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Age-related immunogenicity of meningococcal polysaccharide vaccine in aboriginal children and adolescents living in a Northern Manitoba reserve community.

https://arctichealth.org/en/permalink/ahliterature33624
Source
Pediatr Infect Dis J. 1998 Oct;17(10):860-4
Publication Type
Article
Date
Oct-1998
Author
B J Law
T. Rosenberg
N E MacDonald
F E Ashton
J C Huang
W J King
W J Ferris
G J Gray
Author Affiliation
Department of Medical Microbiology, University of Manitoba, Canada. blaw@ms.umanitoba.ca
Source
Pediatr Infect Dis J. 1998 Oct;17(10):860-4
Date
Oct-1998
Language
English
Publication Type
Article
Keywords
Adolescent
American Native Continental Ancestry Group
Antibodies, Bacterial - biosynthesis
Bacterial Vaccines - immunology
Carrier State - epidemiology
Child
Child, Preschool
Humans
Infant
Manitoba - epidemiology
Meningococcal Infections - epidemiology - prevention & control
Meningococcal Vaccines
Neisseria meningitidis - classification - immunology - isolation & purification
Prospective Studies
Research Support, Non-U.S. Gov't
Serotyping
Abstract
OBJECTIVE: To determine the total and functional serogroup C antibody response to a quadrivalent meningococcal polysaccharide vaccine in a group of aboriginal infants, children and adolescents. A secondary objective was to determine their prevalence of meningococcal carriage. DESIGN: Open prospective, before and after intervention study. SUBJECTS: Aboriginal children ages 0.5 to 19.9 years, living in a single Northern community and eligible for a public health immunization campaign conducted in all Manitoba native reserve communities to control a meningococcal serogroup C, electrophoretic type (ET) 15 outbreak. No outbreak cases had occurred in the community at the time of the study. METHODS: Total serogroup C capsular polysaccharide antibody (CPA) and functional bactericidal antibody (BA) responses were measured by enzyme-linked immunosorbent assay and bactericidal assay, respectively. RESULTS: Neisseria meningitidis was recovered from the oropharynx of 13 (5.2%) of 249 aboriginal children including 4 (1.6%) serogroup C isolates, all with the designation C:2a:P1.2,5 ET15. Paired sera from 152 children were available for assay. For CPA the geometric mean concentrations and proportions with > or =2 microg/ml before and after immunization were 0.69, 18% and 12.3, 96%, respectively. A significant increase in serum CPA was achieved by children of all ages, with the greatest response occurring after age 11 years. Among infants or =2 microg/ml. For BA the pre- and post-vaccine geometric mean titers were 1.02 and 45.9. The response was significantly associated with age. BA titers > or =1:8 were present, before and after immunization, respectively, in 0 and 0% of infants or =2-year-olds. CONCLUSION: The age-related total and functional group C meningococcal antibody response after quadrivalent polysaccharide vaccine among aboriginals is similar to that reported for Caucasian children. After age 2 all children made excellent CPA and BA responses. In the younger age groups the BA response was blunted but 82 to 95% achieved CPA titers of > or =2 microg/ml.
PubMed ID
9802625 View in PubMed
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Chickenpox vaccination, not chickenpox, should be routine for Canadian children.

