Determinants of timeliness in early childhood vaccination among mothers with vaccination cards in Sindh province, Pakistan:a secondary analysis of cross-sectional survey data

OBJECTIVE: Untimely vaccination refers to receiving the given dose before (early) or after (delayed) the recommended time window. The purpose of this study was to assess the extent of timeliness of childhood vaccinations and examine the determinants of vaccination timeliness in Sindh province, Pakistan. DESIGN: Cross-sectional analysis of data from the 2013 and 2014 Maternal and Child Health Program Indicator Surveys. SETTING: Community-based maternal and child health surveys. PARTICIPANTS: Among 10 200 respondents of Maternal and Child Health Program Indicator Surveys, 1143 women who had a live birth in the 2 years preceding the survey were included. OUTCOMES: At the participants' home, an interviewer asked mothers to show their children's vaccination cards, which contained information regarding vaccinations. Children's vaccination status was categorised into timely or early/delayed compared with vaccination schedule. A logistic regression analysis using Firth's penalised likelihood was performed to identify factors associated with timeliness of vaccinations. RESULTS: 238 children (20.8% of children who received a full set of basic vaccinations) received all vaccinations on schedule among children who received a full set of basic vaccinations. The percentages of timely vaccinations ranged from 2.3% for second measles vaccination to 89.3% for bacillus Calmette-Guérin. Child's age and place of delivery were associated with timely vaccinations. Older child age and institutional delivery were associated with decreased timely vaccination rate. CONCLUSIONS: Home-based vaccination record is a key tool to improve the timeliness of vaccinations. The redesigned vaccination cards, the new electronic registries for vaccination card information and the vaccination tracking system to remind the second/third vaccination visits may be helpful to improve timely vaccinations for children under 2 years old

Factors affecting complete and timely childhood immunization coverage in Sindh, Pakistan; A secondary analysis of cross- sectional survey data

Background Pakistan has a high burden of newborn mortality, which would be significantly preventable through appropriate routine immunization. The purpose of this study was to measure the basic timely childhood immunization coverage and to identify determinants of factors influencing childhood immunization coverage in Sindh, Pakistan. Methods Data from Maternal and Child Health Program Indicator Survey 2013-2014 which was conducted in Sindh province of Pakistan was used. Outcome measure was full coverage of the basic immunization schedule from child's vaccination card. The association of receiving basic immunization with demographic factors, socioeconomic status, mother and child health information sources, and perinatal care factors were tested by binary logistic regression. Results Among 2,253 children, 1,156 (51.3%) received age-based full basic immunization. The basic immunization rates were 69.1% for under five weeks old, 38.3% for six to nine weeks, 18.8% for 10-13 weeks, 44.0% for 14 weeks-eight months, 60.4% for nine to 11 months, and 59.1% for over one year. Child's age, number of living children, parents' education level, wealth, the source of mother and child health information, number of antenatal care, and assistance during delivery were associated with completing basic immunization. Conclusions The overall full basic immunization coverage in Pakistan was still low. Policy makers should identify children at risk of low immunization coverage and obstacles of receiving antenatal care, implement educational interventions targeting on less educated parents, and conduct mass immunization campaigns for timely and complete immunization

Genetic analysis of ORF5 of recent Korean porcine reproductive and respiratory syndrome viruses (PRRSVs) in viremic sera collected from MLV-vaccinating or non-vaccinating farms

The 23 open reading frame (ORF) 5 sequences of Korean type II porcine reproductive and respiratory syndrome virus (PRRSV) were collected from viremic sera from the (modified live vaccine) MLV-vaccinating and non-vaccinating farms from 2007 to 2008. The samples were phylogenetically analyzed with previous ORF5 sequences, including type I Korean PRRSV, and previously reported or collected sequences from 1997 to 2008. A MN184-like subgroup of type II Korean PRRSV was newly identified in the viremic sera collected from 2007 to 2008. And of the type I PRRSVs, one subgroup had 87.2~88.9% similarity with the Lelystad virus, showing a close relationship with the 27~2003 strain of Spain. The maximum parsimony tree of type II PRRSV from 1997 to 2008 showed that they had evolved to four lineages, subgroups 1, 2, 3 and 4. Most of the recently collected type II PRRSVs belonged to subgroup 4 (48%). The region of three B-cell epitopes and two T-cell epitopes of ORF5 amino acids sequences was considerably different from the MLV in subgroups 3 and 4. In conclusion, the existence of type I PRRSV, which was genetically different from Lelystad virus (Prototype of type I PRRSV), and heterologous type II PRRSVs of viremic pigs detected even in the MLV-vaccinating farms indicated the need for new vaccine approaches for the control of PRRSV in Korea

Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)

PurposePrevious studies suggest that the concentration of 25-hydroxyvitamin D [25(OH)D] in cord blood may show an inverse association with respiratory tract infections (RTI) during childhood. The aim of the present study was to examine the influence of 25(OH)D concentrations in cord blood on infant RTI in a Korean birth cohort.MethodsThe levels of 25(OH)D in cord blood obtained from 525 Korean newborns in the prospective COhort for Childhood Origin of Asthma and allergic diseases were examined. The primary outcome variable of interest was the prevalence of RTI at 6-month follow-up, as diagnosed by pediatricians and pediatric allergy and pulmonology specialists. RTI included acute nasopharyngitis, rhinosinusitis, otitis media, croup, tracheobronchitis, bronchiolitis, and pneumonia.ResultsThe median concentration of 25(OH)D in cord blood was 32.0 nmol/L (interquartile range, 21.4 to 53.2). One hundred and eighty neonates (34.3%) showed 25(OH)D concentrations less than 25.0 nmol/L, 292 (55.6%) showed 25(OH)D concentrations of 25.0-74.9 nmol/L, and 53 (10.1%) showed concentrations of ≥75.0 nmol/L. Adjusting for the season of birth, multivitamin intake during pregnancy, and exposure to passive smoking during pregnancy, 25(OH)D concentrations showed an inverse association with the risk of acquiring acute nasopharyngitis by 6 months of age (P for trend=0.0004).ConclusionThe results show that 89.9% of healthy newborns in Korea are born with vitamin D insufficiency or deficiency (55.6% and 34.3%, respectively). Cord blood vitamin D insufficiency or deficiency in healthy neonates is associated with an increased risk of acute nasopharyngitis by 6 months of age. More time spent outdoors and more intensified vitamin D supplementation for pregnant women may be needed to prevent the onset of acute nasopharyngitis in infants

Impacts of Smoking Ban Policies on Billiard Hall Sales in South Korea Using Objective Sales Information of a Credit Card Company: Quasi-Experimental Study

BackgroundSmoking ban policies (SBPs) are potent health interventions and offer the potential to influence antismoking behavior. The Korean government completely prohibited smoking in indoor sports facilities, including billiard halls, since the government revised the National Health Promotion Act in December 2017. ObjectiveThis study aimed to examine the impact of the SBP on the economic outcomes of indoor sports facilities, particularly billiard halls. MethodsThis study used credit card sales data from the largest card company in South Korea. Data are from January 2017 to December 2018. Monthly sales data were examined across 23 administrative neighborhoods in Seoul, the capital city of South Korea. We conducted the interrupted time series model using the fixed effects model and the linear regression with panel-corrected standard errors (PCSE). ResultsThe sales and transactions of billiard halls were not significantly changed after the introduction of the SBP in the full PCSE models. The R2 of the full PCSE model was 0.967 for sales and 0.981 for transactions. ConclusionsThe introduction of the SBP did not result in substantial economic gains or losses in the sales of billiard halls. In addition to existing price-based policies, the enhanced SBP in public-use facilities, such as billiard halls, can have a positive synergistic effect on reducing smoking prevalence and preventing secondhand smoke. Health policy makers can actively expand the application of SBPs and make an effort to enhance social awareness regarding the necessity and benefits of public SBPs for both smokers and the owners of hospitality facilities

Influence of COVID-19-Related Interventions on the Number of Inpatients with Acute Viral Respiratory Infections: Using Interrupted Time Series Analysis

After the first COVID-19 patient was diagnosed, non-pharmaceutical interventions such as social distancing and behavior change campaigns were implemented in South Korea. The social distancing policy restricted unnecessary gatherings and activities to prevent local transmission. This study aims to evaluate the effect of social distancing, a strategy for COVID-19 prevention, on the number of acute respiratory infection inpatients. This study used the number of hospitalized patients with acute respiratory infection from the Infectious Disease Portal of the Korea Centers for Disease Control and Prevention (KCDC) between the first week of January 2018, to the last week of January 2021. Intervention 1t represents the first patient occurrence of COVID-19, Intervention 2t represents the relaxing of the social distancing policy. We used acute respiratory infection statistics from Korea and segmented regression analysis was used. The analysis showed that the trend of the number of acute respiratory infection inpatients decreased after the implementation of the first patient incidence of COVID-19 due to prevention activities. After the relaxing of the social distancing policy, the number of inpatients with acute respiratory infections significantly increased. This study verified the effect of social distancing on the reduction in hospital admissions for acute respiratory viral infections

