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  1. Article ; Online: A systematic methodology to assess the identity of plants in historical texts: A case study based on the Byzantine pharmacy text John the Physician's Therapeutics.

    Lardos, Andreas / Patmore, Kristina / Allkin, Robert / Lazarou, Rebecca / Nesbitt, Mark / Scott, Andrew C / Zipser, Barbara

    Journal of ethnopharmacology

    2023  Volume 322, Page(s) 117622

    Abstract: ... John the Physician's Therapeutics in its Commentary version (JC) as a case study. The methodology has ...

    Abstract Ethnopharmacological relevance: In recent decades, the study of historical texts has attracted research interest, particularly in ethnopharmacology. All studies of the materia medica cited in ancient and medieval texts share a concern, however, as to the reliability of modern identifications of these substances. Previous studies of European or Mediterranean texts relied mostly on authoritative dictionaries or glossaries providing botanical identities for the historical plant names in question. Several identities they suggest, however, are questionable and real possibility of error exists.
    Aim of the study: This study aims to develop and document a novel and interdisciplinary methodology providing more objective assessment of the identity of the plants (and minerals) described in these resources.
    Materials and methods: We developed an iterative experimental approach, using the 13th century Byzantine recipe text John the Physician's Therapeutics in its Commentary version (JC) as a case study. The methodology has six stages and relies on comparative analyses including statistical evaluation of botanical descriptions and information about medicinal uses drawn from both historical and modern sources. Stages 1-4 create the dataset, stage 5 derives the primary outcomes to be reviewed by experts in stage 6.
    Results: Using Disocorides' De Materia Medica (DMM) (1st century CE) as the culturally related reference text for the botanical descriptions of the plants cited in JC, allowed us to link the 194 plants used medicinally in JC with 252 plants cited in DMM. Our test sample for subsequent analyses consisted of the 50 JC plant names (corresponding to 61 DMM plants) for which DMM holds rich morphological information, and the 130 candidate species which have been suggested in the literature as potential botanical identities of those 50 JC plant names. Statistical evaluation of the comparative analyses revealed that in the majority of the cases, our method detected the candidate species having a higher likelihood of being the correct attribution from among the pool of suggested candidates. Final assessment and revision provided a list of the challenges associated with applying our methodology more widely and recommendations on how to address these issues.
    Conclusions: We offer this multidisciplinary approach to more evidence-based assessment of the identity of plants in historical texts providing a measure of confidence for each suggested identity. Despite the experimental nature of our methodology and its limitations, its application allowed us to draw conclusions about the validity of suggested candidate plants as well as to distinguish between alternative candidates of the same historical plant name. Fully documenting the methodology facilitates its application to historical texts of any kind of cultural or linguistic background.
    MeSH term(s) Humans ; Plants, Medicinal ; Medicine, Traditional/history ; Phytotherapy/history ; Materia Medica/history ; Reproducibility of Results ; Ethnopharmacology/history ; Pharmacy ; Physicians
    Chemical Substances Materia Medica
    Language English
    Publishing date 2023-12-19
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 134511-4
    ISSN 1872-7573 ; 0378-8741
    ISSN (online) 1872-7573
    ISSN 0378-8741
    DOI 10.1016/j.jep.2023.117622
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Book ; Online ; E-Book: Development of Biopharmaceutical Drug-Device Products

    Jameel, Feroz / Skoug, John W. / Nesbitt, Robert R.

    (AAPS Advances in the Pharmaceutical Sciences Series, ; 35)

    2020  

    Abstract: The biotechnology/biopharmaceutical sector has tremendously grown which led to the invention of engineered antibodies such as Antibody Drug Conjugates (ADCs), Bispecific T-cell engager (BITES), Dual Variable Domain (DVD) antibodies, and fusion proteins ... ...

