Interventions for High-Burden Infectious Diseases in Children and Adolescents: A Meta-analysis
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Approximately 2.2 million deaths were reported among school-age children and young people in 2019, and infectious diseases remain the leading causes of morbidity and mortality, especially in low and middle-income countries. We aim to synthesize evidence on interventions for high-burden infectious diseases among children and adolescents aged 5 to 19 years.We conducted a comprehensive literature search until December 31, 2020. Two review authors independently screened studies for relevance, extracted data, and assessed risk of bias.We included a total of 31 studies, including 81 596 participants. Sixteen studies focused on diarrhea; 6 on tuberculosis; 2 on human immunodeficiency virus; 2 on measles; 1 study each on acute respiratory infections, malaria, and urinary tract infections; and 2 studies targeted multiple diseases. We did not find any study on other high burden infectious diseases among this age group. We could not perform meta-analysis for most outcomes because of variances in interventions and outcomes. Findings suggests that for diarrhea, water treatment, water filtration, and zinc supplementation have some protective effect. For tuberculosis, peer counseling, contingency contract, and training of health care workers led to improvements in tuberculosis detection and treatment completion. Continuation of cotrimoxazole therapy reduced the risk of tuberculosis and hospitalizations among human immunodeficiency virus-infected children and reduced measles complications and pneumonia cases among measles-infected children. Zinc supplementation led to a faster recovery in urinary tract infections with a positive effect in reducing symptoms.There is scarcity of data on the effectiveness of interventions for high-burden infectious diseases among school-aged children and adolescents.Objective This study was conducted to find out the epidemiological characteristics of measles and evaluate the measles for its control and prevention.Methods Statistical analysis was conducted on the data of measles incidence in Huizhou City from 2004 to 2010.ELISA was adopted to detect IgM antibody in serum.Results A total of 2 842 cases were reported during the seven-year period,the annually average morbidity was 11.69/100 000.A sporadic epidemic pattern was evident with widely distributed affected cases and significant seasonality.Measles mainly occurred during May to July,the incidence of measles between 0~14 years old groups was higher than that of the other age groups.Unimmunized cases or cases with unknown immunization history accounted for 90.04% of the overall cases.Conclusions Routine immunization of measles should be reinforced and boost vaccination should be carried out in proper time to prevent and control measles,at the same time the measles campaign should be implemented to adult.In addition,perfecting measles surveillance system must be taken.
Routine immunization
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Objective To investigate effective prevention of measles of children.Methods The investigator analyzed retrospectively the data of 108 measle patients hospitalized from January 1999 to December 2003.Results The incidence of measles showed increasing trend,for example,the incidence of measles in 2003 was 2.7 times that in 2002.The incidence of measles of infants(under 8 months) was 22.2%,the incidence of measles of floating population was 11.11%.It was found that the incidence of measles among the patients with measles vaccination was 45.37%,meanwhile the incidence of measles among the patients without measles vaccination was 44.44%.10.19% of the patients were not sure whether they had measles vaccination or not.87.04% of the cases had not contacted measles patients.Some cases were atypical.Conclusion The in creasing trend of child measles merits attention.
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SUMMARY This study examined the epidemiological and clinical characteristics of measles in Wenzhou, China. From 2000 to 2010, a total of 13271 measles cases were reported in Wenzhou, with epidemics occurring every 3-4 years. Forty-five per cent of the cases were aged <1 year and 27·2% were aged >14 years. Of 2262 hospitalized measles cases, 66·3% were diagnosed with pneumonia, and three cases died from respiratory failure. The number of measles cases of infants requiring hospitalization increased from birth to age 8 months and declined thereafter. Measurement of serum measles antibody levels in normal infants indicates that over 80% of infants in Wenzhou may be susceptible to measles by age 6 months. The existence of a sufficient pool of unvaccinated children and the decreased level of passively transferred measles antibodies in infants from vaccinated mothers contributed to the sustained transmission observed in Wenzhou.
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This paper was to study the measles epidemiological characteristics in 1999 in Hebei Province and to monitor the running status of measles surveillance system. In 1999, a total of 540 suspected measles cases were reported in the province, of which 280 were clinically diagnosed, 124 were laboratory identified and 136 were excluded by ELISA test, so the measles cases were 404. These cases distributed in 60 counties of 11 cities of the province, accounting for 34.9% of the total counties of the province. The 10 counties that reported ten more measles cases, accounted for 16.7% of the counties giving case report, 244 measles cases were reported by 10 counties and 1 county had a highest reporting of 49 cases. These data showed measles case distribution was not only scattered but also centralized. 276 measles cases concentrated in March to May, accounting for 68.3% of the total cases. Male patients were more than the females. 70.8% of the measles cases were children under 15 years old among whom preschool and primary school children were predominant. 50.2% cases definitely had measles immune history. The clinical symtoms were mild, 82.3% of the children under 15 years old were complicated with pneumonia. According to the regional distribution of measles cases, we suggested that, in 2000, a catch-up mass immunization campaign should be implemented in children under 15years old in Cangzhou and Baoding cities. Analyzing the immune history of measles cases by age, there appeared problems in the routine immunization, suggestions about timeliness and quality of measles vaccination were given. Because of the high sensitivity and low specificity in the clinical diagnostic standard of measles cases, we suggest to put more effort to serological diagnosis. In addition, aimed to the failed reporting and delayed reporting of measles cases made by the surveillance system, a solution of strict management and professional training was proposed.
