation; veterinary science (including assessment of biosecurity and establishment of test...

  17. [Possible method of eradication of poliomyelitis as an infection].

    Seĭbil', V B; Malyshkina, L P

    2012-01-01

    Problem of poliomyelitis eradication is examined in the review. After the eradication of wild poliovirus, vaccine poliomyelitis virus continues to circulate in the human population. In rare cases it can cause the development of the disease. The authors describe disadvantages of the use of oral and inactivated poliomyelitis vaccines and note that by using oral poliomyelitis vaccine and eradication only of wild poliovirus, eradication of poliomyelitis as an infection will not succeed. As one of the approaches to reach this goal the authors propose the use of various enterovirus interference. Use of live enterovirus vaccine is described and its advantages and disadvantages are examined.

  18. Clinical evaluation of four one-week triple therapy regimens in eradicating Helicobacter pyloriinfection

    Chuan-Yong Guo; Yun-Bin Wu; Heng-Lu Liu; Jian-Ye Wu; Min-Zhang Zhong

    2004-01-01

    AIM: TO evaluate clinical efficacy of four one-week triple therapies in eradicating Helicobacter pylori infection.METHODS: In this clinical trial, 132 patients with duodenal ulcer and chronic gastritis were randomly divided into four 20 mg+ amoxicillin 1 000 mg + clarithromycin 250 mg), OFC (omeprazole 20 mg + furazolidone 100 mg + clarithromycin 250 mg), OFA (omeprazole 20 mg + furazolidone 100 mg + amoxicillin 1000 mg) and OMC (omeprazole 20 mg +metronidazole 200 mg + cladthromycin 250 mg), respectively.Each drug was taken twice daily for one week. The 13C urea breath test was carried out 4-8 weeks after treatment to determine the success of H pylori eradication.RESULTS: A total of 127 patients completed the treatment.The eradication rate for H pylori infection was 90.3%,90.9%, 70.9% and 65.6%, respectively in OAC, OFC OMC and OFA groups.CONCLUSION: A high eradication rate can be achieved with one-week OAC or OFC triple therapy. Thus, oneweek triple therapies with OAC and OFC are recommended for Chinese patients with duodenal ulcers and chronic gastritis.

  19. [Role of the National Poliovirus Laboratory for the Program of eradication and poliomyelitis surveillance].

    Trallero, Gloria; Cabrerizo, María; Avellón, Ana

    2013-01-01

    The Spanish acute flaccid paralysis surveillance network is coordinated by the National Poliovirus Laboratory (NPL), which, since 1998, carries out polioviruses (PV) and other enteroviruses detected characterization by cell culture and molecular techniques. A total of 110,725 (70046+40679) samples were studied between 1998-2012 and enteroviruses were detected in 8% of these. Among these enteroviruses 241 PV were characterized as PV Sabin-like, except samples belong to an imported poliomyelitis case, all of which were characterised as vaccine derived PV type 2. The NPL has carried out the serotyping and the intratypic differentiation of all the isolated PV in Spain of any syndrome. It is shown that wild PV has not circulated in our country during the 15 years studied and that has led to the signing of the Act of the "eradication of poliomyelitis in Spain" by WHO in 2001, and the /"certification of the eradication of wild PV free for European countries" on 21 June 2002. Currently only 3 countries have endemic transmission of wild PV (Pakistan, Afghanistan and Nigeria). Until a complete worldwide eradication, was achieved, Spain will actively continue to participate in the maintenance of the poliomyelitis eradication infrastructure by monitoring and vaccination as well as the wild PV containment plan to avoid the spread of wild PV.

  20. Monitoring polio supplementary immunization activities using an automated short text messaging system in Karachi, Pakistan

    Murtaza, A; Khoja, S; Zaidi, AK; Ali, SA

    2014-01-01

    Abstract Problem Polio remains endemic in many areas of Pakistan, including large urban centres such as Karachi. Approach During each of seven supplementary immunization activities against polio in Karachi, mobile phone numbers of the caregivers of a random sample of eligible children were obtained. A computer-based system was developed to send two questions – as short message service (SMS) texts – automatically to each number after the immunization activity: “Did the vaccinator visit your house?” and “Did the enrolled child in your household receive oral polio vaccine?” Persistent non-responders were phoned directly by an investigator. Local setting A cluster sampling technique was used to select representative samples of the caregivers of young children in Karachi in general and of such caregivers in three of the six “high-risk” districts of the city where polio cases were detected in 2011. Relevant changes In most of the supplementary immunization activities investigated, vaccine coverages estimated using the SMS system were very similar to those estimated by interviewing by phone those caregivers who never responded to the SMS messages. In the high-risk districts investigated, coverages estimated using the SMS system were also similar to those recorded – using lot quality assurance sampling – by the World Health Organization. Lessons learnt For the monitoring of coverage in supplementary immunization activities, automated SMS-based systems appear to be an attractive and relatively inexpensive option. Further research is needed to determine if coverage data collected by SMS-based systems provide estimates that are sufficiently accurate. Such systems may be useful in other large-scale immunization campaigns. PMID:24700982

  1. Serum and mucosal antibody responses to inactivated polio vaccine after sublingual immunization using a thermoresponsive gel delivery system.

    White, Jessica A; Blum, Jeremy S; Hosken, Nancy A; Marshak, Joshua O; Duncan, Lauren; Zhu, Changcheng; Norton, Elizabeth B; Clements, John D; Koelle, David M; Chen, Dexiang; Weldon, William C; Oberste, M Steven; Lal, Manjari

    2014-01-01

    Administering vaccines directly to mucosal surfaces can induce both serum and mucosal immune responses. Mucosal responses may prevent establishment of initial infection at the port of entry and subsequent dissemination to other sites. The sublingual route is attractive for mucosal vaccination, but both a safe, potent adjuvant and a novel formulation are needed to achieve an adequate immune response. We report the use of a thermoresponsive gel (TRG) combined with a double mutant of a bacterial heat-labile toxin (dmLT) for sublingual immunization with a trivalent inactivated poliovirus vaccine (IPV) in mice. This TRG delivery system, which changes from aqueous solution to viscous gel upon contact with the mucosa at body temperature, helps to retain the formulation at the site of delivery and has functional adjuvant activity from the inclusion of dmLT. IPV was administered to mice either sublingually in the TRG delivery system or intramuscularly in phosphate-buffered saline. We measured poliovirus type-specific serum neutralizing antibodies as well as polio-specific serum Ig and IgA antibodies in serum, saliva, and fecal samples using enzyme-linked immunosorbent assays. Mice receiving sublingual vaccination via the TRG delivery system produced both mucosal and serum antibodies, including IgA. Intramuscularly immunized animals produced only serum neutralizing and binding Ig but no detectable IgA. This study provides proof of concept for sublingual immunization using the TRG delivery system, comprising a thermoresponsive gel and dmLT adjuvant.

  2. ROLE OF MEDICAL REHABILITATION TREATMENT IN POST-POLIO SYNDROME – A CASE REPORT

    DOGARU Gabriela

    2015-05-01

    Full Text Available The term post-polio syndrome (PPS was introduced in 1985 by Halstead. It is characterized by sudden or progressive muscle weakness, new muscular atrophy, muscle pain, fatigue, functional impotence, cold intolerance, after a period of at least 15 years from acute polio virus infection, a period of neurological and functional stability, in the absence of other medical explanation [1]. The reported prevalence of PPS is between 15% and 80% of all patients with previous polio virus infections [2, 3]. Poliomyelitis continues to be a public health problem, because the consequences of the disease last throughout life. In Europe, there are about 700,000 persons who survived the infection and are still alive. Non-randomized studies with kinesitherapy programs with a duration between 6 weeks and 7 months, involving isokinetic and isometric endurance muscle training, have demonstrated an increase of muscle strength in the case of patients with mild or moderate muscle weakness, and a reduction of muscle fatigue [7, 8, 9]. The differential diagnosis of PPS can be difficult because of the need to exclude both neurological and non-neurological conditions that aggravate the pre-existing motor deficit. Rehabilitation programs using therapeutic means: kinesitherapy, thermotherapy, hydrothermotherapy, occupational therapy represent the only way to limit functional deficit and to improve pain, playing an important role in the long-term management and care of patients.

  3. Interference of Vaccine Derived Polio Viruses with Diagnosis of Enteroviral Diseases in Neonatal Period

    Nakhaei, Alireza Ataei; Alborzi, Abdolvahab; Ziyaeyan, Mazyar

    2016-01-01

    Introduction Enteroviruses (EV) are a common cause of neonatal sepsis especially at the junction of summer and fall. Aim This study was planned to find the frequency of Enteroviral (EV) sepsis among neonates with clinical sepsis. Materials and Methods This is a prospective descriptive study. Rectal and pharyngeal swab samples were taken from all neonates with clinical sepsis and a control group of neonates with simple jaundice. EV was confirmed by both cell culture and RT-PCR. Anti polio antiserum was used to differentiate Polioviruses from Non Polio EVs (NPEV). Results We had 67 neonates with clinical sepsis and 31 cases of simple jaundice during 105 days. NPEVs were isolated from 2 cases (2.9%) of the sepsis arm and one neonate (3.2%) of the jaundice group. Polio virus was isolated from 16.2% and 15.3% of OPV recipients in the sepsis and jaundice group respectively. Conclusion Enteroviruses were not a common cause for neonatal sepsis in Nemazi hospital at the time of this study. OPV vaccinated neonates commonly pass the vaccine virus in their pharynx and stool which can be mistaken with NPEV. PMID:28050469

  4. Polio chronicles: warm springs and disability politics in the 1930s.

    Rogers, Naomi

    2009-01-01

    During the 1920s and 1930s, disabled polio survivors initiated a campaign which made them active, dissenting subjects in public discourse about disease and disability. Its source was a core of Warm Springs patients who wanted more than a healing refuge. They were well aware of the need to construct a new image of the disabled, and saw the resort's high public profile as a potent weapon in a cultural war to remake popular images of the disabled, whether as pathetic charitable objects or as horrific movie villains. Drawing on their own, disheartening experiences, this group of activists boldly critiqued the medical care offered most disabled patients as well as the training and attitudes of doctors, nurses and physical therapists. Protesting the narrow, medicalized definition of rehabilitation, they provocatively posed the need to "rehabilitate" prejudiced, able-bodied employers and health professionals. And most of all, they consciously designed the polio center at Warm Springs to function not as an inward-looking refuge but as an exemplar of the way polio survivors and other disabled people should be allowed to live, work and love. This story begins and ends in the 1930s. It traces a rise and fall: the rise of an activist community at the rehabilitative center at Warm Springs; and its decline with the creation of the National Foundation for Infantile Paralysis (known popularly as the March of Dimes) in 1937.

  5. Efficacy of fermented milk and whey proteins in Helicobacter pylori eradication: a review.

    Sachdeva, Aarti; Rawat, Swapnil; Nagpal, Jitender

    2014-01-21

    Helicobacter pylori (H. pylori) eradication is considered a necessary step in the management of peptic ulcer disease, chronic gastritis, gastric adenocarcinoma and mucosa associated lymphoid tissue lymphoma. Standard triple therapy eradication regimens are inconvenient and achieve unpredictable and often poor results. Eradication rates are decreasing over time with increase in antibiotic resistance. Fermented milk and several of its component whey proteins have emerged as candidates for complementary therapy. In this context the current review seeks to summarize the current evidence available on their role in H. pylori eradication. Pertinent narrative/systematic reviews, clinical trials and laboratory studies on individual components including fermented milk, yogurt, whey proteins, lactoferrin, α-lactalbumin (α-LA), glycomacropeptide and immunoglobulin were comprehensively searched and retrieved from Medline, Embase, Scopus, Cochrane Controlled Trials Register and abstracts/proceedings of conferences up to May 2013. A preponderance of the evidence available on fermented milk-based probiotic preparations and bovine lactoferrin suggests a beneficial effect in Helicobacter eradication. Evidence for α-LA and immunoglobulins is promising while that for glycomacropeptide is preliminary and requires substantiation. The magnitude of the potential benefit documented so far is small and the precise clinical settings are ill defined. This restricts the potential use of this group as a complementary therapy in a nutraceutical setting hinging on better patient acceptability/compliance. Further work is necessary to identify the optimal substrate, fermentation process, dose and the ideal clinical setting (prevention/treatment, first line therapy/recurrence, symptomatic/asymptomatic, gastritis/ulcer diseases etc.). The potential of this group in high antibiotic resistance or treatment failure settings presents interesting possibilities and deserves further exploration.

  6. Onset of Ulcerative Colitis after Helicobacter pylori Eradication Therapy: A Case Report.

    Chiba, Mitsuro; Tsuji, Tsuyotoshi; Takahashi, Kenichi; Komatsu, Masafumi; Sugawara, Takeshi; Ono, Iwao

    2016-01-01

    In Japan, Helicobacter pylori eradication has been approved since 2013 for treatment of H pylori-induced chronic gastritis, in an attempt to reduce the prevalence of gastric cancer, a leading cancer in Japan. H pylori infection affects more than 50% of the world's population. H pylori eradication therapy is generally safe. To our knowledge, no case of newly diagnosed ulcerative colitis occurring immediately after H pylori eradication therapy has previously been reported.A 63-year-old man received a diagnosis of chronic gastritis and H pylori infection. In early March 2014, primary H pylori eradication therapy was initiated; lansoprazole, amoxicillin, and clarithromycin were administered for 1 week. Beginning on the fourth day, he had watery diarrhea twice a day. From the 11th day, bloody stools and watery diarrhea increased to 6 times a day. Colonoscopy, performed on the 40th day after termination of drug therapy, revealed diffuse inflammation in the distal aspect of the colon, with histologic findings consistent with ulcerative colitis. He was admitted to the hospital and was provided with a semivegetarian diet and metronidazole. He noticed a gradual decrease in the amount of blood in his feces then a disappearance of the blood. A fecal occult blood test on the 11th hospital day recorded 337 ng/mL. Fecal occult blood test is not indicated during macroscopic bloody stool but is indicated after disappearance of bloody stool. Therefore, he achieved clinical remission by the 11th hospital day. He was in remission on discharge.New onset of ulcerative colitis should be added to a list of adverse events of H pylori eradication therapy.

  7. High efficacy of gemifloxacin-containing therapy in Helicobacter Pylori eradication

    Mahmoudi, Laleh; Farshad, Shohreh; Seddigh, Mehrdad; Mahmoudi, Paria; Ejtehadi, Fardad; Niknam, Ramin

    2016-01-01

    Abstract Background: Helicobacter pylori (H pylori) is a common gastric pathogen which is associated with chronic gastritis, peptic ulcer, and gastric cancer. It has worldwide distribution with higher incidence in developing countries. Gemifloxacin is a fluoroquinolone antibiotic with documented in vitro activity against H pylori. Considering that there is no clinical data to verify gemifloxacin efficacy in H pylori eradication, this pilot clinical trial was designed. Methods: This prospective pilot study was performed during February 2014 to February 2015. A regimen of gemifloxacin (320 mg single dose) plus twice daily doses of amoxicillin1g, bismuth 240 mg, and omeprazole 20 mg for 14 days were prescribed for H pylori infected patients in whom a first-line standard quadruple therapy (clarithromycin–amoxicillin–bismuth–omeprazole) had failed. To confirm H pylori eradication a 13C-urea breath test was performed 4 weeks after treatment. Compliance and incidence of adverse effects were evaluated by questionnaires. Results: A total of 120 patients were enrolled consecutively; out of which 106 patients achieved H pylori eradication; per-protocol and intention-to-treat eradication rates were 91.4% (95% CI: 85.5–97.6) and 88.3% (95% CI: 75.4–92.4) respectively. Three patients (2.5%) failed to take at least 80% of the drugs and excluded from the final analysis. Adverse effects were reported in 42% of patients, most commonly including nausea (15%) and diarrhea (13.3%), which was intense in 1 patient and led to the discontinuation of treatment. In total, 96.7% (116/120) of the patients took the medications correctly. Conclusion: This study revealed that gemifloxacin-containing quadruple therapy provides high H pylori eradication rate (≥90% PP cure rate), and this agent can be included in the list of second-line H pylori therapeutic regimens. PMID:27759625

  8. Broadly Neutralizing Antibodies for HIV Eradication.

    Stephenson, Kathryn E; Barouch, Dan H

    2016-02-01

    Passive transfer of antibodies has long been considered a potential treatment modality for infectious diseases, including HIV. Early efforts to use antibodies to suppress HIV replication, however, were largely unsuccessful, as the antibodies that were studied neutralized only a relatively narrow spectrum of viral strains and were not very potent. Recent advances have led to the discovery of a large portfolio of human monoclonal antibodies that are broadly neutralizing across many HIV-1 subtypes and are also substantially more potent. These antibodies target multiple different epitopes on the HIV envelope, thus allowing for the development of antibody combinations. In this review, we discuss the application of broadly neutralizing antibodies (bNAbs) for HIV treatment and HIV eradication strategies. We highlight bNAbs that target key epitopes, such as the CD4 binding site and the V2/V3-glycan-dependent sites, and we discuss several bNAbs that are currently in the clinical development pipeline.

  9. Invasive mammal eradication on islands results in substantial conservation gains.

    Jones, Holly P; Holmes, Nick D; Butchart, Stuart H M; Tershy, Bernie R; Kappes, Peter J; Corkery, Ilse; Aguirre-Muñoz, Alfonso; Armstrong, Doug P; Bonnaud, Elsa; Burbidge, Andrew A; Campbell, Karl; Courchamp, Franck; Cowan, Philip E; Cuthbert, Richard J; Ebbert, Steve; Genovesi, Piero; Howald, Gregg R; Keitt, Bradford S; Kress, Stephen W; Miskelly, Colin M; Oppel, Steffen; Poncet, Sally; Rauzon, Mark J; Rocamora, Gérard; Russell, James C; Samaniego-Herrera, Araceli; Seddon, Philip J; Spatz, Dena R; Towns, David R; Croll, Donald A

    2016-04-12

    More than US$21 billion is spent annually on biodiversity conservation. Despite their importance for preventing or slowing extinctions and preserving biodiversity, conservation interventions are rarely assessed systematically for their global impact. Islands house a disproportionately higher amount of biodiversity compared with mainlands, much of which is highly threatened with extinction. Indeed, island species make up nearly two-thirds of recent extinctions. Islands therefore are critical targets of conservation. We used an extensive literature and database review paired with expert interviews to estimate the global benefits of an increasingly used conservation action to stem biodiversity loss: eradication of invasive mammals on islands. We found 236 native terrestrial insular faunal species (596 populations) that benefitted through positive demographic and/or distributional responses from 251 eradications of invasive mammals on 181 islands. Seven native species (eight populations) were negatively impacted by invasive mammal eradication. Four threatened species had their International Union for the Conservation of Nature (IUCN) Red List extinction-risk categories reduced as a direct result of invasive mammal eradication, and no species moved to a higher extinction-risk category. We predict that 107 highly threatened birds, mammals, and reptiles on the IUCN Red List-6% of all these highly threatened species-likely have benefitted from invasive mammal eradications on islands. Because monitoring of eradication outcomes is sporadic and limited, the impacts of global eradications are likely greater than we report here. Our results highlight the importance of invasive mammal eradication on islands for protecting the world's most imperiled fauna.

  10. Insect Eradication and Containment of Invasive Alien Species

    Insect eradication programs are nearly always targeted at recently arrived invasive species with significant pest potential. They attempt to contain a pest to a defined area and then completely eliminate the pest from that area. From a Federal regulatory standpoint, eradication programs are undert...

  11. 76 FR 53165 - Certification Related to Aerial Eradication in Colombia

    2011-08-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Certification Related to Aerial Eradication in Colombia Pursuant to the authority vested in the Secretary of... for aerial eradication of illicit crops in Colombia is being used in accordance with EPA...

  12. Gastric cancer development after the successful eradication of Helicobacter pylori

    Kaname Uno; Katsunori Iijima; Tooru Shimosegawa

    2016-01-01

    Gastric cancer(GC) develops as a result of inflammationassociated carcinogenesis due to Helicobacter pylori(H. pylori) infection and subsequent defects in genetic/epigenetic events. Although the indication for eradication therapy has become widespread, clinical studies have revealed its limited effects in decreasing the incidence of GC. Moreover, research on biopsy specimens obtained by conventional endoscopy has demonstrated the feasibility of the restoration of some genetic/epigenetic alterations in the gastric mucosa. Practically, the number of sporadic cases of primary/metachronous GC that emerge after successful eradication has increased, while on-going guidelines recommend eradication therapy for patients with chronic gastritis and those with background mucosa after endoscopic resection for GC. Accordingly, regular surveillance of numerous individuals who have received eradication therapy is recommended despite the lack of biomarkers. Recently, the focus has been on functional reversibility after successful eradication as another cue to elucidate the mechanisms of restoration as well as those of carcinogenesis in the gastric mucosa after H. pylori eradication. We demonstrated that Congo-red chromoendoscopy enabled the identification of the multifocal distribution of functionally irreversible mucosa compared with that of restored mucosa after successful eradication in individuals at extremely high risk for GC. Further research that uses functional imaging may provide new insights into the mechanisms of regeneration and carcinogenesis in the gastric mucosa post-eradication and may allow for the development of useful biomarkers.

  13. Gastric cancer development after the successful eradication of Helicobacter pylori.

    Uno, Kaname; Iijima, Katsunori; Shimosegawa, Tooru

    2016-03-15

    Gastric cancer (GC) develops as a result of inflammation-associated carcinogenesis due to Helicobacter pylori (H. pylori) infection and subsequent defects in genetic/epigenetic events. Although the indication for eradication therapy has become widespread, clinical studies have revealed its limited effects in decreasing the incidence of GC. Moreover, research on biopsy specimens obtained by conventional endoscopy has demonstrated the feasibility of the restoration of some genetic/epigenetic alterations in the gastric mucosa. Practically, the number of sporadic cases of primary/metachronous GC that emerge after successful eradication has increased, while on-going guidelines recommend eradication therapy for patients with chronic gastritis and those with background mucosa after endoscopic resection for GC. Accordingly, regular surveillance of numerous individuals who have received eradication therapy is recommended despite the lack of biomarkers. Recently, the focus has been on functional reversibility after successful eradication as another cue to elucidate the mechanisms of restoration as well as those of carcinogenesis in the gastric mucosa after H. pylori eradication. We demonstrated that Congo-red chromoendoscopy enabled the identification of the multi-focal distribution of functionally irreversible mucosa compared with that of restored mucosa after successful eradication in individuals at extremely high risk for GC. Further research that uses functional imaging may provide new insights into the mechanisms of regeneration and carcinogenesis in the gastric mucosa post-eradication and may allow for the development of useful biomarkers.

  14. Can we eradicate gastric MALT-lymphoma?

    Angelo Zullo

    2013-04-01

    Full Text Available The incidence of primary gastric lymphoma in Italy is considerably higher than that observed in the rest of Europe. It is widely accepted that gastric B-cell, low-grade mucosalassociated lymphoid tissue (MALT lymphoma is caused by specific host-bacterial interactions that occur during Helicobacter pylori infection. This review examines recent findings on the origins, diagnosis, treatment, and follow-up of gastric MALT lymphomas. Clinical and endoscopic findings at diagnosis vary widely. In a substantial number of cases, the patient presents only vague dyspeptic symptoms or poorly defined abdominal pain with no macroscopic lesions on the gastric mucosa. Review of data from 32 trials in which a total of 1,387 MALT-lymphoma patients of the stomach were treated solely with H. pylori eradication revealed high remission rates when the disease is treated early (stage I-II1. Neoplasia confined to the submucosa, antral localization of tumors, and negativity for the API2-MALT1 translocation were associated with a high probability of remission following H. pylori eradication. When the latter approach is not sufficient, radiotherapy, chemotherapy and, in selected cases, surgery are associated with high success rates; data on the efficacy of monoclonal antibody therapy (rituximab are still limited. Five-year survival rates are higher than 90%. Patients whose tumors have been eliminated require close, long-term endoscopic follow-up since recurrence has been reported in some cases. Broader clinical follow-up is also advisable because the incidence of other solid tumors and of cardiovascular events is reportedly increased in these patients.

  15. Smallpox: emergence, global spread, and eradication.

    Fenner, F

    1993-01-01

    Speculatively, it is suggested that variola virus, the cause of smallpox, evolved from an orthopoxvirus of animals of the central African rain forests (possibly now represented by Tatera poxvirus), some thousands of years ago, and first became established as a virus specific for human beings in the dense populations of the Nile valley perhaps five thousand years ago. By the end of the first millennium of the Christian era, it had spread to all the densely populated parts of the Eurasian continent and along the Mediterranean fringe of north Africa. It became established in Europe during the times of the Crusades. The great voyages of European colonization carried smallpox to the Americas and to Africa south of the Sahara. Transported across the Atlantic by Europeans and their African slaves, it played a major role in the conquest of Mexico and Peru and the European settlement of north America. Variolation, an effective preventive inoculation, was devised as early as the tenth century. In 1798 this practice was supplanted by Jenner's cowpox vaccine. In 1967, when the disease was still endemic in 31 countries and caused ten to fifteen million cases and about two million deaths annually, the World Health Organization embarked on a programme that was to see the disease eradicated globally just over ten years later, and the world was formally declared to be free of smallpox in May 1980. Smallpox is unique--a specifically human disease that emerged from some animal reservoir, spread to become a worldwide, severe and almost universal affliction, and finally underwent the reverse process to emergence, namely global eradication.

  16. Early Attempts to Eradicate Helicobacter pylori after Endoscopic Resection of Gastric Neoplasm Significantly Improve Eradication Success Rates

    Huh, Cheal Wung; Youn, Young Hoon; Jung, Da Hyun; Park, Jae Jun; Kim, Jie-Hyun; Park, Hyojin

    2016-01-01

    Purpose After endoscopic resection (ER) of gastric tumors, eradication of Helicobacter pylori (H. pylori) infection is advised to reduce metachronous recurrence. Optimal timing of such therapy (yet to be established) was investigated herein, examining early active and late scarring stages of post-ER iatrogenic ulcers. Materials and Methods Analysis included 514 patients who received proton-pump inhibitor (PPI)-based triple therapy for H. pylori eradication after ER for gastric neoplasms between January 2008 and June 2015. Clinicopathologic characteristics, particularly the timing of triple therapy, were used to compare eradication rates, assigning patients to early- (≤2 weeks), intermediate- (2–8 weeks), and late-phase (≥8 weeks) treatment groups. Results H. pylori eradication rates differed significantly by timing of triple therapy after ER (early, 90.0%; intermediate, 76.2%, late, 72.4%; p ulcer, and duration of therapeutic regimen. Early initiation of H. pylori eradication was also identified as a significant independent predictor of eradication success in multivariate analysis (Odds ratio = 3.67, 95% CI 2.18–6.16; p <.001). Conclusion In patients undergoing ER of gastric tumors, early post-ER attempts at eradication of H. pylori offer the best chance of eradication success. PMID:27588679

  17. First-line eradication of Helicobacter pylori:Are the standard triple therapies obsolete? A different perspective

    Gyrgy; Miklós; Buzás

    2010-01-01

    Studies concerning the eradication of Helicobacter pylori have resulted in a proliferation of meta-analyses. To date, there are 303 meta-analyses cited in PubMed, 113 dealing with the therapy of the infection. A chronological analysis of the results of meta-analyses performed between 1998 and 2010 shows that first-line standard triple therapies achieved eradication rates on an intention-to-treat basis of around 80%; prolonging treatment to 14, but not 10 d should improve the results. The proton pump inhibit...

  18. Late onset polio sequelae : Disabilities and handicaps in a population-based cohort of the 1956 poliomyelitis outbreak in The Netherlands

    Ivanyi, Barbara; Nollet, E; Redekop, WK; De Haan, R; Wohlgemuht, M; van Wijngaarden, JK; de Visser, Marianne

    1999-01-01

    Objective: To investigate the prevalence of new neuromuscular symptoms, disabilities, and handicaps in a group of polio survivors. Design: A self-constructed health questionnaire about neuromuscular complaints and disability and handicap levels during the stable period after recovery from polio and

  19. Sex-differential effect on infant mortality of oral polio vaccine administered with BCG at birth in Guinea-Bissau. A natural experiment.

    Christine Stabell Benn

    Full Text Available BACKGROUND: The policy to provide oral polio vaccine (OPV at birth was introduced in low-income countries to increase coverage. The effect of OPV at birth on overall child mortality was never studied. During a trial of vitamin A supplementation (VAS at birth in Guinea-Bissau, OPV was not available during several periods. We took advantage of this "natural experiment" to test the effect on mortality of receiving OPV at birth. METHODOLOGY: Between 2002 and 2004, the VAS trial randomised normal-birth-weight infants to 50,000 IU VAS or placebo administered with BCG. Provision of OPV at birth was not part of the trial, but we noted whether the infants received OPV or not. OPV was missing during several periods in 2004. We used Cox proportional hazards models to compute mortality rate ratios (MRR of children who had received or not received OPV at birth. PRINCIPAL FINDINGS: A total of 962 (22.1% of the 4345 enrolled children did not receive OPV at birth; 179 children died within the first year of life. Missing OPV at birth was associated with a tendency for decreased mortality (adjusted MRR = 0.69 (95% CI = 0.46-1.03, the effect being similar among recipients of VAS and placebo. There was a highly significant interaction between OPV at birth and sex (p = 0.006. Not receiving OPV at birth was associated with a weak tendency for increased mortality in girls (1.14 (0.70-1.89 but significantly decreased mortality in boys (0.35 (0.18-0.71. CONCLUSIONS: In our study OPV at birth had a sex-differential effect on mortality. Poliovirus is almost eradicated and OPV at birth contributes little to herd immunity. A randomised study of the effect of OPV at birth on overall mortality in both sexes is warranted.

  20. Managing breaches of containment and eradication of invasive plant populations.

    Fletcher, Cameron S; Westcott, David A; Murphy, Helen T; Grice, Anthony C; Clarkson, John R

    2015-02-01

    Containment can be a viable strategy for managing invasive plants, but it is not always cheaper than eradication. In many cases, converting a failed eradication programme to a containment programme is not economically justified. Despite this, many contemporary invasive plant management strategies invoke containment as a fallback for failed eradication, often without detailing how containment would be implemented.We demonstrate a generalized analysis of the costs of eradication and containment, applicable to any plant invasion for which infestation size, dispersal distance, seed bank lifetime and the economic discount rate are specified. We estimate the costs of adapting eradication and containment in response to six types of breach and calculate under what conditions containment may provide a valid fallback to a breached eradication programme.We provide simple, general formulae and plots that can be applied to any invasion and show that containment will be cheaper than eradication only when the size of the occupied zone exceeds a multiple of the dispersal distance determined by seed bank longevity and the discount rate. Containment becomes proportionally cheaper than eradication for invaders with smaller dispersal distances, longer lived seed banks, or for larger discount rates.Both containment and eradication programmes are at risk of breach. Containment is less exposed to risk from reproduction in the 'occupied zone' and three types of breach that lead to a larger 'occupied zone', but more exposed to one type of breach that leads to a larger 'buffer zone'.For a well-specified eradication programme, only the three types of breach leading to reproduction in or just outside the buffer zone can justify falling back to containment, and only if the expected costs of eradication and containment were comparable before the breach.Synthesis and applications. Weed management plans must apply a consistent definition of containment and provide sufficient implementation detail

  1. Rebamipide Improves Chronic Inflammation in the Lesser Curvature of the Corpus after Helicobacter pylori Eradication: A Multicenter Study

    Tomoari Kamada

    2015-01-01

    Full Text Available Background and Aim. Although many epidemiologic studies have shown that Helicobacter pylori eradication has prophylactic effects on gastric cancer, it does not completely eliminate the risk of gastric cancer. We aimed to investigate the changes in histological gastritis in patients receiving rebamipide treatment after H. pylori eradication. Methods. 206 patients who had undergone H. pylori eradication were evaluated. Of these, 169 patients who achieved successful eradication were randomly allocated to 2 groups: the rebamipide group (n = 82 and the untreated group (n = 87. The primary endpoints were histopathological findings according to the updated Sydney system at the start of the study and after 1 year. Results. Final assessment for histological gastritis was possible in 50 cases from the rebamipide group and 53 cases from the untreated group. The activity and atrophy improved in both the rebamipide and untreated groups, and no significant intergroup differences were observed. Chronic inflammation affecting the lesser curvature of the corpus was significantly improved in the rebamipide group compared to in the untreated group (1.12±0.08 versus 1.35±0.08; P = 0.043. Conclusions. Rebamipide treatment after H. pylori eradication alleviated chronic inflammation in the lesser curvature of the corpus compared to that in the untreated group. This trial is registered with UMIN000002369.

  2. Two injections of diphtheria-tetanus-pertussis-polio vaccine as the backbone of a simplified immunization schedule in developing countries.

    Cohen, H; Nagel, J

    1984-01-01

    From studies of antibody levels induced against poliovirus types 1, 2, and 3 and against diphtheria and tetanus toxins as well as from epidemiologic studies comparing the protective effect in children of two and three doses of diphtheria-tetanus-pertussis (DTP) vaccine, respectively, it can be concluded that two injections of DTP-polio vaccine administered at least four months apart will induce immunity against the four diseases. An immunization schedule can be built up in which bacille Calmette-Guérin (BCG) vaccine is given simultaneously with the first DTP-polio injection at the age of three to eight months and vaccination against measles and--if needed--yellow fever is performed simultaneously with the second DTP-polio immunization at the age of nine to 14 months.

  3. Treatment of low-grade gastric malt lymphoma using Helicobacter pylori eradication

    Grgov Saša

    2015-01-01

    Full Text Available Background/Aim. Lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma of the stomach usually occurs as a consequence of Helicobacter pylori (H. pylori infection. The aim of this study was to investigate the long-term effect of treatment of low-grade gastric MALT lymphoma with the H. pylori eradication method. Methods. In the period 2002-2012 in 20 patients with dyspepsia, mean age 55.1 years, the endoscopic and histologic diagnosis of gastric MALT lymphoma in the early stages were made. Histological preparations of endoscopic biopsy specimens were stained with hematoxyllineosin (HE, histochemical and immunohistochemical methods. Results. Endoscopic findings of gastritis were documented in 25% of the patients, and 75% of the patients had hypertrophic folds, severe mucosal hyperemia, fragility, nodularity, exulcerations and rigidity. Histopathologically, pathognomonic diagnostic criterion were infiltration and destruction of glandular epithelium with neoplastic lymphoid cells, the so-called lymphoepithelial lesions. In all 20 patients H. pylori was verified by rapid urease test and Giemsa stain. After the triple eradication therapy complete remission of MALT lymphoma was achieved in 85% of the patients, with no recurrence of lymphoma and H. pylori infection in the average follow-up period of 48 months. In 3 (15% of the patients, there was no remission of MALT lymphoma 12 months after the eradication therapy. Of these 3 patients 2 had progression of MALT lymphoma to diffuse large-cell lymphoma. Conclusion. Durable complete re-mission of low-grade gastric MALT lymphoma is achieved in a high percentage after eradication of H. pylori infection, thus preventing the formation of diffuse large-cell lymphoma and gastric adenocarcinoma.

  4. Six challenges in the eradication of infectious diseases

    Petra Klepac

    2015-03-01

    Full Text Available Eradication and elimination are increasingly a part of the global health agenda. Once control measures have driven infection to low levels, the ecology of disease may change posing challenges for eradication efforts. These challenges vary from identifying pockets of susceptibles, improving monitoring during and after the endgame, to quantifying the economics of disease eradication versus sustained control, all of which are shaped and influenced by processes of loss of immunity, susceptible build-up, emergence of resistance, population heterogeneities and non-compliance with control measures. Here we discuss how modelling can be used to address these challenges.

  5. Age-dependent eradication of Helicobacter pylori in Japanese patients

    Satoshi; Mamori; Akihiro; Higashida; Fumiaki; Kawara; Katsuhiro; Ohnishi; Akihiko; Takeda; Eri; Senda; Cho; Ashida; Hajime; Yamada

    2010-01-01

    AIM:To determine the general risk factors affecting the failure rate of first-line eradication therapy in Japanese patients with Helicobacter pylori(H.pylori)infection.METHODS:The present study enrolled 253 patients who had an H.pylori infection,underwent gastroendoscopy,and were treated with H.pylori eradication therapy.Eradication therapy consisted of 30 mg lansoprazole plus 750 mg amoxicillin and 400 mg clarithromycin twice daily for 7 d.All of the patients underwent a 13 C urea breath test at least 1 mo...