    Author's details edited by Feroz Jameel, John W. Skoug, Robert R. Nesbitt
    Series title AAPS Advances in the Pharmaceutical Sciences Series, ; 35
    Advances in the pharmaceutical sciences
    Collection Advances in the pharmaceutical sciences
    Abstract The biotechnology/biopharmaceutical sector has tremendously grown which led to the invention of engineered antibodies such as Antibody Drug Conjugates (ADCs), Bispecific T-cell engager (BITES), Dual Variable Domain (DVD) antibodies, and fusion proteins that are currently being used as therapeutic agents for immunology, oncology and other disease conditions. Regulatory agencies have raised the bar for the development and manufacture of antibody-based products, expecting to see the use of Quality by Design (QbD) elements demonstrating an in-depth understanding of product and process based on sound science. Drug delivery systems have become an increasingly important part of the therapy and most biopharmaceuticals for self-administration are being marketed as combination products. A survey of the market indicates that there is a strong need for a new book that will provide “one stop shopping” for the latest information and knowledge of the scientific and engineering advances made over the last few years in the area of biopharmaceutical product development. The new book entitled Development of Biopharmaceutical Drug Device Products is a reference text for scientists and engineers in the biopharmaceutical industry, academia or regulatory agencies. With insightful chapters from experts in the field, this new book reviews first principles, covers recent technological advancements and provides case studies and regulatory strategies relating to the development and manufacture of antibody-based products. It covers topics such as the importance of early preformulation studies during drug discovery to influence molecular selection for development, formulation strategies for new modalities, and the analytical techniques used to characterize them. It also addresses important considerations for later stage development such as the development of robust formulations and processes, including process engineering and modeling of manufacturing unit operations, the design of analytical comparability studies, and characterization of primary containers (pre-filled syringes and vials). Finally, the latter half of the book reviews key considerations to ensure the development and approval of a patient-centered delivery system design. This involves the evolving regulatory framework with perspectives from both the US and EU industry experts, the role of international standards, design control/risk management, human factors and its importance in the product development and regulatory approval process, as well as review of the risk-based approach to bridging between devices used in clinical trials and the to-be-marketed device. Finally, case studies are provided throughout. The typical readership would have biology and/or engineering degrees and would include researchers, scientific leaders, industry specialists and technology developers working in the biopharmaceutical field. .
    Keywords Pharmaceutical technology ; Pharmacy ; Pharmaceutical Sciences/Technology ; Biofarmàcia ; Tecnologia farmacèutica ; Immunoglobulines
    Subject code 615.6
    Language English
    Size 1 online resource (XVIII, 893 p. 302 illus., 256 illus. in color.)
    Edition 1st ed. 2020.
    Publisher Springer International Publishing ; Imprint: Springer
    Publishing place Cham
    Document type Book ; Online ; E-Book
    Remark Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
    ISBN 3-030-31415-4 ; 3-030-31414-6 ; 978-3-030-31415-6 ; 978-3-030-31414-9
    DOI 10.1007/978-3-030-31415-6
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  3. Article ; Online: Prenatal substance use in the rural and Appalachian state: Project WATCH study 2020-2022.

    Umer, Amna / Garrow, Jana / Nesbitt, Makena / Lilly, Christa / Lefeber, Candice / Breyel, Janine / John, Collin

    The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association

    2023  Volume 39, Issue 4, Page(s) 804–815

    Abstract: Purpose: To examine the prevalence, patterns, and correlates of prenatal substance use in the rural Appalachian state of West Virginia (WV).: Methods: Population-based cohort (Project WATCH) of all women (N = 34,309) who gave birth between February ... ...