https://arctichealth.org/en/permalink/ahliterature194457
Source
CMAJ. 2001 May 15;164(10):1454-5
Publication Type
Article
Date
May-15-2001
Author
B J Law
Author Affiliation
Winnipeg Health Sciences Centre, Departments of Medical Microbiology and of Pediatrics and Child Health, University of Manitoba, Winnipeg, Man. blaw@ms.umanitoba.ca
Source
CMAJ. 2001 May 15;164(10):1454-5
Date
May-15-2001
Language
English
Publication Type
Article
Keywords
Adult
Canada - epidemiology
Chickenpox - complications - economics - epidemiology - prevention & control
Chickenpox Vaccine
Child
Child Welfare
Child, Preschool
Cost of Illness
Humans
Immunization Programs - organization & administration
Needs Assessment
Vaccination - methods
Notes
Cites: Pediatr Ann. 1999 Aug;28(8):516-2910483597
Cites: Pediatrics. 1999 Jul;104(1 Pt 1):7-1410390253
Cites: Pediatrics. 2000 May;105(5):E6010799624
Cites: J Infect Dis. 2000 Aug;182(2):383-9010915066
Cites: JAMA. 2000 Sep 13;284(10):1271-910979114
Cites: Pediatr Infect Dis J. 2000 Nov;19(11):1053-911099085
Cites: Epidemiol Infect. 2000 Dec;125(3):651-6911218215
Cites: N Engl J Med. 2001 Mar 29;344(13):955-6011274621
Cites: Biken J. 1984 Sep;27(2-3):119-226100048
Cites: Pediatrics. 1991 May;87(5):604-101850506
Cites: Vaccine. 1991 Sep;9(9):643-71659052
Cites: Pediatrics. 1993 Dec;92(6):833-78233746
Cites: Pediatrics. 1994 Oct;94(4 Pt 1):524-67936864
Cites: J Infect Dis. 1998 Jun;177(6):1701-49607852
Cites: Pediatrics. 1999 Jul;104(1 Pt 1):1-610390252
Cites: Pediatr Infect Dis J. 1999 Dec;18(12):1041-610608621
PubMed ID
11387920 View in PubMed
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Economic evaluation of respiratory syncytial virus infection in Canadian children: a Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study.

https://arctichealth.org/en/permalink/ahliterature208033
Source
J Pediatr. 1997 Jul;131(1 Pt 1):113-7
Publication Type
Article
Date
Jul-1997
Author
J M Langley
E E Wang
B J Law
D. Stephens
F D Boucher
S. Dobson
J. McDonald
N E MacDonald
I. Mitchell
J L Robinson
Author Affiliation
Department of Pediatrics, Izask Walton Killam-Grace Health Centre, Halifax, Nova Scotia, Canada.
Source
J Pediatr. 1997 Jul;131(1 Pt 1):113-7
Date
Jul-1997
Language
English
Publication Type
Article
Keywords
Absenteeism
Adult
Ambulatory Care - economics
Bronchiolitis - economics - therapy - virology
Canada
Child, Preschool
Cohort Studies
Cost Control
Cost of Illness
Direct Service Costs
Evaluation Studies as Topic
Fees, Medical
Female
Health Care Costs
Health Care Rationing
Health Expenditures
Hospitalization - economics
Humans
Infant
Infant, Newborn
Information Systems
Length of Stay - economics
Patient Admission
Prospective Studies
Respiratory Syncytial Virus Infections - economics - therapy
Respiratory Tract Infections - economics - therapy
Sensitivity and specificity
United States
Women, Working
Abstract
To quantify the cost and distribution of health care resources consumed annually in management of Canadian children from birth to 4 years of age with respiratory syncytial virus (RSV) infection.
Estimates of direct medical expenditures (in 1993 U.S. dollars) were collected from a prospective cohort study of hospitalized children with RSV and from national and provincial databases.
The annual cost of RSV-associated illness was almost $18 million. The largest component of direct expenditures (62%) was for inpatient care for the estimated 0.7% of all infected children ill enough to require admission. Physician fees comprised only 4% of inpatient expenses. Expenditures for ambulatory patients accounted for 38% of direct costs.
The greatest reductions in the economic cost of RSV infections will be found in interventions that reduce duration of or prevent hospital stay. Costs for management of RSV infection in children in the Canadian health care system are considerably less than charges reported in the United States.
PubMed ID
9255201 View in PubMed
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Nosocomial respiratory syncytial virus infection in Canadian pediatric hospitals: a Pediatric Investigators Collaborative Network on Infections in Canada Study.

https://arctichealth.org/en/permalink/ahliterature207081
Source
Pediatrics. 1997 Dec;100(6):943-6
Publication Type
Article
Date
Dec-1997
Author
J M Langley
J C LeBlanc
E E Wang
B J Law
N E MacDonald
I. Mitchell
D. Stephens
J. McDonald
F D Boucher
S. Dobson
Author Affiliation
Department of Pediatrics, Izaak Walton Killam Grace Health Centre and Dalhousie University, Halifax, Nova Scotia, Canada.