  6. And they shall walk: ideal versus reality in polio rehabilitation in the United States

    Wilson, Daniel J.

    2009-06-01

    Full Text Available This essay explores the significance that rehabilitation physicians and polio patients in the United States put on recovering the ability to walk. Polio often paralyzed or severely weakened the legs of those who contracted the disease. Regaining the ability to walk was thus a significant measure of recovery from the disease. However, walking meant more than the physical act itself. Regaining the ability to walk meant, in a symbolic sense, that one was no longer disabled, that one had again become normal. This attitude was shared by rehabilitation specialists and patients alike. This essay examines this attitude and the cultural values it embodied through a study of the efforts of selected polio survivors to learn to walk again and of the rehabilitation literature that held walking as an ideal. It also explores what happened when polio patients were unable to walk again because of the severity of their paralysis.

    En este artículo se analiza la importancia que tiene la recuperación de la capacidad de andar para los especialistas en rehabilitación y los pacientes de polio en los Estados Unidos. La polio iba a menudo acompañada de parálisis o de una grave debilitación de las piernas en aquellas personas que contraían la enfermedad. El recuperar la capacidad de andar era por lo tanto un importante factor indicativo de la recuperación de la enfermedad. Sin embargo, el andar significaba algo más que la simple acción física. El recuperar la movilidad significaba simbólicamente que uno dejaba de ser un minusválido y que volvía a ser una persona normal. Esta postura la compartían tanto los especialistas en rehabilitación como los pacientes. Este artículo analiza esta actitud y los valores culturales derivados de la misma, a través de un estudio sobre los esfuerzos llevados a cabo por un grupo seleccionado de supervivientes de polio para aprender a andar de nuevo así como de un análisis de la literatura sobre la rehabilitaci

  7. Effect of Multiple Simultaneous Vaccines on Polio Seroresponse and Associated Health Outcomes

    2015-01-01

    responses to biological warfare vaccines in human vaccinees. Clin Infect Dis 2006;43:1–7. 20] Butler D. Admission on Gulf War vaccines spurs debate on...Naval Health Research Center Effect of Multiple, Simultaneous Vaccines on Polio Seroresponse and Associated Health Outcomes Michael P...Diego, California 92106-3521 E a M C a b a A R R A A K P I S M T T 1 t c i o c i A h 0 Vaccine 33 (2015) 2842–2848 Contents lists available at

  8. The immunological effects of oral polio vaccine provided with BCG vaccine at birth

    Jensen, Kristoffer Jarlov; Karkov, Hanne Sophie; Lund, Najaaraq

    2014-01-01

    BACKGROUND: Vaccines may have non-specific effects. An observational study from Guinea-Bissau suggested that oral polio vaccine at birth (OPV0) provided with Bacillus Calmette-Guérin (BCG) vaccine was associated with down-regulation of the immune response to BCG vaccine 6 weeks later. Based...... BCG alone at birth, and subsequently randomised to have a blood sample taken at 2, 4 or 6 weeks post-randomisation. Excreted levels of cytokines (IL-2, IL-5, IL-10, TNF-α and IFN-γ) were measured from whole blood in vitro stimulations with a panel of recall vaccine antigens (BCG, PPD, OPV), mitogen...

  9. [Belated diagnosis of medullar compression in a case of post-polio syndrome].

    Boulay, C; Hamonet, C; Galaup, N; Djindjian, M; Montagne, A; Vivant, R

    2001-03-01

    The physiatrist observes about his practice individuals with sequela of old poliomyelitics. A part of them have unusual fatigue and muscular pains and weakness. The hypothesis of an evolution of neuro-biological mechanism suggested by few authors isn't, actually, demonstrated. More probably, the modifications of lesional and, functional changes with disability observed are the consequence of elderly effects and decreasing of physical activites. We report a case of spinal cord compression by intramedullar tumor, associated with a post-polio syndrome.

  10. Los rotarios y la erradicación de la polio en el Perú

    Jorge Lossio

    2013-09-01

    Full Text Available This paper analyzes the process of the erradication of polio desease in Perú during the period of 1985-1991 following an initiative of the Pan American Health Organization (PAHO which was financed by the Rotary Club International. Accordingly, this paper shows the problems this organization had to face during those years due to inefficient government apparatus as well as the presence of an internal armed conflict across the country. This situation did not frighten away the Rotarians, who not only aided financially, but also volunteered and personally helped with the "sweep" (mass vaccination in both, urban and rural areas of Peru.

  11. Eradication of multidrug-resistant pseudomonas biofilm with pulsed electric fields.

    Khan, Saiqa I; Blumrosen, Gaddi; Vecchio, Daniela; Golberg, Alexander; McCormack, Michael C; Yarmush, Martin L; Hamblin, Michael R; Austen, William G

    2016-03-01

    Biofilm formation is a significant problem, accounting for over eighty percent of microbial infections in the body. Biofilm eradication is problematic due to increased resistance to antibiotics and antimicrobials as compared to planktonic cells. The purpose of this study was to investigate the effect of Pulsed Electric Fields (PEF) on biofilm-infected mesh. Prolene mesh was infected with bioluminescent Pseudomonas aeruginosa and treated with PEF using a concentric electrode system to derive, in a single experiment, the critical electric field strength needed to kill bacteria. The effect of the electric field strength and the number of pulses (with a fixed pulse length duration and frequency) on bacterial eradication was investigated. For all experiments, biofilm formation and disruption were confirmed with bioluminescent imaging and Scanning Electron Microscopy (SEM). Computation and statistical methods were used to analyze treatment efficiency and to compare it to existing theoretical models. In all experiments 1500 V are applied through a central electrode, with pulse duration of 50 μs, and pulse delivery frequency of 2 Hz. We found that the critical electric field strength (Ecr) needed to eradicate 100-80% of bacteria in the treated area was 121 ± 14 V/mm when 300 pulses were applied, and 235 ± 6.1 V/mm when 150 pulses were applied. The area at which 100-80% of bacteria were eradicated was 50.5 ± 9.9 mm(2) for 300 pulses, and 13.4 ± 0.65 mm(2) for 150 pulses. 80% threshold eradication was not achieved with 100 pulses. The results indicate that increased efficacy of treatment is due to increased number of pulses delivered. In addition, we that showed the bacterial death rate as a function of the electrical field follows the statistical Weibull model for 150 and 300 pulses. We hypothesize that in the clinical setting, combining systemic antibacterial therapy with PEF will yield a synergistic effect leading to improved

  12. Attempted eradication of Porphyrio porphyrio Linnaeus in the Florida Everglades

    Dave EGGEMAN

    2011-01-01

    Full Text Available Porphyrio porphyrio (Fulica porphyrio Linnaeus was reported to the South Florida Water Management District in a Water Conservation Area and in constructed wetlands in the Everglades in 2006. A rapid assessment, including casual observations and surveys of land managers, indicated a limited number of P. porphyrio (~300 birds was present, and an eradication attempt was initiated. From 2006 – 2008, more than 3100 P. porphyrio were killed by shotgun from airboats during 73 hunts, suggesting the initial population assessment was severely underestimated. After removing nearly 1500 P. porphyrio in 2008, we concluded that eradication was not possible. Failure of this eradication attempt is attributed to P. porphyrio’s affinity with dense emergent vegetation, which greatly limited shooting effectiveness. Further, the failed eradication underscores the importance of a reporting network to improve early detection and the chance to eliminate naturalized or feral populations of non‐native species.

  13. Mid-Columbia - Yellow-flag Iris Eradication 2014

    US Fish and Wildlife Service, Department of the Interior — The project as described was to attempt to eradicate yellow-flag iris from Toppenish, McNary and Columbia National Wildlife Refuges using chemical and, where...

  14. Mid-Columbia - Eradication of Yellow-flag Iris 2013

    US Fish and Wildlife Service, Department of the Interior — The project as described was to attempt to eradicate yellow-flag iris from Toppenish, McNary and Columbia National Wildlife Refuges using chemical and, where...

  15. The Veron Community Scabies Education and Eradication Program

    White, Jeremy Jason

    2009-01-01

    Skin infections by the ectoparasitic mite Sarcoptes scabiei are a preventable source of morbidity worldwide. While scabies affects all socioeconomic sectors, it is especially prominent in the developing world where crowding, poor hygiene, and limited access to basic health care are commonplace. Mass eradication efforts of this parasite have historically been hampered by delivery and compliance issues surrounding topical standards of care. There have been advances in eradication over the las...

  16. Eradication of hepatitis C virus could improve immunological status and pyoderma gangrenosum-like lesions.

    Kondo, Yasuteru; Iwata, Tomoaki; Haga, Takahiro; Kimura, Osamu; Ninomiya, Masashi; Kakazu, Eiji; Kogure, Takayuki; Morosawa, Tatsuki; Aiba, Setsuya; Shimosegawa, Tooru

    2014-02-01

    Hepatitis C virus (HCV) can affect immune cells and induce various kinds of immune-related diseases including pyoderma gangrenosum. We experienced a difficult-to-treat case of pyoderma gangrenosum-like lesions in a patient with HCV infection. The patient was treated with pegylated interferon (PEG IFN)-α-2b and ribavirin (RBV) therapy and achieved a sustained virological response. Before the eradication of HCV, the frequency of T-helper 17 cells was remarkably high in comparison to chronic hepatitis C patients without extrahepatic immune-related diseases. Moreover, we could detect negative and positive strand-specific HCV RNA in the CD19(+) B lymphocytes and CD4(+) T lymphocytes. However, after the eradication of HCV, the immunological status became normal and the pyoderma gangrenosum-like lesions became stable without immunosuppressive therapy. Here, we report a sequential immunological analysis during PEG IFN/RBV therapy and the beneficial effect of HCV eradication in difficult-to-treat pyoderma gangrenosum-like lesions.

  17. Brazil: from reduction of poverty to a commitment to eradicate extreme poverty

    Lena Lavinas

    2012-04-01

    Full Text Available The aim of this article is to summarise certain positive results achieved by the Lula government in the sphere of social policy and to highlight the new challenges taken on by President Dilma Rousseff in terms of eradicating extreme poverty, after her first year in government. After Lula’s success with social policy, Rousseff has committed herself to eradicating extreme poverty over the short term (the four years of her mandate in a federation that is marked by weak links in cooperation, a distinct heterogeneity within the federated bodies and profound socio-economic inequality among citizens. Under Lula’s government, the factors that most helped to reduce poverty and inequality were the recovery of the minimum salary’s real value in rates higher than that of inflation, as well as an increase in formal employment, with the creation of approximately 12,000,000 jobs in eight years. For Dilma’s term of office, which began with a downturn in economic growth rates, an even bigger challenge lies ahead. In light of this, the article evaluates the prospects for success of Dilma’s government in terms of eradicating extreme poverty in Brazil.

  18. Mucoadhesive and muco-penetrating delivery systems for eradication of helicobacter pylori

    Saahil Arora

    2012-01-01

    Full Text Available Helicobacter pylori (H. pylori, the major culprit for peptic ulcer, has a unique way of survival in harsh acidic environment of the stomach by colonizing deep in the gastric mucosal layer. Failure of conventional therapies against H. pylori for complete eradication has major limitations like low residence time of delivery system in stomach, poor penetration of drug in gastric mucosa, acidic degradation of antibiotics, and development of antibiotics resistance. The poor penetration of antibiotics through thick viscoelastic mucosal gel results in incomplete eradication of H. pylori. Various investigators have formulated novel gastro-retentive drug delivery systems such as floating systems, mucoadhesive systems, pH-sensitive gel systems, and muco-penetrating delivery systems for increasing the concentration of antibiotic in close proximity to the site of H. pylori infection. This review summarizes the novel drug delivery approaches investigated during the last few years and suggests that a high eradication rate can be achieved by therapy comprising of muco-penetrating delivery systems of antibiotics against H. pylori.

  19. After Beijing: emphasis on poverty eradication.

    1996-01-01

    In March 1996, during its first meeting since the Fourth World Conference on Women, the UN Commission on the Status of Women (CSW), called for a gender perspective to be integrated into policies and programs dealing with poverty, child and dependent care, and the media. Three expert panels examined each of these areas through a format which encouraged dialogue and led to the adoption of 17 resolutions, decisions, and agreed conclusions as well as a recommendation that the UN adopt a multi-year work program for the CSW to allow it to review progress in elimination of the 12 main obstacles to women's advancement identified at Beijing. Among the resolutions adopted by the CSW were calls to 1) take a broad and integrated approach to poverty eradication, 2) enhance women's empowerment and autonomy, 3) promote equity and equality in the public domain, 4) promote women's employment, 5) give women social and economic protection when they are unable to work, 6) counteract negative images of women and sex-stereotyping in the media, 7) reduce the representation of violence against women in the media, 8) strengthen the role of women in global communications, 9) encourage the participation of men in child and dependent care, and 10) recognize women's double burden of work. The CSW also agreed to pursue further discussions about drafting an optional protocol to the 1979 Convention on the Elimination of All Forms of Discrimination Against Women. Among its other actions, the CSW called for mechanisms to protect the rights of women migrant workers, to protect women and children during armed conflicts, to include gender-based human rights violations in UN activities, and to address the root factors which lead to social ills such as trafficking in women and girls. In addition, the CSW submitted a draft resolution demanding that Israel protect the rights of Palestinian women and their families.

  20. EFFECT OF TRUNK ROTATION EXERCISE ON SCOLIOSIS IN POST- POLIO RESIDUAL PARALYSIS

    Jibi Paul

    2013-12-01

    Full Text Available Background:This study conducted to find out the effectiveness of trunk flexion rotation, extension rotationand combined flexion rotation & extension rotation exercises in reduction of scoliosis. Twenty fivemale scolioticsubjects secondary to post-polio residual paralysis were selected for the study as per the inclusionand exclusioncriteria.Method:Materials used for the study were Rontgenograph, Protractor, Pencil and Scale to evaluate the Cobb’sangle. Purposive random sampling method used to select the subjects in three groups for the study. Each groupA, B and C performed trunk flexion rotation, extension rotation and combined flexion rotation and extensionrotation exercises respectively. Subjects performed exercise regularly twice a day for five months under thesupervision of the researcher. The subjects did exercise for one hour with one minute rest in between eachmovement. Cobb’s angle was measured before and after the treatment program for each subject.Results:The calculated t’ value of group A, B and C were 11.00, 9.00 and 10.95 respectively at 5% level andP < 0.0001 for all groups, there for it was significant in reduction of angle of scoliosis among post- polio residualparalysis. The comparative study found that there was no significant difference in reduction of scoliosis amongthe groups.Conclusion:Based on the statistical analysis performed it could conclude that all the groups undergone trunkrotation exercises have improvement in terms of reduction of scoliosis but there was no much difference betweenthe groups on reduction of scoliosis

  1. Transmission dynamics of oral polio vaccine viruses and vaccine-derived polioviruses on networks.

    Kim, Jong-Hoon; Rho, Seong-Hwan

    2015-01-07

    One drawback of oral polio vaccine (OPV) is the potential reversion to more transmissible, virulent circulating vaccine-derived polioviruses (cVDPVs), which may cause outbreaks of paralytic poliomyelitis. Previous modeling studies of the transmission of cVDPVs assume an unrealistic homogeneous mixing of the population and/or ignore that OPV viruses and cVDPVs compete for susceptibles, which we show is a key to understanding the dynamics of the transmission of cVDPVs. We examined the transmission of OPV viruses and cVDPVs on heterogeneous, dynamic contact networks using differential equation-based and individual-based models. Despite the lower transmissibility, OPV viruses may outcompete more transmissible cVDPVs in the short run by spreading extensively before cVDPVs emerge. If viruses become endemic, however, cVDPVs eventually dominate and force OPV viruses to extinction. This study improves our understanding of the emergence of cVDPVs and helps develop more detailed models to plan a policy to control paralytic polio associated with the continued use of OPV in many countries.

  2. Feasibility of Mating Disruption for Agricultural Pest Eradication in an Urban Environment: Light Brown Apple Moth (Lepidoptera: Tortricidae) in Perth.

    Soopaya, Rajendra; Woods, Bill; Lacey, Ian; Virdi, Amandip; Mafra-Neto, Agenor; Suckling, David Maxwell

    2015-08-01

    Eradication technologies are needed for urban and suburban situations, but may require different technologies from pest management in agriculture. We investigated mating disruption of a model moth species recently targeted for eradication in Californian cities, by applying dollops of SPLAT releasing a two-component sex pheromone of the light brown apple moth in 2-ha plots in low-density residential Perth, Australia. The pheromone technology was applied manually at ∼1.5 m height to street and garden trees, scrubs, and walls at 500 dollops per hectare of 0.8 g containing ∼80 mg active two-component pheromone. Catches of male moths were similar among all plots before treatment, but in treated areas (six replicates) pheromone trap catches were substantially reduced for up to 29 wk posttreatment, compared with untreated control plot catches (three replicates). The treatment with pheromone reduced catch to virgin females by 86% (P < 0.001) and reduced the occurrence of mating by 93%, compared with three equivalent untreated control plot catches (P < 0.001). Eradication programs are following an upward trend with globalization and the spread of invasive arthropods, which are often first detected in urban areas. Eradication requires a major increase in the communication distance between individuals, but this can be achieved using sex pheromone-based mating disruption technology, which is very benign and suitable for sensitive environments. The need for new socially acceptable tools for eradication in urban environments is likely to increase because of increasing need for eradications.

  3. Usefulness of Endoscopic Imaging to Visualize Regional Alterations in Acid Secretion of Noncancerous Gastric Mucosa after Helicobacter pylori Eradication

    Iijima, Katsunori; Abe, Yasuhiko; Koike, Tomoyuki; Takahashi, Yasushi; Ara, Nobuyuki; Shimosegawa, Tooru

    2016-01-01

    Purpose Endoscopic diagnosis of gastric cancer (GC) that emerges after eradication of Helicobacter pylori may be affected by unique morphological changes. Using comprehensive endoscopic imaging, which can reveal biological alterations in gastric mucosa after eradication, previous studies demonstrated that Congo red chromoendoscopy (CRE) might clearly show an acid non-secretory area (ANA) with malignant potential, while autofluorescence imaging (AFI) without drug injection or dyeing may achieve early detection or prediction of GC. We aimed to determine whether AFI might be an alternative to CRE for identification of high-risk areas of gastric carcinogenesis after eradication. Materials and Methods We included 27 sequential patients with metachronous GC detected during endoscopic surveillance for a mean of 82.8 months after curative endoscopic resection for primary GC and eradication. After their H. pylori infection status was evaluated by clinical interviews and 13C-urea breath tests, the consistency in the extension of corpus atrophy (e.g., open-type or closed-type atrophy) between AFI and CRE was investigated as a primary endpoint. Results Inconsistencies in atrophic extension between AFI and CRE were observed in 6 of 27 patients, although CRE revealed all GC cases in the ANA. Interobserver and intraobserver agreements in the evaluation of atrophic extension by AFI were significantly less than those for CRE. Conclusions We demonstrated that AFI findings might be less reliable for the evaluation of gastric mucosa with malignant potential after eradication than CRE findings. Therefore, special attention should be paid when we clinically evaluate AFI findings of background gastric mucosa after eradication (University Hospital Medical Information Network Center registration number: UMIN000020849). PMID:27752392

  4. Tracking Vaccination Teams During Polio Campaigns in Northern Nigeria by Use of Geographic Information System Technology: 2013–2015

    Touray, Kebba; Mkanda, Pascal; Tegegn, Sisay G.; Nsubuga, Peter; Erbeto, Tesfaye B.; Banda, Richard; Etsano, Andrew; Shuaib, Faisal; Vaz, Rui G.

    2016-01-01

    Introduction. Nigeria is among the 3 countries in which polio remains endemic. The country made significant efforts to reduce polio transmission but remains challenged by poor-quality campaigns and poor team performance in some areas. This article demonstrates the application of geographic information system technology to track vaccination teams to monitor settlement coverage, reduce the number of missed settlements, and improve team performance. Methods. In each local government area where tracking was conducted, global positioning system–enabled Android phones were given to each team on a daily basis and were used to record team tracks. These tracks were uploaded to a dashboard to show the level of coverage and identify areas missed by the teams. Results. From 2012 to June 2015, tracking covered 119 immunization days. A total of 1149 tracking activities were conducted. Of these, 681 (59%) were implemented in Kano state. There was an improvement in the geographic coverage of settlements and an overall reduction in the number of missed settlements. Conclusions. The tracking of vaccination teams provided significant feedback during polio campaigns and enabled supervisors to evaluate performance of vaccination teams. The reports supported other polio program activities, such as review of microplans and the deployment of other interventions, for increasing population immunity in northern Nigeria. PMID:26609004

  5. Where Are the Disabled in the History of Education? The Impact of Polio on Sites of Learning

    Altenbaugh, Richard J.

    2006-01-01

    Viewing disabled people as historical actors, this essay ponders emerging disability historiography, distilling three key characteristics--the norm, prejudice and human agency--and applies them to specific cases related to the polio phenomenon of the twentieth century, focusing on the closely related experiences of childhood, families and…

  6. Malaria eradication: the economic, financial and institutional challenge

    Hanson Kara

    2008-12-01

    Full Text Available Abstract Malaria eradication raises many economic, financial and institutional challenges. This paper reviews these challenges, drawing on evidence from previous efforts to eradicate malaria, with a special focus on resource-poor settings; summarizes more recent evidence on the challenges, drawing on the literature on the difficulties of scaling-up malaria control and strengthening health systems more broadly; and explores the implications of these bodies of evidence for the current call for elimination and intensified control. Economic analyses dating from the eradication era, and more recent analyses, suggest that, in general, the benefits of malaria control outweigh the costs, though few studies have looked at the relative returns to eradication versus long-term control. Estimates of financial costs are scanty and difficult to compare. In the 1960s, the consolidation phase appeared to cost less than $1 per capita and, in 1988, was estimated to be $2.31 per capita (both in 2006 prices. More recent estimates for high coverage of control measures suggest a per capita cost of several dollars. Institutional challenges faced by malaria eradication included limits to the rule of law (a major problem where malaria was concentrated in border areas with movement of people associated with illegal activities, the existence and performance of local implementing structures, and political sustainability at national and global levels. Recent analyses of the constraints to scaling-up malaria control, together with the historical evidence, are used to discuss the economic, financial and institutional challenges that face the renewed call for eradication and intensified control. The paper concludes by identifying a research agenda covering: ∘ issues of the allocative efficiency of malaria eradication, especially using macro-economic modelling to estimate the benefits and costs of malaria eradication and intensified control, and studies of the links between

  7. Improving polio vaccination during supplementary campaigns at areas of mass transit in India

    Bahl Sunil

    2010-05-01

    Full Text Available Abstract Background In India, children who are traveling during mass immunization campaigns for polio represent a substantial component of the total target population. These children are not easily accessible to health workers and may thus not receive vaccine. Vaccination activities at mass transit sites (such as major intersections, bus depots and train stations, can increase the proportion of children vaccinated but the effectiveness of these activities, and factors associated with their success, have not been rigorously evaluated. Methods We assessed data from polio vaccination activities in Jyotiba Phule Nagar district, Uttar Pradesh, India, conducted in June 2006. We used trends in the vaccination results from the June activities to plan the timing, locations, and human resource requirements for transit vaccination activities in two out of the seven blocks in the district for the July 2006 supplementary immunization activity (SIA. In July, similar data was collected and for the first time vaccination teams also recorded the proportion of children encountered each day who were vaccinated (a new monitoring system. Results In June, out of the 360,937 total children vaccinated, 34,643 (9.6% received vaccinations at mass transit sites. In the July SIA, after implementation of a number of changes based on the June monitoring data, 36,475 children were vaccinated at transit sites (a 5.3% increase. Transit site vaccinations in July increased in the two intervention blocks from 18,194 to 21,588 (18.7% and decreased from 16,449 to 14,887 (9.5% in the five other blocks. The new monitoring system showed the proportion of unvaccinated children at street intersection transit sites in the July campaign decreased from 24% (1,784/7,405 at the start of the campaign to 3% (143/5,057 by the end of the SIA, consistent with findings from the more labor-intensive post-vaccination coverage surveys routinely performed by the program. Conclusions Analysis of

  8. Helicobacter pylori eradication therapy: A review of current trends.

    Olokoba, A B; Obateru, O A; Bojuwoye, M O

    2013-01-01

    Helicobacter pylori has been implicated in the formation of chronic gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue lymphoma and gastric cancer. Eradication of H. Pylori has been recommended as treatment and prevention for these complications. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include H. Pylori, current treatment and emerging therapy. Only articles in English were included. There has been a substantial decline in the H. pylori eradication rates over the years, despite the use of proton pump inhibitor and bismuth salts for triple and quadruple therapies respectively. The reasons for eradication failure are diverse, among them, antibiotic resistance is an important factor in the treatment failure. Primary resistance to clarithromycin or metronidazole significantly affects the efficacy of eradication therapy. This has led to the introduction of second line, third line "rescue," and sequential therapies for resistant cases. Subsequently, new antibiotic combinations with proton-pump inhibitors and bismuth salts are being studied in the last decade, to find out the antibiotics that are capable of increasing the eradication rates. Some of these antibiotics include Levofloxacin, Doxycycline, Rifaximin, Rifampicin, Furazolidone based therapies. Studies are ongoing to determine the efficacy of Lactoferrin based therapy.

  9. Helicobacter pylori eradication therapy: A review of current trends

    A B Olokoba

    2013-01-01

    Full Text Available Helicobacter pylori has been implicated in the formation of chronic gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue lymphoma and gastric cancer. Eradication of H. Pylori has been recommended as treatment and prevention for these complications. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include H. Pylori, current treatment and emerging therapy. Only articles in English were included. There has been a substantial decline in the H. pylori eradication rates over the years, despite the use of proton pump inhibitor and bismuth salts for triple and quadruple therapies respectively. The reasons for eradication failure are diverse, among them, antibiotic resistance is an important factor in the treatment failure. Primary resistance to clarithromycin or metronidazole significantly affects the efficacy of eradication therapy. This has led to the introduction of second line, third line "rescue," and sequential therapies for resistant cases. Subsequently, new antibiotic combinations with proton-pump inhibitors and bismuth salts are being studied in the last decade, to find out the antibiotics that are capable of increasing the eradication rates. Some of these antibiotics include Levofloxacin, Doxycycline, Rifaximin, Rifampicin, Furazolidone based therapies. Studies are ongoing to determine the efficacy of Lactoferrin based therapy.

  10. The effect of prophylaxis with chloroquine and proguanil on delayed-type hypersensitivity and antibody production following vaccination with diphtheria, tetanus, polio, and pneumococcal vaccines

    Gyhrs, A; Pedersen, B K; Bygbjerg, I;

    1991-01-01

    (1,000 mg/week), or 4) proguanil hydrochloride (200 mg/day) for six weeks. Skin testing was performed on days 0 and 28. Vaccinations with diphtheria, tetanus, polio, and pneumococcal polysaccharide antigen vaccines were performed on day 28, and the presence of specific antibodies was determined...... dosages, does not induce any detectable suppression of delayed-type hypersensitivity or vaccination responses to diphtheria, tetanus, polio, or pneumococcal polysaccharide antigens....

  11. Helicobacter pylori eradication as a preventive tool against gastric cancer.

    Hamajima, Nobuyuki; Goto, Yasuyuki; Nishio, Kazuko; Tanaka, Daisuke; Kawai, Sayo; Sakakibara, Hisataka; Kondo, Takaaki

    2004-01-01

    Helicobacter pylori (H. pylori), which increases the risk of gastric diseases, including digestive ulcers and gastric cancer, is highly prevalent in Asian countries. There is no doubt that eradication of the bacterium is effective as a treatment of digestive ulcer, but eradication aiming to reduce the gastric cancer risk is still controversial. Observational studies in Japan demonstrated that the eradication decreased the gastric cancer risk among 132 stomach cancer patients undergoing endoscopical resection (65 treated with omeprazol and antibiotics and 67 untreated). In Columbia, 976 participants were randomized into eight groups in a three-treatment factorial design including H. pylori eradication, resulting in significant regression in the H. pylori eradication group. A recent randomized study in China also showed a significant reduction of gastric cancer risk among those without any gastric atrophy, intestinal metaplasia, and dysplasia. Efficacy of eradication may vary in extent among countries with different incidence rates of gastric cancer. Since the lifetime cumulative risk (0 to 84 years old) of gastric cancer in Japan is reported to be 12.7% for males and 4.8% for females (Inoue and Tominaga, 2003), the corresponding values for H. pylori infected Japanese can be estimated at 21.2% in males and 8.0% in females under the assumptions that the relative risk for infected relative to uninfected is 5 and the proportion of those infected is 0.5. Both the fact that not all individuals are infected among those exposed and the knowledge that only a small percentage of individuals infected with the bacterium develop gastric cancer, indicate the importance of gene-environment interactions. Studies on such interactions should provide useful information for anti-H. pylori preventive strategies.

  12. The Rakiura Titi Islands Restoration Project: community action to eradicate Rattus rattus and Rattus exulans for ecological restoration and cultural wellbeing

    McClelland, P.J; Coote,; Trow,; Hutchins,; Nevins, HannahRose M.; Adams, Josh; Newman, J.; Moller, H.; Veitch, C.R.; Clout, Mike N.; Towns, D. R.

    2011-01-01

    In 2003, a non-profit group, Ka Mate Nga Kiore, was set up to oversee the restoration of four Maori-owned islands off the south coast of Stewart Island, New Zealand. The first step in the restoration was to eradicate ship rats (Rattus rattus) from three islands and Pacific rats (R. exulans) from another. The eradication was funded by the Command Oil Spill Trustee Council which managed the mitigation money from an oil spill off the Californian coast in 1998. The funding was coordinated via Oikonos Ecosystem Knowledge, a non-profit USA group primarily involved in seabird research and restoration. The project was primarily to benefit sooty shearwater (Puffinus griseus) and to sustain a culturally important customary harvest of their chicks by Rakiura Maori. However, like all island eradications, a wide range of other species also benefited from the removal of rats. The New Zealand Department of Conservation provided technical advice and assistance for the planning and implementation of the eradication programme. This paper describes how, with appropriate funding, community and technical support, rodent eradications can be achieved on private islands. In this case, a range of institutions and individuals joined to achieve a common goal that highlighted a significant international conservation action. We urge that more international and local-community-led restoration projects be initiated in the future.

  13. ‘Do not eat those apples; they’ve been on the ground!’: polio epidemics and preventive measures, Sweden 1880s-1940s

    Axelsson, Per

    2009-06-01

    Full Text Available This article will address how Swedish scientists, physicians and public health officers tried to combat the polio epidemics in the pre-vaccine era. It shows that once polio was considered as an epidemic disease the preventive measures used were based on the hindrance of other infectious diseases. It also illustrates how epidemiological and laboratory studies to some degree affected the thoughts of how polio should be prevented, and that Swedish ideas and experiences differed from those put forward in the USA.

    Este artículo trata sobre cómo los científicos, médicos y funcionarios de la sanidad pública de Suecia intentaron combatir la epidemia de la polio en la era anterior a la vacuna y expone que en cuanto la polio fue considerada como una epidemia, las medidas preventivas que se aplicaron se basaban en las de otras enfermedades contagiosas. También ilustra en qué medida los estudios epidemiológicos y los análisis de laboratorio influyeron en la manera de prevenir la polio y también demuestra que las opiniones y experiencias en Suecia eran diferentes a las de los Estados Unidos.

  14. Land Right Registration and Property Development for Poverty Eradication and Slum Clearance in Nigeria

    Olusegun Olaopin Olanrele

    2014-12-01

    Full Text Available The focus of this paper is to unfold the implication of non-registration of land rights on the achievement of the poverty eradication and slum clearance targets of the United Nation's Millennium development goals in Nigeria. The paper is based on empirical survey of land holding in the outskirts of Ibadan city and the rural areas in Oyo State, of Nigeria. A case study research method was adopted and data were collected with the use of questionnaire survey and secondary data was also extracted from the state land registry office in respect of total cost of documentation of subsequent transaction on titled/registered land. The study found that ignorance and government insensitivity in addition to high cost and delay are among major constraints to land titling. Only a few opportune people can afford the land right formalization process and they do so when it becomes necessary. These unequivocally militate against the achievement of the poverty and slum eradication goals of the UN. The paper suggested simplification of the titling procedure, cost reduction, computerization and public enlightenment on the benefits of registered land right to facilitate efficient land right registration towards adequate housing for the citizenry.

  15. The effect of probiotics supplementation on Helicobacter pylori eradication rates and side effects during eradication therapy: a meta-analysis.

    Yini Dang

    Full Text Available BACKGROUND: Previous meta-analyses reported that probiotics improve the effectiveness of Helicobacter pylori (H. pylori eradication during antibiotic therapy, while results regarding a possible reduction of side effects remained inconclusive. Moreover, the effectiveness of different strains of probiotics has not been studied so far. It is further conceivable that probiotics will produce additional effects only if antibiotics are relatively ineffective. METHODS: This meta-analysis includes eligible randomized controlled trials examining effects of probiotics supplementation on eradication rates (ER and side effects, published up to May 2014. Sub-group analysis was performed to compare different probiotic strains and antibiotic therapies with different effectiveness in controls (ER 80%. Publication bias was assessed with funnel plots and Harbord's test. The quality of the trials was assessed with the Cochrane risk of bias tool. RESULTS: Thirty-three RCTs involving a total of 4459 patients met the inclusion criteria in case of eradication rates of which 20 assessed total side effects in addition. Overall, the pooled eradication rate in probiotics supplementation groups was significantly higher than in controls (ITT analysis: RR 1.122, 95% CI 1.086-1.159, PP analysis: RR 1.114, 95% CI 1.070-1.159. Sub group-analysis could, however, confirm this finding only for four individual strains (Lactobacillus acidophilus, Lactobacillus casei DN-114001, Lactobacillus gasseri, and Bifidobacterium infantis 2036 and for relatively ineffective antibiotic therapies. There was a significant difference between groups in the overall incidence of side effects (RR 0.735, 95% CI 0.598-0.902. This result was, however, only confirmed for non-blinded trials. CONCLUSIONS: The pooled data suggest that supplementation with specific strains of probiotics compared with eradication therapy may be considered an option for increasing eradication rates, particularly when antibiotic

  16. Progress and peril: poliomyelitis eradication efforts in Pakistan, 1994-2013.

    Alexander, James P; Zubair, Mufti; Khan, Muzaffar; Abid, Nima; Durry, Elias

    2014-11-01

    Pakistan is one of 3 countries where transmission of indigenous wild poliovirus (WPV) has never been interrupted. Numbers of confirmed polio cases have declined by >90% from preeradication levels, although outbreaks occurred during 2008-2013. During 2012 and 2013, 58 and 93 WPV cases, respectively, were reported, almost all of which were due to WPV type 1. Of the 151 WPV cases reported during 2012-2013, 123 (81%) occurred in the conflict-affected Federally Administered Tribal Areas (FATA) and in security-compromised Khyber Pakhtunkhwa province. WPV type 3 was isolated from only 3 persons with polio in a single district in 2012. During August 2012-December 2013, 62 circulating vaccine-derived poliovirus type 2 cases were detected, including 40 cases (65%) identified in the FATA during 2013. Approximately 350 000 children in certain districts of the FATA have not received polio vaccine during supplementary immunization activities (SIAs) conducted since mid-2012, because local authorities have banned polio vaccination. In other areas of Pakistan, SIAs have been compromised by attacks targeting polio workers, which started in mid-2012. Further efforts to reach children in conflict-affected and security-compromised areas will be necessary to prevent reintroduction of WPV into other areas of Pakistan and other parts of the world.

  17. Quality of life in Swedish patients with post-polio syndrome with a focus on age and sex.

    Jung, Tae-Du; Broman, Lisbet; Stibrant-Sunnerhagen, Katharina; Gonzalez, Henrik; Borg, Kristian

    2014-06-01

    To investigate the health-related quality of life (QOL) in Swedish patients with post-polio syndrome (PPS), with a focus on sex and age. A total of 364 patients were recruited from five Swedish post-polio clinics. Analysis was carried out using SF-36 and data were compared with those of a normal population. QOL was significantly lower in PPS patients for all eight subdomains and the two main scores (physical compound score and mental compound score) when compared with the controls. Male patients had a significantly higher QOL than female patients for all subdomains and also for mental compound score and physical compound score, a phenomenon also observed in the normal population. There was a decrease in QOL in the physical domains and an increase in vitality with age. PPS decreases health-related QOL in both sexes, more in female patients. QOL for physical domains decreases whereas vitality increases with age in both sexes.

