Age at cytomegalovirus, Epstein Barr virus and varicella zoster virus infection and risk of atopy: The Born in Bradford cohort, UK.

BACKGROUND: The prevalence of allergic diseases has increased in recent decades, but the causes remain unclear. Changes in the epidemiology of childhood infections could have contributed, but the current evidence is inconclusive. This study aims to investigate whether age at cytomegalovirus (CMV), Epstein-Barr virus (EBV) or varicella zoster virus (VZV) infection is associated with the development of atopy. METHODS: A total of 2559 children were enrolled in the Born in Bradford Allergy and Infection Study. Serum samples collected at 12 and 24 months were tested for CMV-IgG, EBV-IgG and VZV-IgG for 1000 children to establish age at infection. Skin prick testing (SPT) was conducted at age 4 years. RESULTS: Serology and SPT results were available for 740 children. Of these, 135 (18%) were atopic. In girls, there was a strong association of CMV infection in the second year with increased odds of atopy (adjusted OR 4.38, 95% CI 1.87-10.29) but this was not observed in boys. Age at EBV or VZV infection was not associated with risk of atopy in unadjusted analysis, but there was effect modification by sex; girls infected with VZV in the second year of life had increased odds of atopy (adjusted OR 2.85, 95% CI 1.29-6.30). CONCLUSIONS: Our results highlight potential sex-specific effects of age at CMV infection and age at VZV infection on risk of atopy, which provide insight into the mechanisms involved in the development of atopy

Cytomegalovirus, Epstein-Barr virus and varicella zoster virus infection in the first two years of life: a cohort study in Bradford, UK.

BACKGROUND: Cytomegalovirus (CMV), Epstein Barr virus (EBV) and varicella-zoster virus (VZV) are common herpesviruses frequently acquired in childhood, which establish persistent, latent infection and are likely to impact the developing immune system. Little is known about the epidemiology of CMV and EBV infections in contemporary UK paediatric populations, particularly whether age at infection differs by ethnic group. METHODS: Children enrolled in the Born in Bradford Allergy and Infection Study had a blood sample taken and a questionnaire completed at 12 and 24 months of age. Ordered logistic regression quantified associations between ethnicity and other risk factors and age at CMV/EBV/VZV infection (<12 months, 12-24 months, uninfected at 24 months). RESULTS: Pakistani children (n = 472) were more likely to be infected with CMV and EBV at a younger age than White British children (n = 391) (CMV: adjusted odds ratio (OR) 2.53, 95% confidence interval (CI) 1.47-4.33; EBV: adjusted OR 2.16, 95% CI 1.43-3.26). Conversely, Pakistani children had lower odds of being VZV infected in the second year than White British children (adjusted OR 0.57, 95% CI 0.33-0.97). There was a strong association between increasing birth order and later CMV infection in Pakistani children. CONCLUSIONS: We report large differences in CMV and EBV incidence in the first 2 years between Pakistani and White British children born in Bradford, which cannot be explained by differences in risk factors for infection. Our data will inform the optimum schedule for future CMV and EBV vaccination programmes

Seroprevalence of cytomegalovirus, Epstein Barr virus and varicella zoster virus among pregnant women in Bradford: a cohort study.

OBJECTIVE: To estimate the seroprevalence of cytomegalovirus (CMV), Epstein Barr virus (EBV) and varicella zoster virus (VZV) among pregnant women in Bradford by ethnic group and country of birth. METHODS: A stratified random sample of 949 pregnant women enrolled in the Born in Bradford birth cohort was selected to ensure sufficient numbers of White UK born women, Asian UK born women and Asian women born in Asia. Serum samples taken at 24-28 weeks' gestation were tested for CMV IgG, EBV IgG and VZV IgG. Each woman completed a questionnaire which included socio-demographic information. RESULTS: CMV seroprevalence was 49% among the White British women, 89% among South Asian UK born women and 98% among South Asian women born in South Asia. These differences remained after adjusting for socio-demographic factors. In contrast, VZV seroprevalence was 95% among women born in the UK but significantly lower at 90% among South Asian women born in Asia. EBV seroprevalence was 94% overall and did not vary by ethnic group/country of birth. CONCLUSIONS: Although about half of White British women are at risk of primary CMV infection in pregnancy and the associated increased risk of congenital infection, most congenital CMV infections are likely to be in children born to South Asian women with non-primary infection during pregnancy. South Asian women born in South Asia are at risk of VZV infection during pregnancy which could produce congenital varicella syndrome or perinatal chickenpox. Differences in CMV and VZV seroprevalence by ethnic group and country of birth must be taken into account when universal immunisation against these viruses is contemplated

Routinely available cotrimoxazole prophylaxis and occurrence of respiratory and diarrhoeal morbidity in infants born to HIV-infected mothers in South Africa

Objectives. To examine the influence of cotrimoxazole (CTM) prophylaxis on incidence of lower  respiratory tract infections (LRTis) and diarrhoea.Design. A prospective observational cohort study. Morbidity and feeding data on infants born to HN-infected mothers were collected routinely at. clink visits at 1 week, 6 weeks and 3 months, and 3-monthly thereafter, with blood drawn for determining HIV status.Setting. Two hospitals in Durban, South Africa. In one hospital (King Edward VIII Hospital), infants born to HIVinfected mothers recieved CTM prophylaxis and in the other (McCord Hospital) infants did not  receive CTM prophylaxis,Subjects. Infants born to HIV-infected mothers.Outcome measures. Incidence of .LRTI and diarrhoea.Results, Ill. multivariate analysis controlling for breast-feeding status, number of clinic visits and HN infection status, HIVinfected infants with access to C1M prophylaxis had a significantly lower incidence of LRTI (82%) than those without access to prophylaxis. However in HIV-uninfected infants, this was not the case, CTM prophylaxis was associated with a non-significant increased risk for diarrhoea in both infected (odds ratio (OR) 1.58, p = 0.45) aud uninfected infants (OR 1.52, p = 0.10).Conclusions, This observational study .confirms current thinking that CTM prophylaxis is protective  against LRTis in HIV-infected children. However, because of a possible association between CTM prophylaxis and an increased risk of diarrhoea, HIV status of infants should be determined as early as possible in order to prevent tmnecessary exposure of uninfected infants to CTM prophylaxis, while further studies to quantify both beneficial and adverse effects. of CTM prophylaxis are undertaken

