A comparison of post vaccination hepatitis B surface antibody level on the large and appropriate for gestational age infants

Purpose@#The aim of this study was to compare the hepatitis B surface antibody (HBs Ab) titer 1 month after the 4th dose of hepatitis B vaccine administration on the large and appropriate for gestational age infants. @*Materials and Methods@#This cross-sectional study was conducted on 7-month-old cases (n=132) divided into two groups of 2–4 kg (group 1: appropriate for gestational age, 63 cases) and >4 kg (group 2: large for gestational age, 69 cases), whom were vaccinated with a fourdose schedule of hepatitis B vaccine in 2016, Tehran, Iran. @*Results@#Mean birth weight of the groups was 2.98±0.528 and 4.19±0.190 kg, respectively.Hepatitis B surface antigen and hepatitis B core antibody were negative in all cases. HBs Ab level in group 1 and 2 was 13,701.00±11,744.439 and 8,997.15±2,827.191, respectively (95% confidence interval of difference, -7,607.44 to -1,800.25). There was a significant difference between the two groups in antibody titration and antibody logarithm level (p=0.002, p=0.0001). @*Conclusion@#Birth weight may affect the response to the hepatitis B virus vaccine administration.

Rotavirus infection in children with acute gastroenteritis in Iran, a systematic review and meta-analysis

The recent studies show that Rotavirus is important cause of the acute gastroenteritis. The aim of this review is to estimate the number of Rotavirus infection among Iranian children by performing a systematic review and estimating a pooled data. We performed a systematic literature review in relevant databases including PUBMED, MEDLINE, OVID, SID, MAGIRAN, and IRANMEDEX. Search in databases was done in October 10, 2013. Meta-analysis was performed using the STATA statistical package version 11. We assessed heterogeneity by Q-test and used random model for pooling measures of proportion of Rotavirus infection among Iranian children with diarrhea [and 95% confidence intervals [CI]]. Sub group analysis between in-patient and outpatient group were done and publication bias was assessed by Egger and Begg tests. A total of 154 records were identified in our searching. There were 36 studies including a total of 15,368 children with diarrhea. Out of 15,368 children, 6,338 were positive for Rota virus gastroenteritis. Overall pooled estimate of infection with Rotavirus among cases of gastroenteritis was 0.35 [95% CI, 0.28-0.41]. Pooled estimates for hospitalized children and outpatient subgroups were 0.39 [95% CI, 0.30-0.48], and 0.31 [95% CI, 0.23-0.38], respectively. This study supports the importance of Rotavirus in the Iranian population such as common cause of diarrhea among children. Therefore, decision to adopt immunization programs to prevent Rotavirus infection might be helpful in Iran

Immunization against Haemophilus Influenzae type b in Iran; cost utility and cost benefit analyses

Haemophilus Influenzae type b [Hib] is an important cause of morbidity and mortality in children. Although its burden is considerably preventable by vaccine, routine vaccination against Hib has not been defined in the National Immunization Program of Iran. This study was performed to assess the cost-benefit and cost utility of running an Hib vaccination program in Iran. Based on a previous systematic review and meta analysis for vaccine efficacy, we estimated the averted DALYs [Disability adjusted life years] and cost benefit of vaccination. Different acute invasive forms of Hib infection and the permanent sequels were considered for estimating the attributed DALYs. We used a societal perspective for economic evaluation and included both direct and indirect costs of alternative options about vaccination. An annual discount rate of 3% and standard age weighting were used for estimation. To assess the robustness of the results, a sensitivity analysis was performed. The incidence of Hib infection was estimated 43.0 per 100000, which can be reduced to 6.7 by vaccination. Total costs of vaccination were estimated at US$ 15,538,129. Routine vaccination of the 2008 birth cohort would prevent 4079 DALYs at a cost per averted DALY of US$ 4535. If we consider parents' loss of income and future productivity loss of children, it would save US$ 8,991,141, with a benefit cost ratio of 2.14 in the base case analysis. Sensitivity analysis showed a range of 0.78 to 3.14 for benefit to cost ratios. Considering costs per averted DALY, vaccination against Hib is a cost effective health intervention in Iran, and allocating resources for routine vaccination against Hib seems logical

Adverse reactions following immunization with MMR vaccine in children at selected provinces of Iran

Several adverse events following immunization [AEFI] have been attributed to immunization with live attenuated measles, mumps, and rubella [MMR] vaccines. The MMR vaccine was introduced into the routine infant immunization schedule in 2003, followed by a second dose of vaccine at school-entry for children 4 to 6 years of age. The objective of this study was to characterize adverse reactions following MMR vaccination in Iran. Children who received the MMR vaccine and resided in five selected provinces of Iran were examined weekly for four weeks to detect well-known AEFIs that included: parotitis, fever and convulsions, convulsions without fever, encephalopathy, and anaphylactic reactions. Incidence of AEFIs were calculated and compared among recipients in both age groups. During the follow-up period, trained providers reported 792 AEFIs. Parotitis was the most frequent event occurring in 1.8% of recipients. Of 14, 109 children vaccinated at 12 months of age the following AEFIs occurred: parotitis [147], fever and convulsions [8], convulsions [7], encephalopathy [1], and anaphylactic reactions [1]. Of 29,338 children vaccinated to 4 to 6 years of age, parotitis, fever and convulsions, encephalopathy, and anaphylaxis occurred in 626, 5, 1, and 1 child, respectively; no convulsions without fever were reported in this age groups. Parotitis is the most frequent AEFI among MMR vaccine recipients in Iran. Incidence rates of AEFIs following MMR vaccination in Iran are similar to rates of AEFIs reported in other studies