Rotavirus vaccine and diarrhea mortality: quantifying regional variation in effect size

<p>Abstract</p> <p>Background</p> <p>Diarrhea mortality remains a leading cause of child death and rotavirus vaccine an effective tool for preventing severe rotavirus diarrhea. New data suggest vaccine efficacy may vary by region.</p> <p>Methods</p> <p>We reviewed published vaccine efficacy trials to estimate a regional-specific effect of vaccine efficacy on severe rotavirus diarrhea and hospitalizations. We assessed the quality of evidence using a standard protocol and conducted meta-analyses where more than 1 data point was available.</p> <p>Results</p> <p>Rotavirus vaccine prevented severe rotavirus episodes in all regions; 81% of episodes in Latin America, 42.7% of episodes in high-mortality Asia, 50% of episodes in sub-Saharan Africa, 88% of episodes low-mortality Asia and North Africa, and 91% of episodes in developed countries. The effect sizes observed for preventing severe rotavirus diarrhea will be used in <it>LiST</it> as the effect size for rotavirus vaccine on rotavirus-specific diarrhea mortality.</p> <p>Conclusions</p> <p>Vaccine trials have not measured the effect of vaccine on diarrhea mortality. The overall quality of the evidence and consistency observed across studies suggests that estimating mortality based on a severe morbidity reduction is highly plausible.</p

Does Age Affect the Response to Zinc Therapy for Diarrhoea in Bangladeshi Infants?

The benefit of zinc for the treatment of diarrhoea in a cluster-randomized trial of children, aged 3–59 months, living in rural Bangladesh was previously reported. Here, the benefits of zinc stratified by age—3–5 months, 6–11 months, and 12–59 months—are reported. Although the sample sizes in the stratified groups were too small to detect statistical significance in the 3–5-month and 6–11-month age-groups, the trends suggest that there may be a benefit of zinc for the treatment of diarrhoea on the duration of diarrhoea and on subsequent morbidity and mortality. Additional research is needed to better understand the effect of zinc for the treatment of diarrhoea among infants aged less than six months

Quantifying the Association between Campylobacter Infection and Guillain-Barré Syndrome: A Systematic Review

Guillain-Barré Syndrome (GBS) is a neurologic disease that causes ascending paralysis and is triggered by a preceding bacterial or viral infection. Several studies have shown that patients with GBS have a recent history of infection due to Campylobacter jejuni. A literature review of published studies that reported rates of Campylobacter infection before or in conjunction with GBS was done. These reported data were used for calculating the proportion of GBS cases who tested positive for Campylobacter compared to the control population and the incidence of GBS among patients infected with Campylobacter. Results of the analysis suggest that 31% of 2,502 GBS cases included in these papers are attributable to Campylobacter infection

Diarrhea as a risk factor for acute lower respiratory tract infections among young children in low income settings

Diarrhea and acute lower respiratory tract infections (ALRI) are leading causes of morbidity and mortality among children under 5 years of age. We sought to quantify the correlation of diarrhea and respiratory infections within an individual child and to determine if infection with one illness increases the risk of infection with the other during the same time period

Does comorbidity increase the risk of mortality among children under 3 years of age?

Objectives Diarrhoea and pneumonia remain leading causes of morbidity and mortality in children under 5 years of age. Little data is available to quantify the burden of comorbidity and the relationship between comorbid diarrhoea and pneumonia infections and mortality. We sought to quantify the relationship between comorbidity and risk of mortality among young children in two community-based studies conducted among South Asian children. Design Secondary data analysis of two cohort studies. Participants We identified two cohort studies of children under 3 years of age with prospective morbidity at least once every 2 weeks and ongoing mortality surveillance. Outcome measures We calculated the mortality risk for diarrhoea and acute lower respiratory infection (ALRI) episodes and further quantified the risk of mortality when both diseases occur at the same time using a semiparametric additive model. Results Among Nepali children, the estimated additional risk of mortality for comorbid diarrhoea and ALRI was 0.0014 (−0.0033, 0.0060). Among South Indian children, the estimated additional risk of mortality for comorbid diarrhoea and ALRI was 0.0032 (−0.0098, 0.0162). This risk is in addition to the single infection risk of mortality observed among these children. Conclusions We observed an additional risk of mortality in children who experienced simultaneous diarrhoea and ALRI episodes though the CI was wide indicating low statistical support. Additional studies with adequate power to detect the increased risk of comorbidity on mortality are needed to improve confidence around the effect size estimate

Does Age Affect the Response to Zinc Therapy for Diarrhoea in Bangladeshi Infants?

The benefit of zinc for the treatment of diarrhoea in a cluster-randomized trial of children, aged 3-59 months, living in rural Bangladesh was previously reported. Here, the benefits of zinc stratified by age-3-5 months, 6-11 months, and 12-59 months-are reported. Although the sample sizes in the stratified groups were too small to detect statistical significance in the 3-5-month and 6-11-month age-groups, the trends suggest that there may be a benefit of zinc for the treatment of diarrhoea on the duration of diarrhoea and on subsequent morbidity and mortality. Additional research is needed to better understand the effect of zinc for the treatment of diarrhoea among infants aged less than six months