Association between mode of delivery and body mass index at 4-5 years in White British and Pakistani children: the Born in Bradford birth cohort.

BACKGROUND: Globally, it is becoming more common for pregnant women to deliver by caesarean section (CS). In 2020, 31% of births in England were CS, surpassing the recommended prevalence of CS. Concerns have been raised regarding potential unknown consequences of this mode of delivery. Childhood adiposity is also an increasing concern. Previous research provides inconsistent conclusions on the association between CS and childhood adiposity. More studies are needed to investigate the consequences of CS in different populations and ethnicities. Therefore, this study investigates the association between mode of delivery and BMI, in children of 4-5 years and if this differs between White British (WB) and Pakistani ethnicities, in Bradford UK. METHODS: Data were obtained from the Born in Bradford (BiB) cohort, which recruited pregnant women at the Bradford Royal Infirmary, between 2007 and 2010. For these analyses, a sub-sample (n = 6410) of the BiB cohort (n = 13,858) was used. Linear regression models determined the association between mode of delivery (vaginal or CS) and BMI z-scores at 4-5 years. Children were categorised as underweight/healthy weight, overweight and obese, and logistic regression models determined the odds of adiposity. Effect modification by ethnicity was also explored. RESULTS: Multivariable analysis found no evidence for a difference in BMI z-score between children of CS and vaginal delivery (0.005 kg/m2, 95% CI = - 0.062-0.072, p = 0.88). Neither was there evidence of CS affecting the odds of being overweight (OR = 1.05, 95% CI = 0.86-1.28, p = 0.65), or obese (OR = 0.98, 95% CI = 0.74-1.29, p = 0.87). There was no evidence that ethnicity was an effect modifier of these associations (p = 0.97). CONCLUSION: Having CS, compared to a vaginal delivery, was not associated with greater adiposity in children of 4-5 years in this population. Concerns over CS increasing adiposity in children are not supported by the findings reported here using the BiB study population, of both WB and Pakistani families

Strategi Pengembangan Pasar Tradisional Di Kota Semarang

Traditional Market is a favorite place for people, especially the low and middle class to buy the daily needs. Traditional Market has a characteristic, which is the bidding process. Traditional markets in Semarang is one contributor to PAD through the levy and able to absorb a lot of labor as seller\u27s market, pedicab drivers, parking attendants and porters. Currently there are 44 traditional markets in the Semarang. The purpose of this research is to identify factors supporting and obstructing the development of traditional markets in Semarang and formulate the strategy of development traditional markets in Semarang. This research uses qualitative descriptive method by using informant from the Department of Market in Semarang, traditional market seller and the public as a visitor the traditional market in the Semarang. The analysis process begins with identifying the internal and external environment of Department of Market in Semarang using the SWOT analysis to obtain the issues of strategy and then measured by Litmus test. Results of the research strategy of development traditional markets in Semarang City through SWOT analysis contained eight Issues Strategy. Based on the results of litmus test, strategy of development traditional market with the highest score are Optimalizing development and revitalization of traditional markets include ease of access for society and seller and development of traditional markets by utilizing the potential and characteristics

Factors predicting amoxicillin prescribing in primary care among children: a cohort study

Background: Antibiotic prescribing during childhood contributes to antimicrobial resistance, which is a major public health concern. Antibiotics are most commonly prescribed to children for respiratory tract infections (RTI). / Aim: To identify factors associated with amoxicillin prescribing and RTI consultation attendance in primary care in young children. / Design and Setting: Cohort study in Bradford with data from pregnancy to age 24-months collected between 2007-2013, linked to electronic primary care and air pollution data. / Methods: We calculated amoxicillin prescribing rates/1,000 child-years, and fitted mixed-effects logistic regression models, with general practice (GP) surgery as the random effect, to establish risk factors for amoxicillin prescribing and RTI consultation during the first two years. / Results: Among 2,493 children, the amoxicillin prescribing rate was 710/1,000 child-years during the first year (95% CI: 677-744) and 780/1,000 (745-816) during the second year. Odds of amoxicillin prescribing during year one were higher for infants who were male (adjusted OR 1.4 (1.1-1.6)), socio-economically deprived (1.4 (1.0-1.9)), and with a Pakistani ethnic background (1.4 (1.1-1.9)). Odds of amoxicillin prescribing during the second year were higher for infants with a Pakistani ethnic background (1.5 (1.1-2.0)/1.6 (1.2-2.0)) and pre-/early-term infants (1.2 (1.0-1.5)). Additional risk factors included caesarean delivery, congenital anomalies, household overcrowding, birth season, and formal childcare attendance. GP surgery-level variation explained 7-9% of variation in amoxicillin prescribing. / Conclusions: Socio-economic status and ethnic background are strongly associated with amoxicillin prescribing and RTI consultations during childhood. Interventions reducing RTI spread in household and childcare settings may reduce antibiotic prescribing in primary care