  18. Macroeconomics, (Adult) Education, and Poverty Eradication in Southern Africa

    Nhamo, Senia; Nhamo, Godwell

    2006-01-01

    The Millennium Summit held in New York in September 2000 outlined the Millennium Development Goals (MDGs). The first of these involves the eradication of extreme poverty and hunger, setting two targets: halving by 2015 the percentage of the world's populace in 1990 with income less than US-$1 a day (i.e., cutting this percentage from 27.9 to 14%);…

  19. An Assessment of Poverty Eradication Programme (NAPEP in Nigeria

    Adam Adem ANYEBE

    2015-06-01

    Full Text Available Poverty situation in Nigeria has become so serious that in 2013 there were as many as 112 million or 70.0% of the country’s population was living below poverty line. It has realized that poverty anywhere is a threat to peace, security and prosperity everywhere hence the conscious efforts by successive administrations in Nigeria to eradicate all forms of extreme poverty and hunger in a country. In spite of these efforts to eradicate absolute poverty in the country, poverty incidence has been on the rise. This study, therefore, attempted to assess NAPEP as a programme to eradicate extreme poverty in the country. Personal interviews and documents were employed in data collection. The data were analyzed using tables, simple percentages and spearman rank correlation. The study showed among others, that NAPEP as a programme targeted at eradicating extreme poverty has not been effective leading to a mixed bag of limited success and continuing challenges. It was therefore, recommended that the programme should be re-examined and possibly re-designed for effective performance instead of scrapping it.

  20. Scenarios for eradicating foot-and-mouth disease

    Bos, E.J.; Leeuwen, van M.G.A.; Vlieger, de J.J.

    2001-01-01

    Research project commissioned by the Ministery of Agriculture, Nature Management and Fisheries. With the help of desk-research and input-output analysis quantitative information is assembled about the differences in cost for agribusiness and tourism of two eradication scenarios for foot-and-mouth di

  1. A history of bovine tuberculosis eradication policy in Northern Ireland.

    Robinson, P A

    2015-11-01

    Despite many years of state-sponsored efforts to eradicate the disease from cattle through testing and slaughter, bovine tuberculosis (bTB) is still regarded as the most important and complex of animal health challenges facing the British livestock agricultural industry. This paper provides a historical analysis of the ongoing bTB statutory eradication programme in one part of the UK - Northern Ireland (NI) - which began in 1949 as a voluntary scheme, but between 1959 and 1960 became compulsory for all cattle herd-owners. Tracing bTB back through time sets the eradication efforts of the present day within a deeper context, and provides signposts for what developed in subsequent decades. The findings are based primarily on empirical research using historical published reports of the Ministry of Agriculture and state documents held in the public archives in NI, and they emphasize the need to consider the economic, social and political contexts of disease eradication efforts and their influences on both the past and the present.

  2. The role of LP gas in eradicating energy poverty

    Kelly, Michael; Behuria, Sarthak

    2010-09-15

    LP Gas is an ideal solution for dealing with energy poverty. Clean burning, low carbon, extremely efficient, requiring minimal infrastructure or R and D investment and with plentiful long term global supply, LP Gas can be quickly introduced to play an important role in eradicating energy poverty and steering both industrialised and developing countries onto more sustainable energy development paths.

  3. Symptom-based tendencies of Helicobacter pylori eradication in patients with functional dyspepsia

    LingLan; ]ingYu; Yu—LongChen; Ya—LiZhong; HaoZhang; Chang HeJia; YuanYuan; Bo—WeiLiu

    2011-01-01

    AIM: To investigate whether there were symptom-based tendencies in the Helicobacter pylori (H. pylori) eradication in functional dyspepsia (FD) patients. METHODS: A randomized, single-blind, placebo-controlled study of H. pylori eradication for FD was conduct- ed. A total of 195 FD patients with H. pylori infection were divided into two groups: 98 patients in the treatment group were treated with rabeprazole 10 mg twice daily for 2 wk, amoxicillin 1.0 g and clarithromycin 0.5 g twice daily for 1 wk; 97 patients in the placebo group were given placebos as control. Symptoms of FD, such as postprandial fullness, early satiety, nausea, belching,epigastric pain and epigastric burning, were assessed 3 mo after H. pylori eradication. RESULTS: By per-protocol analysis in patients with successful H. pylori eradication, higher effective rates of 77.2% and 82% were achieved in the patients with epigastric pain and epigastric burning than those in the placebo group (P 〈 0.05). The effective rates for postprandial fullness, early satiety, nausea and belching were 46%, 36%, 52.5% and 33.3%, respectively, and there was no significant difference from the placebo group (39.3%, 27.1%, 39.1% and 31.4%) (P 〉 0.05). In 84 patients who received H. pylori eradication therapy, the effective rates for epigastric pain (73.8%) and epigastric burning (80.7%) were higher than those in the placebo group (P 〈 0.05). The effective rates for postprandial fullness, early satiety, nausea and belch- ing were 41.4%, 33.3%, 50% and 31.4%, respective- ly, and did not differ from those in the placebo group (P 〉 0.05). By intention-to-treat analysis, patients with epigastric pain and epigastric burning in the treatment group achieved higher effective rates of 60.8% and 65.7% than the placebo group (33.3% and 31.8%) (P 〈 0.05). The effective rates for postprandial fullness, early satiety, nausea and belching were 34.8%, 27.9%, 41.1% and 26

  4. Effect of Helicobacter pylori eradication on iron deficiency

    ZHANG Zhi-feng; YANG Ning; ZHAO Gang; ZHU Lei; ZHU Ying; WANG Li-xia

    2010-01-01

    Background Iron deficiency (ID) is still a great challenge to health care worldwide. Results of randomized controlled trials (RCTs) evaluating the effect of Helicobacterpylori (H. Py/on) eradication on ID are contradictory. This study aimed to evaluate the effect of H. Pylori eradication on ID with a meta-analysis of RCTs. Methods Five electronic databases were searched for RCTs evaluating the effect of H. Pylori eradication on ID. Summary effects were assessed with the methods recommended by the Cochrane Collaboration. Results Eight studies involving 800 participants were included in this meta-analysis. The overall analysis showed that H. Pylori eradication accelerated the improvement of ferritin levels in ID people (mean difference (MD), 7.74 μg/L; 95% CI, 4.61 to 10.88; P <0.000 01). In a subgroup analysis, H. Pylori eradication accelerated the improvement of ferritin levels one month (MD, 7.00 pg/L; 95% CI, 1.72 to 12.28; P=0.009) and two months (MD, 9.80 μg/L; 95% CI, 2.22 to 17.40; P=0.01)after the initiation of treatment. However, H. Pylori eradication did not show a beneficial effect on the improvement of ferritin levels three months (MD, 7.20 pg/L; 95% CI, -3.25 to 17.65; P=0.18), one year (MD, 10.17 μg/L; 95% CI, -1.00 to 21.34;P=0.07) and forty months (MD, 1.00 pg/L; 95% CI, -0.57 to 2.57; P=0.21) after the initiation of treatment. H. Pylori eradication did not accelerate the improvement of hemoglobin concentrations in the overall analysis (MD, 0.38 g/dl; 95% CI,-0.45 to 1.22; P=0.37). In a subgroup analysis, H. Pylori eradication did not accelerate the improvement of hemoglobin concentrations one month (MD, -0.48 g/dl; 95% CI, -2.39 to 1.42; P=0.62), three months (MD, -0.10 g/dl; 95% CI, -0.35 to 0.15; P=0.44) and forty months (MD, 0.10 g/dl; 95% CI, -0.37 to 0.57; P=0.68) after the initiation of treatment. However, H. Pylori eradication accelerated the improvement of hemoglobin concentrations two months (MD, 1.96 g/dl; 95% CI, 1.48 to 2.44; P <0

  5. Eradication of Pseudomonas aeruginosa cells by cathodic electrochemical currents delivered with graphite electrodes.

    Niepa, Tagbo H R; Wang, Hao; Gilbert, Jeremy L; Ren, Dacheng

    2017-03-01

    Antibiotic resistance is a major challenge to the treatment of bacterial infections associated with medical devices and biomaterials. One important intrinsic mechanism of such resistance is the formation of persister cells that are phenotypic variants of microorganisms and highly tolerant to antibiotics. Recently, we reported a new approach to eradicating persister cells of Pseudomonas aeruginosa using low-level direct electrochemical current (DC) and synergy with the antibiotic tobramycin. To further understand the underlying mechanism and develop this technology toward possible medical applications, we investigated the electricidal activities of non-metallic biomaterial on persister and biofilm cells of P. aeruginosa using graphite-based TGON™ 805 electrodes. We employed both single and dual chamber systems to compare electrochemical factors of TGON and stainless steel 304 electrodes. The results revealed that TGON-based treatments were highly effective against P. aeruginosa persister cells. In the single chamber system, complete eradication of planktonic persister cells (corresponding to a 7-log killing) was achieved with 70μA/cm(2) DC using TGON electrodes within 40min of treatment, while the cell viability in biofilms was reduced by 2 logs within 1h. The killing effects were dose and time dependent with higher current densities requiring less time. Moreover, reduction reactions were found more effective than oxidation reactions, confirming that metal cations are not indispensable, although they may facilitate cell killing. The findings of this study can help develop electrochemical technologies to eradicate persister and biofilm cells for more effective treatment of medical device and biomaterial associated infections.

  6. Azithromycin in a triple therapy for H. pylori eradication in active duodenal ulcer

    Vladimir T. Ivashkin; Tatiana L. Lapina; Oksana Yu. Bondarenko; Olga A. Sklanskaya; Petr Ya. Grigoriev; Yuri V. Vasiliev; Emilia P. Yakovenko; Pavel V. Gulyaev; Valeri I. Fedchenko

    2002-01-01

    AIM: To assess and compare the efficacy and safety of twotriple regimes: A) metronidazole, amoxicillin and omeprazole,which is still widely used in Russia, and B) azithromycin,amoxicillin and omeprazole in healing active duodenal ulcerand H.pylori eradication. METHODS: 100 patients with active duodenal ulcer wereincluded in the open, multicentre, randomized study withcomparative groups. Patients were randomly assigned toone of the following one-week triple regimes: A)metronidazole 500 mg bid, amoxicillin 1 g bid and omeprazole20 mg bid (OAM, n=50) and B) azithromycin 1 g od for thefirst 3 days (total dose 3 g), amoxicillin 1 g bid andomeprazole 20 mg bid (OAA, n=50). Omeprazole 20 mg odwas given after the eradication course as a monotherapyfor three weeks. The control endoscopy was performed 8weeks after the entry. H. pylori infection was determined inthe entry of the study and four weeks after the cessation oftreatment by means of histology and CLO-test.RESULTS: 97 patients completed the study according tothe protocol (1 patient of the OAM group did not come tothe control endoscopy, 2 patients of the OAA group stoppedthe treatment because of mild allergic urticaria). Duodenalulcers were healed in 48 patients of the OAM group (96 %;CI 90.5-100 %) and in 46 patients of the OAA group (92 %;CI 89.5-94.5 %) (p=ns). H. pylori infection was eradicatedin 15 out of 50 patients with OAM (30 %; CI 17-43 %) andin 36 out of 50 patients treated with OAA (72 %; CI 59-85 %)(P<0.001)-ITT analysis.CONCLUSION: The triple therapy with omeprazole,amoxicillin and metronidazole failed to eradicate H. pylori inthe majority of patients, which is an essential argument towithdraw this regimen out of the national recommendations.Macrolide with amoxicillin are preferable to achieve highereradication rates. Azithromycin (1 g od for the first 3 days)can be considered as a successful component of the triplePPI-based regimen.

  7. [Omeprazole/amoxicillin: improved eradication of Helicobacter pylori in smokers because of N-acetylcysteine].

    Zala, G; Flury, R; Wüst, J; Meyenberger, C; Ammann, R; Wirth, H P

    1994-08-09

    Colonization of Helicobacter pylori (HP) beneath the protective film of gastric mucus enables the organism to survive in the hostile environment of the gastric mucosa. N-acetylcysteine (NAC), a sulfhydryl compound with potent mucolytic activity, induces a reduction of gastric barrier mucus thickness of about 75% and reduces mucus viscoelasticity. We therefore tested the hypothesis whether better eradication results could be achieved by addition of NAC to omeprazole/amoxicillin (OME/AMOX). 34 HP positive outpatients with endoscopically documented recurrent duodenal ulcer were included in an ongoing, prospective, randomized trial. Exclusion criteria were: alcoholism, previous gastric surgery, or intake of antibiotics, OME, bismuth salts, corticosteroids or NSAIDs within 4 weeks before study entry. Patients currently smoking > 10 cigarettes/day were classified as smokers. HP infection was confirmed by histology (3 biopsy specimens from gastric antrum and 2 from gastric body; H&E, Giemsa) and at least positive rapid urease test or culture. All 34 patients underwent ulcer therapy with OME (20 mg per day) for 20 days (d 1-20). Group A: in 17 patients (5 females, 12 males, mean age 46 [29-74] years; 8 smokers, 9 nonsmokers) the subsequent eradication therapy, consisting of oral OME (40 mg bid) and AMOX solute (750 mg tid) for 10 days, was combined with NAC solute (2 x 600 mg bid (d 21-30). Group B: 17 patients (2 females, 15 males, mean age 39 [19-70] years; 11 smokers, 6 nonsmokers) underwent eradication therapy without NAC (d 21-30). Control endoscopy was done after a minimal interval of 30 days from the end of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Metabolic consequences of Helicobacter pylori infection and eradication.

    Buzás, György Miklós

    2014-05-14

    Helicobacter pylori (H. pylori) is still the most prevalent infection of the world. Colonization of the stomach by this agent will invariably induce chronic gastritis which is a low-grade inflammatory state leading to local complications (peptic ulcer, gastric cancer, lymphoma) and remote manifestations. While H. pylori does not enter circulation, these extragastric manifestations are probably mediated by the cytokines and acute phase proteins produced by the inflammed mucosa. The epidemiologic link between the H. pylori infection and metabolic changes is inconstant and controversial. Growth delay was described mainly in low-income regions with high prevalence of the infection, where probably other nutritional and social factors contribute to it. The timely eradication of the infection will lead to a more healthy development of the young population, along with preventing peptic ulcers and gastric cancer An increase of total, low density lipoprotein and high density liporotein cholesterol levels in some infected people creates an atherogenic lipid profile which could promote atherosclerosis with its complications, myocardial infarction, stroke and peripheral vascular disease. Well designed and adequately powered long-term studies are required to see whether eradication of the infection will prevent these conditions. In case of glucose metabolism, the most consistent association was found between H. pylori and insulin resistance: again, proof that eradication prevents this common metabolic disturbance is expected. The results of eradication with standard regimens in diabetics are significantly worse than in non-diabetic patients, thus, more active regimens must be found to obtain better results. Successful eradication itself led to an increase of body mass index and cholesterol levels in some populations, while in others no such changes were encountered. Uncertainities of the metabolic consequences of H. pylori infection must be clarified in the future.

  9. Pharmacoeconomics of gastrointestinal drug utilisation prior and post Helicobacter pylori eradication

    Klok, Rogier; van der Veen, W.J.; van der Werf, G.T.; van de Berg, P.B.; Brouwers, J.R.B.J.; Postma, Maarten

    2004-01-01

    BACKGROUND: Eradication of Helicobacter pylori prevents recurrence of peptic ulcer. In pharmacoeconomic analyses it is often presumed that after successful eradication no more gastrointestinal drugs are used. We investigated this presumed positive monetary effect using General Practitioners prescrib

  10. Implementation of a Systematic Accountability Framework in 2014 to Improve the Performance of the Nigerian Polio Program

    Tegegne, Sisay G.; MKanda, Pascal; Yehualashet, Yared G.; Erbeto, Tesfaye B.; Touray, Kebba; Nsubuga, Peter; Banda, Richard; Vaz, Rui G.

    2016-01-01

    Background. An accountability framework is a central feature of managing human and financial resources. One of its primary goals is to improve program performance through close monitoring of selected priority activities. The principal objective of this study was to determine the contribution of a systematic accountability framework to improving the performance of the World Health Organization (WHO)–Nigeria polio program staff, as well as the program itself. Methods. The effect of implementation of the accountability framework was evaluated using data on administrative actions and select process indicators associated with acute flaccid paralysis (AFP) surveillance, routine immunization, and polio supplemental immunization activities. Data were collected in 2014 during supportive supervision, using Magpi software (a company that provides service to collect data using mobile phones). A total of 2500 staff were studied. Results. Data on administrative actions and process indicators from quarters 2–4 in 2014 were compared. With respect to administrative actions, 1631 personnel (74%) received positive feedback (written or verbal commendation) in quarter 4 through the accountability framework, compared with 1569 (73%) and 1152 (61%) during quarters 3 and 2, respectively. These findings accorded with data on process indicators associated with AFP surveillance and routine immunization, showing statistically significant improvements in staff performance at the end of quarter 4, compared with other quarters. Conclusions. Improvements in staff performance and process indicators were observed for the WHO-Nigeria polio program after implementation of a systematic accountability framework. PMID:26823334

  11. HIV eradication: virological chances and clinical perspectives

    Perno C

    2012-11-01

    infected, but viral replicative cycles are absent, and progression of the disease is interrupted. This latter clinical approach may be suitable, and this is where clinical research is directing its efforts. If achievable, infected persons should cope with the virus and keep it under control for decades, without support of chronic antiviral therapy. In conclusion, the proper knowledge of the biological characteristics of HIV helps in selecting the best strategies aimed at obtaining the maximum achievable clinical result.

  12. 9 CFR 72.6 - Interstate movement of cattle from quarantined areas not eradicating ticks.

    2010-01-01

    ... quarantined areas not eradicating ticks. 72.6 Section 72.6 Animals and Animal Products ANIMAL AND PLANT HEALTH... areas not eradicating ticks. Cattle in quarantined areas where tick eradication is not being conducted 3... inspector just prior to final dipping, found to be apparently free of ticks, and be certified as such...

  13. The Tuberculin Test and its Role in the Strategic Management and Eradication of Tuberculosis in Cattle

    Good, M.

    2011-01-01

    This thesis explores the necessity for bovine tuberculosis (bTB) eradication; considers the use the tuberculin test as a tool in bTB eradication and explores the need to select the optimal test methodology, to evaluate outcomes of existing procedures and to progressively modify aspects of a bTB erad

  14. Development of the New Zealand strategy for local eradication of tuberculosis from wildlife and livestock.

    Livingstone, P G; Hancox, N; Nugent, G; Mackereth, G; Hutchings, S A

    2015-06-01

    We describe the progressive development of New Zealand's national strategy for control of tuberculosis (TB) in its agricultural sector over the last four decades. The strategy is globally unique, reflecting the need for effective and co-ordinated management of TB in a wildlife maintenance host, the brushtail possum (Trichosurus vulpecula), in addition to controlling infection in cattle and farmed deer herds. Since the early 1990s, the strategy has been developed by the Animal Health Board (AHB), formed to empower the farming industry to take the leadership role in funding of TB control, policy development and administration. The AHB became the first non-government organisation to develop and gain acceptance by the funders (farming industry and government) of a National Pest Management Strategy (NPMS) under the Biosecurity Act 1993. A key outcome of the NPMS for TB control was the development and inclusion of very challenging objectives that provided direction for management, research and possum control. This paper describes the process whereby the NPMS was revised twice, following achievement of each successive set of strategy objectives within budget. Success was based on firstly, reorganisation of the AHB and its operational systems to achieve increased efficiency; secondly, improved efficiency through contracting possum and disease control, and thirdly research delivering effective and practical applications, while also providing a scientific basis for setting directions for future control strategies. The last revision of the NPMS was implemented in 2011, and included objectives to eradicate Mycobacterium bovis-infected wildlife populations over 2.5 million hectares by 2026. This ambitious objective was adopted only after extensive forecast modelling enabled stakeholders to identify and select the most cost-effective long-term solution for the management of M. bovis-infected possum populations. The accomplishment of New Zealand's TB control programme, in meeting

  15. Macroeconomics, (Adult) Education, and Poverty Eradication in Southern Africa

    Nhamo, Senia; Nhamo, Godwell

    2006-05-01

    The Millennium Summit held in New York in September 2000 outlined the Millennium Development Goals (MDGs). The first of these involves the eradication of extreme poverty and hunger, setting two targets: halving by 2015 the percentage of the world's populace in 1990 with income less than US-1 a day (i.e., cutting this percentage from 27.9 to 14%); and halving the share of people who suffer from hunger. As for education, the MDGs seek to ensure that all children can complete primary schooling by 2015. Drawing on examples from selected southern African countries, the present study examines the need to strengthen economic support for (adult) education as an instrument of poverty eradication. It argues that human capital is one of the fundamental determinants of economic growth, and that this economic resource is essentially determined in both qualitative and quantitative regards by education.

  16. Risks and Benefits of Helicobacter pylori Eradication: Current Status

    Richard H Hunt

    2002-01-01

    Full Text Available In patients with diseases known to be associated with Helicobacter pylori infection, such as peptic ulcer, treatment of the underlying infection is the standard of care. However, in most major consensus management guidelines, including those published in Canada, widespread testing for H pylori infection is not recommended. This practice is not encouraged because of insufficient evidence of cost-benefit in gastric cancer prevention, the potential for increases in antibiotic resistance and the controversial hypothesis of potential negative effects of eradication in certain clinical entities. For example, there is insufficient evidence to recommend against eradicating H pylori discovered in a patient with symptoms of gastroesophageal reflux disease. The management guidelines designed specifically in Canada should, therefore, continue to be applied, with H pylori diagnosed and treated in appropriately selected patients.

  17. Oral Polio Vaccine Influences the Immune Response to BCG Vaccination. A Natural Experiment

    Sartono, E.; Lisse, I.M.; Terveer, E.M.

    2010-01-01

    Background: Oral polio vaccine (OPV) is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW) and normal-birth-weight (NBW) infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did...... not receive OPV at birth, but only BCG. We investigated the effect of OPV given simultaneously with BCG at birth on the immune response to BCG vaccine. Methods and Findings: We compared the in vitro and the in vivo response to PPD in the infants who received OPV and BCG with that of infants who received BCG...... scar (0.95 (0.91-1.00), p = 0.057)). Among children with a scar, OPV was associated with reduced scar size, the regression coefficient being -0.24 (-0.43-0.05), p = 0.012. Conclusions: This study is the first to address the consequences for the immune response to BCG of simultaneous administration...

  18. Evaluation of Radiosensitivity of HeLa Cells Infected with Polio Virus Irradiated by Co 60

    F Seif

    2008-04-01

    Full Text Available ABSTRACT: Introduction & Objective: The main purpose of radiotherapy is exposing enough doses of radiation to tumor tissue and protecting the normal tissues around it. Tumor dose for each session in radiotherapy will be considered based on radiosensitivity of the tissues. The presence of viral diseases in tumoral area can affect the radiosensitivity of cells. This study aimed to evaluate the radiosensitivity of Hela cells infected with poliomyelitis virus irradiated by Co 60. Materials & Methods: In this study, the radiosensitivity of HeLa cells, with or without the viral infection, after gamma radiation of cobalt 60, was assessed. Results: Results of comparison of the radisensitivity of infected and uninfected cells indicates that after 2 Gy irradiation by Co 60, polio infection in low, moderate and high virus load, increases the cell death by 20-30%, 30-40% and 70-90% respectively. Conclusion : Radiosensitivity of tumoral cells increase when they are infected with viral agents. Results of this study showed that non cancer diseases should be considered when prescribing dose fraction in radiotherapy of cancers.

  19. Wearable Monitoring Devices for Assistive Technology: Case Studies in Post-Polio Syndrome

    Giuseppe Andreoni

    2014-01-01

    Full Text Available The correct choice and customization of an orthosis are crucial to obtain the best comfort and efficiency. This study explored the feasibility of a multivariate quantitative assessment of the functional efficiency of lower limb orthosis through a novel wearable system. Gait basographic parameters and energetic indexes were analysed during a Six-Minute Walking Test (6-MWT through a cost-effective, non-invasive polygraph device, with a multichannel wireless transmission, that carried out electro-cardiograph (ECG; impedance-cardiograph (ICG; and lower-limb accelerations detection. Four subjects affected by Post-Polio Syndrome (PPS were recruited. The wearable device and the semi-automatic post-processing software provided a novel set of objective data to assess the overall efficiency of the patient-orthosis system. Despite the small number of examined subjects, the results obtained with this new approach encourage the application of the method thus enlarging the dataset to validate this promising protocol and measuring system in supporting clinical decisions and out of a laboratory environment.

  20. Reliability of contractile properties of the knee extensor muscles in individuals with post-polio syndrome.

    Eric L Voorn

    Full Text Available To assess the reliability of contractile properties of the knee extensor muscles in 23 individuals with post-polio syndrome (PPS and 18 age-matched healthy individuals.Contractile properties of the knee extensors were assessed from repeated electrically evoked contractions on 2 separate days, with the use of a fixed dynamometer. Reliability was determined for fatigue resistance, rate of torque development (MRTD, and early and late relaxation time (RT50 and RT25, using the intraclass correlation coefficient (ICC and standard error of measurement (SEM, expressed as % of the mean.In both groups, reliability for fatigue resistance was good, with high ICCs (>0.90 and small SEM values (PPS: 7.1%, healthy individuals: 7.0%. Reliability for contractile speed indices varied, with the best values found for RT50 (ICCs>0.82, SEM values <2.8%. We found no systematic differences between test and retest occasions, except for RT50 in healthy subjects (p = 0.016.In PPS and healthy individuals, the reliability of fatigue resistance, as obtained from electrically evoked contractions is high. The reliability of contractile speed is only moderate, except for RT50 in PPS, demonstrating high reliability.This was the first study to examine the reliability of electrically evoked contractile properties in individuals with PPS. Our results demonstrate its potential to study mechanisms underlying muscle fatigue in PPS and to evaluate changes in contractile properties over time in response to interventions or from natural course.

  1. Type 2 diabetes mellitus affects eradication rate of Helicobacter pylori

    Mehmet Sargyn; Oya Uygur-Bayramicli; Haluk Sargyn; Ekrem Orbay; Dilek Yavuzer; Ali Yayla

    2003-01-01

    AIM: To study the eradication rate of Helicobacter pylori (Hp) in a group of type 2 diabetes and compared it with an age and sex matched non-diabetic group.METHODS: 40 diabetic patients (21 females, 19 males;56±7 years) and 40 non-diabetic dyspeptic patients (20females, 20 males; 54±9 years) were evaluated. Diabetic patients with dyspeptic complaints were referred for upper gastrointestinal endoscopies; 2 corpus and 2 antral gastric biopsy specimens were performed on each patient. Patients with positive Hp results on histopathological examination comprised the study group. Non-diabetic dyspeptic patients seen at the Gastroenterology Outpatient Clinic and with the same biopsy and treatment protocol formed the control group.A triple therapy with amoxycillin (1 g b.i.d), clarithromycin (500 mg b.i.d) and omeprazole (20 mg b.i.d.) was given to both groups for 10 days. Cure was defined as the absence of Hp infection assessed by corpus and antrum biopsies in control upper gastrointestinal endoscopies performed 6weeks after completing the antimicrobial therapy.RESULTS: The eradication rate was 50 % in the diabetic group versus 85 % in the non-diabetic control group (P<0.001).CONCLUSION: Type 2 diabetic patients showed a significantly lower eradication rate than controls which may be due to changes in microvasculature of the stomach and to frequent antibiotic usage because of recurrent bacterial infections with the development of resistant strains.

  2. Eradication of H pylori for the prevention of gastric cancer

    Karolin Trautmann; Manfred Stolte; Stephan Miehlke

    2006-01-01

    Tnfection with H pylori is the most important known etiological factor associated with gastric cancer. While colonization of the gastric mucosa with H pylori results in active and chronic gastritis in virtually all individuals infected, the likelihood of developing gastric cancer depends on environmental, bacterial virulence and host specific factors. The majority of all gastric cancer cases are attributable to H pylori infection and therefore theoretically preventable. There is evidence from animal models that eradication of H pylori at an early time point can prevent gastric cancer development. However, randomized clinical trials exploring the prophylactic effect of H pylori eradication on the incidence of gastric cancer in humans remain sparse and have yielded conflicting results. Better markers for the identification of patientsat risk for H pylori induced gastric malignancy are needed to allow the development of a more efficient public eradication strategy. Meanwhile, screening and treatment of H pylori in first-degree relatives of gastric cancer patients as well as certain high-risk populations might be beneficial.

  3. Immunization. Safety and Use of Polio Vaccines. Briefing Report to the Chairman, Subcommittee on Natural Resources, Agriculture Research and Environment, Committee on Science, Space, and Technology, House of Representatives.

    General Accounting Office, Washington, DC.

    This report presents information on the status of the safety and use of polio vaccines in the United States. Topics discussed include: (1) the role of the Food and Drug Administration (FDA) in processing an inactivated polio vaccine license application; (2) the steps the federal government has taken to improve the safety of the vaccine; (3) the…

  4. Achieving Standardization

    Henningsson, Stefan

    2016-01-01

    competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has...

  5. Achieving Standardization

    Henningsson, Stefan

    2014-01-01

    competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has...

  6. Knowledge and work performance of multi-purpose workers under national leprosy eradication programme in Satara district, Maharashtra.

    Mohite, R V; Mohite, V R

    2012-01-01

    After integration of leprosy services into general health care services, peripheral health care workers played important role in leprosy elimination. The objectives of present study are to assess the knowledge and work performance of multi-purpose workers and it's correlation towards eradication of leprosy under national leprosy eradication programme in Satara district. The cross sectional study was conducted over a period of 6 months includes 71 Primary health centres (PHCs) and 6 Urban leprosy centres (ULCs) providing leprosy services to whole Satara district, Maharashtra. Random sampling technique was used to select study subjects (Multi-purpose workers, MPWs) and data was collected by using pre-tested semi structured proforma by personal interview method. Percentage distribution and statistical association between knowledge and work performance was analysed. More than 88.31% MPWs had good knowledge about leprosy and National leprosy eradication programme (NLEP), similarly more than 88.42% showed good work performance under NLEP in Satara district. Significant statistical association was existed between age and work experience of MPWs with their work performance under NLEP (chi2=11.2, p=0.023* and chi2=10.1, p=0.038*). Significant correlation was also observed between knowledge of MPWs about leprosy and NLEP with their work performance under NLEP (r=0.66, p=0.001*). Satara district achieved leprosy elimination which was mainly due to very good knowledge and quality work performance by multi-purpose workers.

  7. Active epidemiological surveillance in the program of poliomyelitis eradication in Serbia

    Jevremović Ivana

    2002-01-01

    Full Text Available The main strategy of the worldwide Program of Poliomyelitis Eradication is based on immunization with oral poliovirus vaccine and active epidemiological surveillance aimed to demonstrate the absence of wild poliovirus circulation. The specification of the surveillance in the program, reporting and investigation of certain syndrome – the acute flaccid paralysis - as a specific feature of surveillance of poliomyelitis, is a new experience both for clinicians and epidemiologists. Along with the achieved results, problems in conducting the active epidemiological surveillance in Serbia, applied measures, and suggestions for improving its quality were presented. This experience might help in implementing the active surveillance for some other diseases that could be prevented by vaccine immunization.

  8. [Commemorative lecture of receiving Imamura Memorial Prize. III. Estimating the year of eradication of tuberculosis in Japan].

    Ohmori, M

    1994-09-01

    The year by which tuberculosis could be eradicated, has been discussed for several foreign countries, and based on those results, new strategic plans and goals have been elaborated. Therefore, in Japan too, it was desired to estimate the point at which eradication of tuberculosis would be achieved. The author estimated the year of eradication of tuberculosis, according to the criterion proposed by Dr. Styblo that "tuberculosis is eradicated when the prevalence of tuberculosis infection in the general population has fallen below 1% and continues to decrease". If the risk of infection is changing at a regular rate, it is possible to estimate the risk of infection at any particular time. Once the risk of infection is determined, it is also possible to calculate the age-specific prevalence of infection and the proportion of the population infected with tubercle bacilli at any given time. In Japan, the risk of infection before World War II was assumed to be around 4%; since then, it has declined on average, by 10 to 11% annually. The incidence rate in Japan also has declined, on average, by 10 to 11% annually. However, since late 1970s, the annual speed of decline of the incidence rate has slowed down. Therefore, I assumed that the recent trend of the infection risk is the same as the trend of the recent incidence rate among the 0-29 year age-group. The size of the effect of age on the risk of infection has been discussed. The author also considered age-effects in the model.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Long-term socio-economic consequences and health care costs of poliomyelitis: a historical cohort study involving 3606 polio patients.

    Nielsen, Nete Munk; Kay, Lise; Wanscher, Benedikte; Ibsen, Rikke; Kjellberg, Jakob; Jennum, Poul

    2016-06-01

    Worldwide 10-20 million individuals are living with disabilities after acute poliomyelitis. However, very little is known about the socio-economic consequences and health care costs of poliomyelitis. We carried out a historical register-based study including 3606 individuals hospitalised for poliomyelitis in Copenhagen, Denmark 1940-1954, and 13,795 age and gender-matched Danes. Participants were followed from 1980 until 2012, and family, socio-economic conditions and health care costs were evaluated in different age groups using chi-squared tests, boot-strapped t tests or hazard ratios (HR) calculated in Cox-regression models. The analyses were performed separately for paralytic and non-paralytic polio survivors and their controls, respectively. Compared with controls a higher percentage of paralytic polio survivors remained childless, whereas no difference was observed for non-paralytic polio survivors. The educational level among paralytic as well as non-paralytic polio survivors was higher than that among their controls, employment rate at the ages of 40, 50 and 60 years was slightly lower, whereas total income in the age intervals of 31-40, 41-50 and 51-60 years were similar to controls. Paralytic and non-paralytic polio survivors had a 2.5 [HR = 2.52 (95 % confidence interval (CI); 2.29-2.77)] and 1.4 [HR = 1.35 (95 % CI; 1.23-1.49)]-fold higher risk, respectively, of receiving disability pension compared with controls. Personal health care costs were considerably higher in all age groups in both groups of polio survivors. Individuals with a history of poliomyelitis are well educated, have a slightly lower employment rate, an income similar to controls, but a considerably higher cost in the health care system.

  10. Bilateral lower limb polio, chronic obstructive pulmonary disease, and recurrent acute coronary syndrome in a poly tobacco user: a preventable triple tragedy.

    Aggarwal, Ramesh; Dwivedi, Shridhar

    2012-01-01

    Non communicable diseases in most of the developing countries have surpassed the morbidity and mortality arising from communicable diseases. However there are people who continue to suffer from the residual disabilities of some communicable disease acquired at younger age like polio and develop non communicable diseases like COPD and coronary syndrome at older age primarily because of their tobacco habits. Both of these combination of communicable and non communicable diseases are preventable if timely preventive measures and healthy life style is adopted. This case highlights one such case where patient despite suffering from polio and restrictive lung disease started using tobacco and suffered from obstructive lung disease and coronary syndrome.

  11. Outbreak of poliomyelitis in Tajikistan in 2010: risk for importation and impact on polio surveillance in Europe?

    2010-04-29

    On 23 April 2010, the World Health Organisation announced the confirmation of wild poliovirus serotype 1 (WPV1) in seven samples from children with Acute Flaccid Paralysis in Tajikistan, in the context of a multi-district cluster starting in December 2009. As of 28 April, 32 of 171 reported cases were laboratory-confirmed and most closely related to virus from Uttar Pradesh, India. This outbreak demonstrates the high risk that still exists for importation of wild poliovirus into polio-free regions.

  12. Expresión en escherichia coli de un peptido perteneciente a la proteina vp1 del virus del polio

    Myriam Sánchez de Gómez

    2010-07-01

    Full Text Available Una secuencia sintética de 49 pb codificante para un péptido de la cubierta del virus del Polio se clonó en el vector de fusión pEZZ8, basado en el gen de la proteína A del Staphylococcus aureus. La expresión se hizo en Escherichia coli y la proteína de fusión se recuperó en el sobrenadante. Se purificó mediante cromatografía de afinidad con IgG Sepharosa y se identificó por medio de electroforesis en presencia de SDS.

