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1.
Southeast Asian J Trop Med Public Health ; 1998 Sep; 29(3): 443-50
Article in English | IMSEAR | ID: sea-35934

ABSTRACT

Since 1990, Japanese encephalitis (JE) vaccine has been part of EPI in northern Thailand, where there is a high prevalence of JE and HIV infection. To evaluate the immunogenicity and safety of JE vaccine among HIV-infected children, we conducted a retrospective study of HIV-infected and uninfected children who received 2 doses of JE vaccine at 12 months of age. Pre- and post-immunization plasma specimens were tested by plaque reduction neutralization for antibody levels to JE and dengue(1-4) viruses; titers of > or =10 were considered positive. Excluding 5 children with preimmunization antibodies, 5 of 14 (36%) HIV-infected children and 18 of 27 (67%) uninfected children had positive JE antibody titers after immunization [odds ratio (OR) 0.3, p=0.06]; 31% absolute difference [95% confidence interval (CI) 0-61.7%). The geometric mean titer of HIV-infected children with positive titers was lower than that of control children (15.1 vs, 23.8; p=0.17). No significant vaccine-associated adverse events were noted. We conclude that primary antibody response to JE vaccine was low among HIV-infected children and was approximately half of that seen among uninfected children. In endemic areas, HIV-infected children are likely to be at risk of acquiring JE despite routine immunization with 2 doses.


Subject(s)
Antibodies, Viral/isolation & purification , Blotting, Western , CD4 Lymphocyte Count , Dengue Virus/immunology , Encephalitis, Japanese/immunology , Ethics, Medical , Flavivirus/immunology , HIV Infections/epidemiology , Humans , Immunoenzyme Techniques , Infant , Polymerase Chain Reaction , Retrospective Studies , Thailand/epidemiology , Viral Vaccines/adverse effects
2.
Southeast Asian J Trop Med Public Health ; 1993 Sep; 24(3): 425-35
Article in English | IMSEAR | ID: sea-33578

ABSTRACT

From November 1990 to June 1991 33 acute cases of melioidosis occurred in the Northern Territory, Australia; 25 cases were reported in the capital city, Darwin. We carried out an epidemiological investigation to exclude a common source outbreak, describe the risk factors for disease, and develop and institute appropriate control measures. We compared population based attack rates among various risk groups using logistic regression, and the demographic, medical and behavioral risk factors for melioidosis by a matched case-control study. Environmental Health Officers collected soil, surface water and cooling tower water specimens for Pseudomonas pseudomallei culture. The crude attack rate of melioidosis during the outbreak was 52 per 100,000. Age, gender, race, diabetes and alcohol abuse were independent risk factors for disease. The relative risk of disease in diabetic patients was 12.9 (95% CI 5.1-32.7; p < 0.001) and 6.7 in alcoholic patients (95% CI 2.9-15.2; p < 0.001). We found no significant difference between cases and controls in matched pair analysis for any of several exposure factors studied. We isolated Pseudomonas pseudomallei from 4% of soil samples and 9% of surface water samples. Our study confirms the importance of host factors in the development of melioidosis, and attempts to quantify the risk of disease during the Darwin epidemic. Pseudomonas pseudomallei is widespread in the soil of urban Darwin.


Subject(s)
Acute Disease , Adult , Aged , Aged, 80 and over , Alcoholism/complications , Burkholderia pseudomallei , Case-Control Studies , Diabetes Complications , Disease Outbreaks , Environmental Monitoring , Female , Humans , Incidence , Logistic Models , Male , Matched-Pair Analysis , Melioidosis/epidemiology , Middle Aged , Northern Territory/epidemiology , Odds Ratio , Population Surveillance , Risk Factors , Seasons , Soil Microbiology , Urban Population , Water Microbiology
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