[Show abstract][Hide abstract] ABSTRACT: This study was designed to determine the age-specific rubella seroprevalence in women of childbearing age in Morocco and to contribute to the development of a rubella vaccination strategy in the country. Of 967 women aged 15-39 years tested in 2000, 161 (16.6%) were susceptible to rubella based on absence of IgG antibodies. A significantly higher rate of susceptibility among women aged 15-19 years was observed (29.3%) compared with age 35-39 years (8.3%). An estimated 77,562 live births occur annually to rubella-susceptible women. No statistical difference in seroprevalence was seen between women in rural and urban areas (81.5% and 85.0% respectively). A substantial risk of rubella infection exists for Moroccan women of childbearing age.
Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ 01/2009; 15(3):526-31.
[Show abstract][Hide abstract] ABSTRACT: To evaluate the risk of transmission of SARS coronavirus outside of the health-care setting, close household and community contacts of laboratory-confirmed SARS cases were identified and followed up for clinical and laboratory evidence of SARS infection. Individual- and household-level risk factors for transmission were investigated. Nine persons with serological evidence of SARS infection were identified amongst 212 close contacts of 45 laboratory-confirmed SARS cases (secondary attack rate 4.2%, 95% CI 1.5-7). In this cohort, the average number of secondary infections caused by a single infectious case was 0.2. Two community contacts with laboratory evidence of SARS coronavirus infection had mild or sub-clinical infection, representing 3% (2/65) of Vietnamese SARS cases. There was no evidence of transmission of infection before symptom onset. Physically caring for a symptomatic laboratory-confirmed SARS case was the only independent risk factor for SARS transmission (OR 5.78, 95% CI 1.23-24.24).
Epidemiology and Infection 05/2007; 135(3):392-401. DOI:10.1017/S0950268806006996 · 2.54 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVES AND GOAL: This study was designed to evaluate the extent to which pregnant women in a community with a high syphilis incidence were screened for syphilis according to standard recommendations of twice during prenatal care and at labor and delivery.
Labor and delivery records from 4 hospitals in Miami-Dade County, Florida, were abstracted to obtain maternal and prenatal care characteristics and syphilis screening practices.
Of the 1991 women, records indicated that 1655 (83%) were screened at least once during prenatal care, 220 (11%) were screened twice during prenatal care before delivery, and 184 (9%) were screened twice during prenatal care and at delivery. Attending a private clinic, having more than adequate prenatal care and having private insurance were associated with not being screened at least twice before delivery.
Few women were screened according to standard recommendations, and provider or institutional-related factors affected adequacy of screening.
Sex Transm Dis 12/2006; 33(11):670-4. DOI:10.1097/01.olq.0000216032.52731.ea · 2.84 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To evaluate adherence to the Advisory Committee on Immunization Practices' recommendations on postpartum rubella vaccination in hospitals with a high proportion of foreign-born Latina mothers, the highest risk group for congenital rubella syndrome.
In four large hospitals in Miami-Dade County, maternal medical records for births in 2001 were randomly selected. Using demographic information from birth certificates, vaccination information from medical records, and policy information from a hospital survey, postpartum rubella vaccination rates were characterized among women eligible for vaccination (non-immune and not screened) through univariate and multivariable analyses. Data collection was performed in 2002-2003 and the analysis was completed in 2004-2005.
Among 1991 women, 1209 (61%) were foreign born. Overall, 410 (21%) were eligible for vaccination, and of these 44 (11%) were vaccinated. Vaccination rates were not associated with maternal race/ethnicity or the existence of institutional standing-order vaccination policies. A vaccination order was recorded for 59% (240/410), but even in the presence of an order, only 17% (31/240) of those women were vaccinated.
Despite policies and standing orders to vaccinate, postpartum rubella vaccination rates were very low among all racial/ethnic subgroups in a sample of hospitals caring for high-risk, foreign-born women. These findings suggest that additional system-level interventions, such as comprehensive operational guidelines, must accompany standing orders to vaccinate rubella non-immune women postpartum.
American Journal of Preventive Medicine 03/2006; 30(2):119-24. DOI:10.1016/j.amepre.2005.10.013 · 4.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background: Few studies have measured influenza vaccine effectiveness (VE) in young children, particularly when the antigentic match between vaccine and circulating viruses is suboptimal. This study estimated influenza VE against medically-attended laboratory-confirmed influenza for children aged 6-59 months during the 2003-2004 influenza season.
Methods: In a case-control study conducted in a single pediatric practice through chart reviews, case-patients aged 6-59 months with medically-attended laboratory-confirmed influenza were age matched 1:2 to eligible controls. Vaccination status was ascertained on the date of symptom onset of the case-patient. Conditional logistic regression was used to calculate an odds ratio (OR) for disease while adjusting for underlying medical conditions and sex. VE was estimated by VE = 1-OR.
