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Article: Not only vaccine hesitancy, but also vaccination campaign hesitancy drives measles epidemics in conflict-torn eastern DR Congo.

Van Brusselen, Daan / Dubois, Ali Heshima / Bindu, Lucien Kandundao / Moluh, Zakari / Nzomukunda, Yvonne / Liesenborghs, Laurens

Conflict and health

2024 Volume 18, Issue 1, Page(s) 14

Abstract: The COVID-19 pandemic and vaccine hesitancy are not the only causes of the increase in measles cases in low- and middle-income countries. Measles epidemics, like the recent one in eastern DRC, are often quickly halted by mass vaccination in 'easy to ... ...

Abstract	The COVID-19 pandemic and vaccine hesitancy are not the only causes of the increase in measles cases in low- and middle-income countries. Measles epidemics, like the recent one in eastern DRC, are often quickly halted by mass vaccination in 'easy to reach' refugee camps. However, governmental and humanitarian actors fail to respond effectively in 'hard-to-reach' areas like Masisi, frequently limiting themselves to more accessible areas close to big cities.
Language	English
Publishing date	2024-02-01
Publishing country	England
Document type	Letter
ZDB-ID	2273783-2
ISSN	1752-1505
ISSN	1752-1505
DOI	10.1186/s13031-024-00569-6
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Article ; Online: Air pollution and bronchiolitis: a case-control study in Antwerp, Belgium.

Van Brusselen, Daan / De Troeyer, Katrien / van Vliet, Marinus Pieter / Avonts, Dirk / Nemery, Benoit / Liesenborghs, Laurens / Verhulst, Stijn / Van Herck, Koen / De Bacquer, Dirk

European journal of pediatrics

2024 Volume 183, Issue 5, Page(s) 2431–2442

Abstract: This case-control study aimed to investigate the association between short-term (1 to 5 days) and medium-term (31 days) exposure to air pollutants ( ... ...

Abstract	This case-control study aimed to investigate the association between short-term (1 to 5 days) and medium-term (31 days) exposure to air pollutants (PM
MeSH term(s)	Humans ; Bronchiolitis/epidemiology ; Bronchiolitis/etiology ; Belgium/epidemiology ; Case-Control Studies ; Infant ; Male ; Female ; Air Pollution/adverse effects ; Environmental Exposure/adverse effects ; Particulate Matter/adverse effects ; Particulate Matter/analysis ; Air Pollutants/adverse effects ; Air Pollutants/analysis ; Hospitalization/statistics & numerical data ; Infant, Newborn ; Risk Factors ; Logistic Models
Chemical Substances	Particulate Matter ; Air Pollutants
Language	English
Publishing date	2024-03-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-024-05493-8
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Article ; Online: A case of multisystem inflammatory syndrome (MIS-A) in an adult woman 18 days after COVID-19 vaccination.

Stappers, Sofie / Ceuleers, Britt / Van Brusselen, Daan / Willems, Philippe / de Tavernier, Brecht / Verlinden, Anke

Acta clinica Belgica

2021 Volume 77, Issue 4, Page(s) 772–777

Abstract: We discuss a case of a young woman, presenting a constellation of clinical and biochemical features meeting the current case definition of multisystem inflammatory syndrome in adults (MIS-A), 18 days after receiving her first dose of the Oxford/ ... ...

Abstract	We discuss a case of a young woman, presenting a constellation of clinical and biochemical features meeting the current case definition of multisystem inflammatory syndrome in adults (MIS-A), 18 days after receiving her first dose of the Oxford/AstraZeneca vaccine. Therapy by means of intravenous immunoglobulins was initiated, leading to clinical and biochemical recovery. Although a relationship between MIS-A and the preceding vaccination cannot be confirmed, it can also not be excluded, given the temporal association and the fact that there were no indicators of a preceding SARS-CoV-2 infection.
MeSH term(s)	Adult ; COVID-19 ; COVID-19 Vaccines/adverse effects ; Female ; Humans ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome/chemically induced ; Vaccination
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2021-09-12
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	390201-8
ISSN	2295-3337 ; 0001-5512 ; 1784-3286
ISSN (online)	2295-3337
ISSN	0001-5512 ; 1784-3286
DOI	10.1080/17843286.2021.1977899
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Article ; Online: The burden and surveillance of RSV disease in young children in Belgium-expert opinion.