  13. Vacunología en conflictos armados: una intervención puntual frente a poliomielitis en Afganistán Vaccinology in armed conflicts: a punctual intervention in poliomyelitis eradication in Afghanistan

    Juan M. López-González

    2006-06-01

    Full Text Available Las situaciones de conflicto armado suponen un hándicap para la erradicación de la poliomielitis por las dificultades de acceso a la población susceptible. En Afganistán, tras la operación militar que supuso la caída del régimen talibán, se llevó a cabo por sanitarios militares españoles una intervención dirigida a mejorar el nivel de protección frente a poliomielitis en la población infantil de la zona donde realizaban su misión. Solventados los obstáculos logísticos y de planificación, se efectuaron 2 rondas de vacunación con vacuna de polio inactivada (VPI. Un cuestionario mediado por un intérprete permitió una aproximación al escenario vacunal, proporcionando información sobre las características sociodemográficas de los niños que acudieron, su estado vacunal, sus conocimientos sobre las vacunas y el alcance de los medios empleados para difundir la intervención. Fueron inmunizados 293 y 321 niños en dos rondas. Se observó que muy pocos estaban vacunados con anterioridad (10% y mostraban un bajo conocimiento sobre las vacunas. Los padres no se implicaron en la campaña, que obtuvo mejor resultado de difusión por carteles (70% que por cuñas radiofónicas (10%. La vacunación es una iniciativa de salud que allana el camino hacia la paz.The situations of armed conflict suppose a handicap for the eradication of the poliomyelitis due to the difficulties to access the susceptible population. In Afghanistan, after the military operation which put an end to the Taliban regime, Spanish military sanitarians made an intervention in order to immunize the children of the zone where they were conducting their mission, against poliomyelitis. After having solved planning and logistic problems, two rounds of vaccination with IPV were made. A local translator helped to fill out a questionnaire about the state of immunization in that zone, providing information regarding the socio-demographic data of the children that showed up

  14. Will Synergizing Vaccination with Therapeutics Boost Measles Virus Eradication?

    Plemper, Richard K; Hammond, Anthea L

    2014-01-01

    Introduction Measles virus is a major human pathogen responsible for approximately 150,000 measles deaths annually. The disease is vaccine preventable and eradication of the virus is considered feasible in principle. However, a herd immunity exceeding 95% is required to prevent sporadic viral outbreaks in a population. Declining disease prevalence combined with public anxieties about vaccination safety has increased vaccine refusal especially in the European region, which has resulted in measles resurgence in some areas. Areas covered Here, we discuss whether synergizing effective measles therapeutics with vaccination could contribute to solving an endgame conundrum of measles elimination by accelerating the eradication effort. Based on an anticipated use for protection of high-risk contacts of confirmed measles cases through post-exposure prophylaxis, we identify key elements of the desirable drug profile, review current disease management strategies and the state of experimental inhibitor candidates, evaluate the risk associated with viral escape from inhibition, and consider the potential of measles therapeutics for the management of persistent viral infection of the CNS. Assuming a post-measles world with waning measles immunity, we contemplate the possible impact of therapeutics on controlling the threat imposed by closely related zoonotic pathogens of the same genus as measles virus. Expert opinion Efficacious therapeutics given for post-exposure prophylaxis of high-risk social contacts of confirmed index cases may aid measles eradication by closing herd immunity gaps due to vaccine refusal or failure in populations with overall good vaccination coverage. The envisioned primarily prophylactic application of measles therapeutics to a predominantly pediatric and/or adolescent patient population dictates the drug profile; the article must be safe and efficacious, orally available, shelf-stable at ambient temperature, and amenable to cost-effective manufacture

  15. Sustainable implementation of microhydro to eradicate poverty in Africa

    Jonker Klunne, Wim

    2010-09-15

    Local, micro scale, village level hydropower plants can play an important role towards eradication of poverty in rural areas. However, despite a good understanding of the technology involved and the enormous potential that exists in Africa, relative small numbers of micro hydro projects are currently in operation in Africa. This paper does look into the current situation on the continent with respect to installed systems and projects that are being implemented. It compares different implementation models and will conclude on ingredients for implementation models that will support the sustainable operation of micro hydroplants once built.

  16. Eradication of viral haemorrhagic septicaemia in Danish aquaculture

    Olesen, Niels Jørgen; Skall, Helle Frank; Jensen, Britt Bang

    Eradication of viral haemorrhagic septicaemia in Danish aquaculture Olesen N.J.1, Skall H.F.1, Jensen B.B.2, Henriksen N.H.3, Mellergård S.4, H. Korsholm H.5 1National Veterinary Institute, Technical University of Denmark, Aarhus, Denmark 2Norwegian Veterinary Institute, Oslo, Norway 3Danish...... Aquaculture Association, Silkeborg, Denmark 4Danish Veterinary and Food Administration, Glostrup, Denmark 5Danish Veterinary and Food Administration, Vejle, Denmark Viral haemorrhagic septicaemia (VHS) virus was first isolated in Denmark in 1962, when more than half of the approximately 800 Danish fish farms...

  17. The eradication experience of enzootic bovine leukosis from Lithuania.

    Acaite, J; Tamosiunas, V; Lukauskas, K; Milius, J; Pieskus, J

    2007-11-15

    Before 1985 the situation regarding enzootic bovine leukosis (EBL) in Lithuanian cattle was described only haphazardly. In 1986 serological investigations were initiated together with an eradication programme. The EBL bovine leukosis virus (BLV) situation was monitored by the Institute of Immunology Vilnius University, national and regional veterinary laboratories. Starting in 1986 all EBL-positive cattle were separated from negative cattle into BLV-infected and BLV-free herds. To create the latter, calves were fed pasteurized milk. The seroprevalence in 1990 was 7.29%, but it steadily declined to 0.32% in 2006.

  18. Investing in justice: ethics, evidence, and the eradication investment cases for lymphatic filariasis and onchocerciasis.

    Bailey, Theodore C; Merritt, Maria W; Tediosi, Fabrizio

    2015-04-01

    It has been suggested that initiatives to eradicate specific communicable diseases need to be informed by eradication investment cases to assess the feasibility, costs, and consequences of eradication compared with elimination or control. A methodological challenge of eradication investment cases is how to account for the ethical importance of the benefits, burdens, and distributions thereof that are salient in people's experiences of the diseases and related interventions but are not assessed in traditional approaches to health and economic evaluation. We have offered a method of ethical analysis grounded in theories of social justice. We have described the method and its philosophical rationale and illustrated its use in application to eradication investment cases for lymphatic filariasis and onchocerciasis, 2 neglected tropical diseases that are candidates for eradication.

  19. Recent Insights into Antibiotic Resistance in Helicobacter pylori Eradication

    Wenming Wu

    2012-01-01

    Full Text Available Antibiotics have been useful in the treatment of H. pylori-related benign and malignant gastroduodenal diseases. However, emergence of antibiotic resistance often decreases the eradication rates of H. pylori infections. Many factors have been implicated as causes of treatment failure, but the main antibiotic resistance mechanisms described to date are due to point mutations on the bacterial chromosome, a consequence of a significantly phenotypic variation in H. pylori. The prevalence of antibiotic (e.g., clarithromycin, metronidazole, tetracycline, amoxicillin, and furazolidone resistance varies among different countries; it appears to be partly determined by geographical factors. Since the worldwide increase in the rate of antibiotic resistance represents a problem of relevance, some studies have been performed in order to identify highly active and well-tolerated anti-H. pylori therapies including sequential, concomitant quadruple, hybrid, and quadruple therapy. These represent a promising alternatives in the effort to overcome the problem of resistance. The aim of this paper is to review the current status of antibiotic resistance in H. pylori eradication, highlighting the evolutionary processes in detail at alternative approaches to treatment in the past decade. The underlying resistance mechanisms will be also followed.

  20. Surgical Procedures Needed to Eradicate Infection in Knee Septic Arthritis.

    Dave, Omkar H; Patel, Karan A; Andersen, Clark R; Carmichael, Kelly D

    2016-01-01

    Septic arthritis of the knee is encountered on a regular basis by orthopedists and nonorthopedists. No established therapeutic algorithm exists for septic arthritis of the knee, and there is much variability in management. This study assessed the number of surgical procedures, arthroscopic or open, required to eradicate infection. The study was a retrospective analysis of 79 patients who were treated for septic knee arthritis from 1995 to 2011. Patients who were included in the study had native septic knee arthritis that had resolved with treatment consisting of irrigation and debridement, either open or arthroscopic. Logistic regression analysis was used to explore the relation between the interval between onset of symptoms and index surgery and the use of arthroscopy and the need for multiple procedures. Fifty-two patients met the inclusion criteria, and 53% were male, with average follow-up of 7.2 years (range, 1-16.2 years). Arthroscopic irrigation and debridement was performed in 70% of cases. On average, successful treatment required 1.3 procedures (SD, 0.6; range, 1-4 procedures). A significant relation (P=.012) was found between time from presentation to surgery and the need for multiple procedures. With arthroscopic irrigation and debridement, most patients with septic knee arthritis require only 1 surgical procedure to eradicate infection. The need for multiple procedures increases with time from onset of symptoms to surgery.

  1. [Program fo the eradication of Cochliomyia hominivorax in Northern Africa].

    Cunningham, E P; Abusowa, M; Lindquist, D A; Sidahmed, A E; Vargas-Terán, M

    1992-01-01

    The New World Screwworm (NWS, Cochliomyia hominivorax) is an obligate parasite of warm-blooded animals. The female lays up to 300 eggs in any break in the skin, and the resulting larvae (screwworms) burrow into surrounding living flesh. Infested animals frequently die, while the annual cost of controlling the pest in domestic animals is about US $10 per head. NWS is endemic in tropical Latin America. In 1988, it was detected in Libya, presumable introduced with imported sheep. By 1990, the infestation had spread to an area of 25,000 km2 containing some 2 million livestock. In early 1991, an internationally funded eradication programme was undertaken by FAO, using sterile insects. Each week, 40 million pupae were flown from a production plant in Mexico, and the emerged adults were distributed by over the infested area. Within a few months, the infestation has been eradicated. Whereas 12,000 infested animals were found in 1990, only 6 were detected in 1991. The programme involved the shipping and distribution of 1.3 billion sterile insects, animal inspections totalling 40 million and laboratory examination of 280,000 trapped flies. While the programme cost close to US $75 million, a benefit/cost ration of 50:1 has been estimated.

  2. Esophageal Adenocarcinoma Developing after Eradication of Helicobacter pylori

    Yasuhiko Abe

    2011-07-01

    Full Text Available A 75-year-old man underwent endoscopic hemostatic therapy for hemorrhagic gastric ulcer in September 2002. After healing of the gastric ulcer, he underwent Helicobacter pylori eradication therapy in February 2003. In August 2007, an irregular tumor was detected in the lower esophagus at annual checkup for gastric cancer screening using X-ray. Endoscopic examination showed that the lower margin of the tumor almost coincided with the esophagogastric junction and that a short segment of Barrett’s epithelium existed near the tumor. Biopsies of the tumor showed moderately to poorly differentiated adenocarcinoma. Mild reflux esophagitis and minor hiatal hernia was also observed, and the previously treated gastric ulcer was not recurrent. Absence of H. pylori was confirmed by serum antibody and urea breath test. Surgical resection of the lower esophagus and proximal stomach was performed. The tumor invaded into the muscularis propria of the esophageal wall but had no evidence of lymph node metastasis. Based on macroscopic and pathological findings, the tumor was recognized as esophageal adenocarcinoma. Previous endoscopic examination did not detect any apparent signs of tumor in the esophagogastric junction. As far as we know, this is the first report documenting a newly developed esophageal adenocarcinoma after the successful eradication of H. pylori.

  3. Comparative analysis of measures of viral reservoirs in HIV-1 eradication studies.

    Susanne Eriksson

    2013-02-01

    Full Text Available HIV-1 reservoirs preclude virus eradication in patients receiving highly active antiretroviral therapy (HAART. The best characterized reservoir is a small, difficult-to-quantify pool of resting memory CD4(+ T cells carrying latent but replication-competent viral genomes. Because strategies targeting this latent reservoir are now being tested in clinical trials, well-validated high-throughput assays that quantify this reservoir are urgently needed. Here we compare eleven different approaches for quantitating persistent HIV-1 in 30 patients on HAART, using the original viral outgrowth assay for resting CD4(+ T cells carrying inducible, replication-competent viral genomes as a standard for comparison. PCR-based assays for cells containing HIV-1 DNA gave infected cell frequencies at least 2 logs higher than the viral outgrowth assay, even in subjects who started HAART during acute/early infection. This difference may reflect defective viral genomes. The ratio of infected cell frequencies determined by viral outgrowth and PCR-based assays varied dramatically between patients. Although strong correlations with the viral outgrowth assay could not be formally excluded for most assays, correlations achieved statistical significance only for integrated HIV-1 DNA in peripheral blood mononuclear cells and HIV-1 RNA/DNA ratio in rectal CD4(+ T cells. Residual viremia was below the limit of detection in many subjects and did not correlate with the viral outgrowth assays. The dramatic differences in infected cell frequencies and the lack of a precise correlation between culture and PCR-based assays raise the possibility that the successful clearance of latently infected cells may be masked by a larger and variable pool of cells with defective proviruses. These defective proviruses are detected by PCR but may not be affected by reactivation strategies and may not require eradication to accomplish an effective cure. A molecular understanding of the discrepancy

  4. Integrated human rights and poverty eradication strategy: the case of civil registration rights in Zimbabwe.

    Musarandega, Reuben

    2009-01-01

    High poverty levels characterise sub-Saharan Africa, Zimbabwe included. Over 80 per cent of Zimbabwe's population lived below the total consumption poverty line and 70 per cent below the food poverty line in 2003. This plummeting of social indicators resulted from the freefall suffered by the country's economy from the 1990s, after unsuccessful attempts to implement structural adjustment programmes prescribed by international financial institutions. The ensuing socioeconomic decay, political crisis and international isolation of the country from the late 1990s reversed gains made in social indicators during the 1980s. Development theories attribute poverty to unchecked population growth, political, economic and environmental mismanagement, while developing countries' leaders attribute it to historical imbalances and global political and economic injustices. Despite this debate, poverty continues to evolve, expand and deepen and the need to eradicate it has become urgent. The complex question of what causes and what drives poverty is perpetually addressed and new ideas are emerging to answer the question. One recent view is that failure to centre development on people and to declare poverty a violation of human rights has allowed poverty to grow the world over. This study uses a hypothesised cause of poverty - civil registration - to exemplify the human right nature of poverty, and how a human rights' policy can be used as an instrument to eradicate poverty. The study demonstrates that civil registration is a right of instrumental relevance to poverty; and achieving civil registration grants people access to numerous other rights, some of which will lift them out of poverty, while the failure of civil registration deprives people of access to livelihoods, thereby entrenching them in poverty.

  5. Immunity to polio, measles and rubella in women of child-bearing age and estimated congenital rubella syndrome incidence, Cambodia, 2012.

    Mao, B; Chheng, K; Wannemuehler, K; Vynnycky, E; Buth, S; Soeung, S C; Reef, S; Weldon, W; Quick, L; Gregory, C J

    2015-07-01

    Significant gaps in immunity to polio, measles, and rubella may exist in adults in Cambodia and threaten vaccine-preventable disease (VPD) elimination and control goals, despite high childhood vaccination coverage. We conducted a nationwide serological survey during November-December 2012 of 2154 women aged 15-39 years to assess immunity to polio, measles, and rubella and to estimate congenital rubella syndrome (CRS) incidence. Measles and rubella antibodies were detected by IgG ELISA and polio antibodies by microneutralization testing. Age-structured catalytic models were fitted to rubella serological data to predict CRS cases. Overall, 29.8% of women lacked immunity to at least one poliovirus (PV); seroprevalence to PV1, PV2 and PV3 was 85.9%, 93.4% and 83.3%, respectively. Rubella and measles antibody seroprevalence was 73.3% and 95.9%, respectively. In the 15-19 years age group, 48.2% [95% confidence interval (CI) 42.4-54.1] were susceptible to either PV1 or PV3, and 40.3% (95% CI 33.0-47.5) to rubella virus. Based on rubella antibody seroprevalence, we estimate that >600 infants are born with CRS in Cambodia annually. Significant numbers of Cambodian women are still susceptible to polio and rubella, especially those aged 15-19 years, emphasizing the need to include adults in VPD surveillance and a potential role for vaccination strategies targeted at adults.

  6. Basil O'Connor, the National Foundation for Infantile Paralysis and the Reorganization of Polio Research in the United States, 1935-41.

    Wilson, Daniel J

    2015-07-01

    The costs associated with polio research in the late 1920s were high, while sources for research funding remained scarce. This began to change in the early 1930s with the creation of three private philanthropies that would form the basis of a system to fund polio research adequately: the International Committee for the Study of Infantile Paralysis (1928), The President's Birthday Ball Commission (1934), and the National Foundation for Infantile Paralysis (1938). This article explores how these three organizations shaped the process for directing funds to polio research. Beginning with the International Committee, all three philanthropies used medical advisory committees as vehicles for the review of proposals for research. The National Foundation adopted many of the policies and procedures of the earlier organizations, drawing on the experiences, misfortunes, and successes of its predecessors. The National Foundation also relied on some of the same personnel, although the microbiologist and writer Paul de Kruif, who was an influential figure in the early years, was gradually pushed out. This essay explores the establishment of the medical advisory committees of the National Foundation and reveals how by 1941 under leadership of Basil O'Connor and Dr. Thomas Rivers they developed a systematic and readily legitimated process for directing funding. By 1941, the NFIP had in place the fund-raising capacity to underwrite the scientific research that would ultimately produce two successful polio vaccines in the next twenty years.

  7. The effects of a home-based arm ergometry exercise programme on physical fitness, fatigue and activity in polio survivors: protocol for a randomised controlled trial

    Murray Deirdre

    2012-12-01

    Full Text Available Abstract Background Many Polio survivors have reduced mobility, pain and fatigue, which make access to conventional forms of aerobic exercise difficult. Inactivity leads to increased risk of health problems, many of which are prevalent among Polio survivors. Aerobic exercise programmes in Polio survivors should utilise stable muscle groups and should be designed to minimise exacerbation of pain and fatigue. A home-based arm ergometry aerobic exercise programme may represent an affordable and accessible exercise modality, incorporating exercise prescription principles in this group. Methods/design This is a prospective, single blinded, randomised controlled trial. There are two arms; exercise intervention using arm ergometers and control. Polio survivors meeting eligibility criteria will be recruited and randomly allocated to intervention or control groups. Participants allocated to the intervention group will receive a small arm ergometer and a polar heart rate monitor. They will carry out a home-based moderate intensity (50-70% HRMax aerobic exercise programme for eight weeks, following instruction by the treating physiotherapist. Assessments will occur at baseline and after eight weeks and will include tests of physical fitness, activity, energy cost of walking, fatigue and quality of life. Clinically feasible assessment tools including the Six Minute Arm Test, the Physical Activity Scale for People with Physical Disabilities questionnaire, the Physiological Cost Index, Fatigue Severity Scale and the SF-36v2 will be utilised. Discussion The efficacy of a home-based arm ergometry programme in Polio survivors will be examined. No previous trial has examined such a programme using a wide range of outcome measures pertinent to Polio survivors. This study will provide new information on the impact of arm ergometry on physical fitness, activity, body composition, fatigue, pain, muscle strength, and health related quality of life. Also, the study

  8. Eradication of scrapie with selective breeding: are we nearly there?

    Davidse Aart

    2010-05-01

    Full Text Available Abstract Background Following EU decision 2003/100/EC Member States have recently implemented sheep breeding programmes to reduce the prevalence of sheep with TSE susceptible prion genotypes. The present paper investigates the progress of the breeding programme in the Netherlands. The PrP genotype frequencies were monitored through time using two sets of random samples: one set covers the years 2005 to 2008 and is taken from national surveillance programme; the other is taken from 168 random sheep farms in 2007. The data reveal that although the level of compliance to the breeding programme has been high, the frequency of susceptible genotypes varies substantially between farms. The 168 sheep farms are a subset of 689 farms participating in a postal survey inquiring about management and breeding strategies. This survey aimed to identify how much these strategies varied between farms, in order to inform assessment of the expected future progress towards eradication of classical scrapie. Results On the one hand, we found that compliance to the national breeding program has been high, and the frequency of resistant genotypes is expected to increase further in the next few years. On the other hand, we observed a large variation in prevalence of the scrapie resistant PrP genotype ARR between farms, implicating a large variation of genetic resistance between farms. Substantial between-flock differences in management and breeding strategies were found in the postal survey, suggesting considerable variation in risk of scrapie transmission between farms. Conclusions Our results show that although there has been a good progress in the breeding for scrapie resistance and the average farm-level scrapie susceptibility in the Netherlands has been significantly reduced, still a considerable proportion of farms contain high frequencies of susceptible genotypes in their sheep population. Since 2007 the breeding for genetic resistance is voluntarily again, and

  9. Can hepatitis C be eradicated in the United States?

    Edlin, Brian R; Winkelstein, Emily R

    2014-10-01

    The advent of highly effective antiviral regimens will make the eradication of hepatitis C in high-income countries such as the United States technically feasible. But eradicating hepatitis C will require escalating our response to the epidemic in key domains, including surveillance and epidemiology, prevention, screening, care and treatment, policy, research, and advocacy. Surveillance must be nimble enough to quickly assess the magnitude of new transmission patterns as they emerge. Basic prevention strategies - community-based outreach and education, testing and counseling, and access to sterile injection equipment and opioid substitution therapies - must be scaled up and adapted to target groups in which new epidemics are emerging. All adults should be screened for hepatitis C, but special efforts must focus on groups with increased prevalence through community outreach and rapid testing. Government, industry, and payers must work together to assure full access to health services and antiviral drugs for everyone who is infected. Access to the new regimens must not be compromised by excessively high prices or arbitrary payer restrictions. Partnerships must be forged between hepatitis providers and programs that serve people who inject illicit drugs. Healthcare providers and systems, especially primary care practitioners, need education and training in treating hepatitis C and caring for substance-using populations. Services must be provided to the disadvantaged and stigmatized members of society who bear a disproportionate burden of the epidemic. Environments must be created where people who use drugs can receive prevention and treatment services without shame or stigma. Action is needed to end the policy of mass incarceration of people who use drugs, reduce the stigma associated with substance use, support the human rights of people who use drugs, expand social safety net services for the poor and the homeless, remove the legal barriers to hepatitis C prevention

  10. 75 FR 55626 - Certification Related to Aerial Eradication in Colombia Under the International Narcotics Control...

    2010-09-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Certification Related to Aerial Eradication in Colombia Under the International Narcotics Control and Law... determine and certify that: (1) The herbicide used for aerial eradication of illicit crops in Colombia...

  11. Eradication of Helicobacter pylori Is Associated with the Progression of Dementia: A Population-Based Study

    Yang-Pei Chang

    2013-01-01

    Full Text Available Objective. To evaluate the effect of eradication of Helicobacter pylori (H. pylori on the progression of dementia in Alzheimer’s disease (AD patients with peptic ulcer. Methods. Participants with the diagnosis of AD and peptic ulcer were recruited between 2001 and 2008. We examined the association between eradication of H. pylori and the progression of AD using the multiple regression models. Medication shift from Donepezil, Rivastgmine, and Galantamine to Mematine is defined as progression of dementia according to the insurance of National Health Insurance (NHI under expert review. Results. Among the 30142 AD patients with peptic ulcers, the ratio of medication shift in AD patients with peptic ulcers is 79.95%. There were significant lower incidence comorbidities (diabetes mellitus, hypertension, cerebrovascular disease, coronary artery disease, congestive heart failure and hyperlipidemia in patients with H. pylori eradication as compared with no H. pylori eradication. Eradication of H. pylori was associated with a decreased risk of AD progression (odds ratio [OR] 0.35 [0.23–0.52] as compared with no H. pylori eradication, which was not modified by comorbidities. Conclusions. Eradication of H. pylori was associated with a decreased progression of dementia as compared to no eradication of H. pylori in AD patients with peptic ulcers.

  12. Importance of post-treatment follow-up to secure sufficient eradication therapy for Helicobacter pylori

    Roug, Stine; Madsen, Lone Galmstrup

    2012-01-01

    To optimize the care for Helicobacter pylori-associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure...

  13. Pharmacoeconomics of Helicobacter pylori : eradication versus maintenance therapy in controlling peptic ulcer disease

    Klok, R M; Brouwers, J R; Postma, Maarten

    2001-01-01

    We performed an electronic search in Medline and EMBASE for papers comparing Helicobacter pylori eradication and H(2)RA-maintenance therapy in peptic ulcer. Treatment to eradicate H. pylori in patients with a proven ulcer has a favorable cost-effectiveness compared with maintenance therapy, with ben

  14. [Farmacoeconomical estimation of efficiency of different schemes of eradication therapy of Helicobacter pylori infection in children].

    Kashnikova, S N; Shcherbakov, P L; Kashnikov, V V; Tatarinov, P A; Shcherbakova, M Iu

    2008-01-01

    In this article farmakoekonomical analysis of efficiency of various, the most common in Russia schemes of eradication therapy disoders, associated with H. pylori infection is given to by authors basis on their private experience. All-round studying of the different economical factors influencing on a cost of used schemes is realized, and result of spent complex efficiency eradication therapy is estimated.

  15. Legal Policy Of Corruption Eradication At State-Owned Enterprises Sector In Indonesia

    Zulkipli

    2015-08-01

    Full Text Available A mandate of the constitution of the Republic of Indonesia as the highest law is the creation of Indonesia people that is just and prosperous and then the development in all sectors becomes a necessity for achieving that goal. To achieve continuity and development success the enforcement of law supremacy in the form of prevention and eradication of corruption is a necessary condition condition sine qua non. Type of legal research conducted is normative. This research was carried out by discussion of concepts doctrine and theory principles as well as legislation which is correlated to the philosophical construction on state finances. The results of the research indicated that law enforcement of corruption against the management of limited state-owned enterprises during this that damage SEOs state is one of the important parts in the form of control the management of SOEs whose responsible and integrity. Though on the other hand the debate over the use of the criminal instruments in resolving the problems that occurred in the transaction of SOEs state that damage will continue to occur but against the actor of state-owned companies still put forward the principle of prudence in running the business because in some judicial practice has been expandingconstructing carelessness be a part of unlawful action in corruption crime.

  16. Peste des Petits Ruminants, the next eradicated animal disease?

    Albina, Emmanuel; Kwiatek, Olivier; Minet, Cécile; Lancelot, Renaud; Servan de Almeida, Renata; Libeau, Geneviève

    2013-07-26

    Peste des Petits Ruminants (PPR) is a widespread viral disease caused by a Morbillivirus (Paramyxoviridae). There is a single serotype of PPR virus, but four distinct genetic lineages. Morbidity and mortality are high when occurring in naive sheep and goats populations. Cattle and African buffaloes (Syncerus caffer) are asymptomatically infected. Other wild ruminants and camels may express clinical signs and mortality. PPR has recently spread in southern and northern Africa, and in central and far-east Asia. More than one billion sheep and goats worldwide are at risk. PPR is also present in Europe through western Turkey. Because of its clinical incidence and the restrictions on animal movements, PPR is a disease of major economic importance. A live attenuated vaccine was developed in the 1980s, and has been widely used in sheep and goats. Current researches aim (i) to make it more thermotolerant for use in countries with limited cold chain, and (ii) to add a DIVA mark to shorten and reduce the cost of final eradication. Rinderpest virus-another Morbillivirus-was the first animal virus to be eradicated from Earth. PPRV has been proposed as the next candidate. Considering its wide distribution and its multiple target host species which have an intense mobility, it will be a long process that cannot exclusively rely on mass vaccination. PPR specific epidemiological features and socio-economic considerations will also have to be taken into account, and sustained international, coordinated, and funded strategy based on a regional approach of PPR control will be the guarantee toward success.

  17. Genome editing strategies: potential tools for eradicating HIV-1/AIDS.

    Khalili, Kamel; Kaminski, Rafal; Gordon, Jennifer; Cosentino, Laura; Hu, Wenhui

    2015-06-01

    Current therapy for controlling human immunodeficiency virus (HIV-1) infection and preventing acquired immunodeficiency syndrome (AIDS) progression has profoundly decreased viral replication in cells susceptible to HIV-1 infection, but it does not eliminate the low level of viral replication in latently infected cells, which contain integrated copies of HIV-1 proviral DNA. There is an urgent need for the development of HIV-1 genome eradication strategies that will lead to a permanent or "sterile" cure of HIV-1/AIDS. In the past few years, novel nuclease-initiated genome editing tools have been developing rapidly, including zinc finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), and the CRISPR/Cas9 system. These surgical knives, which can excise any genome, provide a great opportunity to eradicate the HIV-1 genome by targeting highly conserved regions of the HIV-1 long terminal repeats or essential viral genes. Given the time consuming and costly engineering of target-specific ZFNs and TALENs, the RNA-guided endonuclease Cas9 technology has emerged as a simpler and more versatile technology to allow permanent removal of integrated HIV-1 proviral DNA in eukaryotic cells, and hopefully animal models or human patients. The major unmet challenges of this approach at present include inefficient nuclease gene delivery, potential off-target cleavage, and cell-specific genome targeting. Nanoparticle or lentivirus-mediated delivery of next generation Cas9 technologies including nickase or RNA-guided FokI nuclease (RFN) will further improve the potential for genome editing to become a promising approach for curing HIV-1/AIDS.

  18. Early Development of Refl ux Esophagitis after Successful Helicobacter Pylori Eradication in Superfi cial Gastritis

    H H Jeon

    2011-10-01

    Full Text Available The relationship between gastroesophageal refl ux disease (GERD and Helicobacter pylori (H. pylori eradication is still debated. Recently, we had a patient of GERD who had developed it shortly after H. pylori eradication therapy. A 72-year-old man was diagnosed by endoscopy as suffering from severe superfi cial gastritis in the stomach body. A rapid urease test showed H. pylori infection. He was then started on proton pump inhibitor (PPI based therapy for two weeks eradicating H.pylori. After completion of H. pylori eradication, he complained of a heart-burn sensation. Follow-up endoscopy showed refl ux esophagitis, of grade B according to the Los Angeles classifi cation. Since the patient had developed GERD after completion of the triple therapy, their suggests that H. pylori eradication must have triggered the development of de novo GERD after a short period of time. Keywords: GERD, Helicobacter pylori, PPI.

  19. Integrated Strategy for Sustainable Cattle Fever Tick Eradication in USA is Required to Mitigate the Impact of Global Change.

    Pérez de León, Adalberto A; Teel, Pete D; Auclair, Allan N; Messenger, Matthew T; Guerrero, Felix D; Schuster, Greta; Miller, Robert J

    2012-01-01

    The ticks Rhipicephalus (Boophilus) annulatus and R. (B.) microplus, commonly known as cattle and southern cattle tick, respectively, impede the development and sustainability of livestock industries throughout tropical and other world regions. They affect animal productivity and wellbeing directly through their obligate blood-feeding habit and indirectly by serving as vectors of the infectious agents causing bovine babesiosis and anaplasmosis. The monumental scientific discovery of certain arthropod species as vectors of infectious agents is associated with the history of research on bovine babesiosis and R. annulatus. Together, R. microplus and R. annulatus are referred to as cattle fever ticks (CFT). Bovine babesiosis became a regulated foreign animal disease in the United States of America (U.S.) through efforts of the Cattle Fever Tick Eradication Program (CFTEP) established in 1906. The U.S. was declared free of CFT in 1943, with the exception of a permanent quarantine zone in south Texas along the border with Mexico. This achievement contributed greatly to the development and productivity of animal agriculture in the U.S. The permanent quarantine zone buffers CFT incursions from Mexico where both ticks and babesiosis are endemic. Until recently, the elimination of CFT outbreaks relied solely on the use of coumaphos, an organophosphate acaricide, in dipping vats or as a spray to treat livestock, or the vacation of pastures. However, ecological, societal, and economical changes are shifting the paradigm of systematically treating livestock to eradicate CFT. Keeping the U.S. CFT-free is a critical animal health issue affecting the economic stability of livestock and wildlife enterprises. Here, we describe vulnerabilities associated with global change forces challenging the CFTEP. The concept of integrated CFT eradication is discussed in reference to global change.

  20. Integrated strategy for sustainable cattle fever tick eradication in USA is required to mitigate the impact of global change

    Adalberto A. Pérez de León

    2012-06-01

    Full Text Available The ticks Rhipicephalus (Boophilus annulatus and R. (B. microplus, commonly known as cattle and southern cattle tick, respectively, impede the development and sustainability of livestock industries throughout tropical and other world regions. They affect animal productivity and wellbeing directly through their obligate blood feeding habit and indirectly by serving as vectors of the infectious agents causing bovine babesiosis and anaplasmosis. The monumental scientific discovery of certain arthropod species as vectors of infectious agents is associated with the history of research on bovine babesiosis and R. annulatus. Together, R. microplus and R. annulatus are referred to as cattle fever ticks (CFT. Bovine babesiosis became a regulated foreign animal disease in the United States of America (U.S. through efforts of the Cattle Fever Tick Eradication Program (CFTEP established in 1906. The U.S. was declared free of CFT in 1943, with the exception of a permanent quarantine zone in south Texas along the border with Mexico. This achievement contributed greatly to the development and productivity of animal agriculture in the U.S. The permanent quarantine zone buffers CFT incursions from Mexico where both ticks and babesiosis are endemic. Until recently, the elimination of CFT outbreaks relied solely on the use of coumaphos, an organophosphate acaricide, in dipping vats or as a spray to treat livestock, or the vacation of pastures. However, ecological, societal, and economical changes are shifting the paradigm of systematically treating livestock to eradicate CFT. Keeping the U.S. CFT-free is a critical animal health issue affecting the economic stability of livestock and wildlife enterprises. Here, we describe vulnerabilities associated with global change forces challenging the CFTEP. The concept of integrated CFT eradication is discussed in reference to global change.

  1. Efficacy of ebrotidine and ranitidine combined with amoxicillin and metronidazole in the eradication of Helicobacter pylori in patients with duodenal ulcer.

    Popiela, T; Kulig, J; Karcz, D; Tabor, J; Torres, J; Márquez, M; Fillat, O; Herrero, E; Ortiz, J A

    1997-04-01

    This double-blind, randomized, phase III clinical trial was carried out in two parallel groups to assess the efficacy of ebrotidine (N-[(E)-[[2-[[[2-[(diaminomethylene) amino]-4-thiazolyl]methyl]thio]ethyl]amino] methylene]-4-bromo-benzenesulfonamide, CAS 100981-43-9, FI-3542) 400 mg and ranitidine 300 mg given in single evening dose, combined with amoxicillin 750 mg and metronidazole 500 mg three times daily for 14 days, in the eradication of Helicobacter pylori in patients with duodenal ulcer. Thirty patients were included, divided into two groups of 15, to whom one of the study therapies was administered based on a randomization code. Clinical and endoscopic controls were performed 4, 6 and 8 weeks after the onset of the treatment. No differences were seen between the two treatment groups with regard to demographic parameters and clinical histories. They were both perfectly homogeneous. There were no differences between the eradication of both therapies in both the antrum and gastric body samples (over 80% eradication), allowing the results to be classified as satisfactory. Moreover, perfect control was achieved through the study of clinical symptoms, which even disappeared in some cases. There were no differences in the healing rate of the duodenal ulcer after four weeks, 86.7% being achieved for both groups.

  2. Stable isotope analysis as an early monitoring tool for community-scale effects of rat eradication

    Nigro, Katherine M.; Hathaway, Stacie A.; Wegmann, Alex; Miller-ter Kuile, Ana; Fisher, Robert N.; Young, Hillary S.

    2017-01-01

    Invasive rats have colonized most of the islands of the world, resulting in strong negative impacts on native biodiversity and on ecosystem functions. As prolific omnivores, invasive rats can cause local extirpation of a wide range of native species, with cascading consequences that can reshape communities and ecosystems. Eradication of rats on islands is now becoming a widespread approach to restore ecosystems, and many native island species show strong numerical responses to rat eradication. However, the effect of rat eradication on other consumers can extend beyond direct numerical effects, to changes in behavior, dietary composition, and other ecological parameters. These behavioral and trophic effects may have strong cascading impacts on the ecology of restored ecosystems, but they have rarely been examined. In this study, we explore how rat eradication has affected the trophic ecology of native land crab communities. Using stable isotope analysis of rats and crabs, we demonstrate that the diet or trophic position of most crabs changed subsequent to rat eradication. Combined with the numerical recovery of two carnivorous land crab species (Geograpsus spp.), this led to a dramatic widening of the crab trophic niche following rat eradication. Given the established importance of land crabs in structuring island communities, particularly plants, this suggests an unappreciated mechanism by which rat eradication may alter island ecology. This study also demonstrates the potential for stable isotope analysis as a complementary monitoring tool to traditional techniques, with the potential to provide more nuanced assessments of the community- and ecosystem-wide effects of restoration.

