ABSTRACT
OBJECTIVE: To evaluate immunogenicity and tolerability of single dose live attenuated injectable hepatitis A vaccine in four metropolitan cities of India. METHODS: Live attenuated hepatitis A vaccine was administered to 505 children aged 18 to 60 months in four centers across India. Immunogenicity of the vaccine was assessed by estimation of anti-HAV antibody titer at 6 weeks and 6 months following administration of the vaccine. Safety evaluation of the vaccine was also done during the visits. RESULTS: At 6 weeks, 480 subjects (95%) came for the follow-up and 411 (81.4%) subjects reported at the end of 6 months. The geometric mean titer (GMT) of anti-HAV antibody of the subjects who did not have the seroprotective titer at the baseline were assessed at 6 weeks and 6 months which was 81.04 mIU/ml and 150.66 mIU/ml respectively. At 6 weeks, 95.1 % seroconverted and at the end of 6 months, 97.9 % had seroconverted. Both solicited and unsolicited vaccine-induced local and systemic adverse events were insignificant at all the centers, except swelling and induration in a few. CONCLUSION: Live attenuated injectable hepatitis A vaccine was immunogenic and tolerable with minimal reactogenecity, in this study of single dose schedule. Safety profile was also satisfactory in the study population.
Subject(s)
Child, Preschool , Female , Hepatitis A/prevention & control , Hepatitis A Antibodies/analysis , Hepatitis A Vaccines/administration & dosage , Humans , Immunoassay , Infant , MaleSubject(s)
Adolescent , Child , Child, Preschool , Cholelithiasis/epidemiology , Female , Humans , India/epidemiology , Infant , MaleABSTRACT
Acute diarrhoeal disease is one of the major killers in children in the developing countries. A management protocol consisting of "Triple A" (assessment, analysis of clinical presentation and action plan protocol) approach has been found to be rewarding in our set-up. The matter has been dealt with by the authors in this article in its proper perspective.
Subject(s)
Acute Disease , Child , Clinical Protocols , Diarrhea/therapy , Fluid Therapy , Humans , ProbioticsABSTRACT
Rectal swabs/stool specimens from 115 children (0-5 years) suffering with acute diarrhea were screened for non typhoidal salmonella species. 7 (6%) patients were found to be positive for non typhoidal salmonella. 4 (3.47%) were positive for S. paratyphi B and 3 (2.6%) were positive for S. typhimurium. Multidrug resistance was seen in 57 percent of the strains. All strains were sensitive to Ciprofloxacin. All strains were resistant to Ampicillin followed by Ciprofloxacin. All strains were resistant to Ampicillin followed by Gentamycin (43%), Kanamycin (43%), Tetracycline (43%), Streptomycin (28.5%) and Chloramphenicol (28.5%).
Subject(s)
Acute Disease , Anti-Bacterial Agents/pharmacology , Child, Preschool , Diarrhea/microbiology , Drug Resistance, Microbial , Drug Resistance, Multiple , Feces/microbiology , Gastroenteritis/microbiology , Humans , Infant , Infant, Newborn , Microbial Sensitivity Tests , Salmonella/isolation & purification , Salmonella Infections/microbiologyABSTRACT
A case control study was done at the Institute of Child Health, Madras, among prospectively recruited children aged 1-23 months to identify the risk factors for persistent diarrhea. Cases were children with diarrhea persisting for > 14 days. Controls were children with acute diarrhea who had recovered within 7 days. Two controls for each case, matched for age were recruited. The total number of cases and controls recruited were 170 and 340. Fifteen risk factors for association with persistent diarrhea were studied. When the factors were adjusted for covariables by logistic regression, only 6 factors were found to be significant, namely, malnutrition (OR 2.9; 95% CI 1.9-4.5), dysenteric stools (OR 2.4; 95% CI 1.3-4.3), indiscriminate use of antimicrobials (OR 2.4; 95% CI 1.6-3.9), associated illnesses (OR 2.1; 95% CI 1.5-3.1), stools > 10/day (OR 1.8; 95% CI 1.2-2.8) and persistence of dehydration (OR 1.4; 95% CI 1.2-1.7). However, when invasive diarrhea was excluded, weight loss during study period became a significant factor. It is concluded that all children with acute diarrhea should be investigated for associated illnesses and treated adequately, indiscriminate use of antimicrobials should be avoided and nutritional support should be provided.
Subject(s)
Case-Control Studies , Chronic Disease , Diarrhea, Infantile/etiology , Humans , Infant , Prospective Studies , Risk FactorsABSTRACT
An open multicentric trial was conducted on 175 patients to compare the antipyretic efficacy of ibuprofen (7 mg/kg) and paracetamol (8 mg/kg). Children between the age of 4 months and 12 years with fever were admitted to the study, 85 in the ibuprofen group and 90 in the paracetamol group. The axillary temperatures were recorded at half hourly intervals for 2 hours. The mean fall in temperature at 1, 1.5 and 2 hours was similar in both groups and the differences were not statistically significant (p greater than 0.05). At half hour, the fall in temperature (mean +/- SEM) for ibuprofen was 0.1975 +/- 0.0409 and for paracetamol was 0.3843 +/- 0.0490. This absolute difference of 0.19 degrees C was statistically significant (p less than 0.05). We conclude that ibuprofen has antipyretic activity comparable to that of paracetamol and that it could be a valuable alternative antipyretic in clinical practice. There is a need to repeat this trial with higher doses of ibuprofen, to establish a dose response of the drug, if any, and to find an optimally effective dose.