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Article ; Online: Uncovering the Spectrum of Postnatal Zika Infection in Children.

Asturias, Edwin J

2018 Volume 172, Issue 7, Page(s) 624–625

MeSH term(s)	Adolescent ; Child ; Humans ; Infant ; Microcephaly ; Puerto Rico ; Zika Virus ; Zika Virus Infection
Language	English
Publishing date	2018-05-29
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2701223-2
ISSN	2168-6211 ; 2168-6203
ISSN (online)	2168-6211
ISSN	2168-6203
DOI	10.1001/jamapediatrics.2018.0921
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Article ; Online: Differences in parental vaccine confidence and attitudes by health system in Guatemala and their impact on immunization timeliness.

Kuan-Mahecha, Maria A / Rahman, Sabrina / Martínez-Rivera, Paola / Lamb, Molly M / Asturias, Edwin J

Vaccine

2023 Volume 41, Issue 19, Page(s) 3099–3105

Abstract: Objective: The objectives of this study were to evaluate parental confidence and attitudes towards immunization in urban Guatemala between private versus public health systems and their impact on vaccination timeliness in their children.: Methods: A ... ...

Abstract	Objective: The objectives of this study were to evaluate parental confidence and attitudes towards immunization in urban Guatemala between private versus public health systems and their impact on vaccination timeliness in their children. Methods: A cross-sectional survey was conducted in parents 6-18-month-old children who attended well-child outpatient clinics from two health systems (public employee-based insurance and private health care) in Guatemala City from November 2017 through August 2018. Parental demographics, household characteristics, food insecurity, vaccine hesitancy using the WHO SAGE Vaccine Hesitancy Scale, and information on parental use of social media platforms and vaccine information sources were collected. Results: Five hundred-three parents were surveyed, most of them mothers. Only 9 parents reported they had previously refused a vaccine for their child: 8 (3.2 %) from private clinics and 1 (0.4 %) from the public clinic (p = 0.02). Significantly more children attending private clinics (226, 90.4 %) were shown to have a delay in any of their vaccines scheduled for the first 2 years of life compared to those in the public clinic (169, 66.8 %; p < 0.01). Children of parents having a college degree (84.5 vs 70.1 %; p < 0.001), earning more than US$ 1,000 per month (81.5 vs 70.7 %; p < 0.001), and having a computer at home (81.4 vs 70.2; p = 0.007) were more likely to have any delays in the scheduled vaccines. Parents seeking care at private clinics were 1.14 times more at risk of delaying a vaccine compared to those at the public clinic, adjusted for other covariates (p = 0.03, 95 % CI: 1.01, 1.28). Conclusions: In Guatemala, children receiving immunizations at private clinics were significantly more likely than those attending public clinics to be delayed in their immunization schedule and to remain more days without the recommended protection, especially for third doses of the primary vaccine series.
MeSH term(s)	Female ; Humans ; Infant ; Guatemala ; Cross-Sectional Studies ; Vaccination ; Immunization ; Vaccines ; Parents ; Attitude ; Health Knowledge, Attitudes, Practice
Chemical Substances	Vaccines
Language	English
Publishing date	2023-04-13
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2023.03.064
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Article ; Online: Differences in parental vaccine confidence and attitudes by health system in Guatemala and their impact on immunization timeliness

Kuan-Mahecha, Maria A. / Rahman, Sabrina / Martínez-Rivera, Paola / Lamb, Molly M. / Asturias, Edwin J.

Vaccine. 2023 Apr. 13,

2023

Abstract: The objectives of this study were to evaluate parental confidence and attitudes towards immunization in urban Guatemala between private versus public health systems and their impact on vaccination timeliness in their children. A cross-sectional survey ... ...