  3. Strategy to control the invasive alien tree Miconia calvescens in Pacific islands: Eradication, containment or something else?

    Meyer, Jean-Yves; Loope, Lloyd; Goarant, Anne-Claire; Veitch, C.R.; Clout, M.N.; Towns, D. R.

    2011-01-01

    Miconia calvescens (Melastomataceae) is a notorious plant invader in the tropical islands of French Polynesia, Hawaii and New Caledonia. A small tree native to Central and South America, it was first introduced as an ornamental in private botanic gardens in Tahiti (1937), Honolulu (1961), and Nouméa (1970s) where it escaped, became naturalised, and formed dense monospecific stands. More than 80,000 ha are currently invaded in French Polynesia, 10,000 ha in the Hawaiian Islands and 140 ha in New Caledonia. Control programmes have been under way in the Hawaiian Islands (Oahu, Maui, Hawaii, Kauai) and French Polynesia (Raiatea, Tahaa, Nuku Hiva, Fatu Hiva) since the early 1990s, and in New Caledonia (Province Sud) since 2006. Despite more than 15 years of intensive control efforts and millions of plants destroyed, eradication has not been achieved in any of these islands, mainly because the species has multiple features that thwart its elimination (e.g., prolific seed production, active dispersal by alien and native frugivorous birds, large and persistent soil seed bank, shade-tolerance), combined with the difficulty of detecting and destroying plants on rough terrain and steep slopes, insufficient control frequency, and limited financial and human resources. Miconia’s life cycle requires at least four years growth from seedling to fruiting. Consequently, prevention of fruit production may be an effective management strategy for small populations. This “juvenilization” process may allow the eradication of small populations when carefully conducted over a quarter century. 

  4. Maastricht Ⅱ treatment scheme and efficacy of different proton pump inhibitors in eradicating Helicobacter pylori

    Engin Altintas; Orhan Sezgin; Oguz Ulu; Ozlem Aydin; Handan Camdeviren

    2004-01-01

    AIM: The Maastricht Ⅱ criteria suggest the use of amoxicillin and clarithromycin in addition to a proton pump inhibitor over 7-10 d as a first line therapy in the eradication of Helicobacter pylori(H pylori). For each proton pump inhibitor, various rates of eradication have been reported. The present study was to compare the efficacy of different proton pump inhibitors like omeprazole, lansoprazole and pantoprazole in combination with amoxicillin and clarithromycin in the first line eradication of H pylori and to investigate the success of H pylori eradication in our district.METHODS: A total of 139 patients were included having a Helicobacter pylori(+) gastroduodenal disorders diagnosed by means of histology and urease test. Besides amoxicillin (1 000 mg twice a day) and clarithromycin (500 mg twice a day), they were randomized to take omeprazole (20 mg twice a day), or lansoprazole (30 mg twice a day), or pantoprozole (40 mg twice a day) for 14 d. Four weeks after the therapy, the eradication was assessed by means of histology and urease test. It was evaluated as eradicated if the H pylori was found negative in both. The complaints (pain in epigastrium, nocturnal pain, pyrosis and bloating)were graded in accordance with the Licert scale. The compliance of the patients was recorded.RESULTS: The eradication was found to be 40.8% in the omeprazole group, 43.5% in the lansoprazole group and 47.4% in the pantoprazole group. Sixty-three out of 139patients (45%) had eradication. No statistically significant difference was observed between the groups. Significant improvements were seen in terms of the impact on the symptom scores in each group.CONCLUSION: There was no difference between omeprazole, lansoprazole and pantoprazole in H pylori eradication, and the rate of eradication was as low as 45%.Symptoms were improved independent of the eradication in each treatment group. The iow eradication rates suggest that the antibiotic resistance or the genetic differences of

  5. Cattle scourge no more. The eradication of rinderpest and its lessons for global health campaigns.

    Youde, Jeremy

    2013-01-01

    In 2011, the Food and Agriculture Organization of the United Nations (FAO) officially declared rinderpest eradicated. This cattle virus, which has historically had significant political, economic, and social consequences, is only the second infectious disease to disappear from the face of the planet due to concerted human actions. This paper explores the effects that rinderpest has had historically, chronicles the actions of the Global Rinderpest Eradication Campaign (GREP), and discusses the lessons that GREP can offer for combating other infectious diseases. I argue that rinderpest's unique viral characteristics made eradication particularly feasible, but that GREP's activities offer important lessons for fostering international cooperation on controlling infectious disease outbreaks.

  6. Seroprevalence of poliovirus antibodies among 7-month-old infants after 4 doses of oral polio vaccine in Sistan-va-Baluchestan, Islamic Republic of Iran.

    Izadi, S; Shahmahmoodi, S; Zahraei, S M; Dorostkar, F; Majdzadeh, S-R

    2015-04-02

    Despite high coverage rates of polio vaccine in the Islamic Republic of Iran, the seroconversion rates of infants may be inadequate. This study measured seroprevalence of antibodies against poliovirus serotypes 1 to 3 (PV1, PV2 and PV3) in 7-month-old infants who had received at least 4 doses of trivalent oral polio vaccine. A serosurvey was conducted in 2010 in rural areas of Chabahar, Sistan-va-Baluchestan province. Using cluster sampling, 72 eligible infants were tested for antibody against the 3 poliovirus serotypes according to WHO guidelines. Antibody titres ≥ 1:10 were considered positive. The seropositive rates for antibody against PV1, PV2 and PV3 were 84.7%, 95.8% and 70.8% respectively. Only 63.9% of participants were seropositive for antibodies against all 3 poliovirus serotypes. Except for PV2, the seroprevalence of antibody against the other 2 poliovirus serotypes, especially PV3, was unsatisfactory.

  7. Multifaceted contributions: health workers and smallpox eradication in India.

    Bhattacharya, Sanjoy

    2008-01-01

    Smallpox eradication in South Asia was a result of the efforts of many grades of health-workers. Working from within the confines of international organisations and government structures, the role of the field officials, who were of various nationalities and also drawn from the cities and rural enclaves of the countries in these regions, was crucial to the development and deployment of policies. However, the role of these personnel is often downplayed in official histories and academic histories, which highlight instead the roles played by a handful of senior officials within the World Health Organization and the federal governments in the sub-continent. This article attempts to provide a more rounded assessment of the complex situation in the field. In this regard, an effort is made to underline the great usefulness of the operational flexibility displayed by field officers, wherein lessons learnt in the field were made an integral part of deploying local campaigns; careful engagement with the communities being targeted, as well as the employment of short term workers from amongst them, was an important feature of this work.

  8. Eradicating Squatters through Resettlement Programme: A Conceptual Paper

    Keuk Julieven Nonoi

    2016-01-01

    Full Text Available The existence of squatters had caused many issues including poverty, increasing social problems, drug addiction, criminal and low education level. Sadly, the State of Johor is still among a few other states in Peninsular Malaysia with the highest numbers of squatter families. These squatter settlements are not only inhabited by the local people, but consist of foreigners too. The environmental condition is not fitting, with poor sewage system and unplanned housing construction. Consequently, these issues had caused bad images and perception to the general public, as well as to the tourists. In Malaysia, Resettlement Programme is one of the most significant mechanisms in tackling squatters" settlements issue. Hence, the Johor State Government had taken various approaches in trying to eradicate the squatter settlements by relocating them to new locations with planned and better housing. This conceptual paper aims to examine the current literature and assess previous similar study in order to establish an understanding of the crucial provision of resettlement area in trying to eliminate squatters. It employs a qualitative design through assessment related literature and studies. The results confirmed for a further review of resettlement program. Findings from this study further suggest a comprehensive study of the issues revealed.

  9. Use of vaccination in avian influenza control and eradication.

    Marangon, S; Cecchinato, M; Capua, I

    2008-01-01

    Vaccination against avian influenza (AI) infections caused by viruses of the H5 and H7 subtypes has been used in several occasions in recent years with the general objective of controlling and in some cases eradicating the disease. To contain AI infections effectively, vaccination should only be used as part of a comprehensive control strategy that also includes biosecurity, quarantine, surveillance, education, and elimination of infected and at-risk poultry. Although properly used, potent AI vaccines can prevent disease and death, increase resistance to infection, reduce virus replication and shedding, and reduce viral transmission, they cannot completely prevent AI virus replication. A wide variety of vaccines against AI has been developed and tested in experimental conditions, but only inactivated whole AI virus vaccines and recombinant H5-AI vaccines have been licensed and widely used in various countries. AI vaccination programmes should be adapted to local conditions to guarantee efficacy and sustainability. In particular, vaccination programmes should be modulated in diverse situations according to the virus strain involved, the characteristics of the poultry producing sector, the capacity of the veterinary infrastructure, and the availability of adequate resources. Based on the eco-epidemiological situation in the affected region/area/compartment and the assessment of the risk of AI introduction, different vaccination strategies could be implemented to control AI: (i) routine vaccination performed in endemic areas; (ii) emergency vaccination in the face of an epidemic; and (iii) preventative vaccination carried out whenever a high risk of virus incursion is identified.

  10. Book review: Mosquito eradication: The story of killing Campto

    Lapointe, Dennis

    2015-01-01

    In 1826, the paradise that was the Hawaiian Islands was changed forever when the first mosquito species was accidentally introduced to the island of Maui. Though it has not lived up to its potential as a vector of human disease in the islands, Culex quinquefasciatus and the avian pathogens it transmits laid waste to perhaps the world's most remarkable insular avifauna. Today the lowland native forests, once deafening with birdsong, are largely devoid of native birds and Cx. quinquefasciatus has become an inextricable part of our natural areas. In the Hawaiian Islands, the conservation community struggles to keep invasive species out and to control a number of species that have become naturalized. Despite the millions of dollars spent, these efforts never seem enough to slow the erosion of our native biota. The restoration and long-term preservation of Hawaiian forest birds depend on the nearly complete control of mosquito-borne avian disease, an obstacle that to many land managers appears insurmountable. To rally hope in Hawai`i, the conservation community needs to see a success. As a Pacific island, Hawai`i shares similar conservation problems with New Zealand and has often looked to that nation for innovation and inspiration. Mosquito Eradication: The Story of Killing Campto may be our latest inspiration.

  11. Prospects for malaria eradication in sub-Saharan Africa.

    Ricardo Aguas

    Full Text Available BACKGROUND: A characteristic of Plasmodium falciparum infections is the gradual acquisition of clinical immunity resulting from repeated exposures to the parasite. While the molecular basis of protection against clinical malaria remains unresolved, its effects on epidemiological patterns are well recognized. Accumulating epidemiological data constitute a valuable resource that must be intensively explored and interpreted as to effectively inform control planning. METHODOLOGY/PRINCIPAL FINDING: Here we apply a mathematical model to clinical data from eight endemic regions in sub-Saharan Africa. The model provides a quantitative framework within which differences in age distribution of clinical disease are assessed in terms of the parameters underlying transmission. The shorter infectious periods estimated for clinical infections induce a regime of bistability of endemic and malaria-free states in regions of mesoendemic transmission. The two epidemiological states are separated by a threshold that provides a convenient measure for intervention design. Scenarios of eradication and resurgence are simulated. CONCLUSIONS/SIGNIFICANCE: In regions that support mesoendemic transmission, intervention success depends critically on reducing prevalence below a threshold which separates endemic and malaria-free regimes.

  12. Introduced arctic fox eradication at Rat Island, Aleutian Islands, Alaska, summer 1984

    US Fish and Wildlife Service, Department of the Interior — Mechanical means similar to those employed on Amata Island during the summer of 1983 were used to attempt eradication of fox on Rat Island. These labor intensive...

  13. Willapa - Willapa Bay Early Season Spartina Mapping and Eradication (Phase 1 and 2)

    US Fish and Wildlife Service, Department of the Interior — The Willapa National Wildlife Refuge (Willapa NWR) continued a successful program aimed at eradicating the non-native cordgrass, Spartina alterniflora (Spartina)...

  14. Initial Pseudomonas aeruginosa infection in patients with cystic fibrosis: characteristics of eradicated and persistent isolates

    Tramper-Stranders, G. A.; van der Ent, C. K.; Molin, Søren;

    2012-01-01

    Clin Microbiol Infect 2012; 18: 567574 Abstract Despite intensive eradication therapy, some CF patients with early Pseudomonas aeruginosa infection rapidly develop a chronic infection. To elucidate factors associated with this persistence, bacterial characteristics of early P. aeruginosa isolates...

  15. Eradication of Polynesian Rats (rattus exulans) from Rose Atoll National Wildlife Refuge, American Samoa

    US Fish and Wildlife Service, Department of the Interior — A 38-day poison and trap campaign was conducted on Rose Atoll National Wildlife Refuge to eradicate Polynesian rats in order to reduce their impact of seabird eggs...

  16. Is the treatment of Enterobius vermicularis co-infection necessary to eradicate Dientamoeba fragilis infection?

    José A. Boga

    2016-08-01

    Conclusions: Co-infection with E. vermicularis may act as a factor favoring D. fragilis infection by preventing eradication measures. This suggests that both parasites should be treated simultaneously.

  17. Eradication of carriage with methicillin-resistant Staphylococcus aureus: determinants of treatment failure

    H.S.M. Ammerlaan; J.A.J.W. Kluytmans; H. Berkhout; A. Buiting; E.I.G.B. de Brauwer; P.J. van den Broek; P. van Gelderen; S.C.A.P. Leenders; A. Ott; C.J.J. Richter; L. Spanjaard; I.J.B. Spijkerman; F.H. van Tiel; G.P. Voorn; M.W.H. Wulf; J. van Zeijl; A. Troelstra; M.J.M. Bonten

    2011-01-01

    Background: Using data from an observational study in which the effectiveness of a guideline for eradication of methicillin-resistant Staphylococcus aureus (MRSA) carriage was evaluated, we identified variables that were associated with treatment failure. Methods: A multivariate logistic regression

  18. Which factors affect the success or failure of eradication campaigns against alien species?

    Pluess, Therese; Jarošík, Vojtěch; Pyšek, Petr; Cannon, Ray; Pergl, Jan; Breukers, Annemarie; Bacher, Sven

    2012-01-01

    Although issues related to the management of invasive alien species are receiving increasing attention, little is known about which factors affect the likelihood of success of management measures. We applied two data mining techniques, classification trees and boosted trees, to identify factors that relate to the success of management campaigns aimed at eradicating invasive alien invertebrates, plants and plant pathogens. We assembled a dataset of 173 different eradication campaigns against 94 species worldwide, about a half of which (50.9%) were successful. Eradications in man-made habitats, greenhouses in particular, were more likely to succeed than those in (semi-)natural habitats. In man-made habitats the probability of success was generally high in Australasia, while in Europe and the Americas it was higher for local infestations that are easier to deal with, and for international campaigns that are likely to profit from cross-border cooperation. In (semi-) natural habitats, eradication campaigns were more likely to succeed for plants introduced as an ornamental and escaped from cultivation prior to invasion. Averaging out all other factors in boosted trees, pathogens, bacteria and viruses were most, and fungi the least likely to be eradicated; for plants and invertebrates the probability was intermediate. Our analysis indicates that initiating the campaign before the extent of infestation reaches the critical threshold, starting to eradicate within the first four years since the problem has been noticed, paying special attention to species introduced by the cultivation pathway, and applying sanitary measures can substantially increase the probability of eradication success. Our investigations also revealed that information on socioeconomic factors, which are often considered to be crucial for eradication success, is rarely available, and thus their relative importance cannot be evaluated. Future campaigns should carefully document socioeconomic factors to

  19. Which factors affect the success or failure of eradication campaigns against alien species?

    Therese Pluess

    Full Text Available Although issues related to the management of invasive alien species are receiving increasing attention, little is known about which factors affect the likelihood of success of management measures. We applied two data mining techniques, classification trees and boosted trees, to identify factors that relate to the success of management campaigns aimed at eradicating invasive alien invertebrates, plants and plant pathogens. We assembled a dataset of 173 different eradication campaigns against 94 species worldwide, about a half of which (50.9% were successful. Eradications in man-made habitats, greenhouses in particular, were more likely to succeed than those in (semi-natural habitats. In man-made habitats the probability of success was generally high in Australasia, while in Europe and the Americas it was higher for local infestations that are easier to deal with, and for international campaigns that are likely to profit from cross-border cooperation. In (semi- natural habitats, eradication campaigns were more likely to succeed for plants introduced as an ornamental and escaped from cultivation prior to invasion. Averaging out all other factors in boosted trees, pathogens, bacteria and viruses were most, and fungi the least likely to be eradicated; for plants and invertebrates the probability was intermediate. Our analysis indicates that initiating the campaign before the extent of infestation reaches the critical threshold, starting to eradicate within the first four years since the problem has been noticed, paying special attention to species introduced by the cultivation pathway, and applying sanitary measures can substantially increase the probability of eradication success. Our investigations also revealed that information on socioeconomic factors, which are often considered to be crucial for eradication success, is rarely available, and thus their relative importance cannot be evaluated. Future campaigns should carefully document

  20. Dual therapy for third-line Helicobacter pylori eradication and urea breath test prediction

    Toshihiro Nishizawa; Hidekazu Suzuki; Takama Maekawa; Naohiko Harada; Tatsuya Toyokawa; Toshio Kuwai; Masanori Ohara

    2012-01-01

    We evaluated the efficacy and tolerability of a dual therapy with rabeprazole and amoxicillin (AMX) as an empiric third-line rescue therapy.In patients with failure of first-line treatment with a proton pump inhibitor (PPI)-AMX-clarithromycin regimen and second-line treatment with the PPI-AMX-metronidazole regimen,a third-line eradication regimen with mbeprazole (10 mg q.i.d.) and AMX (500 mg q.i.d.) was prescribed for 2 wk.Eradication was confirmed by the results of the 13C-urea breath test (UBT) at 12 wk after the therapy.A total of 46 patients were included; however,two were lost to followup.The eradication rates as determined by per-protocol and intention-to-treat analyses were 65.9% and 63.0%,respectively.The pretreatment UBT results in the subjects showing eradication failure; those patients showing successful eradication comprised 32.9 ± 28.8 permil and 14.8 ± 12.8 permil,respectively.The pretreatment UBT results in the subjects with eradication failure were significantly higher than those in the patients with successful eradication (P =0.019).A low pretreatment UBT result (≤ 28.5 permil) predicted the success of the eradication therapy with a positive predictive value of 81.3% and a sensitivity of 89.7%.Adverse effects were reported in 18.2% of the patients,mainly diarrhea and stomatitis.Dual therapy with rabeprazole and AMX appears to serve as a potential empirical third-line strategy for patients with low values on pretreatment UBT.

  1. Helicobacter Pylori eradication therapy: getting research into practice.

    McDonnell, R

    2003-01-01

    Helicobacter Pylori (H. Pylori) is the primary cause of duodenal ulcer (DU). Guidelines recommend that all patients with DU be considered for Helicobacter Pylori Eradication Therapy (HPET). However, the proportion of patients with DU on long term anti-ulcer medication receiving HPET is small. This study examined the effectiveness of the continuing medical education (CME) network of the Irish College of General Practitioners (ICGP) in promoting best practice in DU treatment among GPs in an eastern region of Ireland. Ninty eight GPs recruited from the CME network of the ICGP were randomised in two cohorts. Cohort 1 received an (early) intervention; GPs were asked to identify their patients with DU receiving long term anti-ulcer medication and prescribe HPET according to defined criteria. Cohort 2 received the intervention later. Prescribing of HPET was monitored using routine prescribing data. Twenty per cent (286\\/1,422) of patients in cohort 1 and 19.2% (127\\/661) in cohort 2 had a DU. After exclusions, 53% (152\\/286) in cohort 1 and 30.7% (39\\/127) in cohort 2, were eligible for HPET. A significantly higher proportion of patients in cohort 1 received HPET compared with cohort 2 during the early intervention period (13.8% vs 0.0%, p<0.05). Reasons for not prescribing HPET included concurrent illness in patients, failure to comply with treatment. Best practice guidelines on HPET treatment of DU can be successfully applied using CME networks. This model could be repeated in another therapeutic area where established research is not yet current practice.

  2. BIOCIDE TREATMENT OF PONDS IN SCOTLAND TO ERADICATE SIGNAL CRAYFISH

    PEAY S.

    2006-01-01

    Full Text Available This trial aimed to eradicate illegally introduced signal crayfish Pacifastacus leniusculus in the North Esk catchment, Scotland. Sites treated were (1 an isolated gravel-pit (c. 9,000 m3, with crayfish present for 6 years; (2 three dammed ponds, (c. 5,000 m3 and (3 a leaking, offline pond (c. 6,000 m3, with crayfish for two years. Preliminary toxicity tests with substrate present indicated doses. Treatment at sites (1 and (2 (in October 2004, water temperature 13°C comprised deoxygenation with sodium sulphite to stimulate emergence, then application of natural pyrethrum (Pyblast. Exposed margins were sprayed with Pyblast to prevent escapes. Crayfish mortality was high, but one survivor was seen after 5 days. Pyblast was applied from a tank with Na2SO3 residue, which subsequent investigation indicated reduced Pyblast below the target 0.1 mg l-1. Site (1 was re-treated (end October, target 0.15 mg l-1 Pyblast, no Na2SO3, 9°C. Mortality was confirmed using caged crayfish. Prior to treatment at site (2, throughflow was stopped and fish removed. Biomonitoring was carried out with freshwater shrimps Gammarus in the adjacent watercourse. Treatment of site (3 (December, target 0.2 mg l-1, 4°C necessitated continuous back-pumping of leakage for a 2-week recovery period to avoid contamination of the river downstream. Caged crayfish took up to 5 days for 100% mortality. No crayfish were found in a summer survey after the treatments with Pyblast alone, but were caught in the ponds with Na2SO3 pre-treatment. Monitoring is required for 2-5 years.

  3. Driven to extinction? The ethics of eradicating mosquitoes with gene-drive technologies.

    Pugh, Jonathan

    2016-09-01

    Mosquito-borne diseases represent a significant global disease burden, and recent outbreaks of such diseases have led to calls to reduce mosquito populations. Furthermore, advances in 'gene-drive' technology have raised the prospect of eradicating certain species of mosquito via genetic modification. This technology has attracted a great deal of media attention, and the idea of using gene-drive technology to eradicate mosquitoes has been met with criticism in the public domain. In this paper, I shall dispel two moral objections that have been raised in the public domain against the use of gene-drive technologies to eradicate mosquitoes. The first objection invokes the concept of the 'sanctity of life' in order to claim that we should not drive an animal to extinction. In response, I follow Peter Singer in raising doubts about general appeals to the sanctity of life, and argue that neither individual mosquitoes nor mosquitoes species considered holistically are appropriately described as bearing a significant degree of moral status. The second objection claims that seeking to eradicate mosquitoes amounts to displaying unacceptable degrees of hubris. Although I argue that this objection also fails, I conclude by claiming that it raises the important point that we need to acquire more empirical data about, inter alia, the likely effects of mosquito eradication on the ecosystem, and the likelihood of gene-drive technology successfully eradicating the intended mosquito species, in order to adequately inform our moral analysis of gene-drive technologies in this context.

  4. The results of Helicobacter pylori eradication on repeated bleeding in patients with stomach ulcer.

    Horvat, Darko; Vcev, Aleksandar; Soldo, Ivan; Timarac, Jasna; Dmitrović, Branko; Misević, Tonci; Ivezić, Zdravko; Kraljik, Nikola

    2005-06-01

    The triple therapy of Helicobacter pylori eradication prevents repeated bleeding from stomach ulcer. The aim of this one-way blind prospective study was to evaluate the efficiency of the two-week triple therapy for Helicobacter pylori eradication in preventing renewed bleeding in patients with stomach ulcer within one year. This research included 60 hospitalized patients with bleeding stomach ulcer and positive Helicobacter pylori infection, 34 men and 26 women (average age 59.7 years). The patients were given therapeutic scheme of omeprazol--amoxicilin--metrodinazol (OAM) eradication for 14 days. Eradication of H. pylori infection was defined as lack of proof of the infection one month or several months after therapy suspension. By applying triple OAM therapy within two weeks the eradication was successful in 72%. In the group of 17 H. pylori positive patients there were 8 patients (47.6%) with repeated stomach ulcer and 3 patients (18%) with bleeding. Within the group of 43 H. pylori negative patients there were only 2 patients (4.65%) with repeated stomach ulcer and 1 patient (2%) with bleeding, during the observed period of 12 months. This research confirms the hypothesis about the necessity of eradication of Helicobacter pylori infection in patients with bleeding stomach ulcer as prevention of repeated bleeding.

  5. Helicobacter pylori Eradication for Prevention of Metachronous Recurrence after Endoscopic Resection of Early Gastric Cancer.

    Bang, Chang Seok; Baik, Gwang Ho; Shin, In Soo; Kim, Jin Bong; Suk, Ki Tae; Yoon, Jai Hoon; Kim, Yeon Soo; Kim, Dong Joon

    2015-06-01

    Controversies persist regarding the effect of Helicobacter pylori eradication on the development of metachronous gastric cancer after endoscopic resection of early gastric cancer (EGC). The aim of this study was to assess the efficacy of Helicobacter pylori eradication after endoscopic resection of EGC for the prevention of metachronous gastric cancer. A systematic literature review and meta-analysis were conducted using the core databases PubMed, EMBASE, and the Cochrane Library. The rates of development of metachronous gastric cancer between the Helicobacter pylori eradication group vs. the non-eradication group were extracted and analyzed using risk ratios (RRs). A random effect model was applied. The methodological quality of the enrolled studies was assessed by the Risk of Bias table and by the Newcastle-Ottawa Scale. Publication bias was evaluated through the funnel plot with trim and fill method, Egger's test, and by the rank correlation test. Ten studies (2 randomized and 8 non-randomized/5,914 patients with EGC or dysplasia) were identified and analyzed. Overall, the Helicobacter pylori eradication group showed a RR of 0.467 (95% CI: 0.362-0.602, P < 0.001) for the development of metachronous gastric cancer after endoscopic resection of EGC. Subgroup analyses showed consistent results. Publication bias was not detected. Helicobacter pylori eradication after endoscopic resection of EGC reduces the occurrence of metachronous gastric cancer.

  6. Ecosystem implications of conserving endemic versus eradicating introduced large herbivores in the Galapagos Archipelago

    Bastille-Rousseau, Guillaume; Gibbs, James P.; Campbell, Karl; Yackulic, Charles B.; Blake, Stephen

    2017-01-01

    Restoration of damaged ecosystems through invasive species removal and native species conservation is an increasingly common practice in biodiversity conservation. Estimating the degree of ecosystem response attributable specifically to eradication of exotic herbivores versus restoration of native herbivores is often difficult and is complicated by concurrent temporal changes in other factors, especially climate. We investigated the interactive impacts of native mega-herbivores (giant tortoises) and the eradication of large alien herbivores (goats) on vegetation productivity across the Galapagos Archipelago. We examined archipelago-wide patterns of Normalized Difference Vegetation Index (NDVI) as a proxy for vegetation productivity between 2001 and 2015 and evaluated how goat and historical and current tortoise occurrence influenced productivity. We used a breakpoint analysis to detect change in trends in productivity from five targeted areas following goat eradication. We found a positive association between tortoise occurrence and vegetation productivity and a negative association with goat occurrence. We also documented an increase in plant productivity following goat removal with recovery higher in moister regions than in arid region, potentially indicating an alternate stable state has been created in the latter. Climate variation also contributed to the detected improvement in productivity following goat eradication, sometimes obscuring the effect of eradication but more usually magnifying it by up to 300%. Our work offers perspectives regarding the effectiveness and outcomes of eradicating introduced herbivores and re-introducing native herbivores, and the merits of staging them simultaneously in order to restore critical ecosystem processes such as vegetation productivity.

  7. Saliva Secretion and Efficacy of Helicobacter Pylori Eradication in Peptic Ulcer Patients

    Sh. Abdollahzadeh

    2011-12-01

    Full Text Available Objective: It has been noted that the presence of Helicobacter pylori (H. pyloriin the oral cavity may affect the outcome of eradication therapy. This condition is associated with the recurrence of gastric infection. The optimum secretion of salivapromotes oral health consequently influencing H. pylori eradication. The purpose of this study was to investigate the relation between salivary secretion and the efficacy of H. pylori eradication from the stomach.Materials and Methods: Forty five patients with gastric H. pylori infection were enrolled in this study. Diagnosis of H. pylori infection was confirmed by endoscopy,biopsy, urease test and histological examination. Salivary secretion of all participants was determined under standard condition before the beginning of antibacterial treatment. Then the patients were treated with a 14-day course anti-H. pylori regimen consisting of amoxicillin, omeprazole, metronidazole and bismuth. The efficacy of eradication therapy was evaluated 4 weeks after the end of the treatment course. Mann-Whitney U test was used to analyze the variables.Results: The median of salivary secretion among successful and unsuccessful H. pylori eradication groups was 0.48 ml/min and 0.24 ml/min, respectively (p=0.005.Conclusion: Although the type of drug regimens is challenging, the efficacy of H. pylori eradication from the stomach might be reduced by lower salivary secretion.

  8. Changes in Cardiac Varices and Their Clinical Significance after Eradication of Esophageal Varices by Band Ligation

    Seung Woon Park

    2016-01-01

    Full Text Available Background and Aims. Cardiac varices (CVs in patients with type 1 gastroesophageal varices (GOV1s usually disappear with treatment for esophageal varices (EVs by endoscopic injection sclerotherapy (EIS. However, whether this applies to patients treated with endoscopic band ligation (EBL for EVs remains unclear. We evaluated the effect of EVs eradication by EBL on CVs. Methods. We included cirrhotic patients whose EVs had been eradicated using EBL and excluded those who had been treated using EIS, those who had received endoscopic therapy for CVs, and those who were combined with hepatocellular carcinoma. Results. A total of 123 patients were enrolled. The age was 59.7 ± 11.7 years, and 96 patients (78.0% were men. Thirty-eight patients (30.9% had EVs only, while 85 (69.1% had GOV1s. After EVs eradication, the CVs disappeared in 55 patients (64.7%. EVs recurred in 40 patients, with recurrence rates at 1, 2, and 3 years of 16.0%, 29.6%, and 35.6%, respectively, the recurrence being more frequent in patients who had undergone EBL for secondary prophylaxis and in those with persisting CVs after EVs eradication (P=0.003. Conclusions. CVs frequently disappeared when EVs were eradicated using EBL in patients with GOV1s. Persistence of CVs after EVs eradication by EBL was associated with EVs recurrence.

  9. Novel Vaccine Approach Achieves “Functional Cure” of AIDS Virus in Monkeys | Poster

    By Frank Blanchard, Staff Writer, and Jeff Lifson, Guest Writer Scientists at the Oregon Health & Science University and the AIDS and Cancer Virus Program of the Frederick National Laboratory for Cancer Research have used a novel vaccine approach to achieve a “functional cure” and apparent eradication of infection with a monkey version of the AIDS virus.

  10. What Is Needed to Eradicate Lymphatic Filariasis? A Model-Based Assessment on the Impact of Scaling Up Mass Drug Administration Programs.

    Randee J Kastner

    Full Text Available Lymphatic filariasis (LF is a neglected tropical disease for which more than a billion people in 73 countries are thought to be at-risk. At a global level, the efforts against LF are designed as an elimination program. However, current efforts appear to aim for elimination in some but not all endemic areas. With the 2020 goal of elimination looming, we set out to develop plausible scale-up scenarios to reach global elimination and eradication. We predict the duration of mass drug administration (MDA necessary to reach local elimination for a variety of transmission archetypes using an existing model of LF transmission, estimate the number of treatments required for each scenario, and consider implications of rapid scale-up.We have defined four scenarios that differ in their geographic coverage and rate of scale-up. For each scenario, country-specific simulations and calculations were performed that took into account the pre-intervention transmission intensity, the different vector genera, drug regimen, achieved level of population coverage, previous progress toward elimination, and potential programmatic delays due to mapping, operations, and administration.Our results indicate that eliminating LF by 2020 is unlikely. If MDA programs are drastically scaled up and expanded, the final round of MDA for LF eradication could be delivered in 2028 after 4,159 million treatments. However, if the current rate of scale-up is maintained, the final round of MDA to eradicate LF may not occur until 2050.Rapid scale-up of MDA will decrease the amount of time and treatments required to reach LF eradication. It may also propel the program towards success, as the risk of failure is likely to increase with extended program duration.

  11. Effect of Helicobacter pylori eradication therapy in rosacea patients Efecto del tratamiento erradicador frente a Helicobacter pylori en la rosácea

    D. Boixeda de Miquel

    2006-06-01

    Full Text Available Objective: the causal relation between rosacea and Helicobacter pylori infection is discussed. We evaluated the clinical evolution of rosacea after infection eradication. Patients and methods: we have prospectively studied 44 patients diagnosed with rosacea. Helicobacter pylori infection was determined, and infected patients were treated with eradication therapy. The evolution of dermatological symptoms in a subgroup of 29 infected patients in whom eradication had been achieved was followed during 16.8 (± 17.8 months. Median age was 50.6 (± 14.1 years for 22 women (75.9% and 7 men (24.1%. Clinical response according to gender and clinical subtype of rosacea was evaluated. Results: complete improvement was observed in 10 patients (34.5%; 95% CI: 18.6-54.3%, relevant improvement in 9 (31.1%; 95% CI: 16-51%, poor improvement in 5 (17.2%; 95% CI: 6.5-36.4%, and absence of improvement in 5 cases (17.2%; 95% CI: 6.5-36.4%. No significant differences in dermatological evolution according to sex were observed. Regarding subtype of rosacea there was a relevant improvement in 83.3% (95% CI: 64.1-93.8% of cases with papulopustular type as opposed to 36.5% (95% CI: 20-56.1% of cases with erythematous predominance, p = 0.02. Conclusions: based on these results, the relation between Helicobacter pylori and rosacea is supported, and infection should be investigated in these patients because an appreciable percentage of patients diagnosed with rosacea and Helicobacter pylori infection can benefit from eradication therapy, mainly in the papulopustular subtype.

  12. The threat of vaccine associated poliomyelitis in India: medicolegal issues involved.

    Rajput, Meena; Sharma, Luv

    2010-12-01

    India is among the world's large reservoirs of wild poliovirus (WPV) with 559 confirmed cases of poliomyelitis (wild virus) being reported in 2008. The World Health Organization's program for the eradication of poliomyelitis in third world countries like India is associated with major ethical and medico-legal implications. Two vaccines are available in India for poliomyelitis i.e. oral polio vaccine (OPV) and inactivated polio vaccine (IPV), of which OPV is used in the eradication campaign, the case count for 2009 being 36 out of a total of 384 reported cases globally, the case count for mid 2010 being 19 cases out of 84 reported globally. There are widespread reports of vaccine derived poliomyelitis as well as vaccine associated poliomyelitis (VAP) from different parts of the country, which can be linked to resurgence of polio in several states or to the failure of the polio drive (Polio Sundays). Though an extended comprehensive polio campaign is on and both money and manpower are being dumped for achieving the goal of polio eradication, the ground reality is entirely different. The argument that wild polio strains have surfaced to hamper the drive cannot account for all post vaccination cases. The Indian Academy of Paediatrics has forcefully suggested replacement of OPV by IPV, as the effectiveness of IPV far exceeds the cost benefit of OPV. IPV has by and large replaced OPV in many parts of the world. The second issue is the threat of litigation on the health department once the post vaccination cases rise even further. There are certain other socio-ethical issues discussed in this paper on a subject which has an important bearing on the health statistics of this country.

