While there have been no cases of type-2 wild poliovirus for over 20 years, transmission of type-2 vaccine-derived poliovirus (VDPV2) and associated paralytic cases in several continents represent a threat to eradication. The withdrawal of the type-2 component of oral poliovirus vaccine (OPV2) was implemented in April 2016 to stop VDPV2 emergence and secure eradication of all poliovirus type 2. Globally, children born after this date have limited immunity to prevent transmission. Using a statistical model, we estimate the emergence date and source of VDPV2s detected between May 2016 and November 2019. Outbreak response campaigns with monovalent OPV2 are the only available method to induce immunity to prevent transmission. Yet, our analysis shows that using monovalent OPV2 is generating more paralytic VDPV2 outbreaks with the potential for establishing endemic transmission. The novel OPV2 is urgently required, alongside a contingency strategy if this vaccine does not materialize or perform as anticipated.
Summaryobjective This paper describes determinants of insecticide treated net (ITN) ownership and use in malarious areas of Eritrea. With ITN distribution and re-treatment now free for all living in these areas, we examine barriers (other than cost) to access and use of ITNs. We explore the differences between use of an ITN as a proportion of all households in the survey (the roll back malaria indicator), and use of an ITN as a proportion of those households who already own an ITN.methods A modified two-stage cluster design was used to collect data from a sample of households (n ¼ 2341) in the three most malarious administrative zobas (zones or provinces). Logistic regression was used to analyse the data.results Our findings suggest environmental heterogeneity among zobas (including program effects specific to each zoba), perception of risk, and proximity to a clinic are important predictors of ITN possession and use. Among households with at least one ITN, 17.0% reported that children under five were not under an ITN the night before the survey, while half of all such households did not have all occupants using them the night before the survey. The number of ITNs, as well as zoba, was also significant determinants of use in these households with at least one ITN.
There had been a few challenges in the introduction of Hepatitis B vaccination in India, however, this provide opportunity to learn for future scale up. For successful introduction and expansion of any new vaccine in national or state immunization program; clear and timely central level instructions and oversight and improved stock management is required. At state and district levels; quality trainings, effective supervision and monitoring, improving data recording and reporting are key factor for success. The additional focus on Hep B birth dose administration may help in improving coverage.
Until there is an effective vaccine, changing sexual behavior (e.g., use of condoms or fewer partners) is still the only course of action that can slow the spread of HIV for most Africans. But exactly which factors influence behavior change and how are still debated. This article examines the notion that as the HIV/AIDS epidemic strengthens and spreads through communities in Africa, and mortality mounts, behaviors that prevent transmission should be changing. We focus on men in three countries--Uganda, Kenya, and Zambia--examining determinants of their behavior change, and analyze the relative importance of knowing someone who has died of AIDS as compared with other factors such as age, education level, knowledge of HIV/AIDS, economic status, and marital status. Data from three DHS surveys in Uganda (1995), Zambia (1996), and Kenya (1998) are fitted to a model predicting behavior change. Results from this cross-sectional, multinational study suggest that married and working men aged 20-40 are significantly more likely to have changed their behavior. Personal experience of AIDS is a significant predictor of behavior change in Uganda and Zambia, and is marginally significant in Kenya. One implication in the context of the epidemic is that behavior change is partly determined by the high level of mortality experienced by African communities. A second implication is that higher levels of disclosure, or lower levels of denial of AIDS as a cause of death, may help individuals change their behavior.
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