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Since 1990, the decrease of measles morbidity rates and the increase of the areas with limited measles transmission are observed in Poland. In 1997, 338 measles cases was reported, the lowest number of measles cases ever reported. This represents 47% decrease from the number of measles cases (639) reported in 1996. The increase of the number of measles incidence during last two month of 1997 may forecast epidemic 1998 year. The laboratory confirmation of suspected measles, especially sporadic cases should be implemented in all voivodeships in Poland.
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Objective To know the situation and epidemiological features of measles and rubella serology in Changde from 2007 to 2009,to provide a scientific basis for achieving the goal of elimination of measles on schedule and promoting the development of expanded program on immunization(EPI).Methods The epidemiological features and laboratory test results of suspected measles cases in Changde during the period of 2007～2009 were analyzed.Results Totally 1,057 samples of suspected measles cases were detected during the period of 2007～2009,of which 360 were positive for measles IgM,with the positive rate of 34.1%.The suspected measles cases were inspected in different districts(counties and cities).The peak time of measles was from March to June.Measles occurred mainly in children aged 1 to 5 years.Conclusions Non-vaccination and non-full-course vaccination are the main reasons for measles onset.The key to control of measles is the implementation of immunization against measles,the enhancement of disease surveillance,the improvement of laboratory diagnosis,and timely control of local outbreaks of measles.
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Objective This study is to analyze the epidemiology of measles in Heze in 2005,and to revise the strategy for measles control as well as its vaccination.Methods The data comes from routine report system for infectious disease and annual statistics.Results 479 suspected measles cases were reported in 2005,416 measles cases were confirmed.Of the epidemiological modes,sporadic cases and outbreak cases coexisted.The measles in some districts had affected the measles morbidity of the whole city.Measles cases mainly happened among preschool children and adults.In confirmed measles cases,19.23% had measles vaccine immunization history,36.30% were non-vaccined and 44.47% were uncertain.Conclusion The age distribution and vaccination status of measles cases remind that the routine immunization service should be strengthended.At the same time the measles campaign should be implemented to adult.In addition,perfecting measles surveillance system must be taken.
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In order to know the status of measles epidemic and achieve the goal for measles control,we analyzed the data of measles cases from Jan.2000 to Dec.2002 in Shaanxi Province.The results showed that the average measles incidence in 2000-2002 increased 65.7%,as compared with that of 1997-1999.Both the sporadic and epidemic measles in some districts existed at the same time and the reported measles cases extensively distributed in all districts of Shaanxi Province.The outbreaks of measles in some districts had affected the measles morbidity of the whole province.The prevalent season was from March to June,the incidence of measles between 0～2 year old and betweew 6～8 year old age groups were higher than that in the other age groups. We concluded that 25% of the total measles cases were not immunized and 24% without vaccination records through analyzing the measles cases vaccination history.The age distribution and vaccination status of measles cases remind that the routine immunization service and the second dose service should be strengthened,at the same time the measles campaign should be implemented to a certain age group of children.In addition,readjusting the old vaccination schedule and perfecting measles surveillance system must be taken.
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Objective The data of measles reported by the measles surveillance system in Zhejiang Province. Methods From January,2001 to December,2003,the data of measles were analyzed to direct the measles control in the futrue. Results The results showed that the average measles incidence rate in 2001-2003 was higher than that of 1998-2000.Both the sporadic and epidemic measles in some districts existed at the same time and the reported measles cases extensively distributed in all districts of Zhejiang Province. The measles in some districts had affected the measles morbidity of the whole Province. The prevalent season was from March to June,the incidence of measles between 0-2 years old and between 6-8 years old groups were higher than that of the other age groups. Conclusion We concluded that 30% of the total measles cases were not immunized and 30% without vaccination records through analyzing the measles cases vaccination history.The age distribution and vaccination status of measles cases remind that the routine immunization service should be strengthened,at the same time the measles campaign should be implemented to adult. In addition,prefecting measles surveillance system must be taken.
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[Objective] To analyze the changing of age characteristic of measles cases in Baoding City from 1999-2007 in order to provide reference to the strategy adjustments for measles surveillance and immunization to eliminate measles. [Meth-ods] Age characteristics of measles cases from 1999 to 2007 were analyzed with epidemiological analysis. [Results] Measles cases of 1-14 years old accounted for 75.90% in 1999-2002, 45.95% in 2003-2007, which descended gradually. Measles cas-es of under 1 year old accounted for 0.92% in 1999-2002, 22.33% in 2003-2007, which was a increasing tendency. Measles cases of over 15 years old accounted for 14.86% in 1999-2002, 30.72% in 2003-2007, which was a increasing tendency. [Conclusion] Though accelerated measles control, measles mainly takes place in people aged under 1 and over 15 years ole and age distribution of measles cases is remarkably different in different areas in Baoding. We should pay attention to the tran-sient population on measles immunization and surveillance.
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