Day 1 :
Keynote Forum
Majid Malaki
Majid Malaki . Pediatric nephrologist . Tehran . Iran
Keynote: Factors Affecting on Hepatitis B Seroprotection in Hemodialysis Patients
Biography:
Majid Malaki has his expertise in renal failure epidemiology and health problems associated with patients affected to renal failure , immunity and vaccination is an important matter in these cases before transplantation during renal failure and after transplantation and impaired immunity and factors that may be affecting on their successful immunization is my target for further study
Abstract:
Hemodialysis (HD) patients are more prone to hepatitis B virus (HBV) infection. Immunity acquired by hepatitis B (HB) vaccine in these patients is often inadequate. The presence of HBV infection is important due to the fact that affected patients may have significant clinical deterioration after transplantation.1 End-stage renal disease (ESRD) patients, either on dialysis or not, show lower immune response rates (50%–80%) to the vaccine when compared with immunocompetent individuals (95%).2 Antibody response against HBV has improved up to 80% in HD patients by doubling the dose (40 μg/dose) and also by administering an additional dose.2,3 Blood antibody levels of HB antigen (anti-HBs) ≥10 IU/L are considered protective in healthy individuals; however, there is a belief that higher levels (>100 IU/L) are desirable in patients on chronic HD.3 The persistence of immunity in HD patient is not long lasting, and after three years, 41% of responders lost their immunity. In addition, age also has an effect on persistence of immunity.4 The antibody titer drops up to 50% in chronic renal failure and 15% of general population after one year.5 It has been shown that age, durationof HD, nutritional factors, and phase reactive proteins such as C-reactive protein are ineffective in prediction of immune response rate but urea clearance ratio have positive effect on this response (HB antibody ≥100) that may reach up to 89% among those with a mean age of 45 years.6 our study show Gender, age, ESRD duration, inflammatory condition, and albumin level have no effect onHB immune response, whereas predialysis session urea and hemoglobin level can effect partially on vaccination response rate, but they cannot guarantee HB antibody rising over 100 IU/L or to have a long-lasting response. It seems that chronic renal failure patients have an incomplete response to HB vaccination, and the best time for vaccination in these patients is before urea levels rise and hemoglobin levels drop.
- Vaccine Research & Development, Vaccines Types, HIV Vaccines, Vaccine induced immunity.
Location: WEBINAR
Session Introduction
Mohammad Ismail Zubair
Ministry of Public Health, Afghanistan
Title: Factors Affecting Immunization Coverage in Afghanistan
Biography:
Dr. Mohammad Ismail Zubair, graduated from Kabul Medical University, Curative Medicine Faculty in 2009, and did his MSc in Health Policy & Management from Aga Khan University in 2016. Dr. Zubair has been working in public health since 2010 with MoPH and different national and international organizations.
Abstract:
Afghanistan's Expanded Program on Immunization (EPI) annually targets around 1.4 million children aged below 1 year to protect against 10 vaccine-preventable diseases and 4.1 million pregnant women to protect them and their newborns from tetanus through routine immunization services. Despite significant efforts by the Government and partners, Afghanistan’s immunization indicators have not met the expected benchmarks. The aim of this study was to assess the factors affecting Immunization coverage in Afghanistan and explore the NEPI present situation and the way forward. A mixed-method operational research design was used. Desk review, quantitative and qualitative data collection approaches used. The study participants were EPI frontline workers, mid-level and senior management staff. Quantitative data collection methods included vaccine centers observation and immunization services provider’s interviews. Qualitative arm included semi-structured interviews. Analysis of qualitative data was done manually and codes and themes were generated from findings. At community level the main constraints of demand side are low community awareness, myths about vaccines, and low community ownership; supply side barriers are ambiguous micro-planning, white areas, unequal geographical distribution of fixed centers, lack of female vaccinators, weak outreach and mobile services. Whereas, low management and technical capacity, minimum salary, weak coordination and communication, low performance accountability are mid-level constraints. Meanwhile, lack of clarity in strategic directions; using old management; no growth opportunity for staff; weak data management and use; lack program evaluation are the senior management/ policy level barriers. Aforementioned factors have direct effect on national coverage of immunization in Afghanistan. It is important that these factors become explicit to healthcare providers, health system managers, and policy makers in order to continuously monitor and improve vaccine service provision in the country and to meet the expected benchmarks.