Raes, Marc / Daelemans, Siel / Cornette, Luc / Moniotte, Stéphane / Proesmans, Marijke / Schaballie, Heidi / Frère, Julie / Vanden Driessche, Koen / Van Brusselen, Daan

European journal of pediatrics

2022 Volume 182, Issue 1, Page(s) 451–460

Abstract: Infections with respiratory syncytial virus (RSV) can cause severe disease. In young children, RSV is the most common cause of lower respiratory tract illness and life-threatening infections most commonly occur in the first years of life. In adults, ... ...

Abstract	Infections with respiratory syncytial virus (RSV) can cause severe disease. In young children, RSV is the most common cause of lower respiratory tract illness and life-threatening infections most commonly occur in the first years of life. In adults, elderly and immunocompromised people are most vulnerable. Recently there has been an acceleration in the development of candidate RSV vaccines, monoclonal antibodies and therapeutics which are expected to become available in Europe within the next 2-10 years. Understanding the true burden of childhood RSV disease will become very important to support public health authorities and policy makers in the assessment of new therapeutic opportunities against RSV disease. A systematic literature search was performed to map local data on the burden of RSV disease and to evaluate available RSV surveillance systems. A group of 9 paediatric infectious diseases specialists participated in an expert panel. The purpose of this meeting was to evaluate and map the burden associated with RSV infection in children, including patient pathways and the epidemiological patterns of virus circulation in Belgium. Sources of information on the burden of RSV disease in Belgium are very limited. For the outpatient setting, it is estimated that 5-10% of young patients seen in primary care are referred to the hospital. Around 3500 children between 0 and 12 months of age are hospitalized for RSV-bronchiolitis every year and represent the majority of all hospitalizations. The current Belgian RSV surveillance system was evaluated and found to be insufficient. Knowledge gaps are highlighted and future perspectives and priorities offered. Conclusion: The Belgian population-based RSV surveillance should be improved, and a hospital-led reporting system should be put in place to enable the evaluation of the true burden of RSV disease in Belgium and to improve disease management in the future. What is known: • RSV bronchiolitis is a very important cause of infant hospitalization. • The burden of disease in the community is poorly studied and underestimated. What is new: • This expert opinion summarizes knowledge gaps and offers insights that allow improvement of local surveillance systems in order to establish a future-proof RSV surveillance system.
MeSH term(s)	Humans ; Infant ; Infant, Newborn ; Belgium/epidemiology ; Bronchiolitis/epidemiology ; Bronchiolitis/virology ; Hospitalization ; Population Surveillance ; Respiratory Syncytial Virus Infections/epidemiology ; Respiratory Syncytial Virus, Human
Language	English
Publishing date	2022-11-12
Publishing country	Germany
Document type	Journal Article ; Systematic Review
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-022-04698-z
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Article ; Online: Transplacental transfer of cobalt: Evidence from a study of mothers and their neonates in the African Copperbelt.

Kayembe-Kitenge, Tony / Nkulu, Célestin Banza Lubaba / Musanzayi, Sébastien Mbuyi / Kasole, Toni Lubala / Ngombe, Leon Kabamba / Obadia, Paul Musa / Van Brusselen, Daan / Mukoma, Daniel Kyanika Wa / Musambo, Taty Muta / Mulangu, Augustin Mutombo / Banza, Patient Nkulu / Katoto, P D M C / Smolders, Erik / Nemery, Benoit / Nawrot, Tim

Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS)

2023 Volume 80, Page(s) 127294

Abstract: Background: Transfer of the trace metal cobalt (Co) from mother to foetus has not been documented in populations with high environmental exposure to Co, as is the case in the African Copperbelt mining region. We analysed data obtained from 246 mother- ... ...