Source
Pediatrics. 1997 Dec;100(6):943-6
Date
Dec-1997
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Child, Preschool
Cross Infection - epidemiology - prevention & control - transmission
Hospitals, Pediatric
Humans
Incidence
Infant
Infection Control - methods - standards - statistics & numerical data
Length of Stay
Multivariate Analysis
Organizational Policy
Prospective Studies
Respiratory Syncytial Virus Infections - epidemiology - prevention & control - transmission
Abstract
To determine nosocomial transmission of respiratory syncytial virus (RSV) in Canadian pediatric hospitals, outcomes associated with nosocomial disease, and infection control practices.
A prospective cohort study in the 1992 to 1994 winter respiratory seasons.
Nine Canadian pediatric university-affiliated hospitals.
Hospitalized children with symptoms of lower respiratory tract infection (at least one of cough, wheezing, dyspnea, tachypnea, and apnea) and RSV antigen identified in a nasopharyngeal aspirate.
Of 1516 children, 91 (6%) had nosocomial RSV (NRSV), defined as symptoms of lower respiratory tract infection and RSV antigen beginning >72 hours after admission. The nosocomial ratio (NRSV/[com-munity-acquired RSV {CARSV})] + NRSV) varied by site from 2.8% to 13%. The median length of stay attributable to RSV for community-acquired illness was 5 days, but 10 days for nosocomial illness. Four children with NRSV (4. 4%) died within 2 weeks of infection, compared with 6 (0.42%) with CARSV (relative risk = 10.4, 95% confidence interval: 3.0, 36.4). All sites isolated RSV-positive patients in single rooms or cohorted them. In a multivariate model, no particular isolation policy was associated with decreased nosocomial ratio, but gowning to enter the room was associated with increased risk of RSV transmission (incidence rate ratio 2.81; confidence interval: 1.65, 4.77).
RSV transmission risk in Canadian pediatric hospitals is generally low. Although use of barrier methods varies, all sites cohort or isolate RSV-positive patients in single rooms. Children with risk factors for severe disease who acquire infection nosocomially have prolonged stays and excess mortality.
PubMed ID
9374561 View in PubMed
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Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) prospective study of risk factors and outcomes in patients hospitalized with respiratory syncytial viral lower respiratory tract infection.

https://arctichealth.org/en/permalink/ahliterature215871
Source
J Pediatr. 1995 Feb;126(2):212-9
Publication Type
Article
Date
Feb-1995
Author
E E Wang
B J Law
D. Stephens
Author Affiliation
Clinical Epidemiology Unit, Hospital for Sick Children, Toronto, Ontario, Canada.
Source
J Pediatr. 1995 Feb;126(2):212-9
Date
Feb-1995
Language
English
Publication Type
Article
Keywords
Antigens, Viral - analysis
Canada - epidemiology
Child, Preschool
Cohort Studies
Hospitalization - statistics & numerical data
Humans
Infant
Logistic Models
Oximetry
Prognosis
Prospective Studies
Respiratory Syncytial Virus Infections - epidemiology - immunology - therapy - virology
Respiratory Syncytial Viruses - immunology - isolation & purification
Respiratory Tract Infections - epidemiology - immunology - therapy - virology
Risk factors
Statistics, nonparametric
Treatment Outcome
Abstract
To provide information on disease attributable to respiratory syncytial viral lower respiratory tract infection (RSV LRI) and to quantify the morbidity associated with various risk factors.
Prospective cohort study.
Patients hospitalized with RSV LRIs at seven centers were eligible for study if they were younger than 2 years of age, or hospitalized patients of any age if they had underlying cardiac or pulmonary disease or immunosuppression.
