Browsing by Author "Danovaro-Holliday, M Carolina"
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Item Factors associated with reported diarrhoea episodes and treatment-seeking in an urban slum of Kolkata, India.(2004-06-12) Sur, Dipika; Manna, Byomkesh; Deb, Alok K; Deen, Jacqueline L; Danovaro-Holliday, M Carolina; von Seidlein, Lorenz; Clemens, John D; Bhattacharya, Sujit KIn an urban slum in eastern Kolkata, India, reported diarrhoea rates, healthcare-use patterns, and factors associated with reported diarrhoea episodes were studied as a part of a diarrhoea-surveillance project. Data were collected through a structured interview during a census and healthcare-use survey of an urban slum population in Kolkata. Several variables were analyzed, including (a) individual demographics, such as age and educational level, (b) household characteristics, such as number of household members, religious affiliation of the household head, building material, expenditure, water supply and sanitation, and (c) behaviour, such as hand-washing after defecation and healthcare use. Of 57,099 study subjects, 428 (0.7%) reported a diarrhoea episode sometime during the four weeks preceding the interview. The strongest independent factors for reporting a history of diarrhoea were having another household member with diarrhoea (adjusted odds ratio [OR]=3.8; 95% confidence interval [CI] 3.3-4.4) and age less than 60 months (adjusted OR=3.7; 95% CI 3.0-4.7). The first choice of treatment by the 428 subjects was as follows: 151 (35%) had self- or parent-treatment, 150 (35%) consulted a private allopathic practitioner, 70 (16%) went directly to a pharmacy, 29 (7%) visited a hospital, 14 (3%) a homoeopathic practitioner, 2 (0.5%) an ayurvedic practitioner, and 12 (3%) other traditional healers. The choices varied significantly with the age of patients and their religion. The findings increase the understanding of the factors and healthcare-use patterns associated with diarrhoea episodes and may assist in developing public-health messages and infrastructure in Kolkata.Item The feasibility of a school-based VI polysaccharide vaccine mass immunization campaign in Hue City, central Vietnam: streamlining a typhoid fever preventive strategy.(2006-05-24) Thiem, Vu Dinh; Danovaro-Holliday, M Carolina; Canh, Do Gia; Son, Nguyen Dinh; Hoa, Nyugen Thai; Thuy, Dang Thi Dieu; Ochiai, R Leon; Lan, Nguyen Thi; Hop, Tran Quang; Ali, Mohammad; Park, Jin Kyung; Abu-Elyazeed, Remon; Holliday, Kris; Ivanoff, Bernard; Anh, Dang Duc; Pang, Tikki; Donner, Allan; Galindo, Claudia M; Trach, Dang Duc; Clemens, John D; Acosta, Camilo JWe report the coverage, safety, and logistics of a school-based typhoid fever immunization campaign that took place in Hue City, central Vietnam; a typhoid fever endemic area. A cluster-randomized evaluation-blinded controlled trial was designed where 68 schools (cluster) were randomly allocated the single dose Vi polysaccharide vaccine (Typherix) or the active control hepatitis A vaccine (Havrix). A safety surveillance system was implemented. A total of 32,267 children were immunized with a coverage of 57.5%. Strong predictors for vaccination were attending primary schools, peri-urban location of the school, and low family income. Human resources were mainly schoolteachers and the campaign was completed in about 1 month. Most adverse events reported were mild. Safe injection and safe sharp-waste disposal practices were followed. A typhoid fever school-based immunization campaign was safe and logistically possible. Coverage was moderate and can be interpreted as the minimum that could have been achievable because individual written informed consent procedures were sought for the first time in Hue City and the trial nature of the campaign. The lessons learned, together with cost-effectiveness results to be obtained by the end of follow-up period, will hopefully accelerate the introduction of Vi typhoid fever vaccine in Vietnam.Item The role of epidemiology in the introduction of vi polysaccharide typhoid fever vaccines in Asia.(2004-09-22) Acosta, Camilo J; Galindo, Claudia M; Ochiai, R Leon; Danovaro-Holliday, M Carolina; Page, Anne-Laure; Thiem, Vu Dinh; Park, Jin Kyoung; Park, Eunsik; Koo, Hyewon; Wang, Xuan-Yi; Abu-Elyazeed, Remon; Ali, Mohammad; Albert, M John; Ivanoff, Bernard; Pang, Tikki; Xu, Zhi-Yi; Clemens, John DDespite the availability of at least two licensed typhoid fever vaccines--injectable sub-unit Vi polysaccharide vaccine and live, oral Ty21a vaccine--for the last decade, these vaccines have not been widely introduced in public-health programmes in countries endemic for typhoid fever. The goal of the multidisciplinary DOMI (Diseases of the Most Impoverished) typhoid fever programme is to generate policy-relevant data to support public decision-making regarding the introduction of Vi polysaccharide typhoid fever immunization programmes in China, Viet Nam, Pakistan, India, Bangladesh, and Indonesia. Through epidemiological studies, the DOMI Programme is generating these data and is offering a model for the accelerated, rational introduction of new vaccines into health programmes in low-income countries. Practical and specific examples of the role of epidemiology are described in this paper. These examples cover: (a) selection of available typhoid fever vaccines to be introduced in the programme, (b) generation of policy-relevant data, (c) providing the 'backbone' for the implementation of other multidisciplinary projects, and (d) generation of unexpected but useful information relevant for the introduction of vaccines. Epidemiological studies contribute to all stages of development of vaccine evaluation and introduction.