Abstract	The objectives of this study were to evaluate parental confidence and attitudes towards immunization in urban Guatemala between private versus public health systems and their impact on vaccination timeliness in their children. A cross-sectional survey was conducted in parents 6–18-month-old children who attended well-child outpatient clinics from two health systems (public employee-based insurance and private health care) in Guatemala City from November 2017 through August 2018. Parental demographics, household characteristics, food insecurity, vaccine hesitancy using the WHO SAGE Vaccine Hesitancy Scale, and information on parental use of social media platforms and vaccine information sources were collected. Five hundred-three parents were surveyed, most of them mothers. Only 9 parents reported they had previously refused a vaccine for their child: 8 (3.2 %) from private clinics and 1 (0.4 %) from the public clinic (p = 0.02). Significantly more children attending private clinics (226, 90.4 %) were shown to have a delay in any of their vaccines scheduled for the first 2 years of life compared to those in the public clinic (169, 66.8 %; p < 0.01). Children of parents having a college degree (84.5 vs 70.1 %; p < 0.001), earning more than US$ 1,000 per month (81.5 vs 70.7 %; p < 0.001), and having a computer at home (81.4 vs 70.2; p = 0.007) were more likely to have any delays in the scheduled vaccines. Parents seeking care at private clinics were 1.14 times more at risk of delaying a vaccine compared to those at the public clinic, adjusted for other covariates (p = 0.03, 95 % CI: 1.01, 1.28). In Guatemala, children receiving immunizations at private clinics were significantly more likely than those attending public clinics to be delayed in their immunization schedule and to remain more days without the recommended protection, especially for third doses of the primary vaccine series.
Keywords	academic degrees ; children ; computers ; cross-sectional studies ; demographic statistics ; food security ; health services ; insurance ; public health ; risk ; vaccination ; vaccines ; Guatemala ; Confidence ; Attitudes ; Refusal ; Private ; Media ; Timeliness
Language	English
Dates of publication	2023-0413
Publishing place	Elsevier Ltd
Document type	Article ; Online
Note	Pre-press version
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2023.03.064
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Article ; Online: Women scientist and the will to prevent Hib disease.

Asturias, Edwin J

The Pediatric infectious disease journal

2014 Volume 33, Issue 12, Page(s) 1311

MeSH term(s)	Carrier State/epidemiology ; Carrier State/microbiology ; Carrier State/prevention & control ; Child ; Female ; Haemophilus Infections/epidemiology ; Haemophilus Infections/microbiology ; Haemophilus Infections/prevention & control ; Haemophilus Infections/transmission ; Haemophilus influenzae type b/isolation & purification ; History, 20th Century ; History, 21st Century ; Humans ; Male ; Mucocutaneous Lymph Node Syndrome/diagnosis ; Mucocutaneous Lymph Node Syndrome/pathology ; Mucocutaneous Lymph Node Syndrome/therapy ; Post-Exposure Prophylaxis/methods
Language	English
Publishing date	2014-12
Publishing country	United States
Document type	Biography ; Historical Article ; Letter
ZDB-ID	392481-6
ISSN	1532-0987 ; 0891-3668
ISSN (online)	1532-0987
ISSN	0891-3668
DOI	10.1097/INF.0000000000000447
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Article ; Online: Vital sign predictors of severe influenza among children in an emergent care setting.

Rao, Suchitra / Moss, Angela / Lamb, Molly / Innis, Bruce L / Asturias, Edwin J

PloS one

2022 Volume 17, Issue 8, Page(s) e0272029

Abstract: Background: Decisions regarding the evaluation of children with influenza infection rely on the likelihood of severe disease. The role of early vital signs as predictors of severe influenza infection in children is not well known. Our objectives were to ...