    Abstract Purpose: To examine the prevalence, patterns, and correlates of prenatal substance use in the rural Appalachian state of West Virginia (WV).
    Methods: Population-based cohort (Project WATCH) of all women (N = 34,309) who gave birth between February 2020 and June 2022. A composite substance use variable included 9 categories: "no substance use," "opioids," "cannabis," "sedatives/hypnotics," "stimulants," "opioids and cannabis," "opioids and stimulants," "cannabis and stimulants," and "opioids, cannabis, and stimulants." These data were gathered through self-report, medical records, and/or positive drug screen at labor and delivery.
    Findings: 12.4% of women used one or more substances (opioids, cannabis, stimulants, and sedatives/hypnotics) during their current pregnancy. The mean age of women using cannabis was 25.34 (SD = 5.31), stimulants was 28.88 (SD = 5.62), and opioid was 30.19 (SD = 4.78). White women were more likely to use opioids (aOR = 2.19, 95% CI 1.46, 3.28) and less likely to use cannabis (aOR = 0.39, 95% CI 0.34, 0.44) compared to minority racial groups. Women with cannabis use were more likely to live in urban versus rural regions (aOR = 1.47, 95% CI 1.33, 1.62). The odds of using any type of substance(s) were significantly higher in women who smoked (aOR range 4.17-30.85), had Medicaid (aOR range 1.52-7.65), and those receiving inadequate prenatal care (aOR range 1.96-16.83).
    Conclusions: In this rural Appalachian state, 1 in 8 women used 1 or more substances (opioids, cannabis, stimulants, and/or sedatives/hypnotics) during pregnancy and the type of substance used varied by sociodemographic and health-related factors. These factors should inform state-level strategies and initiatives to address the substance use crisis for this population.
    MeSH term(s) Humans ; Female ; Pregnancy ; Analgesics, Opioid/therapeutic use ; Substance-Related Disorders/epidemiology ; Substance-Related Disorders/drug therapy ; Appalachian Region/epidemiology ; Hypnotics and Sedatives ; Central Nervous System Stimulants/therapeutic use ; Hallucinogens
    Chemical Substances Analgesics, Opioid ; Hypnotics and Sedatives ; Central Nervous System Stimulants ; Hallucinogens
    Language English
    Publishing date 2023-02-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 639160-6
    ISSN 1748-0361 ; 0890-765X
    ISSN (online) 1748-0361
    ISSN 0890-765X
    DOI 10.1111/jrh.12752
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: A diverse diapsid tooth assemblage from the Early Triassic (Driefontein locality, South Africa) records the recovery of diapsids following the end-Permian mass extinction.

    Hoffman, Devin K / Hancox, John P / Nesbitt, Sterling J

    PloS one

    2023  Volume 18, Issue 5, Page(s) e0285111

    Abstract: Mass extinctions change the trajectory of evolution and restructure ecosystems. The largest mass extinction, the end-Permian, is a particularly interesting case due to the hypothesized delay in the recovery of global ecosystems, where total trophic level ...

    Abstract Mass extinctions change the trajectory of evolution and restructure ecosystems. The largest mass extinction, the end-Permian, is a particularly interesting case due to the hypothesized delay in the recovery of global ecosystems, where total trophic level recovery is not thought to have occurred until 5-9 million years after the extinction event. Diapsids, especially archosauromorphs, play an important role in this recovery, filling niches left vacant by therapsids and anapsids. However, the nature of lineage and ecological diversification of diapsids is obscured by the limited number of continuous, well-dated stratigraphic sections at the Permian-Triassic boundary and continuing through the first half of the Triassic. The Karoo Basin of South Africa is one such record, and particularly the late Early Triassic (Olenekian) Driefontein locality fills this gap in the diapsid fossil record. We collected a total of 102 teeth of which 81 are identified as diapsids and the remaining 21 as identified as temnospondyls. From the sample, seven distinct tooth morphotypes of diapsids are recognized, six of which are new to the locality. We used a combination of linear measurements, 3D geomorphometrics, and nMDS ordination to compare these morphotypes and made inferences about their possible diets. Although the morphotypes are readily differentiated in nMDS, the overall morphological disparity is low, and we infer five morphotypes are faunivorous with the other two potentially omnivorous or piscivorous based on their morphological similarities with dentitions from extant diapsids, demonstrating an unsampled taxonomic and ecological diversity of diapsids in the Early Triassic based on teeth. Although ecological specialization at Driefontein may be low, it records a diversity of diapsid taxa, specifically of archosauromorph lineages.
    MeSH term(s) Ecosystem ; Extinction, Biological ; South Africa ; Fossils ; Tooth ; Biological Evolution ; Biodiversity
    Language English
    Publishing date 2023-05-01
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0285111
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Femoral specializations to locomotor habits in early archosauriforms.