Influence of COVID-19-Related Interventions on the Number of Inpatients with Acute Viral Respiratory Infections: Using Interrupted Time Series Analysis

After the first COVID-19 patient was diagnosed, non-pharmaceutical interventions such as social distancing and behavior change campaigns were implemented in South Korea. The social distancing policy restricted unnecessary gatherings and activities to prevent local transmission. This study aims to evaluate the effect of social distancing, a strategy for COVID-19 prevention, on the number of acute respiratory infection inpatients. This study used the number of hospitalized patients with acute respiratory infection from the Infectious Disease Portal of the Korea Centers for Disease Control and Prevention (KCDC) between the first week of January 2018, to the last week of January 2021. Intervention 1t represents the first patient occurrence of COVID-19, Intervention 2t represents the relaxing of the social distancing policy. We used acute respiratory infection statistics from Korea and segmented regression analysis was used. The analysis showed that the trend of the number of acute respiratory infection inpatients decreased after the implementation of the first patient incidence of COVID-19 due to prevention activities. After the relaxing of the social distancing policy, the number of inpatients with acute respiratory infections significantly increased. This study verified the effect of social distancing on the reduction in hospital admissions for acute respiratory viral infections

Factors Affecting Breastfeeding Practices in Sindh Province, Pakistan: A Secondary Analysis of Cross-Sectional Survey Data

Breastfeeding practices are critical for child health and growth. This paper investigates demographic factors, socioeconomic status, and information sources that affect breastfeeding practices in Sindh Province, Pakistan. A secondary analysis was performed of data on 10,028 women with a birth in the preceding two years who had participated in the 2013–14 Maternal and Child Health Program Indicator Survey. Multiple logistic regressions were used to test the association between breastfeeding status (ever breastfed and still breastfeeding) and age, number of living children, residence, education, wealth, information sources about breastfeeding, assistance during delivery, and place of delivery. Of the 9955 women included in the analysis, 97.9% had breastfed and 83.9% were still breastfeeding at the time of the survey. Being in the second, third, or fourth wealth quintiles and receiving breastfeeding information from relatives and friends were associated with ever breastfeeding. Women who were 35 years or older, living in a town/small city, higher maternal education, middle wealth quintile, and receiving breastfeeding information from the media were associated with still breastfeeding. The findings suggest the need to develop interventions considering maternal socioeconomic status and peer counseling interventions. Mass media campaigns to promote breastfeeding practices should be accompanied by governmental restrictions on the marketing of infant formula

Impact of Socio-Economic Factors and Health Information Sources on Place of Birth in Sindh Province, Pakistan:A Secondary Analysis of Cross-Sectional Survey Data

Medical facility birth with skilled birth attendance is essential to reduce maternal mortality. The purpose of this study was to assess the demographic characteristics, socio-economic factors, and varied health information sources that may influence the uptake of birth services in Pakistan. We used pooled data from Maternal-Child Health Program Indicator Survey 2013 and 2014. Study population was 9719 women. Generalized linear model with log link and a Poisson distribution was used to identify factors associated with place of birth. 3403 (35%) women gave birth at home, and 6316 (65%) women gave birth at a medical facility. After controlling for all covariates, women's age, number of children, education, wealth, and mother and child health information source (doctors and nurses/midwives) were associated with facility births. Women were significantly less likely to give birth at a medical facility if they received maternal-child health information from low-level health workers or relatives/friends. The findings suggest that interventions should target disadvantaged and vulnerable groups of women after considering rural-urban differences. Training non-health professionals may help improve facility birth. Further research is needed to examine the effect of individual information sources on facility birth, both in urban and rural areas in Pakistan

A back-to-back tumor composed of papillary renal cell carcinoma and oncocytoma treated by laparoscopic partial nephrectomy: a case report

Abstract Background Renal oncocytoma is the most common benign renal tumor, and papillary renal cell carcinoma is the second most common histologic subtype of renal cell carcinoma. Renal tumors containing different components such as papillary renal cell carcinoma and oncocytoma are extremely rare. Case presentation A renal mass was incidentally detected in a 52-year-old Korean woman, and a computed tomographic scan showed a 32-mm multicystic mass with some calcifications in the lower pole of the right kidney. She underwent laparoscopic partial nephrectomy without any perioperative complications. We found a papillary renal cell carcinoma and an oncocytoma in a tumor mass. Conclusions The possibility of a mixed malignant tumor should be considered while treating benign tumors such as oncocytoma