Abstract	Background: Decisions regarding the evaluation of children with influenza infection rely on the likelihood of severe disease. The role of early vital signs as predictors of severe influenza infection in children is not well known. Our objectives were to determine the value of vital signs in predicting hospitalization/recurrent emergency department (ED) visits due to influenza infection in children. Methods: We conducted a prospective study of children aged 6 months to 8 years of age with influenza like illness evaluated at an ED/UC from 2016-2018. All children underwent influenza testing by PCR. We collected heart rate, respiratory rate and temperature, and converted heart rate (HR) and respiratory rate (RR) to z-scores by age. HR z scores were further adjusted for temperature. Our primary outcome was hospitalization/recurrent ED visits within 72 hours. Vital sign predictors with p< 0.2 and other clinical covariates were entered into a multivariable logistic regression model to determine odds ratios (OR) and 95% CI; model performance was assessed using the Brier score and discriminative ability with the C statistic. Results: Among 1478 children, 411 (27.8%) were positive for influenza, of which 42 (10.2%) were hospitalized or had a recurrent ED visit. In multivariable analyses, adjusting for age, high-risk medical condition and school/daycare attendance, higher adjusted respiratory rate (OR 2.09, 95%CI 1.21-3.61, p = 0.0085) was a significant predictor of influenza hospitalization/recurrent ED visits. Conclusions: Higher respiratory rate adjusted for age was the most useful vital sign predictor of severity among young children with PCR-confirmed influenza.
MeSH term(s)	Child ; Child, Preschool ; Emergency Service, Hospital ; Hospitalization ; Humans ; Infant ; Influenza, Human/diagnosis ; Influenza, Human/epidemiology ; Prospective Studies ; Vital Signs/physiology
Language	English
Publishing date	2022-08-12
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0272029
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Article ; Online: Community perceptions of vaccine advocacy for children under five in rural Guatemala.

Williams, Joshua T B / Robinson, Kelsey / Abbott, Elizabeth / Rojop, Neudy / Shiffman, Michelle / Rice, John D / O'Leary, Sean T / Asturias, Edwin J

PLOS global public health

2023 Volume 3, Issue 5, Page(s) e0000728

Abstract: Historically, partnerships with community leaders (e.g., religious leaders, teachers) have been critical to building vaccination confidence, but leaders may be increasingly vaccine hesitant. In rural Guatemala, the extent of vaccine hesitancy among ... ...

Abstract	Historically, partnerships with community leaders (e.g., religious leaders, teachers) have been critical to building vaccination confidence, but leaders may be increasingly vaccine hesitant. In rural Guatemala, the extent of vaccine hesitancy among community leaders is unclear, as are their perceptions of advocacy for childhood vaccines. We sought to: (i) compare Guatemalan religious leaders' and community leaders' attitudes toward childhood vaccines, (ii) describe leaders' experiences and comfort with vaccination advocacy, and (iii) describe community members' trust in them as vaccination advocates. In 2019, we surveyed religious leaders, other community leaders, and parents of children under five in rural Guatemala. We recorded participant demographic information and assessed participant vaccine hesitancy regarding childhood vaccines. We analyzed data descriptively and via adjusted regression modeling. Our sample included 50 religious leaders, 50 community leaders, and 150 community members (response rate: 99%); 14% of religious leaders and community leaders were vaccine hesitant, similar to community members (P = 0.71). In the prior year, 47% of leaders had spoken about vaccines in their formal role; 85% felt responsible to do so. Only 28% of parents trusted politicians "a lot" for vaccine advice, versus doctors (72%; P < 0.01), nurses (62%; P < 0.01), religious leaders (49%; P < 0.01), and teachers (48%; P < 0.01). In this study, religious leaders and community leaders were willing but incompletely engaged vaccination advocates. Most community members trusted doctors and nurses a lot for vaccination advice; half trusted teachers and religious leaders similarly. Public health officials in rural Guatemala can complement efforts by doctors and nurses through partnerships with teachers and religious leaders to increase vaccination confidence and delivery.
Language	English
Publishing date	2023-05-22
Publishing country	United States
Document type	Journal Article
ISSN	2767-3375
ISSN (online)	2767-3375
DOI	10.1371/journal.pgph.0000728
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Article ; Online: Evaluation of Influenza Vaccine Effectiveness Among Young Children Receiving Consecutive Versus Nonconsecutive Vaccination During Influenza A(H3N2)-Predominant Seasons.

Rao, Suchitra / Moss, Angela / Lamb, Molly M / Asturias, Edwin J

Journal of the Pediatric Infectious Diseases Society

2020 Volume 10, Issue 3, Page(s) 359–362

Abstract: A test-negative case-control analysis of 1478 children aged 6 months to 8 years of age seeking care at an emergency/urgent care setting with influenza like illness during the 2016-17 and 2018-19 (H3N2 predominant) influenza seasons demonstrated that ... ...

