A cluster randomized non-inferiority field trial on the immunogenicity and safety of tetanus toxoid vaccine kept in controlled temperature chain compared to cold chain234

BACKGROUND: In resource-poor settings, cold chain requirements present barriers for vaccine delivery. We evaluated the immunogenicity and safety of tetanus toxoid (TT) vaccine in &quot;Controlled Temperature Chain&quot; (CTC; up to 40 degrees C for &lt;30 days before administration), compared to standard cold chain (SCC; 2-8 degrees C). Prior to the study, stability parameters of TT-CTC were shown to meet international requirements. METHODS: A cluster randomized, non-inferiority trial was conducted in Moissala district, Chad, December 2012-March 2013. Thirty-four included clusters were randomized to CTC or SCC. Women aged 14-49 years, eligible for TT vaccination and with a history of &lt;/=1 TT dose, received two TT doses 4 weeks apart. Participants were blinded to allocation strategy. Tetanus antibody titers were measured using standard ELISA at inclusion and 4 weeks post-TT2. Primary outcome measures were post-vaccination seroconversion and fold-increase in geometric mean concentrations (GMC). Non-inferiority was by seroconversion difference (TTSCC-TTCTC) &lt;5% and ratio of GMCs (TTSCC/TTCTC) &lt;1.5. Adverse events were monitored at health centers and at next contact with participants. RESULTS: A total of 2128 women (CTC=1068; SCC=1060) were recruited. Primary intention to vaccinate analysis included 1830 participants; 272 of these were included in the seroconversion analysis. Seroconversion was reached by &gt;95% of participants; upper 95%CI of the difference was 5.6%. Increases in GMC were over 4-fold; upper 95%CI of GMC ratio was 1.36 in the adjusted analysis. Few adverse events were recorded. CONCLUSIONS: This study demonstrates the immunogenicity and safety of TT in CTC at &lt;40 degrees C for &lt;30 days. The high proportion of participants protected at baseline results in a reduction of power to detect a 5% non-inferiority margin. However, results at a 10% non-inferiority margin, the comparable GMC increases and vaccine&#039;s stability demonstrated in the preliminary phase indicate that CTC can be an alternative strategy for TT delivery in situations where cold chain cannot be maintained</p

Egg masses of the Patagonian squid Doryteuthis (Amerigo) gahi

Egg masses of the Patagonian squid Doryteuthis (Amerigo) gahi attached to giant kelp (Macrocystis pyrifera) in the Magellanic channels of the sub-Antarctic ecoregion in southern South America is documented for the first time. Of seven egg masses observed between 2008 and 2011, one was taken to the laboratory to be analysed and photographed. Comprising long transparent capsules containing eggs, the masses were strongly attached to the stipes of M. pyrifera. This macroalgae is a potentially important economic resource due to its multiple industrial uses; this study shows that it also serves an important ecological role as a spawning substrate for D. gahi

Validation française du Caregiving Strain Questionnaire sur une population de parents d’enfants avec troubles du spectre de l’autisme

International audienc