Evaluation of Intussusception after Monovalent Rotavirus Vaccination in Africa.

Postlicensure evaluations have identified an association between rotavirus vaccination and intussusception in several high- and middle-income countries. We assessed the association between monovalent human rotavirus vaccine and intussusception in lower-income sub-Saharan African countries.Using active surveillance, we enrolled patients from seven countries (Ethiopia, Ghana, Kenya, Malawi, Tanzania, Zambia, and Zimbabwe) who had intussusception that met international (Brighton Collaboration level 1) criteria. Rotavirus vaccination status was confirmed by review of the vaccine card or clinic records. The risk of intussusception within 1 to 7 days and 8 to 21 days after vaccination among infants 28 to 245 days of age was assessed by means of the self-controlled case-series method.Data on 717 infants who had intussusception and confirmed vaccination status were analyzed. One case occurred in the 1 to 7 days after dose 1, and 6 cases occurred in the 8 to 21 days after dose 1. Five cases and 16 cases occurred in the 1 to 7 days and 8 to 21 days, respectively, after dose 2. The risk of intussusception in the 1 to 7 days after dose 1 was not higher than the background risk of intussusception (relative incidence [i.e., the incidence during the risk window vs. all other times], 0.25; 95% confidence interval [CI], <0.001 to 1.16); findings were similar for the 1 to 7 days after dose 2 (relative incidence, 0.76; 95% CI, 0.16 to 1.87). In addition, the risk of intussusception in the 8 to 21 days or 1 to 21 days after either dose was not found to be higher than the background risk.The risk of intussusception after administration of monovalent human rotavirus vaccine was not higher than the background risk of intussusception in seven lower-income sub-Saharan African countries. (Funded by the GAVI Alliance through the CDC Foundation.)

The clinicohistopathologic study of oral submucous fibrosis: A new staging system with treatment strategies

Introduction: Oral submucous fibrosis (OSMF), a precancerous condition, is highly prevalent in the Indian subcontinent. The current classification systems focus on either clinical and/or histopathologic features; hence, a need has arisen to formulate a staging system with emphasis on treatment strategies. Aims and Objectives: The objective of the study was to devise the staging system which is suggestive of treatment strategies based on the clinical and histopathological staging. Study Design: The study sample consisted of 100 OSMF patients categorized into clinical stages of Andrade and Khanna′s staging system and histological grading of Andrade and Khanna′s grading system. Thereafter, clinical features were reevaluated for modifying the Andrade and Khanna′s staging system. Results: Based on the findings of the current study, certain clinical features were modified among all the stages of Andrade and Khanna′s classification system for OSMF. Conclusion: The present study has devised a new staging system for OSMF with objective clinical and histopathological criteria which provide guidance for treatment plan

Body height from tooth size: A novel study on stature estimation by odontometric parameters

Introduction: Stature is the height of a person in the upright posture. Based upon the principle that the various long bones correlate positively with stature, stature correlation to skull and jaw dimensions has been frequently reported among various populations. Objective: The study was conducted to investigate the possibility of predicting the height of an individual using selected odontometric parameters as a forensic tool. Materials and Methods: The study sample consisted of 100 randomly selected subjects. Measurements of maxillary intercanine width (IC), maxillary interpremolar width (IP), and mesiodistal width of six permanent maxillary anterior teeth (CW) were made directly on the subject by means of a digital vernier caliper. Height (H) of patients was measured with anthropometer. Results: Significant correlation was observed between height and maxillary IC width (P < 0.05), whereas correlation between height and the combined width of six anterior teeth as well as IP width was found to be nonsignificant. Conclusion: The maxillary IC width can be used successfully to calculate the stature of an individual from fragmentary remains

Adolescents and age of consent to HIV testing: an updated review of national policies in sub-Saharan Africa.

OBJECTIVES: In sub-Saharan Africa (SSA) where HIV burden is highest, access to testing, a key entry point for prevention and treatment, remains low for adolescents (aged 10-19). Access may be hampered by policies requiring parental consent for adolescents to receive HIV testing services (HTS). In 2013, the WHO recommended countries to review HTS age of consent policies. Here, we investigate country progress and policies on age of consent for HIV testing. DESIGN: Comprehensive policy review. DATA SOURCES: Policies addressing HTS were obtained through searching WHO repositories and governmental and non-governmental websites and consulting country and regional experts. ELIGIBILITY CRITERIA: HTS policies published by SSA governments before 2019 that included age of consent. DATA EXTRACTION AND SYNTHESIS: Data were extracted on HTS age of consent including exceptions based on risk and maturity. Descriptive analyses of included policies were disaggregated by Eastern and Southern Africa (ESA) and Western and Central Africa (WCA) subregions. RESULTS: Thirty-nine policies were reviewed, 38 were eligible; 19/38 (50%) permitted HTS for adolescents ≤16 years old without parental consent. Of these, six allowed HTS at ≥12 years old, two at ≥13, two at ≥14, five at ≥15 and four at ≥16. In ESA, 71% (n=15/21) allowed those of ≤16 years old to access HTS, while only 24% (n=6/25) of WCA countries allowed the same. Maturity exceptions including marriage, sexual activity, pregnancy or key population were identified in 18 policies. In 2019, 63% (n=19/30) of policies with clear age-based criteria allowed adolescents of 12-16 years old to access HIV testing without parental consent, an increase from 37% (n=14/38) in 2013. CONCLUSIONS: While many countries in SSA have revised their HTS policies, many do not specify age of consent. Revision of SSA consent to HTS policies, particularly in WCA, remains a priority to achieve the 2025 goal of 95% of people with HIV knowing their status