Differences between demographic groups in the coverage of dose 1, timely dose 1, and series completion for Hib vaccine and PCV in Shanghai children, 2012.

<p>Hib: Haemophilus influenzae type b; PCV: 7-valent pneumococcal conjugate vaccine.</p><p>*P<0.05, chi-square test from binomial regression with identity link.</p><p>**P<0.0001, chi-square test from binomial regression with identity link.</p>a<p>Series completion was calculated for only those children with dose 1; variable constructed from manufacturers' recommendations.</p>b<p>Timeliness was constructed from manufacturers' recommendations.</p>c<p>The likelihood ratio test comparing adjusted models 1 and 2 was not significant for the outcome “PCV series completion,” indicating that the fit did not improve with the addition of the interaction term.</p

Coverage of dose 1, series completion, and timely dose 1 for Hib vaccine and PCV by sex, birth year and residency status of Shanghai children, 2012.

<p>Hib: <i>Haemophilus influenzae</i> type b; PCV: 7-valent pneumococcal conjugate vaccine.</p><p>*P<0.05, chi-square test of homogeneity across demographic characteristic.</p><p>**P<0.0001, chi-square test of homogeneity across demographic characteristic or Fisher's Exact Test.</p>a<p>Series completion was calculated for only those children with dose 1; variable constructed from manufacturers' recommendations.</p>b<p>Timeliness was constructed from manufacturers' recommendations.</p

Demographic characteristics, birth year, and residency status of the study population, Shanghai, China, 2012.

<p>Demographic characteristics, birth year, and residency status of the study population, Shanghai, China, 2012.</p

Vaccines^a available in Shanghai, China, in 2012.

a<p>Vaccine list is non-exhaustive.</p>b<p>In addition, many vaccines on the EPI list are also available for a fee from international vaccine manufacturers.</p

Trends of vaccine-preventable diseases in Afghanistan from the Disease Early Warning System, 2009–2015

<div><p>Background</p><p>Afghanistan’s public health system was neglected during decades of military and civil conflict, and trends in infectious disease occurrence remain poorly characterized. This study examines cyclical and long-term trends of six vaccine-preventable diseases: pneumonia, diarrhea, meningitis, typhoid, measles, and acute viral hepatitis.</p><p>Methods</p><p>Using weekly data collected between 2009 and 2015 through Afghanistan’s Disease Early Warning System, we calculated monthly case counts, and fit a Poisson regression with a Fourier transformation for seasonal cycles and dummy variables for year.</p><p>Results</p><p>We found the greatest incidence of diarrhea and typhoid in the summer, pneumonia in the winter, and measles in the late spring. Meningitis and acute viral hepatitis did not demonstrate substantial seasonality. Rates of pneumonia and diarrhea were constant across years whereas rates of meningitis, typhoid, and acute viral hepatitis decreased. Measles incidence increased in 2015.</p><p>Conclusions</p><p>Communicable disease reporting systems can guide public health operations–such as the implementation of new vaccines, and permit evaluation of health interventions. For example, measles supplementary immunization activities in Afghanistan have not slowed long-term transmission of the disease, but decreases in typhoid fever and acute viral hepatitis are probably tied to improvements in sanitation in the country.</p></div

Characteristics of suspected cases of six diseases from Afghanistan’s Disease Early Warning System, 2009–2015.

<p>Characteristics of suspected cases of six diseases from Afghanistan’s Disease Early Warning System, 2009–2015.</p

Diarrhea characteristics in Afghanistan’s Disease Early Warning System, 2015.

<p>Diarrhea characteristics in Afghanistan’s Disease Early Warning System, 2015.</p

Annual and seasonal trends for suspected cases of six diseases from Afghanistan’s Disease Early Warning System, 2009–2015.

<p>Annual and seasonal trends for suspected cases of six diseases from Afghanistan’s Disease Early Warning System, 2009–2015.</p

Observed and modeled data from six diseases in Afghanistan’s Disease Early Warning System, 2009–2015.

<p>Observed and modeled data from six diseases in Afghanistan’s Disease Early Warning System, 2009–2015.</p

Demographic distribution of study participants in Shanghai, China.

<p>Demographic distribution of study participants in Shanghai, China.</p