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  • 1
    In: Journal of Medical Virology, Wiley, Vol. 92, No. 3 ( 2020-03), p. 279-287
    Abstract: Rubella virus causes a mild disease; however, infection during the first trimester of pregnancy may lead to congenital rubella syndrome (CRS) in over 80% of affected pregnancies. Vaccination is recommended and has been shown to effectively reduce CRS incidence. Uganda plans to introduce routine rubella vaccination in 2019. The World Health Organization recommends assessing the disease burden and obtaining the baseline molecular virological data before vaccine introduction. Sera collected during case‐based measles surveillance from January 2005 to July 2018 were tested for rubella immunoglobulin M (IgM) antibodies. Sera from confirmed rubella outbreaks from January 2012 to August 2017 were screened using real‐time reverse‐transcription polymerase chain reaction (RT‐PCR); for positive samples, a region within the E1 glycoprotein coding region was amplified and sequenced. Of the 23 196 suspected measles cases serologically tested in parallel for measles and rubella, 5334 (23%) were rubella IgM‐positive of which 2710 (50.8%) cases were females with 2609 (96.3%) below 15 years of age. Rubella IgM‐positive cases were distributed throughout the country and the highest number was detected in April, August, and November. Eighteen (18%) of the 100 sera screened were real‐time RT‐PCR‐positive of which eight (44.4%) were successfully sequenced and genotypes 1G and 2B were identified. This study reports on the seroprevalence and molecular epidemiology of rubella. Increased knowledge of former and current rubella viruses circulating in Uganda will enhance efforts to monitor the impact of vaccination as Uganda moves toward control and elimination of rubella and CRS.
    Type of Medium: Online Resource
    ISSN: 0146-6615 , 1096-9071
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2020
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    detail.hit.zdb_id: 1475090-9
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  • 2
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 52, No. 4 ( 2023-08-02), p. 1150-1162
    Abstract: Despite providing tetanus-toxoid-containing vaccine (TTCV) to infants and reproductive-age women, Uganda reports one of the highest incidences of non-neonatal tetanus (non-NT). Prompted by unusual epidemiologic trends among reported non-NT cases, we conducted a retrospective record review to see whether these data reflected true disease burden. Methods We analysed nationally reported non-NT cases during 2012–2017. We visited 26 facilities (14 hospitals, 12 health centres) reporting high numbers of non-NT cases (n = 20) or zero cases (n = 6). We identified non-NT cases in facility registers during 1 January 2016–30 June 2017; the identified case records were abstracted. Results During 2012–2017, a total of 24 518 non-NT cases were reported and 74% were ≥5 years old. The average annual incidence was 3.43 per 100 000 population based on inpatient admissions. Among 482 non-NT inpatient cases reported during 1 January 2016–30 June 2017 from hospitals visited, 342 (71%) were identified in facility registers, despite missing register data (21%). Males comprised 283 (83%) of identified cases and 60% were ≥15 years old. Of 145 cases with detailed records, 134 (92%) were clinically confirmed tetanus; among these, the case-fatality ratio (CFR) was 54%. Fourteen cases were identified at two hospitals reporting zero cases. Among & gt;4000 outpatient cases reported from health centres visited, only 3 cases were identified; the remainder were data errors. Conclusions A substantial number of non-NT cases and deaths occur in Uganda. The high CFR and high non-NT burden among men and older children indicate the need for TTCV booster doses across the life course to all individuals as well as improved coverage with the TTCV primary series. The observed data errors indicate the need for data quality improvement activities.
    Type of Medium: Online Resource
    ISSN: 0300-5771 , 1464-3685
    RVK:
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1494592-7
    detail.hit.zdb_id: 187909-1
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  • 3
    Online Resource
    Online Resource
    Public Library of Science (PLoS) ; 2017
    In:  PLOS ONE Vol. 12, No. 9 ( 2017-9-8), p. e0184549-
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 12, No. 9 ( 2017-9-8), p. e0184549-
    Type of Medium: Online Resource
    ISSN: 1932-6203
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2017
    detail.hit.zdb_id: 2267670-3
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  • 4
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 10, No. Supplement_2 ( 2023-11-27)
    Abstract: Data from clinical trials show that novel oral poliovirus vaccine type 2 (nOPV2) is safe. However, nOPV2 is under emergency use listing, and continued vaccine safety monitoring is required to support licensure and World Health Organization (WHO) prequalification. In January 2022, Uganda introduced nOPV2 in a national supplementary immunization activity (SIA) in response to a circulating vaccine derived poliovirus outbreak, vaccinating 9.8 million children & lt; 5 years old. We sought to identify and characterize safety events following nOPV2 vaccination Methods We evaluated the safety of nOPV2 following the SIA in Uganda using a multi-pronged approach: 1) routine passive surveillance for adverse events following immunization (AEFI), 2) active hospital-based surveillance for adverse events of special interest (AESI) 3) active acute flaccid paralysis (AFP) surveillance, and 4) active, cohort event monitoring (CEM) among a nationally representative sample of 2000 households in 200 enumeration areas for 42 days following administration of the nOPV2 vaccine. The national AEFI committee conducted causality assessment for all reported serious AEFI and pre-specified AESI conditions using global guidelines. Results During 14 January–11 March 2022, 1,157 adverse events were identified: 43 (3.7%) from passive surveillance, 5 (0.43%) from hospital-based surveillance, 157 (14%) from AFP surveillance, and 952 (82%) from CEM. The most commonly reported adverse events identified through CEM 0-3 days post-vaccination were fever (n=377, 40%), diarrhea (n=147, 15%), and malaise (n=107, 11%). Through all surveillance systems, 171 events underwent causality assessment. Among these 7 (4%) were classified as vaccine product-related reactions (1 acute disseminated encephalomyelitis, 1 encephalitis, 1 fever, 3 gastro-enteritis, and 1 painful lower limbs), 101 (59%) were classified as coincidental events, and 63 (37%) were downgraded. Conclusion The majority of identified serious AEFI were classified as coincidental events. No unexpected safety signals were identified among children & lt; 5 years old during the nOPV2 SIA in Uganda. This evaluation provides critical data to contribute to the vaccine’s safety profile and informs recommendations for use, pre-qualification, and licensure. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2757767-3
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