IntroductionRotavirus (RV) vaccination was introduced in Belgium in 2006. With the high uptake it had (>85%), a sharp decline in hospitalizations was observed during the first years after vaccine introduction. The objective of this study was to investigate whether this decline was maintained and to simulate projections.MethodsThe Rotavirus Belgium Impact Study allowed an analysis of the RV vaccine impact amongst children in 11 hospitals in Belgium over a 9-year period (2005–2013) with 2 years pre- and 7 years post-vaccine introduction. Results were compared by year and by subsequent birth cohort aging up to 5 years. The two different analysis methods helped dismantling the different (direct and indirect) effects of vaccine protection to simulate future hospitalization trends.ResultsDuring the whole observation period, 40,552 RV detection tests were performed of which 5832 were positive (14.4%). After RV vaccine introduction, a significant reduction in number of tests performed (−38%) was combined with a dramatic drop in numbers of positive tests (−76.6%). The decreases were spectacular during the first two years of vaccine introduction; after that period, the decrease flattened. Cross-sectional comparison with cohort data showed that the initial drop was heavily influenced by the herd effect of the vaccine. Cohort analysis demonstrated a low rate of residual disease over time, suggesting another infection source other than the child population.ConclusionThe residual disease will be maintained in the community when a same vaccination strategy is continued over time, starting vaccination of children only at 6 weeks’ time.FundingGlaxoSmithKline Biologicals SA.Trial registrationClinicalTrials.gov identifier, NCT01563146.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-015-0099-1) contains supplementary material, which is available to authorized users.
During each winter period hospital emergency rooms and pediatric wards are often overwhelmed by high patient influx with infectious diseases leading to chaotic conditions with poor quality of care (QoC) delivery as a consequence. The conditions could be improved if we were able to better control the influx by introducing for instance better prevention strategies against some of the most frequent infectious diseases. New prevention strategies using vaccination against rotavirus infection were introduced in Belgium in November 2006. We developed a measure of hospital QoC suitable for assessing the impact of pediatric rotavirus vaccination. The study is retrospective collecting routine data on bed and staff management in one pediatric hospital in Belgium. The data were divided in pre-and post-vaccination periods during rotavirus-epidemic and non-epidemic periods. The scores were constructed using Explanatory Factor Analysis (EFA). All patients enrolled were admitted to the pediatric ward over the period from 1 January 2004 to 31 December 2009. The results of the epidemic period indicated that bed-day occupancy, bed-day turnover and unplanned readmissions for acute gastroenteritis were lower in the post-vaccination compared with the pre-vaccination periods. The QoC scores were therefore significantly lower (indicating improved QoC) after the introduction of rotavirus vaccination, compared with pre-vaccination. The data suggests that the reduction in the winter peak of rotavirus-related hospitalizations after the introduction of the vaccine reduces pressure on hospital resources and improves the quality of hospital care. The findings should be further tested in similar settings.
Serum progesterone and estrogen concentrations were investigated during pregnancy and few days after birth. Blood samples were collected twice / month from 24 numbered animals ( 12ewes and 12 does) . serum was isolated and kept under -20C untill hormonal analysis. Enzyme -Linked Immunosorbent assay (ELISA) using (ELISA Reader Dona 3200). Progesterone concentrations of pregnant ewes and does were showed steadily increased to reach 24.9+ 2.5 ng/ml and 30.34+ 2.3ng/ml in ewes and does, during 4 th month and declined to 0.6 and 2.5 ng/ ml after birth in ewes and does, respectively. Estrogen hormone levels in ewes were increased significantly during pregnancy to maximum 98.7+4.3ng/ml by 5 th month and sharply declined to 4.1+0.06 after birth. While in does estrogen level increased significantly and steadily to 1150.6+ 6.23 pg/ml during last month of pregnancy and to 5.9+ 0.4 pg/ml after birth. The present work indicated levels of progesterone hormone increased during 1 st and 2 nd months in ewes and does, while the significant increased from 3 rd month on .Estrogen reach maximum concentrations during last month in doe Which higher about 11 times than that of ewes .It is useful means to diagnosis pregnancy of ewes and does by hormonal methods after mating 20-30 days.
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