    Pintore, Romain / Houssaye, Alexandra / Nesbitt, Sterling J / Hutchinson, John R

    Journal of anatomy

    2021  Volume 240, Issue 5, Page(s) 867–892

    Abstract: The evolutionary history of archosaurs and their closest relatives is characterized by a wide diversity of locomotor modes, which has even been suggested as a pivotal aspect underlying the evolutionary success of dinosaurs vs. pseudosuchians across the ... ...

    Abstract The evolutionary history of archosaurs and their closest relatives is characterized by a wide diversity of locomotor modes, which has even been suggested as a pivotal aspect underlying the evolutionary success of dinosaurs vs. pseudosuchians across the Triassic-Jurassic transition. This locomotor diversity (e.g., more sprawling/erect; crouched/upright; quadrupedal/bipedal) led to several morphofunctional specializations of archosauriform limb bones that have been studied qualitatively as well as quantitatively through various linear morphometric studies. However, differences in locomotor habits have never been studied across the Triassic-Jurassic transition using 3D geometric morphometrics, which can relate how morphological features vary according to biological factors such as locomotor habit and body mass. Herein, we investigate morphological variation across a dataset of 72 femora from 36 different species of archosauriforms. First, we identify femoral head rotation, distal slope of the fourth trochanter, femoral curvature, and the angle between the lateral condyle and crista tibiofibularis as the main features varying between bipedal and quadrupedal taxa, all of these traits having a stronger locomotor signal than the lesser trochanter's proximal extent. We show a significant association between locomotor mode and phylogeny, but with the locomotor signal being stronger than the phylogenetic signal. This enables us to predict locomotor modes of some of the more ambiguous early archosauriforms without relying on the relationships between hindlimb and forelimb linear bone dimensions as in prior studies. Second, we highlight that the most important morphological variation is linked to the increase of body size, which impacts the width of the epiphyses and the roundness and proximodistal position of the fourth trochanter. Furthermore, we show that bipedal and quadrupedal archosauriforms have different allometric trajectories along the morphological variation in relation to body size. Finally, we demonstrate a covariation between locomotor mode and body size, with variations in femoral bowing (anteroposterior curvature) being more distinct among robust femora than gracile ones. We also identify a decoupling in fourth trochanter variation between locomotor mode (symmetrical to semi-pendant) and body size (sharp to rounded). Our results indicate a similar level of morphological disparity linked to a clear convergence in femoral robusticity between the two clades of archosauriforms (Pseudosuchia and Avemetatarsalia), emphasizing the importance of accounting for body size when studying their evolutionary history, as well as when studying the functional morphology of appendicular features. Determining how early archosauriform skeletal features were impacted by locomotor habits and body size also enables us to discuss the potential homoplasy of some phylogenetic characters used previously in cladistic analyses as well as when bipedalism evolved in the avemetatarsalian lineage. This study illuminates how the evolution of femoral morphology in early archosauriforms was functionally constrained by locomotor habit and body size, which should aid ongoing discussions about the early evolution of dinosaurs and the nature of their evolutionary "success" over pseudosuchians.
    MeSH term(s) Animals ; Biological Evolution ; Dinosaurs/anatomy & histology ; Femur/anatomy & histology ; Habits ; Locomotion ; Lower Extremity ; Phylogeny
    Language English
    Publishing date 2021-11-28
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2955-5
    ISSN 1469-7580 ; 0021-8782
    ISSN (online) 1469-7580
    ISSN 0021-8782
    DOI 10.1111/joa.13598
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Prenatal substance use in the rural and Appalachian state: Project WATCH study 2020‐2022