Abstract	Background: Transfer of the trace metal cobalt (Co) from mother to foetus has not been documented in populations with high environmental exposure to Co, as is the case in the African Copperbelt mining region. We analysed data obtained from 246 mother-infant pairs included (at delivery) in a previously published case-control study on birth defects, done in Lubumbashi (Democratic Republic of Congo) between March 1, 2013, and Feb 28, 2015. Methods: Co was measured by Inductively Coupled Plasma Mass Spectrometry in maternal blood, maternal urine, umbilical cord blood and placental tissue, as available. Results: The Co concentrations [geometric mean (GM) with interquartile range (IQR)] in maternal blood (GM 1.77 µg/L, IQR 1.07-2.93) and urine (GM 7.42 µg/g creatinine, IQR 4.41-11.0) were highly correlated (Spearman r = 0.71, n = 166; p < 0.001) and considerably higher than reference values determined for general populations elsewhere in the world. The concentrations of Co in umbilical cord blood (GM 2.41 µg/L) were higher (Wilcoxon test, p < 0.001) than in maternal blood (GM 1.37 µg/L), with a correlation between both values (Spearman r = 0.34; n = 127, p < 0.001). Co concentrations in placental tissue (geometric mean 0.02 µg/g wet weight) correlated with concentrations in maternal blood (Spearman r = 0.50, n = 86, p < 0.001) and in neonatal blood (Spearman r = 0.23, n = 83, p = 0.039). Conclusion: This first study of maternal and neonatal Co concentrations in the African Copperbelt provides strong evidence of a high transfer of Co from mother to foetus.
MeSH term(s)	Infant ; Infant, Newborn ; Humans ; Female ; Pregnancy ; Cobalt/analysis ; Mothers ; Case-Control Studies ; Placenta ; Zambia ; Fetal Blood/chemistry
Chemical Substances	Cobalt (3G0H8C9362)
Language	English
Publishing date	2023-08-26
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1236267-0
ISSN	1878-3252 ; 1611-602X ; 0946-672X
ISSN (online)	1878-3252 ; 1611-602X
ISSN	0946-672X
DOI	10.1016/j.jtemb.2023.127294
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Article ; Online: Lupus anticoagulant hypoprothrombinaemia syndrome: An instructive paediatric case.

Vandamme, Sarah / Desclée, Emilie / Ver Elst, Kristien / Weekx, Steven / Maes, Philip / Van Brusselen, Daan / Vermeiren, Sigrid

Journal of paediatrics and child health

2020 Volume 57, Issue 3, Page(s) 443–444

MeSH term(s)	Antiphospholipid Syndrome/complications ; Antiphospholipid Syndrome/diagnosis ; Blood Coagulation Disorders ; Child ; Humans ; Hypoprothrombinemias/diagnosis ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic
Chemical Substances	Lupus Coagulation Inhibitor
Language	English
Publishing date	2020-04-12
Publishing country	Australia
Document type	Case Reports ; Journal Article
ZDB-ID	1024476-1
ISSN	1440-1754 ; 1034-4810
ISSN (online)	1440-1754
ISSN	1034-4810
DOI	10.1111/jpc.14889
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Article ; Online: Growth and neurodevelopment in low birth weight versus normal birth weight infants from birth to 24 months, born in an obstetric emergency hospital in Haiti, a prospective cohort study.

Hilaire, Marjorie / Andrianou, Xanthi D / Lenglet, Annick / Ariti, Cono / Charles, Kessiane / Buitenhuis, Sonja / Van Brusselen, Daan / Roggeveen, Harriet / Ledger, Elizabeth / Denat, Rodnie Selva / Bryson, Lindsay

BMC pediatrics

2021 Volume 21, Issue 1, Page(s) 143

Abstract: Background: Low birthweight (LBW) infants are at higher risk of mortality and morbidity (growth, chronic disease and neurological problems) during their life. Due to the high incidence of (pre-) eclampsia in Haiti, LBW infants are common. We assessed ... ...

