BackgroundThe recent H1N1 influenza A pandemic was marked by multiple reports of illness and hospitalization in children, suggesting that children may have played a major role in the propagation of the virus. A comprehensive detailed analysis of the attack rates among children as compared with their contacts in various settings is of great importance for understanding their unique role in influenza pandemics.Methodology/Principal FindingsWe searched MEDLINE (PubMed) and Embase for published studies reporting outbreak investigations with direct measurements of attack rates of the 2009 pandemic H1N1 influenza A among children, and quantified how these compare with those of their contacts. We identified 50 articles suitable for review, which reported school, household, travel and social events. The selected reports and our meta-analysis indicated that children had significantly higher attack rates as compared to adults, and that this phenomenon was observed for both virologically confirmed and clinical cases, in various settings and locations around the world. The review also provided insight into some characteristics of transmission between children and their contacts in the various settings.Conclusion/SignificanceThe consistently higher attack rates of the 2009 pandemic H1N1 influenza A among children, as compared to adults, as well as the magnitude of the difference is important for understanding the contribution of children to disease burden, for implementation of mitigation strategies directed towards children, as well as more precise mathematical modeling and simulation of future influenza pandemics.
The objective of this integrative review was to describe current US
trends for health technology-enabled adherence interventions among behaviorally
HIV-infected youth (ages 13–29 years), and present the feasibility and
efficacy of identified interventions. A comprehensive search was executed across
five electronic databases (January 2005–March 2016). Of the 1911
identified studies, nine met the inclusion criteria of quantitative or mixed
methods design, technology-enabled adherence and or retention intervention for
US HIV-infected youth. The majority were small pilots. Intervention dose varied
between studies applying similar technology platforms with more than half not
informed by a theoretical framework. Retention in care was not a reported
outcome, and operationalization of adherence was heterogeneous across studies.
Despite these limitations, synthesized findings from this review demonstrate
feasibility of computer-based interventions, and initial efficacy of SMS texting
for adherence support among HIV-infected youth. Moving forward, there is a
pressing need for the expansion of this evidence base.
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