    Umer, Amna / Garrow, Jana / Nesbitt, Makena / Lilly, Christa / Lefeber, Candice / Breyel, Janine / John, Collin

    The Journal of Rural Health. 2023 Sept., v. 39, no. 4 p.804-815

    2023  

    Abstract: PURPOSE: To examine the prevalence, patterns, and correlates of prenatal substance use in the rural Appalachian state of West Virginia (WV). METHODS: Population‐based cohort (Project WATCH) of all women (N = 34,309) who gave birth between February 2020 ... ...

    Abstract PURPOSE: To examine the prevalence, patterns, and correlates of prenatal substance use in the rural Appalachian state of West Virginia (WV). METHODS: Population‐based cohort (Project WATCH) of all women (N = 34,309) who gave birth between February 2020 and June 2022. A composite substance use variable included 9 categories: “no substance use,” “opioids,” “cannabis,” “sedatives/hypnotics,” “stimulants,” “opioids and cannabis,” “opioids and stimulants,” “cannabis and stimulants,” and “opioids, cannabis, and stimulants.” These data were gathered through self‐report, medical records, and/or positive drug screen at labor and delivery. FINDINGS: 12.4% of women used one or more substances (opioids, cannabis, stimulants, and sedatives/hypnotics) during their current pregnancy. The mean age of women using cannabis was 25.34 (SD = 5.31), stimulants was 28.88 (SD = 5.62), and opioid was 30.19 (SD = 4.78). White women were more likely to use opioids (aOR = 2.19, 95% CI 1.46, 3.28) and less likely to use cannabis (aOR = 0.39, 95% CI 0.34, 0.44) compared to minority racial groups. Women with cannabis use were more likely to live in urban versus rural regions (aOR = 1.47, 95% CI 1.33, 1.62). The odds of using any type of substance(s) were significantly higher in women who smoked (aOR range 4.17‐30.85), had Medicaid (aOR range 1.52‐7.65), and those receiving inadequate prenatal care (aOR range 1.96‐16.83). CONCLUSIONS: In this rural Appalachian state, 1 in 8 women used 1 or more substances (opioids, cannabis, stimulants, and/or sedatives/hypnotics) during pregnancy and the type of substance used varied by sociodemographic and health‐related factors. These factors should inform state‐level strategies and initiatives to address the substance use crisis for this population.
    Keywords labor ; narcotics ; pregnancy ; prenatal care ; rural health ; West Virginia
    Language English
    Dates of publication 2023-09
    Size p. 804-815.
    Publishing place John Wiley & Sons, Ltd
    Document type Article ; Online
    Note JOURNAL ARTICLE
    ZDB-ID 639160-6
    ISSN 0890-765X
    ISSN 0890-765X
    DOI 10.1111/jrh.12752
    Database NAL-Catalogue (AGRICOLA)

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  7. Article ; Online: Clinical Effectiveness and Utilisation of Cardiac Rehabilitation After Hospital Discharge: Data Linkage Analysis of 84,064 Eligible Discharged Patients (2016-2021).

    Beleigoli, Alline / Foote, Jonathon / Gebremichael, Lemlem G / Bulamu, Norma B / Astley, Carolyn / Keech, Wendy / Tavella, Rosanna / Gulyani, Aarti / Nesbitt, Katie / Pinero de Plaza, Maria Alejandra / Ramos, Joyce S / Ludlow, Marie / Nicholls, Stephen J / Chew, Derek P / Beltrame, John / Clark, Robyn A

    Heart, lung & circulation

    2024  

    Abstract: Background: Despite the highest levels of evidence on cardiac rehabilitation (CR) effectiveness, its translation into practice is compromised by low participation.: Aim: This study aimed to investigate CR utilisation and effectiveness in South ... ...

