Evaluation of Immune Response to Hepatitis B Vaccine among Malnourished Children in Yemen

Objectives: To determine the coverage rate of hepatitis B virus (HBV) vaccine and to evaluate the immune response to HBV vaccine by measuring hepatitis B surface antibody (anti-HBs) among malnourished under-five-year old children.Methods: A cross-sectional study was conducted in two tertiary hospitals in Yemen; Al-Sabeen Maternity and Child Hospital in Sana’a and the Yemeni-Swedish Hospital in Taiz city in the period from March 2014 to Dec. 2014. The target population was malnourished children aged from 6 to 59 months old with a history of three HBV vaccine doses in infancy. According to the World Health Organization’s definition of malnutrition, 121 malnourished children were enrolled in the study. Data of malnourished children were collected using a pre-designed, pre-tested questionnaire. Two milliliters of venous blood were taken, and anti-HBs was then tested by enzyme linked immunosorbent assay. An anti-HBs level of at least 10 IU/L was considered a successful response to the vaccine.Results: The coverage rate of HBV vaccine among malnourished children was 89.3%, being higher among girls (52.1%) than boys (37.2%). Response to HBV vaccine (≥10 IU/L) was observed in 72.2% (78/108) of children while 27.8% (30/108) of children failed to respond to the vaccine, with a statistically significant difference (p <0.001).Conclusions: A good HBV vaccine coverage rate was found among malnourished Yemeni children, with a moderate rate of protection. Therefore, re-vaccination or administration of booster doses to a substantial proportion of vaccinated children should be considered

Barriers to Completing TB Diagnosis in Yemen: Services Should Respond to Patients' Needs

Objectives and Background Obtaining a diagnosis of tuberculosis (TB) is a prerequisite for accessing specific treatment, yet one third of estimated new cases are missed worldwide by National Programmes. This study investigated economic, geographical, socio-cultural and health system factors hindering adults' attendance and completion of the TB diagnostic process in Yemen, to inform interventions designed to improve patient access to services. Methodology The study employed a mixed methods design comprising a cross-sectional survey and In-Depth-Interviews (IDIs) and Focus Group Discussions (FGDs) among patients abandoning the diagnosis or registering for treatment. Adults with cough of ≥2 weeks attending a large governmental referral centre in Sana'a, Yemen, between 2009 and 2010, were eligible to participate. Results 497 and 446 (89.7%) participants were surveyed the first and second day of attending the services and 48 IDIs and 12 FGDs were also conducted. The majority of patients were disadvantaged and had poor literacy (61% illiterate), had travelled from rural areas (47%) and attended with companions (84%). Key barriers for attendance identified were clinic and transport costs (augmented by companions), distance from home, a preference for private services, strong social stigma and a lack of understanding of the diagnostic process. There were discrepancies between patient- and doctor-reported diagnosis and 46% of patients were unaware that TB treatment is free. Females faced more difficulties to attend than men. The laboratory practice of providing first-day negative smear results and making referrals to the private sector also discouraged patients from returning. Strategies to bring TB diagnostic services closer to communities and address the multiple barriers patients face to attend, will be important to increase access to TB diagnosis and care

Rotavirus and norovirus infections in children in Sana'a, Yemen

Summary objectives To describe the epidemiology of rotavirus and norovirus infection among children with acute gastroenteritis in Sana'a, Yemen. conclusions Rotavirus and norovirus infections are common causes of gastroenteritis in Yemen. Rotavirus vaccines could play a significant role in the control of acute childhood diarrhoea in this setting. keywords norovirus, rotavirus, Yeme

Reasons why women face difficulties accessing healthcare facilities (Questionnaire 1).

<p>Reasons why women face difficulties accessing healthcare facilities (Questionnaire 1).</p

Proportion of smears positive and additional yield of specimens collected by expectorated or induced sputum and gastric and nasopharyngeal aspirates.

*<p>Number of additional children identified, N = number, pos = positive.</p

Characteristics of participants attending TB diagnostic services and their companions.

<p>Characteristics of participants attending TB diagnostic services and their companions.</p

Knowledge of TB among new patients (Questionnaire 1).

<p>Knowledge of TB among new patients (Questionnaire 1).</p