Abstract	Background: Low birthweight (LBW) infants are at higher risk of mortality and morbidity (growth, chronic disease and neurological problems) during their life. Due to the high incidence of (pre-) eclampsia in Haiti, LBW infants are common. We assessed the anthropometric growth (weight and length) and neurodevelopmental delay in LBW and normal birthweight (NBW) infants born at an obstetric emergency hospital in Port au Prince, Haiti, between 2014 and 2017. Methods: Infants were followed at discharge and 3, 6, 12, 15, 18, 21 and 24 months of corrected gestational age. At each visit they underwent a physical checkup (weight, length, physical abnormalities, identification of morbidities). At 6, 12, 18 and 24 months they underwent a neurodevelopmental assessment using the Bayley Scale III (motor, cognitive and communication skills). We modelled the trajectories between birth and 24 months of age of NBW compared to LBW infants for weight, length, and raw scores for Bayley III assessments using mixed linear models. Results: In total 500 LBW and 210 NBW infants were recruited of which 333 (46.7%) were followed up for 24 months (127 NBW; 60.5% and 206 LBW; 41.2%) and 150 died (LBW = 137 and NBW = 13). LBW and NBW babies gained a mean 15.8 g and 11.4 g per kg of weight from discharge per day respectively. The speed of weight gain decreased rapidly after 3 months in both groups. Both groups grow rapidly up to 6 months of age. LBW grew more than the NBW group during this period (22.8 cm vs. 21.1 cm). Both groups had WHZ scores <- 2 up to 15 months. At 24 months NBW babies scored significantly higher on the Bayley scales for gross motor, cognitive and receptive and expressive communication skills. There was no difference between the groups for fine motor skills. Conclusion: LBW babies that survive neonatal care in urban Haiti and live up to 24 months of age, perform similar to their NBW for weight, length and fine motor skills. LBW babies are delayed in gross motor, cognitive and communication skills development. Further research on the clinical significance of these findings and long term implications of this neurodevelopmental delay is needed.
MeSH term(s)	Birth Weight ; Female ; Haiti ; Hospitals ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Prospective Studies
Language	English
Publishing date	2021-03-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2041342-7
ISSN	1471-2431 ; 1471-2431
ISSN (online)	1471-2431
ISSN	1471-2431
DOI	10.1186/s12887-021-02605-3
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Article: Improving pediatric TB diagnosis in North Kivu (DR Congo), focusing on a clinical algorithm including targeted Xpert MTB/RIF on gastric aspirates.

Van Brusselen, Daan / Simons, Erica / Luendo, Tony / Habarugira, Delphine / Ngowa, Jimmy / Mitutso, Nadine Neema / Moluh, Zakari / Steenssens, Mieke / Seguin, Rachelle / Vochten, Hilde / Ngabo, Lucien / Isaakidis, Petros / Ferlazzo, Gabriella

Conflict and health

2020 Volume 14, Page(s) 26

Abstract: Background: The incidence of tuberculosis (TB) in the Democratic Republic of the Congo (DRC) is 323/100,000. A context of civil conflict, internally displaced people and mining activities suggests a higher regional TB incidence in North Kivu. Médecins ... ...