  13. Does Helicobacter pylori Eradication Reduce the Risk of Open Angle Glaucoma in Patients With Peptic Ulcer Disease?

    Chen, Hsin-Yi; Lin, Cheng-Li; Chen, Wen-Chi; Kao, Chia-Hung

    2015-09-01

    To investigate whether Helicobacter pylori (H pylori) eradication would influence the risk of primary open angle glaucoma (POAG) in patients with peptic ulcer disease. From the Longitudinal Health Insurance Database 2000, 6061 patients with peptic ulcer and receiving H pylori eradication therapy were recruited. The study cohort was subdivided into early (within 1 year) and late (after 1 year) eradication cohorts. The 24,244 control cohort subjects were those who without peptic ulcer and without receiving H pylori eradication therapy and were frequency-matched with the H pylori eradication cohort by age, sex, and the year of receiving H pylori eradication therapy. The higher incidence of POAG was observed in late H pylori eradication cohort and in early H pylori eradication cohort than in control cohort (1.57, 1.32, and 0.95, per 1000 person-year, respectively). However, overall risk of glaucoma was not significantly higher in the late eradication than in the early eradication (adjusted hazard ratio = 0.85, 95% confidence interval = 0.48-1.53). The POAG incidence was greater in the late H pylori eradication cohort when follow-up duration ≤ 5 years (1.59, per 1000 person-years). However, when follow-up duration >5 years, the incidence of POAG was greater in the early H pylori eradication cohort (1.68, per 1000 person-years). These relationships were not associated with a significantly increased or decreased risk of POAG in multivariable analyses. Either early or late H pylori eradication does not significantly reduce the risk of glaucoma in patients with peptic ulcer disease compared with normal control.

  14. Strengthening Routine Immunization in Areas of Northern Nigeria at High Risk for Polio Transmission During 2012–2014

    Ali, Daniel; Banda, Richard; Mohammed, Abdulaziz; Adagadzu, Julie; Murele, Bolatito; Seruyange, Rachel; Makam, Jeevan; Mkanda, Pascal; Okpessen, Bassey; Tegegne, Sisay G.; Folorunsho, Adeboye S.; Erbeto, Tesfaye B.; Yehualashet, Yared G.; Vaz, Rui G.

    2016-01-01

    Background. Following the 2012 declaration by World Health Organization (WHO) Regional Director for Africa and the WHO Executive Board to ramp up routine immunization (RI) activities, began to intensify activities to strengthen RI. This study assessed how the intensification of RI helped strengthen service delivery in local government areas (LGAs) of northern Nigeria at high risk for polio transmission. Methods. A retrospective study was performed by analyzing RI administrative data and findings from supportive supervisory visits in 107 high-risk LGAs. Results. Our study revealed that administrative coverage with 3rd dose of diphtheria-pertussis-tetanus vaccine in the 107 high-risk LGAs improved from a maximum average coverage of 33% during the preintensification period of 2009–2011 to 74% during the postintensification period of 2012–2014. Conclusions. Routine immunization could be strengthened in areas where coverage is low, and RI has been identified to be weak when certain key routine activities are intensified. PMID:26917576

  15. Contribution of Contact Sampling in Increasing Sensitivity of Poliovirus Detection During A Polio Outbreak-Somalia, 2013.

    Moturi, Edna; Mahmud, Abdirahman; Kamadjeu, Raoul; Mbaeyi, Chukwuma; Farag, Noha; Mulugeta, Abraham; Gary, Howard; Ehrhardt, Derek

    2016-04-01

    Background.  In May 2013, a wild poliovirus type 1 (WPV1) outbreak reported in Somalia provided an opportunity to examine the contribution of testing contacts to WPV detection. Methods.  We reviewed acute flaccid paralysis (AFP) case-patients and linked contacts reported in the Somalia Surveillance Database from May 9 to December 31, 2013. We restricted our analysis to AFP case-patients that had ≥3 contacts and calculated the contribution of each contact to case detection. Results.  Among 546 AFP cases identified, 328 AFP cases had ≥3 contacts. Among the 328 AFP cases with ≥3 contacts, 93 WPV1 cases were detected: 58 cases (62%; 95% confidence interval [CI], 52%-72%) were detected through testing stool specimens from AFP case-patients; and 35 cases (38%; 95% CI, 28%-48%) were detected through testing stool specimens from contacts, including 19 cases (20%; 95% CI, 14%-30%) from the first contact, 11 cases (12%; 95% CI, 7%-20%) from the second contact, and 5 cases (5%; 95% CI, 2%-12%) from the third contact. Among the 103 AFP cases with ≥4 contacts, 3 (6%; 95% CI, 2%-16%) of 52 WPV1 cases were detected by testing the fourth contact. No additional WPV1 cases were detected by testing >4 contacts. Conclusions.  Stool specimens from 3 to 4 contacts of persons with AFP during polio outbreaks are needed to maximize detection of WPV cases.

  16. Hepatitis C eradication with sofosbuvir leads to significant metabolic changes

    Morales, Amilcar L; Junga, Zachary; Singla, Manish B; Sjogren, Maria; Torres, Dawn

    2016-01-01

    AIM To assess the effect of sofosbuvir (SOF) based regimens on glycemic and lipid control. METHODS This is a retrospective analysis of hepatitis C virus (HCV)-infected patients treated and cured with a SOF regimen [SOF/ribavirin/interferon, SOF/simeprevir, or SOF/ledipasvir (LDV) ± ribavirin] from January 2014 to March 2015. Patients with hemoglobin A1C (HbA1C) and lipid panels within six months before and six months after therapy were identified and included in our study. Due to the known hemolytic effect of ribavirin, HbA1C was obtained a minimum of three months post-treatment for the patients treated with a ribavirin regimen. Medical history, demographics, HCV genotype, pre-therapy RNA, and liver biopsies were included in our analysis. The patients who started a new medication or had an adjustment of baseline medical management for hyperlipidemia or diabetes mellitus (DM) were excluded from our analysis. RESULTS Two hundred and thirty-four patients were reviewed, of which 60 patients met inclusion criteria. Sixty-three point three percent were male, 26.7% were Caucasian, 41.7% were African American and 91.7% were infected with hepatitis C genotype 1. Mean age was 60.6 ± 6.7 years. Thirty-nine patients had HbA1C checked before and after treatment, of which 22 had the diagnosis of DM type 2. HbA1C significantly decreased with treatment of HCV (pretreatment 6.66% ± 0.95% vs post-treatment 6.14% ± 0.65%, P < 0.005). Those treated with SOF/LDV had a lower HbA1C response than those treated with other regimens (0.26% ± 0.53% vs 0.71% ± 0.83%, P = 0.070). Fifty-two patients had pre- and post-treatment lipid panels; there was a significant increase in low-density lipoprotein (LDL) and total cholesterol (TC) after treatment (LDL: 99.5 ± 28.9 mg/dL vs 128.3 ± 34.9 mg/dL, P < 0.001; TC: 171.6 ± 32.5 mg/dL vs 199.7 ± 40.0 mg/dL, P < 0.001). Pre-treatment body-mass index (BMI) did not differ from post-treatment BMI (P = 0.684). CONCLUSION Eradication of HCV with a

  17. Chagas disease: control, elimination and eradication. Is it possible?

    Jose Rodrigues Coura

    2013-12-01

    wild triatomines in that area. Finally, a characteristic that is greatly in evidence currently is the migration of people with Chagas disease from endemic areas of Latin America to non-endemic countries. This has created a new dilemma for these countries: the risk of transmission through blood transfusion and the onus of controlling donors and treating migrants with the disease. As an enzooty of wild animals and vectors, and as an anthropozoonosis, Chagas disease cannot be eradicated, but it must be controlled by transmission elimination to man.

  18. Block copolymer mixtures as antimicrobial hydrogels for biofilm eradication.

    Lee, Ashlynn L Z; Ng, Victor W L; Wang, Weixin; Hedrick, James L; Yang, Yi Yan

    2013-12-01

    Current antimicrobial strategies have mostly been developed to manage infections due to planktonic cells. However, microbes in their nature state will tend to exist by attaching to and growing on living and inanimate surfaces that result in the formation of biofilms. Conventional therapies for treating biofilm-related infections are likely to be insufficient due to the lower susceptibility of microbes that are embedded in the biofilm matrix. In this study, we report the development of biodegradable hydrogels from vitamin E-functionalized polycarbonates for antimicrobial applications. These hydrogels were formed by incorporating positively-charged polycarbonates containing propyl and benzyl side chains with vitamin E moiety into physically cross-linked networks of "ABA"-type polycarbonate and poly(ethylene glycol) triblock copolymers. Investigations of the mechanical properties of the hydrogels showed that the G' values ranged from 1400 to 1600 Pa and the presence of cationic polycarbonate did not affect the stiffness of the hydrogels. Shear-thinning behavior was observed as the hydrogels displayed high viscosity at low shear rates that dramatically decreased as the shear rate increased. In vitro antimicrobial studies revealed that the more hydrophobic VE/BnCl(1:30)-loaded hydrogels generally exhibited better antimicrobial/antifungal effects compared to the VE/PrBr(1:30) counterpart as lower minimum biocidal concentrations (MBC) were observed in Staphylococcus aureus (Gram-positive), Escherichia coli (Gram-negative) and Candida albicans (fungus) (156.2, 312.5, 312.5 mg/L for VE/BnCl(1:30) and 312.5, 2500 and 625 mg/L for VE/PrBr(1:30) respectively). Similar trends were observed for the treatment of biofilms where VE/BnCl(1:30)-loaded hydrogels displayed better efficiency with regards to eradication of biomass and reduction of microbe viability of the biofilms. Furthermore, a high degree of synergistic antimicrobial effects was also observed through the co

  19. Thalassemia in the United Arab Emirates: Why it can be prevented but not eradicated

    2017-01-01

    Thalassemia is a genetic blood disorder that causes abnormal hemoglobin. Hemoglobin is a protein in red blood cells that carries oxygen and is made of two proteins from four α-globin genes and two β-globin genes. A defect in one or more of these genes causes thalassemia. The treatment of thalassemia mostly depends on life-long blood transfusions and removal of excessive iron from the blood stream. Such tremendous blood consumption puts pressure on the national blood stock in many countries. In particular, in the United Arab Emirates (UAE), various forms of thalassemia prevention have been used and hence, the substantial reduction of the thalassemia major population has been achieved. However, the thalassemia carrier population still remains high, which leads to the potential increase in the thalassemia major population through carrier-carrier marriages. In this work, we investigate the long-term impact and efficacy of thalassemia prevention measures via mathematical modeling at a population level. To our best knowledge, this type of assessment has not been done before and there is no mathematical model that has investigated such a problem for thalassemia or any blood disorders at a population level. By using UAE data, we perform numerical simulations of our model and conduct sensitivity analysis of parameter values to see which parameter values affect most the dynamics of our model. We discover that the prevention measures can contribute to reduce the prevalence of the disease only in the short term but not eradicate the disease in the long term. PMID:28135306

  20. Eradication of Productivity Related Problems Through Lean Principles In Integrated Manufacturing Environment

    Rahul

    2013-06-01

    Full Text Available In this competitive era, manufacturing enterprises struggle to adopt cost-effective manufacturing systems. Overview of the recent manufacturing enterprises shows that successful global manufacturing enterprises have distributed their manufacturing capabilities over the globe. The successes of distributed integrated manufacturing enterprises depend upon the adaptation of appropriate manufacturing technologies like computer integrated manufacturing (CIM under the global collaborative environment along with the principles of lean manufacturing so that their corporate goals are achieved. CIM is an umbrella term which involves automated design, analysis, planning manufacturing, dispatching, customer-interaction, purchasing, cost accounting, inventory control and factory floor functions, which are inter-linked through the computer, to control all the campus-wide manufacturing related operations. It helps to improve the performance of a firm by integrating various areas of manufacturing business in which most of lean ideas are embedded. These lean ideas cause work in a process to be performed with minimum of non-value adding activities and focus on customers’ needs by delivering them at minimum time, with high quality and at minimum cost by eliminating hidden waste. What happens at the shop floor of even an integrated industry is that proper and timely attention is not paid to the intangible lean principles in the manual part of the CIM system which results in substantial loss of the plant productivity. Therefore the objective of this research paper is to investigate the different poor productivity-related problems in a partially integrated manufacturing environment and lay down the remedial measures to eradicate them using ‘Juran’s problem solving techniques’ and various ‘lean tools’ which results in the reduced wastages and hence improved productivity.

  1. Does Helicobacter pylori eradication therapy for peptic ulcer prevent gastric cancer?

    Katsuhiro Mabe; Mikako Takahashi; Haruhumi Oizumi; Hideaki Tsukuma; Akiko Shibata; Kazutoshi Fukase; Toru Matsuda; Hiroaki Takeda; Sumio Kawata

    2009-01-01

    AIM: To investigate the effects of Helicobacter pylori (H pylori ) eradication therapy for treatment of peptic ulcer on the incidence of gastric cancer. METHODS: A multicenter prospective cohort study was conducted between November 2000 and December 2007 in Yamagata Prefecture, Japan. The study included patients with H pylori -positive peptic ulcer who decided themselves whether to receive H pylori eradication (eradication group) or conventional antacid therapy (non-eradication group). Incidence of gastric cancer in the two groups was determined based on the results of annual endoscopy and questionnaire surveys, as well as Yamagata Prefectural Cancer Registry data, and was compared between the two groups and by results of H pylori therapy. RESULTS: A total of 4133 patients aged between 13 and 91 years (mean 52.9 years) were registered, and 56 cases of gastric cancer were identified over a mean follow-up of 5.6 years. The sex- and age-adjusted incidence ratio of gastric cancer in the eradication group, as compared with the non-eradication group, was 0.58 (95% CI: 0.28-1.19) and ratios by follow-up period (< 1 year, 1-3 years, > 3 years) were 1.16 (0.27-5.00), 0.50 (0.17-1.49), and 0.34 (0.09-1.28), respectively. Longer follow-up tended to be associated with better prevention of gastric cancer, although not to a significant extent. No significant difference in incidence of gastric cancer was observed between patients with successful eradication therapy (32/2451 patients, 1.31%) and those with treatment failure (11/639 patients, 1.72%). Among patients with duodenal ulcer, which is known to be more prevalent in younger individuals, the incidence of gastric cancer was significantly less in those with successful eradication therapy (2/845 patients, 0.24%) than in those with treatment failure (3/216 patients, 1.39%). CONCLUSION: H pylori eradication therapy for peptic ulcer patients with a mean age of 52.9 years at registration did not significantly decrease the

  2. Perspectives on the History of Bovine TB and the Role of Tuberculin in Bovine TB Eradication

    Margaret Good

    2011-01-01

    Full Text Available Tuberculosis remains a significant disease of animals and humans worldwide. Bovine tuberculosis is caused by Mycobacteria with an extremely wide host range and serious, although currently probably underdiagnosed, zoonotic potential. Where bovine tuberculosis controls are effective, human zoonotic TB, due to Mycobacterium bovis or M. caprae, is uncommon and clinical cases are infrequent in cattle. Therefore, the control and ultimate eradication of bovine tuberculosis is desirable. Tuberculin tests are the primary screening tool used in bovine eradication. The choice of tuberculin test is dependent on the environment in which it is to be used. Tuberculin potency is critical to test performance, and the accurate determination of potency is therefore particularly important. The design of a control or eradication programme should take into consideration the fundamental scientific knowledge, the epidemiological profile of disease, the experience of other eradication programmes, and the presence, in the same ecosystem, of maintenance hosts, in which infection is self-sustaining and which are capable of transmitting infection. A control or eradication programme will necessarily require modification as it progresses and must be under constant review to identify the optimal desirable goals, the efficacy of policy, and constraints to progress.

  3. [Historical aspects of some infectious diseases: is their gradual eradication utopian?].

    Werner, Georges H

    2009-07-01

    Infectious microorganisms (parasites, bacteria, viruses) which caused dramatic epidemics in human populations throughout the centuries, as well as their natural reservoirs and possible vectors, have not disappeared... Plague, cholera, malaria, tuberculosis, rickettsioses are still quite present in some areas of the world. Furthermore new infectious diseases caused by emerging pathogens have recently appeared dramatically, such as AIDS. Eradication of the most severe and lethal infectious diseases remains nevertheless an ambitious but not utopian objective, if one considers the spectacular advances made, more or less recently, in the field of specific vaccinations. For instance, smallpox has been eradicated around 1980. Present efforts are mainly concentrated on poliomyelitis, the eradication of which was hoped to take place in year 2005, but which is still present in a few areas. Eradication of measles, with the presently available vaccine, is a reasonable objective. Eradication of malaria appears to be much more difficult since this infection involves a complex parasite and an insect vector, the mosquito. And, as far as AIDS is concerned, intensive research has not yet led to the conception of an effective vaccine.

  4. A Possible Link between Gastric Mucosal Atrophy and Gastric Cancer after Helicobacter pylori Eradication

    Tahara, Tomomitsu; Shibata, Tomoyuki; Horiguchi, Noriyuki; Kawamura, Tomohiko; Okubo, Masaaki; Ishizuka, Takamitsu; Nagasaka, Mitsuo; Nakagawa, Yoshihito; Ohmiya, Naoki

    2016-01-01

    Background The effect of H. pylori eradication in gastric cancer prevention can be attributed to the improvement of atrophic gastritis, which is a known risk of gastric cancer. However, gastric cancer has also been diagnosed after long-term H. pylori eradication. This study aimed to clarify the association between gastric atrophy and gastric cancer after H. pylori eradication, including its clinicopathological features. Methods A total of 55 consecutive patients with 64 early gastric cancers (EGCs) diagnosed after H. pylori eradication were enrolled. The degree of endoscopic atrophy and the histological degrees of mononuclear cell infiltration, atrophy, and metaplasia in the corpus and adjacent mucosa of the EGCs were determined and scored. Results The majority of EGCs (63/64) were located within the endoscopically assessed atrophic mucosa or along the atrophic border. The adjacent mucosa of the EGCs presented significantly higher degrees of all histological parameters than in the corpus (mononuclear cell infiltration, 0.86+/-0.09 vs. 0.51+/-0.11, P = 0.016; atrophy, 1.77+/-0.13 vs. 0.65+/-0.14, Pgastric ulcers. Conclusions Severe gastric atrophy remained in the adjacent mucosa of the EGCs after H. pylori eradication, which may be linked to gastric carcinogenesis. PMID:27706195

  5. Considering native and exotic terrestrial reptiles in island invasive species eradication programmes in the Tropical Pacific

    Fisher, Richard N.; Veitch, C.R.; Clout, Mike N.; Towns, D. R.

    2010-01-01

    Most island restoration projects with reptiles, either as direct beneficiaries of conservation or as indicators of recovery responses, have been on temperate or xeric islands. There have been decades of research, particularly on temperate islands in New Zealand, on the responses of native reptiles to mammal eradications but very few studies in tropical insular systems. Recent increases in restoration projects involving feral mammal eradications in the tropical Pacific have led to several specific challenges related to native and invasive reptiles. This paper reviews these challenges and discusses some potential solutions to them. The first challenge is that the tropical Pacific herpetofauna is still being discovered, described and understood. There is thus incomplete knowledge of how eradication activities may affect these faunas and the potential risks facing critical populations of these species from these eradication actions. The long term benefit of the removal of invasives is beneficial, but the possible short term impacts to small populations on small islands might be significant. The second challenge is that protocols for monitoring the responses of these species are not well documented but are often different from those used in temperate or xeric habitats. Lizard monitoring techniques used in the tropical Pacific are discussed. The third challenge involves invasive reptiles already in the tropical Pacific, some of which could easily spread accidentally through eradication and monitoring operations. The species posing the greatest threats in this respect are reviewed, and recommendations for biosecurity concerning these taxa are made.

  6. Causal role of Helicobacter pylori infection and eradication therapy in gastric carcinogenesis

    Masanori Ito; Shinji Tanaka; Tomoari Kamada; Ken Haruma; Kazuaki Chayama

    2006-01-01

    Many epidemiological reports indicate that Helicobacter pylori(H pylori) infection plays an important role in gastric carcinogenesis. Several genetic and epigenetic alterations contribute to the initiation, promotion, and progression of the cancer cells in a multi-step manner.H pyloriis known to induce chronic inflammation in the gastric mucosa. Its products, including superoxides,participate in the DNA damage followed by initiation, and the inflammation-derived cytokines and growth factors contribute to the promotion of gastric carcinogenesis.By eradicating H pylori, gastric inflammation can be cured; the therapy diminishes the levels not only of inflammatory cell infiltration, but also atrophyl intestinal metaplasia in part. A randomized controlled trial revealed that the eradication therapy diminished the gastric cancer prevalence in cases without precancerous conditions. In addition, recent epidemiological studies from Japanese groups demonstrated that the development of gastric cancer, especially of the intestinal type, was decreased by successful eradication therapy, although these were designed in a nonrandomized manner. However, it should be mentioned that endoscopic detection is the only way to evaluate the degree of gastric carcinogenesis. We have reported that the endoscopic and histological morphologies could be modified by eradication therapy and it might contribute to the prevalence of gastric cancer development.Considering the biological nature of cancer cell proliferation, it is considered that a sufficiently long-term follow-up would be essential to discuss the anticancer effect of eradication therapy.

  7. Foot-and-mouth disease control and eradication in the Bicol Surveillance Buffer Zone of the Philippines.

    Windsor, P A; Freeman, P G; Abila, R; Benigno, C; Verin, B; Nim, V; Cameron, A

    2011-10-01

    Following the onset of an epidemic of foot and mouth disease (FMD) commencing in 1994 and affecting mainly pigs in the Philippines, a National Plan for the Control and Eradication of the disease was initiated. A disease surveillance buffer zone in the southern Luzon region of Bicol was established to protect the Visayas and Mindanao from infection and enable eventual elimination of the disease in Luzon. With achievement of Office International Epizooties (OIE)-certified FMD freedom with vaccination in the Philippines now imminent, the four components of the disease control strategy are reviewed, including quarantine and animal movement controls, strategic vaccination, surveillance and disease investigation, and enhanced public awareness with school on the air radio programmes. Although numbers of outbreaks declined following widespread vaccination, evaluation of serological responses in vaccinates suggested low levels of immune protection. The cessation of outbreaks was considered more likely a result of animal movement controls, improved surveillance and emergency response capability, and reduction in FMD-risk behaviours by livestock owners, particularly through efforts to enhance public awareness of biosecurity measures by the training of traders, livestock industry personnel and both commercial and smallholder farmers. A two-stage random sampling serosurveillance strategy enabled identification of residual infection that was not detected through opportunistic sampling and negative incident reporting. Intensive investigations of FMD outbreaks, particularly in Albay province in 1999, enabled improved understanding of the risk factors involved in disease transmission and implementation of appropriate interventions. The findings from this review are offered to assist development of FMD control and eradication programmes in other countries in south-east Asia that are now being encouraged to support the OIE goal of FMD freedom with vaccination by 2020.

  8. Efficacy of rifabutin-based triple therapy as second-line treatment to eradicate helicobacter pylori infection

    Méndez Isabel

    2007-07-01

    Full Text Available Abstract Background Rifabutin has been found to be effective in multi-resistant patients after various treatment cycles for Helicobacter pylori (HP infection, but it has not been analysed as a second-line treatment. Therefore, we seek to compare the effectiveness of a treatment regimen including rifabutin versus conventional quadruple therapy (QT. Methods Open clinical trial, randomised and multi-centre, of two treatment protocols: A Conventional regime -QT- (omeprazole 20 mg bid, bismuth citrate 120 mg qid, tetracycline 500 mg qid and metronidazole 500 mg tid; B Experimental one -OAR- (omeprazole 20 mg bid, amoxicillin 1 gr bid, and rifabutin 150 mg bid, both taken orally for 7 days, in patients with HP infection for whom first-line treatment had failed. Eradication was determined by Urea Breath Test (UBT. Safety was determined by the adverse events. Results 99 patients were randomised, QT, n = 54; OAR, n = 45. The two groups were homogeneous. In 8 cases, treatment was suspended (6 in QT and 2 in OAR. The eradication achieved, analysed by ITT, was for QT, 38 cases (70.4%, and for OAR, 20 cases (44.4%; p = 0.009, OR = 1.58. Of the cases analysed PP, QT were 77.1%; OAR, 46.5%; p = 0.002. Adverse effects were described in 64% of the QT patients and in 44% of the OAR patients (p = 0.04. Conclusion A 7-day rifabutin-based triple therapy associated to amoxicillin and omeprazole at standard dose was not found to be effective as a second-line rescue therapy. The problem with quadruple therapy lies in the adverse side effects it provokes. We believe the search should continue for alternatives that are more comfortably administered and that are at least as effective, but with fewer adverse side effects. Trial Registration Current Controlled Trials ISRCTN81058036

  9. Early eradication of persistent Salmonella infection primes antibody-mediated protective immunity to recurrent infection.

    Johanns, Tanner M; Law, Calvin Y; Kalekar, Lokeshchandra A; O'Donnell, Hope; Ertelt, James M; Rowe, Jared H; Way, Sing Sing

    2011-04-01

    Typhoid fever is a systemic, persistent infection caused by host-specific strains of Salmonella. Although the use of antibiotics has reduced the complications associated with primary infection, recurrent infection remains an important cause of ongoing human morbidity and mortality. Herein, we investigated the impacts of antibiotic eradication of primary infection on protection against secondary recurrent infection. Using a murine model of persistent Salmonella infection, we demonstrate protection against recurrent infection is sustained despite early eradication of primary infection. In this model, protection is not mediated by CD4(+) or CD8(+) T cells because depletion of these cells either alone or in combination prior to rechallenge does not abrogate protection. Instead, infection followed by antibiotic-mediated clearance primes robust levels of Salmonella-specific antibody that can adoptively transfer protection to naïve mice. Thus, eradication of persistent Salmonella infection primes antibody-mediated protective immunity to recurrent infection.

  10. Analysis of Pan-European attitudes to the eradication and control of bovine viral diarrhoea.

    Heffernan, C; Misturelli, F; Nielsen, L; Gunn, G J; Yu, J

    2009-02-07

    At present, national-level policies concerning the eradication and control of bovine viral diarrhoea (BVD) differ widely across Europe. Some Scandinavian countries have enacted strong regulatory frameworks to eradicate the disease, whereas other countries have few formal policies. To examine these differences, the attitudes of stakeholders and policy makers in 17 European countries were investigated. A web-based questionnaire was sent to policy makers, government and private sector veterinarians, and representatives of farmers' organisations. In total, 131 individuals responded to the questionnaire and their responses were analysed by applying a method used in sociolinguistics: frame analysis. The results showed that the different attitudes of countries that applied compulsory or voluntary frameworks were associated with different views about the attribution or blame for BVD and the roles ascribed to farmers and other stakeholders in its eradication and control.

  11. The role of acid inhibition in Helicobacter pylori eradication [version 1; referees: 3 approved

    David R. Scott

    2016-07-01

    Full Text Available Infection of the stomach by the gastric pathogen Helicobacter pylori results in chronic active gastritis and leads to the development of gastric and duodenal ulcer disease and gastric adenocarcinoma. Eradication of H. pylori infection improves or resolves the associated pathology. Current treatments of H. pylori infection rely on acid suppression in combination with at least two antibiotics. The role of acid suppression in eradication therapy has been variously attributed to antibacterial activity of proton pump inhibitors directly or through inhibition of urease activity or increased stability and activity of antibiotics. Here we discuss the effect of acid suppression on enhanced replicative capacity of H. pylori to permit the bactericidal activity of growth-dependent antibiotics. The future of eradication therapy will rely on improvement of acid inhibition along with current antibiotics or the development of novel compounds targeting the organism’s ability to survive in acid.

  12. National immunization days and status of poliomyelitis eradication--Philippines, 1993.

    1994-01-14

    The Western Pacific Regional Committee of the World Health Organization (WHO) resolved in 1988 to eradicate poliomyelitis in the region by 1995. Despite intensified surveillance for acute flaccid paralysis (AFP), reported cases of poliomyelitis decreased from 5485 in 1989 to 1909 in 1992. Of the five countries in the region that continue to report endemic poliomyelitis (Cambodia, People's Republic of China Laos, Republic of the Philippines, and Vietnam), reported incidence is lowest in Philippines, which also was the first country in the region to undertake national immunization days (NIDs) with oral poliovirus vaccine (OPV); in addition, other vaccines were administered at vaccination posts by trained health workers. This report assesses the impact of Philippines' first NID, which was initiated as part of its poliomyelitis eradication efforts, and summarizes progress toward eradication of poliomyelitis in Philippines.

  13. Diagnostic value of CagA IgG in the process to eradicate Helicobacter pylori

    Zhi Bang Yang; Pi Long Wang; Ming Ming Gu; Li Hao Chen; Quan Chen; Lin Zhan

    2000-01-01

    AIM To investigate the diagnostic value of CagA IgG in serum.METHODS Seventy three patients with peptic ulcer infected with HP were eradicated by antibioticstherapy. At pretreatment, wk9 and wk20 after treatment, the detection of Hp in gastric muscosa bybacteriologic method were performed, and CagA and whole-cell antigen of HP igG in serum by ELISAmethod were also performed at the same time.RESULTS The IgG titres of Hp CagA and whole-cell antigen changes in accordance with the efficacy ofHp eradicated. The former with an earlier appearance and a greater number of cases decreased to normallevel in comparison with the latter.CONCLUSION CagA IgG is a better index for observing the effectiveness of the eradication of Hp.

  14. The Economic Impact of Eradicating Peste des Petits Ruminants: A Benefit-Cost Analysis.

    Jones, Bryony A; Rich, Karl M; Mariner, Jeffrey C; Anderson, John; Jeggo, Martyn; Thevasagayam, Sam; Cai, Yi; Peters, Andrew R; Roeder, Peter

    2016-01-01

    Peste des petits ruminants (PPR) is an important cause of mortality and production loss among sheep and goats in the developing world. Despite control efforts in a number of countries, it has continued to spread across Africa and Asia, placing an increasing burden on the livelihoods of livestock keepers and on veterinary resources in affected countries. Given the similarities between PPR and rinderpest, and the lessons learned from the successful global eradication of rinderpest, the eradication of PPR seems appealing, both eliminating an important disease and improving the livelihoods of the poor in developing countries. We conducted a benefit-cost analysis to examine the economic returns from a proposed programme for the global eradication of PPR. Based on our knowledge and experience, we developed the eradication strategy and estimated its costs. The benefits of the programme were determined from (i) the averted mortality costs, based on an analysis of the literature, (ii) the downstream impact of reduced mortality using a social accounting matrix, and (iii) the avoided control costs based on current levels of vaccination. The results of the benefit-cost analysis suggest strong economic returns from PPR eradication. Based on a 15-year programme with total discounted costs of US$2.26 billion, we estimate discounted benefits of US$76.5 billion, yielding a net benefit of US$74.2 billion. This suggests a benefit cost ratio of 33.8, and an internal rate of return (IRR) of 199%. As PPR mortality rates are highly variable in different populations, we conducted a sensitivity analysis based on lower and higher mortality scenarios. All the scenarios examined indicate that investment in PPR eradication would be highly beneficial economically. Furthermore, removing one of the major constraints to small ruminant production would be of considerable benefit to many of the most vulnerable communities in Africa and Asia.

  15. Efficacy of Helicobacter pylori eradication therapies: a single centre observational study

    Beales Ian LP

    2001-08-01

    Full Text Available Abstract Background Many Helicobacter pylori eradication regimens have been described. There are little data reporting their efficacy or integration in routine clinical practice. The overall results of eradication therapy in a cohort of patients are described and an algorithm for management outlined. Methods 469 patients receiving eradication therapy in routine clinical practice were evaluated. The successes of individual regimes as first, second and third line therapy were determined. Results Overall success after one, two and three courses of therapy were 73% (95% confidence intervals 69–77%, 94% (91–96% and 98% (97–99% respectively. 10 different regimens, including many non-recommended ones were used as primary therapy. Ranitidine bismuth citrate-amoxicillin-clarithromycin triple therapy (94.8%, 90–99% was significantly more effective than any other combination as primary therapy, including all proton pump inhibitor based triple therapies. Quadruple therapy with bismuth chelate-proton pump inhibitor-tetracycline and a nitroimidazole (70%, 52–88% and ranitidine bismuth citrate-based triple therapy (73%, 56–90% where more effective second line combinations than proton pump inhibitor-triple therapies (37.5%, 12–58%. Third line therapy directed by the results of sensitivity testing improved eradication compared to further empirical antibiotics. The use of a proton pump inhibitor with clarithromycin and a nitroimidazole as initial therapy was associated with a significantly worse overall eradication rate than other combinations. Conclusions Helicobacter pylori eradication rates can be maximised by using ranitidine bismuth citrate-clarithromycin-amoxicillin containing triple therapy, followed by bismuth and nitroimidazle containing second-line therapy, with third line combinations directed by sensitivity testing. Proton pump inhibitor-clarithromycin-metronidazole combinations should be avoided.

  16. Comparative study: Vonoprazan and proton pump inhibitors in Helicobacter pylori eradication therapy

    Sakurai, Kouichi; Suda, Hiroko; Ido, Yumi; Takeichi, Takayuki; Okuda, Ayako; Hasuda, Kiwamu; Hattori, Masahiro

    2017-01-01

    AIM To compare the effectiveness and safety of vonoprazan-based therapy with proton pump inhibitor (PPI)-based therapies to treat Helicobacter pylori (H. pylori). METHODS We retrospectively analysed data from first-line (vonoprazan or PPI with 200 mg clarithromycin and 750 mg amoxicillin twice daily for 7 d) (n = 1353) and second-line (vonoprazan or PPI with 250 mg metronidazole and 750 mg amoxicillin twice daily for 7 d) (n = 261) eradication treatments for H. pylori -positive patients with associated gastrointestinal diseases from April 2014 to December 2015 at Hattori Clinic, Japan. The primary endpoint was the eradication rate, which was assessed with a full analysis set. The secondary endpoints were adverse events and related factors. RESULTS After the first-line treatments, the eradication rates for vonoprazan, esomeprazol, rabeprazole, and lansoprazole were 87.9% (95%CI: 84.9%-90.5%), 71.6% (95%CI: 67.5%-75.5%), 62.9% (95%CI: 52.0%-72.9%), and 57.3% (95%CI: 50.4%-64.1%), respectively. The vonoprazan eradication rate was significantly higher than that of the PPIs (P pylori eradication rate in the vonoprazan group (P = 0.34), whereas it decreased the rates in the PPI groups (P = 0.013). The incidence of adverse events in the vonoprazan group was not different from the PPI group (P = 0.054), although the vonoprazan group exhibited a wider range of adverse events. Vonoprazan-based triple therapy was highly effective as a second-line treatment, with an eradication rate similar to that of PPI-based therapy. CONCLUSION Vonoprazan might be superior to PPIs in first-line H. pylori therapy, particularly for smokers. However, caution is required due to possible adverse events. PMID:28216974

  17. Effect of Helicobacter pylori Eradication on Reflux Esophagitis Therapy: A Multi-center Randomized Control Study

    Yan Xue; Li-Ya Zhou; San-Ren Lin; Xiao-Hua Hou; Zhao-Shen Li; Min-Hu Chen; Xiu-E Yan

    2015-01-01

    Background:Helicobacterpylori (H.pylori) frequently colonizes the stomach.Gastroesophageal reflux disease (GERD) is a common and costly disease.But the relationship ofH.pylori and GERD is still unclear.This study aimed to explore the effect ofH.pylori and its eradication on reflux esophagitis therapy.Methods:Patients diagnosed with reflux esophagitis by endoscopy were enrolled;based on rapid urease test and Warth-Starry stain,they were divided into H.pylori positive and negative groups.H.pylori positive patients were randomly given H.pylori eradication treatment for 1 0 days,then esomeprazole 20 mg bid for 46 days.The other patients received esomeprazole 20 mg bid therapy for 8 weeks.After treatment,three patient groups were obtained:H.pylori positive eradicated,H.pylori positive uneradicated,and H.pylori negative.Before and after therapy,reflux symptoms were scored and compared.Healing rates were compared among groups.The x2 test and t-test were used,respectively,for enumeration and measurement data.Results:There were 176 H.pylori positive (with 92 eradication cases) and 180 negative cases.Healing rates in the H.pylori positive eradicated and H.pylori positive uneradicated groups reached 80.4% and 79.8% (P =0.911),with reflux symptom scores of 0.22 and 0.14 (P =0.588).Healing rates of esophagitis in the H.pylori positive uneradicated and H.pylori negative groups were,respectively,79.8% and 82.2% (P =0.848);reflux symptom scores were 0.14 and 0.21 (P =0.546).Conclusions:Based on esomeprazole therapy,H.pylori infection and eradication have no significant effect on reflux esophagitis therapy.