Abstract	A test-negative case-control analysis of 1478 children aged 6 months to 8 years of age seeking care at an emergency/urgent care setting with influenza like illness during the 2016-17 and 2018-19 (H3N2 predominant) influenza seasons demonstrated that influenza vaccine effectiveness did not vary significantly by the prior seasons' vaccination status. Clinical trials registration: NCT02979626.
MeSH term(s)	Case-Control Studies ; Child ; Child, Preschool ; Humans ; Influenza A Virus, H3N2 Subtype ; Influenza Vaccines ; Influenza, Human/prevention & control ; Seasons ; Vaccination
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2020-08-06
Publishing country	England
Document type	Clinical Study ; Journal Article
ZDB-ID	2668791-4
ISSN	2048-7207 ; 2048-7193
ISSN (online)	2048-7207
ISSN	2048-7193
DOI	10.1093/jpids/piaa080
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Article: Advanced vaccinology education: Landscaping its growth and global footprint

Asturias, Edwin J / Duclos, Philippe / MacDonald, Noni E / Nohynek, Hanna / Lambert, Paul-Henri

Vaccine. 2020 June 19, v. 38, no. 30

2020

Abstract: In preparation for the first Global Vaccinology Training workshop in 2018, a survey of 27 advanced vaccinology courses was conducted to provide a landscape of the vaccinology education around the world. Advanced vaccinology courses have expanded ... ...

Institution	the Global Vaccinology Training Collaborative
Abstract	In preparation for the first Global Vaccinology Training workshop in 2018, a survey of 27 advanced vaccinology courses was conducted to provide a landscape of the vaccinology education around the world. Advanced vaccinology courses have expanded dramatically over the last 20 years, with courses located in almost all regions, but with underrepresentation amongst the Eastern part of the European region, the Eastern Mediterranean and the Western Pacific regions. Most courses are of short duration (<2 weeks), have a global or regional reach, and attract a diverse range of participants from high, middle and low-income countries with representation from public health, academia, industry and less often regulators. Lack of sustainable funding and time commitments of faculty and coordinators is a constraint for most vaccinology courses and needs to be addressed. Continuation and extension of training in vaccinology worldwide will be necessary as increasing number of new and more complex vaccines are introduced, vaccine safety concerns and rumors continue their trend, and reemergence of some vaccine-preventable diseases will require a competent workforce to advance and deploy immunizations to larger populations.
Keywords	education ; industry ; labor force ; public health ; surveys ; vaccine development ; vaccines ; Europe
Language	English
Dates of publication	2020-0619
Size	p. 4664-4670.
Publishing place	Elsevier Ltd
Document type	Article
Note	NAL-AP-2-clean
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2020.05.038
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Article ; Online: What can we learn about influenza infection and vaccination from transcriptomics?

Rao, Suchitra / Ghosh, Debashis / Asturias, Edwin J / Weinberg, Adriana

Human vaccines & immunotherapeutics

2019 Volume 15, Issue 11, Page(s) 2615–2623

Abstract: Transcriptomics studies the set of RNA transcripts produced by the genome using high-throughput sequencing and bioinformatics. This growing field has revolutionized our understanding of host-pathogen interactions, revealing new insights into the host ... ...

Abstract	Transcriptomics studies the set of RNA transcripts produced by the genome using high-throughput sequencing and bioinformatics. This growing field has revolutionized our understanding of host-pathogen interactions, revealing new insights into the host response to influenza infection and vaccination. Studies using transcriptomics have identified a unique immunosignature for influenza discernable from other bacterial and viral pathogens, key transcriptional factors that discriminate early from late, mild versus severe, and symptomatic versus asymptomatic infection. Recent studies evaluating the host response to influenza vaccines have revealed key differences in live versus inactivated influenza vaccines, identified early transcriptional signatures that predict hemagglutinin antibody production following vaccination, increased our understanding of how adjuvants enhance the immune response to influenza vaccine antigens, and demonstrate biologic variability in the response to vaccination due to host factors. These studies demonstrate the potential for influenza transcriptomics to be applied to clinical care, understanding the mechanisms of infection, and informing vaccine development.
MeSH term(s)	Adjuvants, Immunologic ; Antibodies, Viral ; Computational Biology/methods ; Gene Expression Profiling ; Host-Pathogen Interactions/genetics ; Host-Pathogen Interactions/immunology ; Humans ; Influenza Vaccines/immunology ; Influenza, Human/immunology ; Influenza, Human/prevention & control ; Transcriptome ; Vaccination
Chemical Substances	Adjuvants, Immunologic ; Antibodies, Viral ; Influenza Vaccines
Language	English
Publishing date	2019-05-22
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2664176-8
ISSN	2164-554X ; 2164-5515
ISSN (online)	2164-554X
ISSN	2164-5515
DOI	10.1080/21645515.2019.1608744
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Article ; Online: SARS-CoV-2 Viral Shedding and Rapid Antigen Test Performance - Respiratory Virus Transmission Network, November 2022-May 2023.