    Abstract Background: Despite the highest levels of evidence on cardiac rehabilitation (CR) effectiveness, its translation into practice is compromised by low participation.
    Aim: This study aimed to investigate CR utilisation and effectiveness in South Australia.
    Methods: This retrospective cohort study used data linkage of clinical and administrative databases from 2016 to 2021 to assess the association between CR utilisation (no CR received, commenced without completing, or completed) and the composite primary outcome (mortality/cardiovascular re-admissions within 12 months after discharge). Cox survival models were adjusted for sociodemographic and clinical data and applied to a population balanced by inverse probability weighting. Associations with non-completion were assessed by logistic regression.
    Results: Among 84,064 eligible participants, 74,189 did not receive CR, with 26,833 of the 84,064 (31.9%) participants referred. Of these, 9,875 (36.8%) commenced CR, and 7,681 of the 9,875 (77.8%) completed CR. Median waiting time from discharge to commencement was 40 days (interquartile range, 23-79 days). Female sex (odds ratio [OR] 1.12; 95% CI 1.01-1.24; p=0.024), depression (OR 1.17; 95% CI 1.05-1.30; p=0.002), and waiting time >28 days (OR 1.15; 95% CI 1.05-1.26; p=0.005) were associated with higher odds of non-completion, whereas enrolment in a telehealth program (OR 0.35; 95% CI 0.31-0.40; p<0.001) was associated with lower odds of non-completion. Completing CR (hazard ratio [HR] 0.62; 95% CI 0.58-0.66; p<0.001) was associated with a lower risk of 12-month mortality/cardiovascular re-admissions. Commencing without completing was also associated with decreased risk (HR 0.81; 95% CI 0.73-0.90; p<0.001), but the effect was lower than for those completing CR (p<0.001).
    Conclusions: Cardiac rehabilitation (CR) attendance is associated with lower all-cause mortality/cardiovascular re-admissions, with CR completion leading to additional benefits. Quality improvement initiatives should include promoting referral, women's participation, access to telehealth, and reduction of waiting times to increase completion.
    Language English
    Publishing date 2024-03-05
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2020980-0
    ISSN 1444-2892 ; 1443-9506
    ISSN (online) 1444-2892
    ISSN 1443-9506
    DOI 10.1016/j.hlc.2024.01.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Correction to: Nanotechnology-augmented sonodynamic therapy and associated immune-mediated effects for the treatment of pancreatic ductal adenocarcinoma.

    Hadi, Marym Mohammad / Farrell, Sian / Nesbitt, Heather / Thomas, Keith / Kubajewska, Ilona / Ng, Alex / Masood, Hamzah / Patel, Shiv / Sciscione, Fabiola / Davidson, Brian / Callan, John F / MacRobert, Alexander J / McHale, Anthony P / Nomikou, Nikolitsa

    Journal of cancer research and clinical oncology

    2023  Volume 149, Issue 10, Page(s) 8165–8166

    Language English
    Publishing date 2023-01-20
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 134792-5
    ISSN 1432-1335 ; 0171-5216 ; 0084-5353 ; 0943-9382
    ISSN (online) 1432-1335
    ISSN 0171-5216 ; 0084-5353 ; 0943-9382
    DOI 10.1007/s00432-023-04648-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Hepatitis E Virus Outbreak among Tigray War Refugees from Ethopia, Sudan.

    Azman, Andrew S / Gignoux, Etienne / Nesbitt, Robin / Rumunu, John / Aggarwal, Rakesh / Ciglenecki, Iza

    Emerging infectious diseases

    2023  Volume 29, Issue 2

    MeSH term(s) Humans ; Sudan/epidemiology ; Hepatitis E virus/genetics ; Refugees ; Disease Outbreaks
    Language English
    Publishing date 2023-01-24
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1380686-5
    ISSN 1080-6059 ; 1080-6040
    ISSN (online) 1080-6059
    ISSN 1080-6040
    DOI 10.3201/eid2902.221495
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Vaccination coverage and adverse events following a reactive vaccination campaign against hepatitis E in Bentiu displaced persons camp, South Sudan.

