Estimated impact of rotavirus vaccine on hospitalizations and deaths from rotavirus diarrhea among children <5 in Asia

<p><b>Background</b>: Of the 215,000 global deaths from rotavirus estimated in 2013, 41% occur in Asian countries. However, despite a recommendation for global rotavirus vaccination since 2009, only eight countries in Asia have introduced the rotavirus vaccine into their national immunization program as of September 2017. To help policy makers assess the potential value of vaccination, we projected the reduction in rotavirus hospitalizations and deaths following a hypothetical national introduction of rotavirus vaccines in all countries in Asia using data on national-level rotavirus mortality, <5 population, rotavirus hospitalizations rates, routine vaccination coverage, and vaccine effectiveness.</p> <p><b>Methods</b>: To quantify uncertainty, we generated 1,000 simulations of these inputs.</p> <p><b>Results</b>: Our model predicted 710,000 fewer rotavirus hospitalizations, a 49% decrease from the 1,452,000 baseline hospitalizations and 35,000 fewer rotavirus deaths, a 40% decrease from the 88,000 baseline deaths if all 43 Asian countries had introduced rotavirus vaccine. Similar reductions were projected in subanalyses by vaccine introduction status, subregion, and birth cohort size.</p> <p><b>Conclusion</b>: Rotavirus vaccines will substantially reduce morbidity and mortality due to rotavirus infections in Asia.</p

Association between health outcomes and potential mediator.

<p>Association between health outcomes and potential mediator.</p

Socioeconomic Gradient in Childhood Obesity and Hypertension: A Multilevel Population-Based Study in a Chinese Community

<div><p>Background</p><p>This study aims to assess evidence for any socioeconomic gradients in childhood obesity and hypertension in a population-representative sample in Hong Kong, China.</p><p>Methods</p><p>The data of a stratified random sampled growth survey collected in 2005–2006 was matched with a population by-census. Obesity was defined using the International Obesity Task Force standard and hypertension was defined using the Hong Kong norm table. Family socioeconomic status (SES) was measured by maternal education level. Neighbourhood SES was measured by median household income of the neighbourhood. Multilevel Poisson regression models with robust standard error were used to test the association. Body mass indices of children’s parents were included as potential confounders. Intra-school/neighbourhood correlations were adjusted using random factors.</p><p>Results</p><p>Totally 14842 children (age 6–19 years) included in the analysis, in which 16.6% of them were overweight or obese. Children whose mother only completed secondary school or below had higher risk of childhood obesity (RR 1.41, 95% CI 1.13–1.76, p = 0.003) and hypertension (RR 1.18, 95% CI 1.01–1.36, p = 0.03). Meanwhile, children in the lowest neighbourhood SES group had higher risk of childhood underweight (RR 1.61, 95% CI 1.04–2.49, p = 0.03), overweight (RR 1.35, 95% CI 1.05–1.72, p = 0.02), and obesity (RR 2.07, 95% CI 1.11–3.88, p = 0.02).</p><p>Conclusions</p><p>Socioeconomic gradient in childhood obesity and hypertension existed in Hong Kong, one of the most developed cities in China. These results have implications for policymakers and public health experts and highlight the need to monitor trends in other parts of China.</p></div

Prevalence and population attributable fractions of weight and hypertension problems by SES.

<p>Prevalence and population attributable fractions of weight and hypertension problems by SES.</p

Adjusted associations between SES and weight and hypertension status.

<p>All associations were estimated after the adjustment of child’s gender and age, paternal and maternal BMI, and intra-cluster correlation. Tertiary maternal education and low neighbourhood income were the reference groups. Error bars show the 95% confidence intervals. **: p < 0.01; *: p < 0.05</p

Participant characteristics.

<p>Participant characteristics.</p

Lifestyle Intervention Using an Internet-Based Curriculum with Cell Phone Reminders for Obese Chinese Teens: A Randomized Controlled Study

<div><p>Objectives</p><p>Obesity is an increasing public health problem affecting young people. The causes of obesity are multi-factorial among Chinese youth including lack of physical activity and poor eating habits. The use of an internet curriculum and cell phone reminders and texting may be an innovative means of increasing follow up and compliance with obese teens. The objectives of this study were to determine the feasibility of using an adapted internet curriculum and existing nutritional program along with cell phone follow up for obese Chinese teens.</p><p>Design and Methods</p><p>This was a randomized controlled study involving obese teens receiving care at a paediatric obesity clinic of a tertiary care hospital in Hong Kong. Forty-eight subjects aged 12 to 18 years were randomized into three groups. The control group received usual care visits with a physician in the obesity clinic every three months. The first intervention (IT) group received usual care visits every three months plus a 12-week internet-based curriculum with cell phone calls/texts reminders. The second intervention group received usual care visits every three months plus four nutritional counselling sessions.</p><p>Results</p><p>The use of the internet-based curriculum was shown to be feasible as evidenced by the high recruitment rate, internet log-in rate, compliance with completing the curriculum and responses to phone reminders. No significant differences in weight were found between IT, sLMP and control groups.</p><p>Conclusion</p><p>An internet-based curriculum with cell phone reminders as a supplement to usual care of obesity is feasible. Further study is required to determine whether an internet plus text intervention can be both an effective and a cost-effective adjunct to changing weight in obese youth.</p><p>Trial Registration</p><p>Chinese Clinical Trial Registry <a href="http://www.chictr.org/en/proj/search.aspx/ChiCTR-TRC-12002624" target="_blank">ChiCTR-TRC-12002624</a></p></div

Age distribution of children with human parechovirus (HPeV) infection.

<p>All: all 88 children infected with HPeV. Acute GE: 27 children with HPeV regarded as a “probable” cause of acute gastroenteritis. Acute Resp: 11 children with HPeV infection regarded as a “probable” cause of acute respiratory illness. Acute Rash: 12 children with HPeV infection regarded as a “probable” cause of rash illness. Suspected Neuro: 6 children developed convulsion or pallid attack with HPeV as a coinfection with other pathogen(s).</p

Age distribution of children according to the type of human parechovirus (HPeV).

<p>Age distribution of children according to the type of human parechovirus (HPeV).</p

Characteristics of children with rash illness.

<p>Characteristics of children with rash illness.</p