Smith-Jeffcoat, Sarah E / Mellis, Alexandra M / Grijalva, Carlos G / Talbot, H Keipp / Schmitz, Jonathan / Lutrick, Karen / Ellingson, Katherine D / Stockwell, Melissa S / McLaren, Son H / Nguyen, Huong Q / Rao, Suchitra / Asturias, Edwin J / Davis-Gardner, Meredith E / Suthar, Mehul S / Kirking, Hannah L

MMWR. Morbidity and mortality weekly report

2024 Volume 73, Issue 16, Page(s) 365–371

Abstract: As population immunity to SARS-CoV-2 evolves and new variants emerge, the role and accuracy of antigen tests remain active questions. To describe recent test performance, the detection of SARS-CoV-2 by antigen testing was compared with that by reverse ... ...

Abstract	As population immunity to SARS-CoV-2 evolves and new variants emerge, the role and accuracy of antigen tests remain active questions. To describe recent test performance, the detection of SARS-CoV-2 by antigen testing was compared with that by reverse transcription-polymerase chain reaction (RT-PCR) and viral culture testing during November 2022-May 2023. Participants who were enrolled in a household transmission study completed daily symptom diaries and collected two nasal swabs (tested for SARS-CoV-2 via RT-PCR, culture, and antigen tests) each day for 10 days after enrollment. Among participants with SARS-CoV-2 infection, the percentages of positive antigen, RT-PCR, and culture results were calculated each day from the onset of symptoms or, in asymptomatic persons, from the date of the first positive test result. Antigen test sensitivity was calculated using RT-PCR and viral culture as references. The peak percentage of positive antigen (59.0%) and RT-PCR (83.0%) results occurred 3 days after onset, and the peak percentage of positive culture results (52%) occurred 2 days after onset. The sensitivity of antigen tests was 47% (95% CI = 44%-50%) and 80% (95% CI = 76%-85%) using RT-PCR and culture, respectively, as references. Clinicians should be aware of the lower sensitivity of antigen testing compared with RT-PCR, which might lead to false-negative results. This finding has implications for timely initiation of SARS-CoV-2 antiviral treatment, when early diagnosis is essential; clinicians should consider RT-PCR for persons for whom antiviral treatment is recommended. Persons in the community who are at high risk for severe COVID-19 illness and eligible for antiviral treatment should seek testing from health care providers with the goal of obtaining a more sensitive diagnostic test than antigen tests (i.e., an RT-PCR test).
MeSH term(s)	Humans ; COVID-19/diagnosis ; COVID-19/transmission ; SARS-CoV-2/isolation & purification ; SARS-CoV-2/immunology ; SARS-CoV-2/genetics ; COVID-19 Serological Testing ; Adult ; Virus Shedding ; Antigens, Viral/analysis ; Male ; Sensitivity and Specificity ; Female ; Middle Aged ; COVID-19 Nucleic Acid Testing ; Young Adult ; Adolescent ; United States/epidemiology ; Aged ; COVID-19 Testing
Chemical Substances	Antigens, Viral
Language	English
Publishing date	2024-04-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	412775-4
ISSN	1545-861X ; 0149-2195
ISSN (online)	1545-861X
ISSN	0149-2195
DOI	10.15585/mmwr.mm7316a2
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