  18. The Economic Impact of Eradicating Peste des Petits Ruminants: A Benefit-Cost Analysis.

    Bryony A Jones

    Full Text Available Peste des petits ruminants (PPR is an important cause of mortality and production loss among sheep and goats in the developing world. Despite control efforts in a number of countries, it has continued to spread across Africa and Asia, placing an increasing burden on the livelihoods of livestock keepers and on veterinary resources in affected countries. Given the similarities between PPR and rinderpest, and the lessons learned from the successful global eradication of rinderpest, the eradication of PPR seems appealing, both eliminating an important disease and improving the livelihoods of the poor in developing countries. We conducted a benefit-cost analysis to examine the economic returns from a proposed programme for the global eradication of PPR. Based on our knowledge and experience, we developed the eradication strategy and estimated its costs. The benefits of the programme were determined from (i the averted mortality costs, based on an analysis of the literature, (ii the downstream impact of reduced mortality using a social accounting matrix, and (iii the avoided control costs based on current levels of vaccination. The results of the benefit-cost analysis suggest strong economic returns from PPR eradication. Based on a 15-year programme with total discounted costs of US$2.26 billion, we estimate discounted benefits of US$76.5 billion, yielding a net benefit of US$74.2 billion. This suggests a benefit cost ratio of 33.8, and an internal rate of return (IRR of 199%. As PPR mortality rates are highly variable in different populations, we conducted a sensitivity analysis based on lower and higher mortality scenarios. All the scenarios examined indicate that investment in PPR eradication would be highly beneficial economically. Furthermore, removing one of the major constraints to small ruminant production would be of considerable benefit to many of the most vulnerable communities in Africa and Asia.

  19. [Helicobacter pylori infection in patients with functional dyspepsia, eradication rates in the Donetsk region].

    Dorofeev, A É; Rudenko, N N; Agibalov, A N; Kugler, T E; Sibilev, A V; Tomash, O V

    2014-11-01

    We have investigated 175 patients with Rome III diagnostic criteria for functional dyspepsia. 104 (59%) patients were infected with Helicobacter pylori. Three-component (PPI + clarithromycin + amoxicillin) 7-day therapy with the addition of the probiotic was effective in 92 patients (88.4%). Dyspeptic symptoms were resolved in 37 patients with successful eradication (40%). Persistent effect for 6 months was maintained in 24 patients (26%). Eradication efficacy in eliminating of the dyspepsia symptoms was higher in epigastric pain syndrome than postprandial distress syndrome.

  20. Reinfection rate and endoscopic changes after successful eradication of Helicobacter pylori

    Kum; Hei; Ryu; Sun; Young; Yi; Youn; Ju; Na; Su; Jung; Baik; Su; Jin; Yoon; Hae-Sun; Jung; Hyun; Joo; Song

    2010-01-01

    AIM:To determine the long-term outcomes regarding reinfection with Helicobacter pylori(H.pylori)and endoscopic changes after successful H.pylori eradication. METHODS:From June 1994 to January 2007,186 patients(M:F=98:88;mean age 50.0±11.4 years), in whom H.pylori had been successfully eradicated, were enrolled.The mean duration of follow up was 41.2±24.0 mo. RESULTS:H.pylori reinfection occurred in 58 patients (31.2%).The average annual reinfection rate was 9.1% per patient year.No recurrence of peptic ulce...

  1. HOGG1 polymorphism in atrophic gastritis and gastric cancer after Helicobacter pylori eradication

    2010-01-01

    AIM:To investigate the association between Ser326Cys human oxoguanine glycosylase 1(hOGG1) polymorphism and atrophic gastritis and gastric cancer after Helicobacter pylori(H.pylori) eradication.METHODS:A total of 488 subjects(73 patients with gastric cancer,160 with atrophic gastritis after H.pylori eradication and 255 controls) were prospectively collected.Polymerase chain reaction-restriction fragment length polymorphism analysis was performed to distinguish hOGG1 Ser326Cys polymorphism.Statistical analys...

  2. Contain or eradicate? Optimizing the management goal for Australian acacia invasions in the face of uncertainty

    Moore, J.L.; Runge, M.C.; Webber, B.L.; Wilson, J.R.U.

    2011-01-01

    Aim To identify whether eradication or containment is expected to be the most cost-effective management goal for an isolated invasive population when knowledge about the current extent is uncertain. Location Global and South Africa. Methods We developed a decision analysis framework to analyse the best management goal for an invasive species population (eradication, containment or take no action) when knowledge about the current extent is uncertain. We used value of information analysis to identify when investment in learning about the extent will improve this decision-making and tested the sensitivity of the conclusions to different parameters (e.g. spread rate, maximum extent, and management efficacy and cost). The model was applied to Acacia paradoxa DC, an Australian shrub with an estimated invasive extent of 310ha on Table Mountain, South Africa. Results Under the parameters used, attempting eradication is cost-effective for infestations of up to 777ha. However, if the invasion extent is poorly known, then attempting eradication is only cost-effective for infestations estimated as 296ha or smaller. The value of learning is greatest (maximum of 8% saving) when infestation extent is poorly known and if it is close to the maximum extent for which attempting eradication is optimal. The optimal management action is most sensitive to the probability that the action succeeds (which depends on the extent), with the discount rate and cost of management also important, but spread rate less so. Over a 20-year time-horizon, attempting to eradicate A. paradoxa from South Africa is predicted to cost on average ZAR 8 million if the extent is known, and if our current estimate is poor, ZAR 33.6 million as opposed to ZAR 32.8 million for attempting containment. Main conclusions Our framework evaluates the cost-effectiveness of attempting eradication or containment of an invasive population that takes uncertainty in population extent into account. We show that incorporating

  3. The Association of Helicobacter pylori Eradication with the Occurrences of Chronic Kidney Diseases in Patients with Peptic Ulcer Diseases

    Wang, Jiunn-Wei; Hsu, Chien-Ning; Tai, Wei-Chen; Ku, Ming-Kun; Hung, Tsung-Hsing; Tseng, Kuo-Lun; Yuan, Lan-Ting; Nguang, Seng-Howe; Liang, Chih-Ming; Yang, Shih-Cheng; Wu, Cheng-Kun; Hsu, Pin-I; Wu, Deng-Chyang; Chuah, Seng-Kee

    2016-01-01

    The association of Helicobacter pylori eradication with the occurrence of renal dysfunction in patients with peptic ulcer diseases is still unclear. This study aimed to clarify the relevance of H. pylori eradication to the occurrence of chronic kidney diseases in patients with peptic ulcer diseases. Data that were available from 2000–2011 were extracted from the National Health Insurance Research Database in Taiwan, and all patients with peptic ulcer diseases (n = 208 196) were screened for eligibility. We divided randomly selected patients into an H. pylori eradication cohort (cohort A, n = 3593) and matched them by age and sex to a without H. pylori eradication cohort (cohort B, n = 3593). Subgroup analysis was further performed for H. pylori eradication within ≤ 90 days of the diagnosis date (early eradication, n = 2837) and within 91–365 days (non-early eradication, n = 756). Cox proportional hazards regression analysis was used to estimate the association of H. pylori eradication with the risk of developing chronic kidney diseases and mortality. We observed that there were more patients suffering from chronic kidney disease in cohort B than in the early eradication subgroup of cohort A (8.49% vs. 6.70%, respectively, p = 0.0075); the mortality rate was also higher in cohort B (4.76% vs. 3.70%, respectively, p = 0.0376). Old age, pulmonary disease, connective tissue disorders, and diabetes were risk factors for chronic kidney diseases but early H. pylori eradication was a protective factor against chronic kidney diseases (hazard ratio: 0.68, 95% confidence interval: 0.52–0.88, p = 0.0030), and death (hazard ratio: 0.69, 95% confidence interval: 0.49–0.96, p = 0.0297). In conclusion, our findings have important implications suggesting that early H. pylori eradication is mandatory since it is associated with a protective role against the occurrence of chronic kidney diseases. PMID:27764171

  4. Eficácia da vacina Sabin em crianças subnutridas da Amazônia The efficacy of oral polio vaccine in malnourished Amazonian children

    Klaus E. Stewien

    1985-02-01

    Full Text Available A eficácia da vacina Sabin foi determinada em 106 crianças normais e subnutridas da Amazônia, após a administração de uma e duas doses de vacina oral (trivalente. Após a aplicação de uma dose de vacina, verificou-se que apenas 9% das crianças com subnutrição pregressa (crônica e 43% das crianças normais formaram anticorpos neutralizantes (protetores contra dois ou três tipos de poliovírus (p = 0,04. Após duas doses de vacina, os níveis de imunidade dos dois grupos de crianças estudadas acusaram, respectivamente, 32% e 75% (p = 0,001. Estes resultados mostram que a resposta imunitária à vacina Sabin foi sensivelmente inferior no grupo das crianças subnutridas, do que no das crianças normais. Em decorrência disto, será necessário administrar um número maior de doses de vacina oral àquelas crianças, a fim de que níveis satisfatórios de imunidade contra a poliomielite sejam atingidos em toda a população infantil.Various hypotheses have been proposed to explain the diminished efficacy of the oral polio vaccine in underdeveloped tropical regions. In this study, the influence of mild to moderate chronic malnutrition on the development of antibodies to the 3 types of polioviruses was investigated in Brazilian Amazonian children. Vaccines were administered to 106 normal and stunted children, between 5 to 14 months of age, who were not suffering from acute malnutrition (wasting, in poor peri-urban slum areas of Manaus (AM and São Luis (MA during the National Poliomyelitis Vaccination Campaigns of 1981 and 1982. Two weeks after vaccination, blood was collected by digital puncture and the prevalence of neutralizing antibodies for the 3 types of polioviruses was determined in serum at a dilution of 1:8. In children who had received one dose of the vaccine, 43% of normal children had antibodies to 2 or 3 types of polioviruses, against only 9% of stunted children (p = .04. In children who had received 2 doses of vaccine, 75

  5. Comparative Efficacy of Two Doses of Nebulized Colistimethate for the Eradication of Pseudomonas Aeruginosa in Children with Cystic Fibrosis

    Marie-Sophie Brochet

    2007-01-01

    Full Text Available BACKGROUND: Cystic fibrosis (CF affects the respiratory and digestive systems. It evolves toward deterioration of pulmonary function through colonization with Pseudomonas aeruginosa. There is no consensus with respect to its eradication. Nebulized colistimethate is used for eradication treatment, but the optimal dose and duration is yet to be determined.

  6. Leader as achiever.

    Dienemann, Jacqueline

    2002-01-01

    This article examines one outcome of leadership: productive achievement. Without achievement one is judged to not truly be a leader. Thus, the ideal leader must be a visionary, a critical thinker, an expert, a communicator, a mentor, and an achiever of organizational goals. This article explores the organizational context that supports achievement, measures of quality nursing care, fiscal accountability, leadership development, rewards and punishments, and the educational content and teaching strategies to prepare graduates to be achievers.

  7. The influence of pretreatment on cure rates of Helicobacter pylori eradication.

    Janssen, M.J.R.; Laheij, R.J.F.; Jansen, J.B.M.J.; Boer, W.A. de

    2004-01-01

    BACKGROUND: Many patients treated for H. pylori infection have been taking a proton pump inhibitor beforehand. There is conflicting evidence whether pretreatment influences the efficacy of H. pylori eradication. The aim of this study was to investigate the influence of pretreatment on cure rates of

  8. Is tea tree oil effective at eradicating MRSA colonization? A review.

    Flaxman, Deborah; Griffiths, Peter

    2005-03-01

    In vitro studies show that tea tree oil is capable of killing methicillin-resistant Staphylococcus aureus (MRSA) in a laboratory setting. This review of randomized controlled trials (RCTs) was undertaken to find out whether it is effective at eradicating MRSA colonization compared to standard mupirocin-based regimens in colonized patients. A wide range of databases and internet sources were searched to identify published and unpublished studies. Two RCTs were found that researched the effectiveness of tea tree oil preparations against MRSA. One small RCT (n = 30) showed a large but non-significant improvement at eradicating MRSA compared to traditional treatment, whereas a larger study (n = 224) demonstrated little difference in rates of eradication overall (41% for tea tree and 49% for mupirocin, p = 0.286). However, the larger study found that those with nasal colonization receiving a tea tree regimen were more likely to remain colonized with MRSA in the nose (absolute risk increase 31%, ptea tree oil in clinical practice for eradication of MRSA colonization.

  9. A case of severe pseudomembranous colitis diagnosed by colonoscopy after Helicobacter pylori eradication.

    Sato, Satoshi; Chinda, Daisuke; Yamai, Kiyonori; Satake, Ryu; Soma, Yasushi; Shimoyama, Tadashi; Fukuda, Shinsaku

    2014-06-01

    A 65-year-old male was admitted for hemorrhagic gastric ulcer. Since anti-Helicobacter pylori-immunoglobulin G antibody tested positive, eradication therapy was administered using rabeprazole, amoxicillin, and clarithromycin. During hospitalization, colonoscopy showed normal colonic mucosa except for a polyp of the sigmoid colon. He was discharged 4 days after finishing eradication therapy, but fever up and diarrhea appeared on the following day. After re-admission, colonoscopy revealed multiple yellowish-white, small circular membranous elevations, and a diagnosis of pseudomembranous colitis was made. He was successfully treated by oral administration of vancomycin. Concomitant use of antibiotics and a proton pump inhibitor for a hospitalized patient is a risk for pseudomembranous colitis. However, H. pylori eradication therapy should be started at re-introduction of oral feeding in cases of bleeding ulcers because rebleeding can be mortal in patients in 'poor general condition'. Physicians should consider pseudomembranous colitis as a diagnosis for the patients with diarrhea and high fever following H. pylori eradication therapy.

  10. Evaluation of the benefit of addition of clidinium C to a Helicobacter pylori eradication regimen

    Chorami, Maryam; Naderi, Nosratollah; Moghimi-Dehkordi, Bijan; Mirsattari, Dariush; Shalmani, Hamid Mohaghegh

    2013-01-01

    Aim This study aimed to evaluate the success of H.pylori eradication therapy in patients with dyspepsia by therapeutics regimes with and without clidinium C. Background Helicobacter pylori infections are reported in all parts of the world. Appropriate antibiotic therapy can treat infection. The ideal treatment regimen has not been specified. Patients and methods In a randomized, double blind clinical trials study, 250 patients with dyspepsia were enrolled. All patients were treated by Omeprazole, Metronidazole, Amoxicillin and Bismuth (OMAB) for two weeks. One tablet clidinium C before each meal was added to this regimen in the intervention group (A). Urea Breath Test (UBT) was carried out after 8-12 weeks after treatment for evaluation of H.pylori eradication. Results 132 patients in the intervention group (A) and 118 patients in the control group (B) were enrolled to the study. The rate of eradication in group A was significantly higher than group B (62.1% vs. 50%, p=0.04). Conclusion The results supported the effect of clidinium C for increasing of helicobacter pylori eradication, but further studies need to be performed. PMID:24834261

  11. [The eradication of BSE: a touch stone for the veterinary services].

    Perler, L; Guidon, D; Schmidt, J

    2002-12-01

    The eradication of BSE is proving to be a lengthy task. Undisputedly, it has become one of the highest priority tasks of the Veterinary Services in Europe since the disease first occurred in the mid eighties. However, the effects of the ongoing eradication effort also impair important economic agricultural sectors. Risk analysis has never before been such a critical tool in the decision-making processes for eradication of animal diseases, despite the problem that many risk analyses are being conducted in the face of incomplete knowledge about BSE. In the focus are the measures minimizing the risk for humans (such as the ban on specified risk material) and the measures implemented to prevent the spread of the disease in animals with the ban on feeding meat and bone meal to ruminants. Due to the long incubation period, implementation of insufficient measures may not be noticed for many years. Implementation of drastic measures is needed, if the eradication of the disease is to be pursued purposefully.

  12. Efficacy of mupirocin nasal ointment in eradicating Staphylococcus aureus nasal carriage in chronic haemodialysis patients

    D. L. Holton; L. E. Nicolle; D. Diley; K. Bernstein

    1991-01-01

    textabstractTopical 2% mupirocin ointment eradicated chronic Staphylococcus aureus nasal carriage immediately post-therapy in 17 (77%) of 22 haemodialysis patients. Mean time to recurrence was 3.8 weeks. Similar pre-therapy and post-therapy phage types occurred in 12 (71%) of 17 patients. Staphyloco

  13. Furazolidone versus metronidazole in quadruple therapy for eradication of Helicobacter pylori in duodenal ulcer disease

    Malekzadeh, R.; Ansari, R.; Vahedi, H.; Siavoshi, F.; Alizadeh, B.Z.; Eshraghian, M.R.; Vakili, A.; Saghari, M.; Massarrat, S.

    2000-01-01

    Objective: Furazolidone, an old but cheap antibiotic, was shown to be a good alternative to metronidazole in triple therapy for Helicobacter pylori eradication in areas where metronidazole resistant bacteria are common, but randomized studies are lacking. Aim: A randomized controlled trial to determ

  14. Helicobacter pylori Eradication and Gastric Cancer: When Is the Horse Out of the Barn?

    A.C. de Vries; E.J. Kuipers; E.A.J. Rauws

    2009-01-01

    Helicobacter pylori infection is a major risk factor for gastric cancer development. Therefore, H. pylori eradication may be an important approach in the prevention of gastric cancer. However, long-term data proving the efficacy of this approach are lacking. This report describes two patients who de

  15. The effect of Helicobacter pylori eradication on liver enzymes in patients referring with unexplained hypertransaminasemia

    Hassan Salehi

    2014-01-01

    Conclusion: This study showed a decrease in liver enzymes after receiving eradication regimen of H. pylori, suggesting a role for H. pylori infection in at least some of patients with mild unexplained hypertransaminasemia. Further studies are warranted to find the underlying mechanisms by which H. pylori infection affects the liver and clinical importance of such effects.

  16. Total pepsin activity and gastrin in sera as markers of eradication of Helicobacter pylori

    Khoshkholgh, M.; Saberi-Firoozi, M.; Fattahi, M.; Siavoshi, F.; Khatibian, M.; Vahedi, H.; Mikaeli, J.; Ansari, R.; Alizadeh, B.; Malekzadeh, R.; Massarrat, S.

    1994-01-01

    The measurement of total pepsin activity by colorimetry, and gastrin by radioimmunoassay method was performed on the sera of 100 patients (80 with duodenal ulcer and 20 with non-ulcer dyspepsia) before and 4 weeks after the end of antibacterial treatment for eradication of Helicobacter pylori. While

  17. Trisomy 3 may predict a poor response of gastric MALT lymphoma to Helicobacter pylori eradication therapy

    Sawako Taji; Masuji Morita; Masafumi Taniwaki; Kenichi Nomura; Yosuke Matsumoto; Hideaki Sakabe; Naohisa Yoshida; Shoji Mitsufuji; Kazuhiro Nishida; Shigeo Horiike; Shigeo Nakamura

    2005-01-01

    AIM: To investigate the relation of the response to Helicobacter pylori eradication therapy to the depth of tumor invasion and chromosome abnormalities in patients with mucosaassociated lymphoid tissue (MALT) lymphoma and to determine the clinical value of aneuploidy.METHODS: We studied 13 patients with localized gastric MALT lymphoma of stage E1. Before eradication therapy,the depth of tumor invasion was assessed by endoscopic ultrasonography in 8 patients and by endoscopic examination and gastrointestinal series in the remaining patients. To detect chromosomal abnormalities, paraffin-embedded tissue sections of diagnostic biopsy specimens underwent tissuefluorescence in situ hybridization (FISH), using chromosomespecific α-satellite DNA probes for chromosomes 3,7,12,and 18 and YAC clones for t(11;18)(q21;q21).RESULTS: Seven of the 13 patients had complete regression(CR) in response to H pylori eradication therapy. No patient with CR had submucosal tumor invasion. Trisomy 18 was seen in 1 patient with CR, and both trisomies 12 and 18 were present in another patient with CR. All patients with no response or progressive disease had deep submucosal tumor invasion and showed t(11;18)(q21;q21) or trisomy 3. Trisomy 7 was not detected in this series of patients.CONCLUSION: The depth of tumor invasion is an accurate predictor of the response of stage E1 MALT lymphoma to H pylori eradication therapy and is closely associated with the presence of chromosomal abnormalities. Trisomy 3 may predict the aggressive development of MALT lymphoma.

  18. Selected Antimicrobial Essential Oils Eradicate Pseudomonas spp. and Staphylococcus aureus Biofilms

    Kavanaugh, Nicole L.; Ribbeck, Katharina

    2012-01-01

    Biofilms are difficult to eliminate with standard antimicrobial treatments due to their high antibiotic resistance relative to free-living cells. Here, we show that selected antimicrobial essential oils can eradicate bacteria within biofilms with higher efficiency than certain important antibiotics, making them interesting candidates for the treatment of biofilms.

  19. Eradication of carriage with methicillin-resistant Staphylococcus aureus: effectiveness of a national guideline

    H.S.M. Ammerlaan; J.A.J.W. Kluytmans; H. Berkhout; A. Buiting; E.I.G.B. de Brauwer; P.J. van den Broek; P. van Gelderen; S.C.A.P. Leenders; A. Ott; C.J.J. Richter; L. Spanjaard; I.J.B. Spijkerman; F.H. van Tiel; G.P. Voorn; M.W.H. Wulf; J. van Zeijl; A. Troelstra; M.J.M. Bonten

    2011-01-01

    Background: We evaluated the effectiveness of eradication of methicillin-resistant Staphylococcus aureus (MRSA) carriage in the Netherlands after the introduction of a guideline in 2006. The guideline distinguishes complicated (defined as the presence of MRSA infection, skin lesions, foreign-body ma

  20. H pylori eradication:A randomized prospective study of triple therapy with or without ecabet sodium

    2008-01-01

    AIM:To investigate whether adding ecabet sodium to the standard triple therapy for Hpylori infection improve eradication rate.METHODS:Two hundred and fifty-seven H pyloriinfected patients were randomly assigned to standard triple therapy (group A, n=129) or triple therapy plus ecabet sodium(group B, n=128).Successful eradication was defined as a negative 13C-urea breath test 6-8 wk after completion of treatment.RESULTS:After completion of therapy,194/257 patients showed negative 13C-urea breath test results.According to intention-to-treat analysis,the infection was eradicated in 93/129(72.1%)patients in group A and 101/128 (78.9%) in group B (P=0.204).Per-protocol analysis showed successful eradication in 93/118(78.8%)patients from group A and 101/114 (88.6%) from group B (P = 0.044).There were no significant differences in the side effects experienced by the patients in the two treatment groups.CONCLUSION:Our results suggest that the addition of ecabet sodium improves the efficacy of the standard triple therapy for H pylori.

  1. Do We Eradicate Helicobacter pylori in Hospitalized Patients with Peptic Ulcer Disease?

    Frank Wong

    2013-01-01

    Full Text Available BACKGROUND: Helicobacter pylori infection is the most common chronic infection in humans. It is a major contributor to the cause of duodenal and gastric ulcers worldwide. Its eradication has been shown to reduce rates of H pylori-related ulcers as well as other complications such as gastric cancer.

  2. Efficacy of a therapeutic strategy for eradication of Helicobacter pylori infection

    Giuliana Sereni; Francesco Azzolini; Lorenzo Camellini; Debora Formisano; Francesco Decembrino; Veronica Iori; Cristiana Tioli

    2012-01-01

    AIM:To determine the efficacy of our therapeutic strategy for Helicobacter pylori (H.pylori) eradication and to identify predictive factors for successful eradication.METHODS:From April 2006 to June 2010,we retrospectively assessed 2428 consecutive patients (1025 men,1403 women; mean age 55 years,age range 18-92 years) with gastric histology positive for H.pylori infection referred to our unit for 13-C urea breath test (UBT),after first-line therapy with proton pump inhibitor (PPI) b.i.d.+ amoxicillin 1 g b.i.d.+ clarithromycin 500 mg b.i.d.for 7 d.Patients who were still positive to UBT were recommended a second-line therapy (PPI b.i.d.+amoxicillin 1 g b.i.d.+ tinidazole 500 mg b.i.d.for 14 d).Third choice treatment was empirical with PPI b.i.d.+amoxicillin 1 g b.i.d.+ levofloxacin 250 mg b.i.d.for 14 d.RESULTS:Out of 614 patients,still H.pylori-positive after first-line therapy,only 326 and 19 patients respectively rechecked their H.pylori status by UBT after the suggested second and third-line regimens."Per protocol" eradication rates for first,second and thirdline therapy were 74.7% (95% CI:72.7%-76.4%),85.3% (95% CI:81.1%-89.1%) and 89.5% (95% CI:74.9%-103%) respectively.The overall percentage of patients with H.pylori eradicated after two treatments was 97.8% (95% CI:97.1%-98.4%),vs 99.9% (95%CI:99.8%-100%) after three treatments.The study found that eradication therapy was most effective in patients with ulcer disease (P < 0.05,P =0.028),especially in those with duodenal ulcer.Smoking habits did not significantly affect the eradication rate.CONCLUSION:First-line therapy with amoxicillin and clarithromycin produces an H.pylori eradication rate comparable or superior to other studies and secondline treatment can still be triple therapy with amoxicillin and tinidazole.

  3. Anti-HBs levels in infants of hepatitis B carrier mothers after delayed active immunization with recombinant vaccine concomitant with DTP-polio vaccine: Is there need for a second dose of HBIg?

    P.M. Grosheide (Pia Maria); R. Del Canho (R.); M. Voogd (M.); R.A. Heijtink; S.W. Schalm (Solko)

    1994-01-01

    textabstractThe need for an additional dose of hepatitis B immune globulin (HBIg) was studied by comparing infants receiving 1 ml HBIg at birth followed by hepatitis B immunization, concomitant with DTP-polio vaccine, at 3, 4, 5 and 11 months (schedule E), with infants receiving the same schedule wi

  4. Neonatal vitamin A supplementation associated with a cluster of deaths and poor early growth in a randomised trial among low-birth-weight boys of vitamin A versus oral polio vaccine at birth

    Lund, Najaaraq; Biering-Sørensen, Sofie; Andersen, Andreas;

    2014-01-01

    BACKGROUND: The effect of oral polio vaccine administered already at birth (OPV0) on child survival was not examined before being recommended in 1985. Observational data suggested that OPV0 was harmful for boys, and trials have shown that neonatal vitamin A supplementation (NVAS) at birth may...

  5. Financial and Economic Costs of the Elimination and Eradication of Onchocerciasis (River Blindness in Africa.

    Young Eun Kim

    Full Text Available Onchocerciasis (river blindness is a parasitic disease transmitted by blackflies. Symptoms include severe itching, skin lesions, and vision impairment including blindness. More than 99% of all cases are concentrated in sub-Saharan Africa. Fortunately, vector control and community-directed treatment with ivermectin have significantly decreased morbidity, and the treatment goal is shifting from control to elimination in Africa.We estimated financial resources and societal opportunity costs associated with scaling up community-directed treatment with ivermectin and implementing surveillance and response systems in endemic African regions for alternative treatment goals--control, elimination, and eradication. We used a micro-costing approach that allows adjustment for time-variant resource utilization and for the heterogeneity in the demographic, epidemiological, and political situation.The elimination and eradication scenarios, which include scaling up treatments to hypo-endemic and operationally challenging areas at the latest by 2021 and implementing intensive surveillance, would allow savings of $1.5 billion and $1.6 billion over 2013-2045 as compared to the control scenario. Although the elimination and eradication scenarios would require higher surveillance costs ($215 million and $242 million than the control scenario ($47 million, intensive surveillance would enable treatments to be safely stopped earlier, thereby saving unnecessary costs for prolonged treatments as in the control scenario lacking such surveillance and response systems.The elimination and eradication of onchocerciasis are predicted to allow substantial cost-savings in the long run. To realize cost-savings, policymakers should keep empowering community volunteers, and pharmaceutical companies would need to continue drug donation. To sustain high surveillance costs required for elimination and eradication, endemic countries would need to enhance their domestic funding capacity

  6. Pretreatment AKR1B10 expression predicts the risk of hepatocellular carcinoma development after hepatitis C virus eradication

    Murata, Ayato; Genda, Takuya; Ichida, Takafumi; Amano, Nozomi; Sato, Sho; Tsuzura, Hironori; Sato, Shunsuke; Narita, Yutaka; Kanemitsu, Yoshio; Shimada, Yuji; Hirano, Katsuharu; Iijima, Katsuyori; Wada, Ryo; Nagahara, Akihito; Watanabe, Sumio

    2016-01-01

    AIM To clarify the association between aldo-keto reductase family 1 member B10 (AKR1B10) expression and hepatocarcinogenesis after hepatitis C virus eradication. METHODS In this study, we enrolled 303 chronic hepatitis C patients who had achieved sustained virological response (SVR) through interferon-based antiviral therapy. Pretreatment AKR1B10 expression in the liver was immunohistochemically assessed and quantified as a percentage of positive staining area by using image-analysis software. A multivariate Cox analysis was used to estimate the hazard ratios (HRs) of AKR1B10 expression for hepatocellular carcinoma (HCC) development after achieving SVR. The cumulative incidences of HCC development were evaluated using Kaplan-Meier analysis and the log-rank test. RESULTS Of the 303 chronic hepatitis C patients, 153 (50.5%) showed scarce hepatic AKR1B10 expression, quantified as 0%, which was similar to the expression in control normal liver tissues. However, the remaining 150 patients (49.5%) exhibited various degrees of AKR1B10 expression in the liver, with a maximal AKR1B10 expression of 73%. During the median follow-up time of 3.6 years (range 1.0-10.0 years), 8/303 patients developed HCC. Multivariate analysis revealed that only high AKR1B10 expression (≥ 8%) was an independent risk factor for HCC development (HR = 15.4, 95%CI: 1.8-132.5, P = 0.012). The 5-year cumulative incidences of HCC development were 13.7% and 0.5% in patients with high and low AKR1B10 expression, respectively (P < 0.001). During the follow-up period after viral eradication, patients expressing high levels of AKR1B10 expressed markedly higher levels of alanine aminotransferase and α-fetoprotein than did patients exhibiting low AKR1B10 expression. CONCLUSION Chronic hepatitis C patients expressing high levels of hepatic AKR1B10 had an increased risk of HCC development even after SVR. PMID:27672277

  7. Low eradication rate of Helicobacter pylori with triple 7-14 days and quadriple therapy in Turkey

    Yuksel Gumurdulu; Sedat Boyacioglu; Ender Serin; Birol Ozer; Fazilet Kayaselcuk; Kursat Ozsahin; Arif Mansur Cosar; Mlurat Gursoy; Gurden Gur; Ugur Yilmaz

    2004-01-01

    AIM: The eradication rate of Helicobacter pylori(H pylorl)shows variation among countries and regimens of treatment.We aimed to study the eradication rates of different regimens in our region and some factors affecting the rate of eradication.METHODS: One hundred and sixty- four H pylori positive patients (68 males, 96 females; mean age: 48±12 years)with duodenal or gastric ulcer without a smoking history were included in the study. The patients were divided into three groups according to the treatment regimens. Omeprazole 20 mg, clarithromycin 500 mg, amoxicillin 1 g were given twice daily for 1 week (Group I) and 2 weeks (Group II).Patients in Group III Received bismuth subsitrate 300 mg,tetracyline 500 mg and metronidazole 500 mg four times daily in addition to Omeprazole 20 mg twice daily. Two biopsies each before and after treatment were obtained from antrum and corpus, and histopathologically evaluated.Eradication was assumed to be successful if no H pylorus was detected from four biopsy specimens taken after treatment. The effects of factors like age, sex, H pylori density on antrum and corpus before treatment, the total H pylori density, and the inflammation scores on the rate of H pylori eradication were evaluated.RESULTS: The overall eradication rate was 42%. The rates in groups II and III were statistically higher than that in group I (P<0.05). The rates of eradication were 24.5%,40.7% and 61.5% in groups I, II and III, respectively. The eradication rate was negatively related to either corpus H pylori density or total H pylori density (P<0.05). The median age was older in the group in which the eradication failed in comparison to that with successful eradication (55 yr vs 39 yr, P<0.001). No correlation between sex and H pylori eradication was found.CONCLUSION: Our rates of eradication were significantly lower when compared to those reported in literature. We believe that advanced age and high H pylori density are negative predictive factors for

  8. C-type Lectin Receptors for Tumor Eradication: Future Directions

    Streng-Ouwehand, Ingeborg; Unger, Wendy W. J.; Kooyk, Yvette van, E-mail: y.vankooyk@vumc.nl [Department of Molecular Cell Biology and Immunology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam (Netherlands)

    2011-08-08

    Dendritic cells are key regulators in directing immune responses and therefore are under extensive research for the induction of anti-tumor responses. DCs express a large array of receptors by which they scan their surroundings for recognition and uptake of pathogens. One of the receptor-families is the C-type lectins (CLR), which bind carbohydrate structures and internalize antigens upon recognition. Intracellular routing of antigen through CLR enhances loading and presentation of antigen through MHC class I and II, inducing antigen-specific CD4{sup +} and CD8{sup +} T-cell proliferation and skewing T-helper cells. These characteristics make CLRs very interesting targets for DC-based immunotherapy. Profound research has been done on targeting specific tumor antigens to CLR using either antibodies or the natural ligands such as glycan structures. In this review we will focus on the current data showing the potency of CLR-targeting and discuss improvements that can be achieved to enhance anti-tumor activity in the near future.

  9. Adjuvant probiotics improve the eradication effect of triple therapy for Helicobacter pylori infection

    Yi-Qi Du; Tun Su; Jian-Gao Fan; Yu-Xia Lu; Ping Zheng; Xing-Hua Li; Chuan-Yong Guo

    2012-01-01

    AIM:To investigate whether the addition of probiotics can improve the eradication effect of triple therapy for Helicobacter pylori (H.pylori) infection.METHODS:This open randomized trial recruited 234 H.pylori positive gastritis patients from seven local centers.The patients were randomized to one-week standard triple therapy (omeprazole 20 mg bid,clarithromycin 500 mg bid,and amoxicillin 1000 mg bid; OCA group,n =79); two weeks of pre-treatment with probiotics,containing 3 × 107 Lactobacillus acidophilus per day,prior to one week of triple therapy (POCA group,n =78); or one week of triple therapy followed by two weeks of the same probiotics (OCAP group,n =77).Successful eradication was defined as a negative C13 or C14 urease breath test four weeks after triple therapy.Patients were asked to report associated symptoms at baseline and during follow-up,and side effects related to therapy were recorded.Data were analyzed by both intention-to-treat (ITT) and per-protocol (PP) methods.RESULTS:PP analysis involved 228 patients,78 in the OCA,76 in the POCA and 74 in the OCAP group.Successful eradication was observed in 171 patients; by PP analysis,the eradication rates were significantly higher (P =0.007 each) in the POCA (62/76; 81.6%,95%CI 72.8%-90.4%) and OCAP (61/74; 82.4%,95% CI 73.6%-91.2%) groups than in the OCA group (48/78;61.5%,95% CI 50.6%-72.4%).ITT analysis also showed that eradication rates were significantly higher in the POCA (62/78; 79.5%,95% CI 70.4%-88.6%)and OCAP (61/77; 79.2%,95% CI 70%-88.4%)groups than in the OCA group (48/79; 60.8%,95% CI 49.9%-71.7%),(P =0.014 and P =0.015).The symptom relieving rates in the POCA,OCAP and OCA groups were 85.5%,89.2% and 87.2%,respectively.Only one of the 228 patients experienced an adverse reaction.CONCLUSION:Administration of probiotics before or after standard triple therapy may improve H.pylori eradication rates.

  10. Tumor eradication after cyclophosphamide depends on concurrent depletion of regulatory T cells: a role for cycling TNFR2-expressing effector-suppressor T cells in limiting effective chemotherapy.

    van der Most, Robbert G; Currie, Andrew J; Mahendran, Sathish; Prosser, Amy; Darabi, Anna; Robinson, Bruce W S; Nowak, Anna K; Lake, Richard A

    2009-08-01

    Tumor cell death potentially engages with the immune system. However, the efficacy of anti-tumor chemotherapy may be limited by tumor-driven immunosuppression, e.g., through CD25+ regulatory T cells. We addressed this question in a mouse model of mesothelioma by depleting or reconstituting CD25+ regulatory T cells in combination with two different chemotherapeutic drugs. We found that the efficacy of cyclophosphamide to eradicate established tumors, which has been linked to regulatory T cell depletion, was negated by adoptive transfer of CD25+ regulatory T cells. Analysis of post-chemotherapy regulatory T cell populations revealed that cyclophosphamide depleted cycling (Ki-67(hi)) T cells, including foxp3+ regulatory CD4+ T cells. Ki-67(hi) CD4+ T cells expressed increased levels of two markers, TNFR2 and ICOS, that have been associated with a maximally suppressive phenotype according to recently published studies. This suggest that cyclophosphamide depletes a population of maximally suppressive regulatory T cells, which may explain its superior anti-tumor efficacy in our model. Our data suggest that regulatory T cell depletion could be used to improve the efficacy of anti-cancer chemotherapy regimens. Indeed, we observed that the drug gemcitabine, which does not deplete cycling regulatory T cells, eradicates established tumors in mice only when CD25+ CD4+ T cells are concurrently depleted. Cyclophosphamide could be used to achieve regulatory T cell depletion in combination with chemotherapy.