Enrolled (n = 689) and eligible but not enrolled (n = 191) patients were similar in age, duration of illness and proportion with underlying illness, use of intensive care, and ventilation. Of the enrolled patients, 156 had underlying illness. The isolates from 353 patients were typeable: 102 isolates were subgroup A, 250 were subgroup B, and one isolated grouped with both antisera. The mean hospital stay attributable to respiratory syncytial virus (RSV) was 7 days; 110 patients were admitted to intensive care units, 63 were supported by mechanical ventilation, and 6 patients died. Regression models were developed for the prediction of three outcomes: RSV-associated hospital duration, intensive care unit admission, and ventilation treatment. In addition to previously described risk factors for an increased morbidity, such as underlying illness, hypoxia, prematurity and young age, three other factors were found to be significantly associated with complicated hospitalization: aboriginal race (defined by maternal race), a history of apnea or respiratory arrest during the acute illness before hospitalization, and pulmonary consolidation as shown on the chest radiograph obtained at admission. The RSV subgroup, family income, and day care attendance were not significantly associated with these outcomes.
Hypoxia on admission, a history of apnea or respiratory arrest, and pulmonary consolidation should be considered in the management of children with RSV LRIs. Vaccine trials should target patients with underlying heart or lung disease or of aboriginal race.
PubMed ID
7844667 View in PubMed
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Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of admission and management variation in patients hospitalized with respiratory syncytial viral lower respiratory tract infection.

https://arctichealth.org/en/permalink/ahliterature211230
Source
J Pediatr. 1996 Sep;129(3):390-5
Publication Type
Article
Date
Sep-1996
Author
E E Wang
B J Law
F D Boucher
D. Stephens
J L Robinson
S. Dobson
J M Langley
J. McDonald
N E MacDonald
I. Mitchell
Author Affiliation
Department of Pediatrics, Hospital for Sick Children, Ontario.
Source
J Pediatr. 1996 Sep;129(3):390-5
Date
Sep-1996
Language
English
Publication Type
Article
Keywords
Adrenal Cortex Hormones - therapeutic use
Anti-Bacterial Agents - therapeutic use
Bronchodilator Agents - therapeutic use
Canada
Hospitalization
Hospitals, Pediatric
Humans
Immunocompromised Host
Infant
Infant, Newborn
Intensive Care Units - utilization
Length of Stay
Prospective Studies
Respiration, Artificial
Respiratory Syncytial Virus Infections - complications - therapy
Respiratory Tract Infections - complications - therapy
Ribavirin - therapeutic use
Abstract
To describe differences in patients hospitalized with respiratory syncytial virus (RSV) lower respiratory tract infection (LRI) at nine Canadian tertiary care hospitals. In addition, this study describes the variation in use of drug and other interventions.
Data on patients hospitalized with RSV LRI and their outcomes were prospectively collected. Demographic data were obtained on enrollment by center study nurses. Data recorded daily included clinical assessment, oxygen saturation determination, and interventions (bronchodilators, steroids, ribavirin, antibiotics, intensive care, and mechanical ventilation) received during the day. Patients were divided into those with underlying diseases including congenital heart disease, chronic lung disease, immunodeficiency, or multiple congenital anomalies and those who were previously healthy. Mean RSV-associated length of stay and the proportion of patients receiving each intervention in each group were determined by hospital.
A total of 1516 patients were enrolled at nine hospitals during January 1 to June 30, 1993, and January 1 to April 30, 1994. Significant differences were observed among hospitals in the proportion of patients with underlying disease, postnatal age less than 6 weeks, hypoxia, and pulmonary infiltrate on chest radiograph. The mean length of stay varied among hospitals from 8.6 to 11.8 days and 4.6 to 6.7 days in compromised and previously healthy patients, respectively. Except for receipt of bronchodilators, compromised patients were significantly more likely to receive interventions than previously healthy patients. There was variation among hospitals in receipt of most interventions in compromised and previously healthy patients. This variation was statistically significant for previously healthy patients but not statistically significant in those with underlying disease, because the numbers of patients in the latter group were much smaller. The magnitude of the variation for each intervention, however, was not different between those with underlying disease compared with previously healthy patients.
Differences exist among tertiary pediatric hospitals in the nature of the patients admitted with RSV LRI. Variation occurred in the use of five interventions among the hospitals, regardless of whether the patient had underlying illness or was previously healthy. Given their current widespread use, high cost, and potential side effects, randomized clinical trials are needed to determine the efficacy of different drug treatments used to treat infants hospitalized with RSV.