Abstract	Background: The incidence of tuberculosis (TB) in the Democratic Republic of the Congo (DRC) is 323/100,000. A context of civil conflict, internally displaced people and mining activities suggests a higher regional TB incidence in North Kivu. Médecins Sans Frontières (MSF) supports the General Reference Hospital of Masisi, North Kivu, covering a population of 520,000, with an elevated rate of pediatric malnutrition. In July 2017, an adapted MSF pediatric TB diagnostic algorithm, including Xpert MTB/RIF on gastric aspirates (GAs), was implemented. The aim of this study was to evaluate whether the introduction of this clinical pediatric TB diagnostic algorithm influenced the number of children started on TB treatment. Methods: We performed a retrospective analysis of pediatric TB cases started on treatment in the inpatient therapeutic feeding centre (ITFC) and the pediatric ward. We compared data collected in the second half (July to December) of 2016 (before introduction of the new diagnostic algorithm) and the second half of 2017. For the outcome variables the difference between the two years was calculated by a Pearson Chi-square test. Results: In 2017, 94 GAs were performed, compared to none in 2016. Twelve percent (11/94) of samples were Xpert MTB/RIF positive. Sixty-eight children (2.9% of total exits) aged between 3 months and 15 years started TB treatment in 2017, compared to 19 (1.4% of total exits) in 2016 (p 0.002). The largest increase in pediatric TB diagnoses in 2017 occurred in patients with a negative Xpert MTB/RIF result, but clinically highly suggestive of TB according to the newly introduced diagnostic algorithm. Fifty-two (3.1%) children under five years old started treatment in 2017, as compared to 14 (1.3%) in 2016 (p 0.004). The increase was less pronounced and not statistically significant in older patients: sixteen children (2.6%) above 5 years old started TB treatment in 2017 as compared to five (1.3%) in 2016 (p 0.17). Conclusion: After the introduction of an adapted clinical pediatric TB diagnostic algorithm, including Xpert MTB/RIF on gastric aspirates, we observed a significant increase in the number of children - especially under 5 years old - started on TB treatment, mostly on clinical grounds. Increased 'clinician awareness' of pediatric TB likely played an important role.
Language	English
Publishing date	2020-05-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2273783-2
ISSN	1752-1505
ISSN	1752-1505
DOI	10.1186/s13031-020-00281-1
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Article ; Online: Bronchiolitis in COVID-19 times: a nearly absent disease?

Van Brusselen, Daan / De Troeyer, Katrien / Ter Haar, Eva / Vander Auwera, Ann / Poschet, Katleen / Van Nuijs, Sascha / Bael, An / Stobbelaar, Kim / Verhulst, Stijn / Van Herendael, Bruno / Willems, Philippe / Vermeulen, Melissa / De Man, Jeroen / Bossuyt, Nathalie / Vanden Driessche, Koen

European journal of pediatrics

2021 Volume 180, Issue 6, Page(s) 1969–1973

Abstract: Stay-at-home orders, physical distancing, face masks and other non-pharmaceutical interventions (NPIs) do not only impact COVID-19, but also the dynamics of various other infectious diseases. Bronchiolitis is a clinically diagnosed viral infection of the ...

Abstract	Stay-at-home orders, physical distancing, face masks and other non-pharmaceutical interventions (NPIs) do not only impact COVID-19, but also the dynamics of various other infectious diseases. Bronchiolitis is a clinically diagnosed viral infection of the lower respiratory tract, and causes a yearly seasonal wave of admissions in paediatric wards worldwide. We counted 92,5% less bronchiolitis hospitalisations in Antwerp before the expected end of the peak this year (of which only 1 RSV positive), as compared to the last 3 years. Furthermore, there was a >99% reduction in the number of registered RSV cases in Belgium.Conslusion: The 2020 winter bronchiolitis peak is hitherto nonexistent, but we fear a 'delayed' spring/summer bronchiolitis peak when most NPIs will be relaxed and pre-pandemic life restarts. What is known? • Bronchiolitis causes a yearly seasonal wave of admissions in paediatric departments worldwide. • Non-pharmaceutical interventions (NPIs) do not only impact COVID-19, but also the dynamics of various other infectious diseases. What is new? • The 2020 winter bronchiolitis peak is hitherto nonexistent. • A 'delayed' spring or summer bronchiolitis peak could happen when most NPIs will be relaxed and pre-pandemic life restarts.
MeSH term(s)	Belgium ; Bronchiolitis/epidemiology ; Bronchiolitis/therapy ; COVID-19 ; Child ; Humans ; Pandemics ; Respiratory Syncytial Virus Infections/diagnosis ; Respiratory Syncytial Virus Infections/epidemiology ; SARS-CoV-2
Language	English
Publishing date	2021-01-30
Publishing country	Germany
Document type	Journal Article
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-021-03968-6
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Article ; Online: Metal mining and birth defects: a case-control study in Lubumbashi, Democratic Republic of the Congo.