Results: During November 1, 2003 - January 31, 2004, 293 influenza cases were identified. Overall, 86 (29%) cases and 239 (41%) controls were fully vaccinated, 69 (23%) cases and 99 (17%) controls were partially vaccinated and 127 (43%) cases, 246 (42%) controls were unvaccinated and 11 (4%) cases and 2 (0.3%) controls had unknown vaccination statuses. VE among children fully vaccinated when compared with children partially or unvaccinated and with unvaccinated was 38% (p=0.004) and 24% (p=0.15), respectively. Partially vaccinated children had no significant reduction in influenza when compared with unvaccinated children (p=0.46).
Conclusions: Two doses of vaccine provided some protection against laboratory-confirmed influenza among children aged 6-59 months. No VE was found with partial vaccination, supporting the recommendations that children 6-59 months need two doses of vaccine to maximize protective effects.
Infectious Diseases Society of America 2005 Annual Meeting; 10/2005
[Show abstract][Hide abstract] ABSTRACT: WHO recommends that countries considering introduction of rubella vaccine into their immunisation programme assess their burden of congenital rubella syndrome, to determine whether vaccination is warranted. However, few guidelines exist for such assessments in developing countries. We retrospectively estimated the burden of congenital rubella syndrome in Morocco, and assessed our methods of rapid case finding.
We undertook case finding in the two cities with Morocco's main tertiary care referral centres, using medical records from births between Jan 1, 1990, and May 31, 2002, disability records from 1965 to 1997, and retinal examinations from deaf students born between 1985 and 1994, applying the WHO definition for a clinically confirmed case of congenital rubella syndrome. We also reviewed disability data for evidence of epidemic periodicity and estimated yearly incidence of the syndrome from congenital cataract data for births between 1990 and 2001.
We identified 62 clinically confirmed cases of congenital rubella syndrome from medical records, 148 from disability records, and 15 in deaf students. We noted no epidemic periodicity in disability data, and estimated a yearly incidence of the syndrome in Morocco of 8.1-12.7 cases per 100000 livebirths.
We show evidence of congenital rubella syndrome in Morocco and support the addition of rubella vaccination to the national programme. Various data sources can be explored to rapidly assess burden of the syndrome; ophthalmology departments and outpatient cardiology clinics could offer the most potential for such case finding, dependent on documentation practices.
The Lancet 01/2005; 365(9454):135-41. DOI:10.1016/S0140-6736(05)17703-4 · 45.22 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The severe acute respiratory syndrome (SARS) outbreak in Vietnam was amplified by nosocomial spread within hospital A, but no transmission was reported in hospital B, the second of two designated SARS hospitals. Our study documents lack of SARS-associated coronavirus transmission to hospital B workers, despite variable infection control measures and the use of personal protective equipment.
[Show abstract][Hide abstract] ABSTRACT: This study was designed to determine the age-specific rubella seroprevalence in women of childbearing age in Morocco and to contribute to the development of a rubella vaccination strategy in the country. Of 967 women aged 15-39 years tested in 2000, 161 (16.6%) were susceptible to rubella based on absence of IgG antibodies. A significantly higher rate of susceptibility among women aged 15-19 years was observed (29.3%) compared with age 35-39 years (8.3%). An estimated 77 562 live births occur annually to rubella-susceptible women. No statistical difference in seroprevalence was seen between women in rural and urban areas (81.5% and 85.0% respectively). A substantial risk of rubella infection exists for Moroccan women of childbearing age. ﺏﺮﻐﳌﺍ ﰲ ﹰﺎﻣﺎﻋ 39- 15 ﺮﻤﻌﺑ ﺀﺎﺴﻨﻟﺍ ﲔﺑ ﺔﻴﻧﺎﳌﻷﺍ ﺔﺒﺼﺤﻠﻟ ﲇﺼﳌﺍ ﺭﺎﺸﺘﻧﻻﺍ ﻝﱠ ﺪﻌﻣ ﺩﺍﻮﻌﻟﺍ ﺀﺎﺟﺭ ،ﻒﻳﺭ ﻥﺍﺯﻮﺳ ،ﺩﺍﻮﺟ ﻦﺑ ﺰﻳﺰﻌﻟﺍ ﺪﺒﻋ ،ﻁﺎﳌﺯﺍ ﻰﻔﻄﺼﻣ ،ﻡﻮﻠﺑ ﻥﻭﺭﺎﺷ ،ﻱﺪﻳﺎﻗ ﺓﺎﻴﺣ ﰲ ﺏﺎﺠﻧﻹﺍ ﻦﺳ ﰲ ﺀﺎﺴﻨﻟﺍ ﺪﻟ ﺔﻴﻧﺎﳌﻷﺍ ﺔﺒﺼﳊﺍ ﺭﺎﺸﺘﻧﺍ ﻝﱠ ﺪﻌﻣ ﲆﻋ ﻑﱡ