PubMed ID
8804328 View in PubMed
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Respiratory syncytial virus infections in hospitalized Canadian children: regional differences in patient populations and management practices. The Pediatric Investigators Collaborative Network on Infections in Canada.

https://arctichealth.org/en/permalink/ahliterature220543
Source
Pediatr Infect Dis J. 1993 Aug;12(8):659-63
Publication Type
Article
Date
Aug-1993
Author
B J Law
V. De Carvalho
Author Affiliation
Winnipeg Children's Hospital, Manitoba, Canada.
Source
Pediatr Infect Dis J. 1993 Aug;12(8):659-63
Date
Aug-1993
Language
English
Publication Type
Article
Keywords
Age Distribution
Canada - epidemiology
Child, Preschool
Female
Hospital Mortality
Humans
Infant
Male
Morbidity
Respiratory Syncytial Virus Infections - epidemiology - therapy
Respiratory Syncytial Virus, Human
Risk factors
Abstract
Respiratory syncytial virus (RSV) is the most frequent cause of hospitalization for respiratory tract infection during the first 2 years of life. The optimal approach to management remains controversial. During the 1991 to 1992 RSV season RSV-infected children admitted to eight Canadian tertiary care pediatric centers were followed to: (1) assess the morbidity and mortality attributable to RSV infection among hospitalized patients with and without known risk factors for severe disease; and (2) assess regional variation in the management of RSV infection. Of 529 RSV-infected patients 69% (363) had one or more of the risk factors for severe disease and the remaining 31% (166) had none. There were significant differences (P or = 7 days (39%, 6%). Among low risk patients, centers varied significantly (P
PubMed ID
8414779 View in PubMed
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Variable morbidity of respiratory syncytial virus infection in patients with underlying lung disease: a review of the PICNIC RSV database. Pediatric Investigators Collaborative Network on Infections in Canada.

https://arctichealth.org/en/permalink/ahliterature200494
Source
Pediatr Infect Dis J. 1999 Oct;18(10):866-9
Publication Type
Article
Date
Oct-1999
Author
S R Arnold
E E Wang
B J Law
F D Boucher
D. Stephens
J L Robinson
S. Dobson
J M Langley
J. McDonald
N E MacDonald
I. Mitchell
Author Affiliation
Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada.
Source
Pediatr Infect Dis J. 1999 Oct;18(10):866-9
Date
Oct-1999
Language
English
Publication Type
Article
Keywords
Bronchopulmonary Dysplasia - complications - epidemiology - virology
Canada
Hospitalization
Humans
Infant
Infant, Newborn
Lung Diseases - complications - epidemiology - virology
Morbidity
Prospective Studies
Respiration, Artificial
Respiratory Syncytial Virus Infections - complications - epidemiology
Statistics, nonparametric
Abstract
We wished to compare outcomes of respiratory syncytial virus (RSV) infection in children with bronchopulmonary dysplasia (BPD) with those with other pulmonary disorders: cystic fibrosis, recurrent aspiration pneumonitis, pulmonary malformation, neurogenic disorders interfering with pulmonary toilet, and tracheoesophageal fistula.
Children with RSV infection hospitalized at seven Canadian pediatric tertiary care hospitals in 1993 through 1994 and 9 hospitals in 1994 through 1995 were enrolled and prospectively followed. This study is a secondary analysis of data from this prospective cohort.
Of the 1516 patients enrolled the outcomes of 159 with preexisting lung disorders before RSV lower respiratory tract infection constitute this report. There were no significant differences among the 7 groups (BPD, cystic fibrosis, recurrent aspiration pneumonitis, pulmonary malformation, neurogenic disorders interfering with pulmonary toilet, tracheoesophageal fistula, other) for the morbidity measures: duration of hospitalization, intensive care unit (ICU) admission, duration of ICU stay, mechanical ventilation and duration of mechanical ventilation. Patients using home oxygen were more likely to be admitted to the ICU than those who had never or previously used home oxygen (current 57.1%, past 23.8%, never 33.3%, P = 0.03).
Children with other underlying diseases have morbidity similar to those with BPD. Prophylactic interventions against RSV should also be studied in these groups.
PubMed ID
10530581 View in PubMed
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8 records – page 1 of 1.