  11. 2009-2013年脊髓灰质炎疫情分析%Analysis of the world polio cases from 2009 to 2013

    韩辉; 谭克为; 宋亚京; 徐宝梁; 左锋

    2015-01-01

    目的:探讨目前脊髓灰质炎在世界范围内的影响及我国口岸防控脊髓灰质炎疫情的措施。方法收集整理世界卫生组织(WHO)网站内的脊髓灰质炎的相关信息,并对2009-2013年之间脊髓灰质炎疫情进行流行病学统计与分析。结果根据 WHO 所统计的脊髓灰质炎的发病数据,该病的发病情况在近几年得到了有效的控制,但是目前还在尼日利亚、巴基斯坦、阿富汗、索马里和乍得等国持续流行。结论由于我国与持续流行脊灰的国家接壤,并且海外劳务输出和进口贸易的规模逐年增大,导致脊髓灰质炎病毒传入我国的风险较高,加强相关的检疫和监测工作至关重要。%Objective This article observes the world epidemic situation from 2009 to 2013 of poliomyelitis,and explores the present influence of it and the relevant prevention and control measures at frontier ports.Methods This article collects the data and the related situation of the outbreak of poliomyelitis from WHO website,and then carries out the epidemiological statistics and analysis.Results According to the data from WHO,although the on-set of poliomyelitis has been effectively controlled in recent years,there has been sustained prevalence in Nigeria, Pakistan,Afghanistan,Somalia and Chad.Conclusion Because of the contiguity between China and some coun-tries which have sustained prevalence of poliomyelitis and the increasing scale of overseas labor service export and import trade,the risk of the import of polio virus is comparatively high.In order to maintain the “polio -free sta-tus”,the prevention and monitoring of the polio virus still needs to be strengthen at frontier ports.

  12. Update on the Status of Bemisia tabaci in the UK and the Use of Entomopathogenic Fungi within Eradication Programmes

    Andrew G. S. Cuthbertson

    2013-05-01

    Full Text Available The sweetpotato whitefly Bemisia tabaci (Gennadius (Hemiptera: Aleyrodidae continues to be a serious threat to crops worldwide. The UK holds Protected Zone status against this pest and, as a result, B. tabaci entering on plant material is subjected to a policy of eradication. Both B and Q Bemisia biotypes are now regularly intercepted entering the UK. With increasing reports of neonicotinoid resistance in both these biotypes, it is becoming more problematic to control/eradicate. Therefore, alternative means of control are necessary. Entomopathogenic fungi (Lecanicilllium muscarium and Beauveria bassiana offer much potential as control agents of B. tabaci within eradication programmes in the UK.

  13. Malaria vaccine-is it still required? Are vaccine alternatives enough to achieve malaria control?

    Fsadni Claudia

    2014-01-01

    Despite ongoing continuous research towards developing a malaria vaccine, we have still not achieved this target and the malaria parasite continues to kill thousands, especially children in developing countries. However, current control methods have had good results in some countries. Can these control methods be enough or should people still keep hoping for a vaccine? Would eradication of malaria be a possibility if no vaccine remains available?

  14. Protein Kinase C: One Pathway towards the Eradication of Latent HIV-1 Reservoirs

    Lisa N. McKernan

    2012-01-01

    Full Text Available An effective means to eradicate latent reservoirs in HIV-1-infected individuals remains elusive. Attempts to purge these reservoirs were undertaken over a decade ago without success. The subsequent lapse in further clinical attempts since may have been justified as our knowledge of the mechanisms which underpin the latent state still evolves. Although additional novel molecular antagonists of HIV-1 latency have subsequently been reported, these candidate agents have not been tested in human trials for reservoir ablation. This review provides an overview of the protein kinase C (PKC pathway which can be modulated by small molecular agents to induce the expression of latent HIV-1 from within infected reservoir cells. Some of these agents have been tested against select cancers with seemingly tolerable side effects. As such, modulation of the PKC pathway may yet be a viable mechanism toward HIV-1 reservoir eradication.

  15. Eradication of Blastocystis hominis prevents the development of symptomatic Hashimoto's thyroiditis: a case report.

    Rajič, Borko; Arapović, Jurica; Raguž, Kazimir; Bošković, Mladen; Babić, Senaida Marina; Maslać, Suzana

    2015-07-30

    In this case report we describe a 49 year-old man who presented with chronic urticaria, angioedema and soft stool consistency. During diagnostic examinations Hashimoto's thyroiditis was found even though the patient never had clear symptoms of this disease. Blastocystis hominis was isolated through a stool microbiologic examination, implicating that this parasite can cause the development of Hashimoto's thyroiditis and chronic urticaria. After two-weeks treatment with metronidazole the Blastocystis hominis was eradicated, then urticaria and angioedema disappeared. During the four years of follow-up, the patient presented without any symptoms, whereas thyroid hormones were normalized and anti-thyroid antibodies declined. For the first time in the literature we show that eradication of Blastocystis hominis can prevent the development of both symptomatic Hashimoto's thyroiditis and chronic urticaria.

  16. Experimental assessment of disinfection procedures for eradication of Aspergillus fumigatus in food.

    Gangneux, Jean-Pierre; Noussair, Latifa; Bouakline, Adel; Roux, Nicole; Lacroix, Claire; Derouin, Francis

    2004-10-01

    Aspergillus fumigatus spores in food may represent an infectious risk for neutropenic patients. We examined the efficiency of disinfection procedures applicable to foods for eradication of A fumigatus. Boiling and microwave treatment fully decontaminated an experimental spore suspension and naturally contaminated liquid foods (reconstituted dried food, herbal tea). Full decontamination of experimentally contaminated surfaces was only obtained with 70% ethanol or heating at 220 degrees C for 15 minutes. Pepper was decontaminated when heated for 15 minutes at 220 degrees C but not by microwaving. Fruit skin was partially decontaminated by 70% ethanol. We conclude that A fumigatus spores can be eradicated from food by heating to a temperature of at least 100 degrees C. When foods cannot be exposed to high temperature or microwaving, ethanol only partially reduces the level of surface contamination.

  17. Spontaneous Regression of Polyposis following Abdominal Colectomy and Helicobacter pylori Eradication for Cronkhite-Canada Syndrome

    Kimitoshi Kato

    2013-03-01

    Full Text Available The etiology of Cronkhite-Canada syndrome (CCS remains unknown and many cases are refractory to treatment. Therefore, new therapies are urgently needed. Furthermore, a number of CCS cases with gastrointestinal carcinoma have been reported. Our patient had rapid onset of CCS and early development of colon carcinoma associated with adenomas. High anterior resection of the sigmoid colon and ileostomy were performed, and her symptoms and endoscopic and histological findings improved. Helicobacter pylori eradication was carried out 2 years later, surgical closure of an ileal fistula the following year. After 4 months, upper gastrointestinal endoscopy and colonoscopy showed that the CCS lesions had completely disappeared, and biopsies confirmed a normal stomach, duodenum, ileum and colon histologically. The patient has maintained remission for 2 years. The clinical course of this case, showing complete regression of CCS lesions following abdominal colectomy and H. pylori eradication, suggests the significance of H. pylori infection in the treatment of CCS.

  18. Stress-induced hemorrhagic gastric ulcer after successful Helicobacter pylori eradication: two case reports

    Miyamoto Mitsuaki

    2011-06-01

    Full Text Available Abstract Introduction Helicobacter pylori infection is a major cause of gastric ulcers, and Helicobacter pylori eradication drastically reduces ulcer recurrence. It has been reported, however, that severe physical stress is closely associated with gastric ulceration even in Helicobacter pylori -negative patients. Case presentation We report the cases of a 47-year-old Japanese man and a 69-year-old Japanese man who developed psychological stress-induced hemorrhagic gastric ulcers, in both of whom Helicobacter pylori had been successfully eradicated. Conclusion Our cases strongly suggest that not only physical but also psychological stress is still an important pathogenic factor for peptic ulceration and accordingly that physicians should pay attention to the possible presence of psychological stress in the management of patients with peptic ulcers.

  19. Stool antigen tests in the diagnosis of Helicobacter pylori infection before and after eradication therapy

    Lea Veijola; Eveliina Myllyluoma; Riitta Korpela; Hilpi Rautelin

    2005-01-01

    Aim: To evaluate two enzyme immunoassay-based stool antigen tests, Premier Platinum HpSA and Amplified IDEIA HpStAR, and one rapid test, ImmunoCard STAT! HpSA, in the primary diagnosis of Helicobacter pylori (H pylori) infection and after eradication therapy.METHODS: Altogether 1 574 adult subjects were screened with a whole-blood H pylori antibody test and positive results were confirmed with locally validated serology and 13C-urea breath test. All 185 subjects,confirmed to be H pylori positive, and 97 H pylorinegative individuals, randomly selected from the screened study population and with negative results in serology and UBT, were enrolled. After eradication therapy the results of 182 subjects were assessed.RESULTS: At baseline, the sensitivity of HpSA and HpStAR was 91.9% and 96.2%, respectively, and specificity was 95.9% for both tests. ImmunoCard had sensitivity of 93.0% but specificity of only 88.7%. After eradication therapy, HpSA and HpStAR had sernsitivity of 81.3% and 100%, and specificity of 97.0% and 97.6%,respectively. ImmunoCard had sensitivity of 93.8% and specificity of 97.0%. HpSA, HpStAR, and ImmunoCard had PPV 77%, 80%, and 75%, and NPV 98%, 100%,and 99%, respectively.CONCLUSION: In primary diagnosis, the EIA-based tests performed well. After eradication therapy, negative results were highly accurate for all the three tests.HpStAR had the best overall performance.

  20. Role of Helicobacter pylori Eradication Therapy on Platelet Recovery in Chronic Immune Thrombocytopenic Purpura

    Sheema, Khan; Arshi, Naz; Farah, Naz; Imran, Sheikh

    2017-01-01

    Background. Idiopathic thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system destroys native platelets. In this condition an autoantibody is generated against a platelet antigen. ITP affects women more often than men and is more common in children than adults. Objective. To assess the effect of Helicobacter pylori eradication therapy (HPET) on platelet count in Helicobacter pylori associated chronic immune thrombocytopenic purpura (chronic ITP) in adult. Materials and Methods. It is an interventional prospective study conducted at Liaquat University of Medical and Health Sciences, Jamshoro, from 2014 to 2015. A set of 85 patients diagnosed with chronic ITP were included in the study via convenient sampling. Patients with platelets count 3 months were selected. They were posed to first-line investigations which comprised complete blood count (CBC) and peripheral blood smear examination followed by second-line tests including bone marrow examination and Helicobacter pylori stool specific antigen (HpSA-EIA). Standard H. pylori eradication therapy was offered and the patients were assessed at regular intervals for 6 months. Results. Of the 85 study patients, 32 (37.6%) were male and 53 (62.3%) were female. Mean ages of H. pylori positive and negative subjects were 43.89 ± 7.06 and 44.75 ± 7.91 years, respectively. Bone marrow examination confirmed the diagnosis and excluded other related BM disorders. H. pylori stool antigen (HpSA) was detected in 34 (40%) patients and hence regarded as H. pylori positive; the rest were negative. Treatment with eradication therapy significantly improved the mean platelet counts from 48.56 ± 21.7 × 109/l to 94.2 ± 26.8 × 109/l. Conclusion. We concluded that the anti-H. pylori eradication therapy improves blood platelet counts in chronic immune thrombocytopenia.

  1. Cure of peptic gastric ulcer associated with eradication of Helicobacter pylori. Finnish Gastric Ulcer Study Group.

    Seppälä, K; Pikkarainen, P.; Sipponen, P.; Kivilaakso, E.; Gormsen, M H

    1995-01-01

    The effect of Helicobacter pylori eradication on ulcer healing and the relapse rate were investigated in a multicentre trial of 239 gastric ulcer patients. Patients with H pylori positive gastric ulcer were randomly assigned to one of three groups: (A) 10 days' treatment with metronidazole and eight weeks' treatment with colloidal bismuth subcitrate (CBS) (84 patients); (B) 10 days' treatment with metronidazole placebo and eight weeks with CBS (73 patients); or (C) ranitidine (82 patients). A...

  2. China and India : challenges and opportunities for poverty eradication and moderating inequality in Malaysia

    Ragayah Haji Mat Zin

    2006-01-01

    Malaysia has employed the mechanism of growth with equity in an effort to eradicate poverty and ameliorate inequality. During the New Economic Policy period, the government intervened extensively to ensure that all levels of society benefited from economic development and thereby maintain social cohesion. However, the increasing pace of liberalization coupled with developments in the region, such as the rise of China and India, has eroded the government’s ability to ensure the equitable shari...

  3. Preparation and pharmaceutical evaluation of nicotinamide stick for eradication of Staphylococcus epidermidis

    Mohammad Ali Shahtalebi; Rahim Bahrinajafi; Sima Nahavandi

    2014-01-01

    Background: Staphylococcus epidermidis is a part of the skin's normal flora that can cause acne. This study was designed to evaluate the efficacy of nicotinamide as a stick in eradication of staphylococcus. Materials and Methods: For evaluating of Anti-microbial effect on S. epidermidis used well plate method. We chose five plates for nicotinamide and five for mupirocin. The zones of inhibition were measured and compared. Results: The results showed nicotinamide stick had anti-microbial effec...

  4. A vaccinia virus renaissance: new vaccine and immunotherapeutic uses after smallpox eradication.

    Verardi, Paulo H; Titong, Allison; Hagen, Caitlin J

    2012-07-01

    In 1796, Edward Jenner introduced the concept of vaccination with cowpox virus, an Orthopoxvirus within the family Poxviridae that elicits cross protective immunity against related orthopoxviruses, including smallpox virus (variola virus). Over time, vaccinia virus (VACV) replaced cowpox virus as the smallpox vaccine, and vaccination efforts eventually led to the successful global eradication of smallpox in 1979. VACV has many characteristics that make it an excellent vaccine and that were crucial for the successful eradication of smallpox, including (1) its exceptional thermal stability (a very important but uncommon characteristic in live vaccines), (2) its ability to elicit strong humoral and cell-mediated immune responses, (3) the fact that it is easy to propagate, and (4) that it is not oncogenic, given that VACV replication occurs exclusively within the host cell cytoplasm and there is no evidence that the viral genome integrates into the host genome. Since the eradication of smallpox, VACV has experienced a renaissance of interest as a viral vector for the development of recombinant vaccines, immunotherapies, and oncolytic therapies, as well as the development of next-generation smallpox vaccines. This revival is mainly due to the successful use and extensive characterization of VACV as a vaccine during the smallpox eradication campaign, along with the ability to genetically manipulate its large dsDNA genome while retaining infectivity and immunogenicity, its wide mammalian host range, and its natural tropism for tumor cells that allows its use as an oncolytic vector. This review provides an overview of new uses of VACV that are currently being explored for the development of vaccines, immunotherapeutics, and oncolytic virotherapies.

  5. A new prospect in cancer therapy: targeting cancer stem cells to eradicate cancer

    Li-Sha Chen; An-Xin Wang; Bing Dong; Ke-Feng Pu; Li-Hua Yuan; Yi-Min Zhu

    2012-01-01

    According to the cancer stem cell theory,cancers can be initiated by cancer stem cells.This makes cancer stem cells prime targets for therapeutic intervention.Eradicating cancer stem cells by efficient targeting agents may have the potential to cure cancer.In this review,we summarize recent breakthroughs that have improved our understanding of cancer stem cells,and we discuss the therapeutic strategy of targeting cancer stem cells,a promising future direction for cancer stem cell research.

  6. Progress towards the eradication of Tsetse from the Loos islands, Guinea

    Onikoyamou Mory F

    2011-02-01

    Full Text Available Abstract Background The tsetse fly Glossina palpalis gambiensis is the main vector of sleeping sickness (Human African Trypanosomiasis - HAT in West Africa, in particular in littoral Guinea where this disease is currently very active. The Loos islands constitute a small archipelago some 5 km from mainland Guinea, where G. p. gambiensis is well known as a nuisance and potential disease vector by inhabitants of the three main islands, Fotoba, Room, and Kassa. The National Control Program against HAT of Guinea has decided to eradicate tsetse in Loos islands in order to sustainably protect humans and economic activities. After baseline data collection, tsetse control began on the islands in 2006. On each of the three islands a specific combination of control methods was implemented according to the entomological situation found. Results Starting densities before control operations were 10, 3 and 1 tsetse/trap/day in Kassa, Room and Fotoba respectively, but by July 2010, tsetse were no longer caught in any of the sentinel traps used for monitoring. The reduction rate was faster where several control methods were implemented as a combination (impregnated traps and targets ITT, selective groundspraying, epicutaneous insecticide treatment of pigs, and impregnated fences around pig pens, whereas it was slower when ITT were used as the only control method. Conclusions This 100% suppression is a promising step in the eradication process, but G. p. gambiensis may still occur at very low, undetectable, densities on the archipelago. Next step will consist in assessing a 0.05 probability of tsetse absence to ascertain a provisional eradication status. Throughout these operations, a key factor has been the involvement of local teams and local communities without whom such results would be impossible to obtain. Work will continue thanks to the partners involved until total eradication of the tsetse on Loos islands can be declared.

  7. Natural Honey to Eradicate Nasal Methicillin resistant Staphylococcus aureus (MRSA) A Randomised Control Trial

    Poovelikunnel, Toney Thomas

    2016-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is an endemic pathogen of public health concern in Ireland, as in many other health systems. For the nasal clearance of MRSA, the site that is often colonised in humans, the antibiotic mupirocin remains one of the most successful topical antibiotics to date. However, increasing bacterial resistance to mupirocin and limited effective alternate antibiotic options necessitate the need for unconventional approaches to eradicate nasal MRSA. Coloni...

  8. Preparation and pharmaceutical evaluation of nicotinamide stick for eradication of Staphylococcus epidermidis

    Mohammad Ali Shahtalebi; Rahim Bahrinajafi; Sima Nahavandi

    2014-01-01

    Background: Staphylococcus epidermidis is a part of the skin′s normal flora that can cause acne. This study was designed to evaluate the efficacy of nicotinamide as a stick in eradication of staphylococcus. Materials and Methods: For evaluating of Anti-microbial effect on S. epidermidis used well plate method. We chose five plates for nicotinamide and five for mupirocin. The zones of inhibition were measured and compared. Results: The results showed nicotinamide stick had anti-microbial effec...

  9. Standard triple versus levofloxacin based regimen for eradication ofHelicobacter pylori

    Raj; Gopal; Thirthar; Palanivelu; Elamurugan; Vikram; Kate; Sadasivan; Jagdish; Debdatta; Basu

    2013-01-01

    AIM:To compare the eradication rates for Helicobacter pylori(H.pylori) and ulcer recurrence of standard triple therapy(STT) and levofloxacin based therapy(LBT).METHODS:Seventy-four patients with perforated duodenal ulcer treated with simple closure and found to be H.pylori infected on 3 mo follow up were randomized to receive either the STT group comprising of amoxicillin 1 g bid,clarithromycin 500 mg bid and omeprazole 20 mg bid or the LBT group comprising of amoxicillin 1 g bid,levofloxacin 500 mg bid and omeprazole 20 mg bid for 10 d each.The H.pylori eradication rates,side effects,compliance and the recurrence of ulcer were assessed in the two groups at 3 mo follow up.RESULTS:Thirty-four patients in the STT group and 32 patients in the levofloxacin group presented at 3 mo follow up.H.pylori eradication rates were similar with STT and the LBT groups on intention-to-treat(ITT) analysis(69% vs 80%,P = 0.425) and(79% vs 87%,P = 0.513) by per-protocol(PP) analysis respectively.Ulcer recurrence in the STT and LBT groups on ITT analysis was(20% vs 14%,P = 0.551) and(9% vs 6%,P = 1.00) by PP analysis.Compliance and side effects were also comparable between the groups.A complete course of STT costs Indian Rupees(INR) 1060.00,while LBT costs only INR 360.00.CONCLUSION:H.pylori eradication rates and the rate of ulcer recurrence were similar between the STT and LBT.The LBT is a more economical option compared to STT.

  10. Standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori eradication

    2010-01-01

    AIM: To compare the effectiveness of standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori (H. pylori ) eradication in a randomized, double-blinded, comparative clinical trial in China. METHODS: A total of 215 H. pylori -positive patients were enrolled in the study and randomly allocated into three groups: group A (n = 72) received a 10-d bismuth pectin quadruple therapy (20 mg rabeprazole bid , 1000 mg amoxicillin bid , 100 mg bismuth pectin qid , and 500 mg levofloxaci...

  11. Role of Helicobacter pylori eradication in aspirin or non-steroidal anti-inflammatory drug users

    George V. Papatheodoridis; Athanasios J. Archimandritis

    2005-01-01

    Helicobacter pylori (H pylori) infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin at any dosage and formulation represent well-established risk factors for the development of uncomplicated and complicated peptic ulcer disease accounting for the majority of such cases. Although the interaction between H pylori and NSAID/aspirin use in the same individuals was questioned in some epidemiological studies, it has now become widely accepted that they are at least independent risk factors for peptic ulcer disease. According to data from randomized intervention trials, naive NSAID users certainly benefit from testing for H pylori infection and, if positive,H pylori eradication therapy prior to the initiation of NSAID. A similar strategy is also suggested for naive aspirin users, although the efficacy of such an approach has not been evaluated yet. Strong data also support that chronic aspirin users with a recent ulcer complication should be tested for H pyloriinfection and, if positive, receive H pylori eradication therapy after ulcer healing, while they appear to benefit from additional long-term therapy with a proton pump inhibitor (PPI).A similar approach is often recommended to chronic aspirin users at a high risk of ulcer complication. H pylori eradication alone does not efficiently protect chronic NSAID users with a recent ulcer complication or those at a high-risk, who certainly should be treated with long-term PPI therapy, but H pylori eradication may be additionally offered even in this setting. In contrast, testing for H pylorior PPI therapy is not recommended for chronic NSAID/aspirin users with no ulcer complications or those at a low risk of complications.

  12. Role of Helicobacter pylori Eradication Therapy on Platelet Recovery in Chronic Immune Thrombocytopenic Purpura

    Khan Sheema

    2017-01-01

    Full Text Available Background. Idiopathic thrombocytopenic purpura (ITP is a bleeding disorder in which the immune system destroys native platelets. In this condition an autoantibody is generated against a platelet antigen. ITP affects women more often than men and is more common in children than adults. Objective. To assess the effect of Helicobacter pylori eradication therapy (HPET on platelet count in Helicobacter pylori associated chronic immune thrombocytopenic purpura (chronic ITP in adult. Materials and Methods. It is an interventional prospective study conducted at Liaquat University of Medical and Health Sciences, Jamshoro, from 2014 to 2015. A set of 85 patients diagnosed with chronic ITP were included in the study via convenient sampling. Patients with platelets count 3 months were selected. They were posed to first-line investigations which comprised complete blood count (CBC and peripheral blood smear examination followed by second-line tests including bone marrow examination and Helicobacter pylori stool specific antigen (HpSA-EIA. Standard H. pylori eradication therapy was offered and the patients were assessed at regular intervals for 6 months. Results. Of the 85 study patients, 32 (37.6% were male and 53 (62.3% were female. Mean ages of H. pylori positive and negative subjects were 43.89 ± 7.06 and 44.75 ± 7.91 years, respectively. Bone marrow examination confirmed the diagnosis and excluded other related BM disorders. H. pylori stool antigen (HpSA was detected in 34 (40% patients and hence regarded as H. pylori positive; the rest were negative. Treatment with eradication therapy significantly improved the mean platelet counts from 48.56±21.7 × 109/l to 94.2±26.8 × 109/l. Conclusion. We concluded that the anti-H. pylori eradication therapy improves blood platelet counts in chronic immune thrombocytopenia.

  13. Comparison of Sequential Regimen and Standard Therapy for Helicobacter pylori Eradication in Patients with Dyspepsia

    Gh. Roshanaei

    2013-10-01

    Full Text Available Introduction & Objective: Some studies have reported successful eradication rates using se-quential therapy but more recent studies performed in Asia did not find a similar benefit. Due to inconsistencies in the comparison of standard triple drugs therapy and sequential regimen, in the previous researches we decided to compare these treatments in Persian patients. Materials & Methods: This study is a randomized clinical trial, performed in one hundred and forty patients suffering from dyspepsia with indication for H. pylori eradication between No-vember 2010 and March 2012.Patients were randomized in two equal groups. The patients in the first group (standard were treated by omeprazole capsule 20 mg BID, amoxicillin cap-sule 1 gr BID, clarithromycin tablet 500mg BID for 14 days; while the patients in the second group (sequential were treated by omeprazole capsule 20 mg for 10 days, amoxicillin cap-sule 1 gr BID for 5 days, then clarithromycin tablet 500 mg and tinidazole tablet 500 mg BID for other 5 days. 4-6 weeks after the treatment, we compared the eradication of H.pylori be-tween the two groups by urease breathe test with C14. Results: H. pylori infection was successfully cured in 57/70 (81.43% with a 10-day sequen-tial therapy, in 60/70 (85.75% with the standard fourteen-day triple therapy, respectively. Conclusion: We detected no significant differences between the 10-day sequential eradication therapy for H. pylori and 14-day standard triple treatment among the patients. (Sci J Hamadan Univ Med Sci 2013; 20 (3:184-193

  14. Effect of bismuth addition to the triple therapy of Helicobacter pylori eradication

    Ezel Taşdemir

    2012-03-01

    Full Text Available Objective: Success rates of amoxicillin, clarithromycin, and proton-pump inhibitor therapy in the Helicobacter pylori (Hp eradication have been decreasing. The aim of this study was to investigate the impact of bismuth subcitrate addition to triple therapy.Materials and methods: 148 patients diagnosed Hp infection with both histology and Hp stool antigen (HpSA tests were examined retrospectively. The patients were divided into 3 groups according to the eradication therapy. The first group received triple therapy with claritromycine 2x 500 mg, amoxicilline 2x1 g and PPI 2x1 for 14 days (n=40. The second group had bismuth subcitrate 4x120 mg with triple therapy for 14 days (n=73. The third group received 14 days pretreatment with bismuth subcitrate 4x1 together with PPI 2x1 then had triple therapy for 14 days (n=35. (14C urea breath and HpSA tests were used to detect posttreatment H.pylori status.Results: There were no statistical difference between the groups in terms of gender and age (p > 0.05. In group one 12 patients, in group two 20 patients and in group three 10 patients were identified as Hp positive after treatment. Eradication rates were 70% for group one, 72.6% for group two and 71.4% for group three respectively. There was no statistical difference between the groups in terms of eradication rates of treatment (p > 0.05.Conclusions: The addition of bismuth to conventional triple therapy did not affect treatment success rates.

  15. Does Helicobacter pylori infection eradication modify peptic ulcer prevalence? A 10 years' endoscopical survey

    Giorgio Nervi; Giancarlo Colla; Angelo Franzè; Francesco Di Mario; Stefania Liatopoulou; Lucas Giovanni Cavallaro; Alessandro Gnocchi; Nadia Dal Bò; Massimo Rugge; Veronica Iori; Giulia Martina Cavestro; Marta Maino

    2006-01-01

    AIM: To compare peptic ulcer prevalence in patients referred for upper gastrointestinal endoscopy in two Italian hospitals in pre-Helicobacter era and ten years after the progressive diffusion of eradication therapy.METHODS: We checked all the endoscopic examinations consecutively performed in the Gastroenterology Unit of Padova during 1986-87 and 1995-96, and in the Gastroenterology Unit of Parma during 1992 and 2002.Chi Square test was used for statistic analysis.RESULTS: Data from both the endoscopic centers showed a statistically significant decrease in the prevalence of ulcers: from 12.7% to 6.3% (P<0.001) in Padova and from 15.6% to 12% (P<0.001) in Parma.The decrease was significant both for duodenal (from 8.8% to 4.8%, P<0.001) and gastric ulcer (3.9% to 1.5%, P<0.001) in Padova, and only for duodenal ulcer in Parma (9.2% to 6.1%, P<0.001; gastric ulcer: 6.3%to 5.8%, NS).CONCLUSION:Ten years of extensive Helicobacter pylori(H pylori) eradication in symptomatic patients led to a significant reduction in peptic ulcer prevalence.This reduction was particularly evident in Padova, where a project for the sensibilization of H pylori eradication among general practioners was carried out between 1990 and 1992. Should our hypothesis be true, H pylori eradication might in the future lead to peptic ulcer as a rare endoscopic finding.

  16. Running Status and Evaluation of Chinese Polio Laboratories Network in 2009%中国2009年脊髓灰质炎实验室网络的运转情况与评价

    祝双利; 张勇; 严冬梅; 朱晖; 王东艳; 安军静; 安洪秋; 檀晓娟; 陈立

    2013-01-01

    Objective Inorder to evaluate the running status and provide the laboratory data for maintaining polio-free status in China,the virological surveillance database of Chinese polio laboratories network (PLN ;not include Hong Kong Special Administrative Region,Macao Special Administrative Region,and Taiwan Sheng) in 2009 were analyzed.Methods The case investigation data of acute flaccid paralysis (AFP) cases reported by 31 provinces (municipalities,autonomous regions) through expanded programme on immunization surveillance information management system and the database of national polio laboratory (NPL) were analyzed,and the indicators of running status of Chinese PLN were evaluated.Results 9621 stool samples were collected from 4829 AFP cases by Chinese PLN in 2009,and all stool samples were done viral isolation and identification according to 4th World Health Organization (WHO) polio laboratory manual,the rate of viral isolation and identification performed within 28d was 95.4%.There are 158 polioviruses (PV) and 607 of non-polio enteroviruses (NPEV) were isolated from AFP cases,the isolation rates were3.29% and12.63% respectively.214 polio positive isolates were sent to NPL by 31 provincial polio laboratories.Protocol for intratypic differentitation in NPL was VP1 sequencing.There were 284 single serotype PVs were performed VP1 sequencing,there is 1 vaccine-derived polioviruses (VDPVs) and no wild PVs were found in 2009.NPL got full scores and passed the proficiency test and got full accreditation for on-site review by WHO experts in 2009.All 31 provincial polio laboratories passed the proficiency test with the same panel as NPL,they all got full scores.13 provincial polio laboratories joined and passed the on-site review by WHO experts.Conclusion The running status of Chinese PLN was good,polio-free status was maintained in China in 2009; the Chinese PLN ran normally,the laboratory surveillance system was sensitive and laboratory data were provided reference

  17. Clustered lot quality assurance sampling: a tool to monitor immunization coverage rapidly during a national yellow fever and polio vaccination campaign in Cameroon, May 2009.

    Pezzoli, L; Tchio, R; Dzossa, A D; Ndjomo, S; Takeu, A; Anya, B; Ticha, J; Ronveaux, O; Lewis, R F

    2012-01-01

    We used the clustered lot quality assurance sampling (clustered-LQAS) technique to identify districts with low immunization coverage and guide mop-up actions during the last 4 days of a combined oral polio vaccine (OPV) and yellow fever (YF) vaccination campaign conducted in Cameroon in May 2009. We monitored 17 pre-selected districts at risk for low coverage. We designed LQAS plans to reject districts with YF vaccination coverage <90% and with OPV coverage <95%. In each lot the sample size was 50 (five clusters of 10) with decision values of 3 for assessing OPV and 7 for YF coverage. We 'rejected' 10 districts for low YF coverage and 14 for low OPV coverage. Hence we recommended a 2-day extension of the campaign. Clustered-LQAS proved to be useful in guiding the campaign vaccination strategy before the completion of the operations.

  18. Comparison of Triple Therapy plus Probiotic Yogurt vs. Standard Triple Therapy on Helicobacter Pylori Eradication

    Vahid Mirzaee

    2013-04-01

    Full Text Available Background: Treatment of Helicobacter pylori as a major cause of gastric diseases is of utmost concern. We aimed to assess efficacy of triple therapy (amoxicillin, clarithromycin and pantoprazole plus probiotic yogurt (PY on eradication of H. pylori. Materials and Methods: Total 102 H. pylori positive patients were divided to 3 groups equally and randomly. For treatment of each group amoxicillin, clarithromycin and pantoprazole were used. Group A had additional PY and Group B ordinary low fat yogurt in their regimen as well. These groups were compared regarding treatment success.Results: Total number of 88 patients finished the treatment course. The most common experienced side effects were dysgeusia in groups A and B (25.8% and 32.3%, respectively, and dysgeusia with diarrhea and abdominal pain (30.8% in group C. Eradication rate was, respectively, 61.3%, 64.5% and 71.3% in group A, B and C of which difference was not statistically significant. However, the difference between 3 groups in regard to education level was statistically significant (p=0.005.Conclusion: PY enriched triple therapy has decreased side effects of antibiotics consumption; however, this has no impact on eradication of H. pylori. PY and triple therapy can be used concomitantly to increase the patient tolerance.

  19. Rifampicin fails to eradicate mature biofilm formed by methicillin-resistant Staphylococcus aureus

    Keli Cristine Reiter

    2012-08-01

    Full Text Available INTRODUCTION: Antimicrobial activity on biofilms depends on their molecular size, positive charges, permeability coefficient, and bactericidal activity. Vancomycin is the primary choice for methicillin-resistant Staphylococcus aureus (MRSA infection treatment; rifampicin has interesting antibiofilm properties, but its effectivity remains poorly defined. METHODS: Rifampicin activity alone and in combination with vancomycin against biofilm-forming MRSA was investigated, using a twofold serial broth microtiter method, biofilm challenge, and bacterial count recovery. RESULTS: Minimal inhibitory concentration (MIC and minimal bactericidal concentration for vancomycin and rifampicin ranged from 0.5 to 1mg/l and 0.008 to 4mg/l, and from 1 to 4mg/l and 0.06 to 32mg/l, respectively. Mature biofilms were submitted to rifampicin and vancomycin exposure, and minimum biofilm eradication concentration ranged from 64 to 32,000 folds and from 32 to 512 folds higher than those for planktonic cells, respectively. Vancomycin (15mg/l in combination with rifampicin at 6 dilutions higher each isolate MIC did not reach in vitro biofilm eradication but showed biofilm inhibitory capacity (1.43 and 0.56log10 CFU/ml reduction for weak and strong biofilm producers, respectively; p<0.05. CONCLUSIONS: In our setting, rifampicin alone failed to effectively kill biofilm-forming MRSA, demonstrating stronger inability to eradicate mature biofilm compared with vancomycin.

  20. Formulation and evaluation of clarithromycin microspheres for eradication of Helicobacter pylori.

    Rajinikanth, Paruvathanahalli Siddalingam; Karunagaran, Lakshmi Narayanan; Balasubramaniam, Jagdish; Mishra, Brahmeshwar

    2008-12-01

    The objective of the study was to develop a stomach-specific drug delivery system for controlled release of clarithromycin for eradication of Helicobacter pylori (H. pylori). Floating-bioadhesive microspheres of clarithromycin (FBMC) were prepared by emulsification-solvent evaporation method using ethylcellulose as matrix polymer and Carbopol 934P as mucoadhesive polymer. The prepared microspheres were subjected to evaluation for particle size, incorporation efficiency, in vitro buoyancy, in vitro mucoadhesion and in vitro drug release characteristics. The prepared microspheres showed a strong mucoadhesive property with good buoyancy. The formulation variables like polymer concentration and drug concentration influenced the in vitro drug release significantly in simulated gastric fluid (pH. 2.0). The in vivo H. pylori clearance efficiency of prepared FBMC in reference to clarithromycin suspension following repeated oral administration to H. pylori infected Mongolian gerbils was examined by polymerase chain reaction (PCR) technique and by a microbial culture method. The FBMC showed a significant anti-H. pylori effect in the in vivo gerbil model. It was also noted that the required amount of clarithromycin for eradication of H. pylori was significantly less in FBMC than from corresponding clarithromycin suspension. The results further substantiated that FBMC improved the gastric stability of clarithromycin (due to entrapment within the microsphere) and eradicated H. pylori from the gastrointestinal tract more effectively than clarithromycin suspension because of the prolonged gastrointestinal residence time of the formulation.