Van Brusselen, Daan / Kayembe-Kitenge, Tony / Mbuyi-Musanzayi, Sébastien / Lubala Kasole, Toni / Kabamba Ngombe, Leon / Musa Obadia, Paul / Kyanika Wa Mukoma, Daniel / Van Herck, Koen / Avonts, Dirk / Devriendt, Koen / Smolders, Erik / Nkulu, Célestin Banza Lubaba / Nemery, Benoit

The Lancet. Planetary health

2020 Volume 4, Issue 4, Page(s) e158–e167

Abstract: Background: Widespread environmental contamination caused by mining of copper and cobalt has led to concerns about the possible association between birth defects and exposure to several toxic metals in southern Katanga, Democratic Republic of the Congo ( ...

Abstract	Background: Widespread environmental contamination caused by mining of copper and cobalt has led to concerns about the possible association between birth defects and exposure to several toxic metals in southern Katanga, Democratic Republic of the Congo (DRC). We therefore aimed to assess the possible contribution of parental and antenatal exposure to trace metals to the occurrence of visible birth defects among neonates. Methods: We did a case-control study between March 1, 2013, and Feb 28, 2015, in Lubumbashi, DRC. We included newborns with visible birth defects (cases) and healthy neonates born in the same maternity ward (controls). Mothers were interviewed about potentially relevant exposures, including their partners' jobs. Various trace metals were measured by inductively coupled plasma mass spectrometry in maternal urine, maternal blood, umbilical cord blood, placental tissue, and surface dust at home. Multivariable logistic regression analyses were done to calculate adjusted odds ratios and their 95% CIs (CI). Findings: Our study included 138 neonates with visible birth defects (about 0·1% of the 133 662 births in Lubumbashi during the study period) and 108 control neonates. Potential confounders were similarly distributed between cases and controls. Vitamin consumption during pregnancy was associated with a lower risk of birth defects (adjusted odds ratio 0·2, 95% CI 0·1-0·5). Mothers having paid jobs outside the home (2·8, 1·2-6·9) and fathers having mining-related jobs (5·5, 1·2-25·0) were associated with a higher risk of birth defects. We found no associations for trace metal concentrations in biological samples, except for a doubling of manganese (Mn; 1·7, 1·1-2·7) and zinc (Zn; 1·6, 0·9-2·8) in cord blood. In a separate model including placentas, a doubling of Mn at the fetal side of the placenta was associated with an increased risk of birth defects (3·3, 1·2-8·0), as was a doubling of cord blood Zn (5·3, 1·6-16·6). Interpretation: To our knowledge, this is the first study of the effects of mining-related pollution on newborns in sub-Saharan Africa. Paternal occupational mining exposure was the factor most strongly associated with birth defects. Because neither Mn nor Zn are mined in Lubumbashi, the mechanism of the association between their increased prenatal concentrations and birth defects is unclear. Funding: Flemish Interuniversity Council-University Development Cooperation, The Coalition of the North-South movement in Flanders 11.11.11.
MeSH term(s)	Adult ; Case-Control Studies ; Congenital Abnormalities/epidemiology ; Democratic Republic of the Congo/epidemiology ; Environmental Exposure/adverse effects ; Environmental Pollutants/adverse effects ; Environmental Pollutants/blood ; Fathers ; Female ; Humans ; Infant, Newborn ; Male ; Metals/adverse effects ; Metals/blood ; Mining ; Mothers ; Young Adult
Chemical Substances	Environmental Pollutants ; Metals
Language	English
Publishing date	2020-04-30
Publishing country	Netherlands
Document type	Journal Article
ISSN	2542-5196
ISSN (online)	2542-5196
DOI	10.1016/S2542-5196(20)30059-0
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