Summary of studies on interaction between schistosomiasis and <i>Salmonella</i>.

<p>Summary of studies on interaction between schistosomiasis and <i>Salmonella</i>.</p

Additional file 2 of Efficacy of a bivalent killed whole-cell cholera vaccine over five years: a re-analysis of a cluster-randomized trial

Figure S1. (PDF 27.4 kb

Additional file 3 of Efficacy of a bivalent killed whole-cell cholera vaccine over five years: a re-analysis of a cluster-randomized trial

Supplementary Text (Model equations). (PDF 45.5 kb

Flowchart of the disease and observation process reflected in our data.

The top of the flowchart consists of all cases of typhoid fever in the population, which is what we are ultimately interested in estimating. However, three intervening (observation) processes result in a considerable difference between the “actual” cases of typhoid fever and the observed cases of typhoid fever. In all, the observation process is made up of the type of surveillance employed in each study (ϕs), the participation rate of patients seen at each of the study clinics (ϕp,a,j, adjusted for age a and study site j), and the sensitivity of blood culture used to confirm typhoid infection (ϕc,a,j, adjusted for age a and study j). We modeled the observed cases as representing the successful trials of a binomial process (the detection process), where the number of trials is Poisson distributed (with a rate parameter equal to the “true” incidence of typhoid cases, λa,j, at age a and study site j); thus, the number of observed cases is a thinned Poisson distribution with rate parameter equal to the product of the disease rate and the probability of a case being detected at each step of the observation process. We used Bayesian priors to account for the observation process and adequately estimate the underlying disease process.</p

Summary statistics for the candidate predictors included in the predictive model.

Summary statistics for the candidate predictors included in the predictive model.</p

Table_3_Madagascar's EPI vaccine programs: A systematic review uncovering the role of a child's sex and other barriers to vaccination.DOCX

BackgroundImmunizations are one of the most effective tools a community can use to increase overall health and decrease the burden of vaccine-preventable diseases. Nevertheless, socioeconomic status, geographical location, education, and a child's sex have been identified as contributing to inequities in vaccine uptake in low- and middle-income countries (LMICs). Madagascar follows the World Health Organization's Extended Programme on Immunization (EPI) schedule, yet vaccine distribution remains highly inequitable throughout the country. This systematic review sought to understand the differences in EPI vaccine uptake between boys and girls in Madagascar.MethodsA systematic literature search was conducted in August 2021 through MEDLINE, the Cochrane Library, Global Index Medicus, and Google Scholar to identify articles reporting sex-disaggregated vaccination rates in Malagasy children. Gray literature was also searched for relevant data. All peer-reviewed articles reporting sex-disaggregated data on childhood immunizations in Madagascar were eligible for inclusion. Risk of bias was assessed using a tool designed for use in systematic reviews. Data extraction was conducted with a pre-defined data extraction tool. Sex-disaggregated data were synthesized to understand the impact of a child's sex on vaccination status.FindingsThe systematic search identified 585 articles of which a total of three studies were included in the final data synthesis. One additional publication was included from the gray literature search. Data from included articles were heterogeneous and, overall, indicated similar vaccination rates in boys and girls. Three of the four articles reported slightly higher vaccination rates in girls than in boys. A meta-analysis was not conducted due to the heterogeneity of included data. Six additional barriers to immunization were identified: socioeconomic status, mother's education, geographic location, supply chain issues, father's education, number of children in the household, and media access.InterpretationThe systematic review revealed the scarcity of available sex-stratified immunization data for Malagasy children. The evidence available was limited and heterogeneous, preventing researchers from conclusively confirming or denying differences in vaccine uptake based on sex. The low vaccination rates and additional barriers identified here indicate a need for increased focus on addressing the specific obstacles to vaccination in Madagascar. A more comprehensive assessment of sex-disaggregated vaccination status of Malagasy children and its relationship with such additional obstacles is recommended. Further investigation of potential differences in vaccination status will allow for the effective implementation of strategies to expand vaccine coverage in Madagascar equitably.Funding and registrationAH, BT, FM, GN, and RR are supported by a grant from the Bill and Melinda Gates Foundation (grant number: OPP1205877). The review protocol is registered in the Prospective Register of Systematic Reviews (PROSPERO ID: CRD42021265000).</p

Uncertainty in incidence estimates for the Global Burden of Disease regions and subregions made up of low- and middle-income countries.

<p>Uncertainty in incidence estimates for the Global Burden of Disease regions and subregions made up of low- and middle-income countries.</p

Model summary.

<p>A) The posterior marginal probability that each variable was excluded from the model (black) or included as a predictor of the intercept (dark grey) or intercept and slope (light grey) is shown for two chains. Our stochastic search variable selection algorithm could include variables either as a predictor of the intercept (the incidence in 5–14 year olds) or as a predictor of the intercept as well as the slopes (the incidence rate ratios between the other age groups and the referent age group of 5–14 year olds). B) Distribution of the average number of covariates in the model. Chain 1 was initiated using a model that included all the covariates as predictors of the main effect, while chain 2 was initiated as the null model. The null model was never sampled, implying that the models including at least one predictor better described the data than the null model. C) Posterior distributions of age-specific incidence rate ratios between the referent age group (5–14 years of age) and other age groups: <2 years, 2–4 years, ≥15 years old.</p

Basic parameters and distribution of CRP levels in 541 patients.

Basic parameters and distribution of CRP levels in 541 patients.</p

Parsimonious multivariate regressions model of characteristics positively associated with bacteremia in parasitemic children, stratified for parasite count.

<p>¹ OR (CI), odds ratio (95% confidence interval)</p><p>² Dehydration ≥ grade 1 (3–5%)</p><p>Parsimonious multivariate regressions model of characteristics positively associated with bacteremia in parasitemic children, stratified for parasite count.</p