Huda Salah Abdelrahim Elhassan
Khartoum University, faculty of medicine, Sudan
Title: Factors affecting immunization coverage among children aged 12-35 months in Kassala
Biography:
Huda S A Elhassan is a 6th year medical student at Khartoum University
Abstract:
Immunization remains one of the most important public health interventions and cost effective strategies to reduce child mortality and morbidity associated with infectious diseases. A descriptive cross-sectional community based survey was conducted in Kassala locality from November 2017 to January 2018. A modified World Health Organization-Expanded Program on Immunization cluster sampling methods were used for household selection. A total 347 children aged 12 to 35 months were included in the study. Data were collected by using a pre-tested, interviewer administered questionnaire. Bivariate analysis was employed to identify factors associated with full immunization coverage and multiple binary logistic regression analysis was performed for those factors that showed statistically significant association in bivariate analysis and investigate independent predictors by controlling for possible confounders and significances of all tests were decided at p-value of 0.05. Number of fully immunized children was 277(79.8%) according to mother recall, 205(59.1%) were fully vaccinated according to vaccination cards . factors significantly associated with vaccination status of children were: age of the child in months (OR 1.09, 95%CI: 1.04_1.13) available vaccination center (OR .323, 95%CI: .155_.67), walking time to the nearest vaccination center less than 30 minutes (OR5.50, 95%CI: 2.87_10.5) and source of information about vaccination date by family members/friends/ neighbors (OR 3.81, 95%CI: 1.44_10.09). Despite improvement immunization coverage is still low. Age of child, availability of vaccination center and accessibility were the major predictors of children vaccination status.
Biography:
Mr. Girma Birhanu Nurie holds a Master of Public Health in Epidemiology from Addis Ababa University, Ethiopia. He 1 did his BSc in Environmental Health at University of Gondar, and Diploma in Environmental Health at Jimma University, all in Ethiopia. Currently, he is working as Field Epidemiologist, Researcher/ Disease Prevention and Control Officer at Addis Ababa City Administration, Department of Public Health Emergency Management/Bole Sub City Health Office. Mr. Girma Birhanu Nurie’s clinical research work has gained relative international recognition in the Scientific Community. He was an Invited Speaker at the International Academy of Science, Technology, Engineering and Management (IASTEM) Conference/517th International Conference on Medical, Biological, and Pharmaceutical Sciences in Bangkok, Thailand, December 21-22, 2018. Mr. Girma 2 Birhanu Nurie is a former basketball player, with a passion of taking preventive medicine closer to the rural populations in Ethiopia. He enjoys community
Abstract:
Background: Scabies affects people of all countries. In developing countries, children in particular are most susceptible, with an average prevalence of 5–10%. It is very common in Ethiopia, especially during natural or manmade disasters, such as flooding, drought, civil war and conflict, poor water supply and sanitation, and overcrowded living condition. Methods and materials: We conducted 1:2 unmatched case-control study from August 28-November 2, 2017 in Dembiya District, North Gondar Zone, Amhara Region. 40 Cases and 80 controls were randomly selected from the community. Data was collected using structured questionnaire. Analysis was made using Epi Info and SPSS software. Odds Ratio, 95% CI and P-value were used to measure the significance of association in bivariate and multivariate analysis. Variables with p value of equal to or less than 0.05 were reported to be significantly associated with dependent variable. Images/Graphs/Tables Results: We identified 141 Scabies cases with overall attack rate of 2% and Zero case fatality rate. Of reported cases 55% of them were male and the median age of affected population was 16yrs (IQR= 19yrs). Sex (AOR: 0.4, 95% CI: 0.1-0.7), Hand washing with soap (AOR: 0.6, 95% CI: 0.1--0.6), Body bath more than a week (AOR: 1.5, 95% CI: 1.2-4.1), Cloth exchange with infected person (AOR: 3.1, 95% CI: 2.0-4.0), contact history (AOR: 17.0, 95% CI: 13.4-20.0), and water shortage (AOR: 3.3, 95% CI: 2.4-4.5) were significantly associated with scabies. Conclusion: We found poor hygienic practices, sharing of clothing materials, sleeping with people that had contracted scabies was associated with higher frequency of scabies disease. Therefore, increasing awareness creation about the transmission, prevention and control methods of scabies disease is recommended. Key words: Scabies, case-control, Dembiya, Ethiopia, 2017
Biography:
Jay Bahadur Tadan has completed his Doctor of Public Health in 2003 from Institute of Public Health , Japan. He has worked as Executive Director and Health Director in Technical Education of Government of Nepal. Presently he has been working as Chairman of AHEAD- Nepal. He has honoured by various awards including Outstanding Alumni in outstanding research works 2007 by Mahidol University Thailand. He has published four research papers in Lancet/Vaccine Elsevier journal on Live JE SA 14-14-2 vaccine’s efficacy and Immunogenicity in Nepalese children. He has contributed as peer reviewer on dozens of national and international research papers.
Abstract:
A single dose of live-attenuated SA 14-14-2 Japanese encephalitis (JE) vaccine was administered in July 1999 to children living in the Bardiya, Banke and Kailali districts of Nepal. In 2004, the original vaccinated population experienced a fifth seasonal exposure to JE. We performed a case-control study comparing the prevalence of the administration of vaccine in patients with JE hospitalized in the Bardiya and Bheri Zonal hospitals and in age-sex matched controls resident in the Bardiya district. Among the 219 village controls, 114 had been vaccinated (52.1%) while only one of 20 JE cases had received live-attenuated JE vaccine. Five years after administration of a single dose, SA 14-14-2 provided a protective efficacy of 96.2% (CI 73.1-99.9%).