    Nesbitt, Robin C / Asilaza, Vincent Kinya / Gignoux, Etienne / Koyuncu, Aybüke / Gitahi, Priscillah / Nkemenang, Patrick / Duncker, Jetske / Antier, Zelie / Haile, Melat / Gakima, Primitive / Wamala, Joseph F / Loro, Fredrick Beden / Biem, Duol / Rull, Monica / Azman, Andrew S / Rumunu, John / Ciglenecki, Iza

    PLoS neglected tropical diseases

    2024  Volume 18, Issue 1, Page(s) e0011661

    Abstract: Introduction: Hepatitis E (HEV) genotypes 1 and 2 are the common cause of jaundice and acute viral hepatitis that can cause large-scale outbreaks. HEV infection is associated with adverse fetal outcomes and case fatality risks up to 31% among pregnant ... ...

    Abstract Introduction: Hepatitis E (HEV) genotypes 1 and 2 are the common cause of jaundice and acute viral hepatitis that can cause large-scale outbreaks. HEV infection is associated with adverse fetal outcomes and case fatality risks up to 31% among pregnant women. An efficacious three-dose recombinant vaccine (Hecolin) has been licensed in China since 2011 but until 2022, had not been used for outbreak response despite a 2015 WHO recommendation. The first ever mass vaccination campaign against hepatitis E in response to an outbreak was implemented in 2022 in Bentiu internally displaced persons camp in South Sudan targeting 27,000 residents 16-40 years old, including pregnant women.
    Methods: We conducted a vaccination coverage survey using simple random sampling from a sampling frame of all camp shelters following the third round of vaccination. For survey participants vaccinated in the third round in October, we asked about the onset of symptoms experienced within 72 hours of vaccination. During each of the three vaccination rounds, passive surveillance of adverse events following immunisation (AEFI) was put in place at vaccination sites and health facilities in Bentiu IDP camp.
    Results: We surveyed 1,599 individuals and found that self-reported coverage with one or more dose was 86% (95% CI 84-88%), 73% (95% CI 70-75%) with two or more doses and 58% (95% CI 55-61%) with three doses. Vaccination coverage did not differ significantly by sex or age group. We found no significant difference in coverage of at least one dose between pregnant and non-pregnant women, although coverage of at least two and three doses was 8 and 14 percentage points lower in pregnant women. The most common reasons for non-vaccination were temporary absence or unavailability, reported by 60% of unvaccinated people. Passive AEFI surveillance captured few mild AEFI, and through the survey we found that 91 (7.6%) of the 1,195 individuals reporting to have been vaccinated in October 2022 reported new symptoms starting within 72 hours after vaccination, most commonly fever, headache or fatigue.
    Conclusions: We found a high coverage of at least one dose of the Hecolin vaccine following three rounds of vaccination, and no severe AEFI. The vaccine was well accepted and well tolerated in the Bentiu IDP camp community and should be considered for use in future outbreak response.
    MeSH term(s) Humans ; Female ; Pregnancy ; Adolescent ; Young Adult ; Adult ; Vaccination Coverage ; Refugees ; Hepatitis E/epidemiology ; Hepatitis E/prevention & control ; South Sudan/epidemiology ; Vaccination/adverse effects ; Immunization Programs
    Language English
    Publishing date 2024-01-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2429704-5
    ISSN 1935-2735 ; 1935-2735
    ISSN (online) 1935-2735
    ISSN 1935-2735
    DOI 10.1371/journal.pntd.0011661
    Database MEDical Literature Analysis and Retrieval System OnLINE

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