Suchergebnisse

von John Paget ; Volltext // Exemplar mit der Signatur: München, Bayerische Staatsbibliothek -- Austr. 5464 x-1

von John Paget ; Volltext // Exemplar mit der Signatur: München, Bayerische Staatsbibliothek -- Austr. 5464 x-2

BACKGROUND: The European Centres for Disease Prevention and Control (ECDC) estimates that seasonal influenza causes 4-50 million symptomatic infections in the EU/EEA each year and 15,000-70,000 European citizens die of causes associated with influenza. We used modelling methods to estimate influenza-associated mortality for the European Union by age group and country. METHODS: We compiled influenza-associated respiratory mortality estimates for 31 countries around the world (11 countries in the EU) during 2002-2011 (excluding the 2009 pandemic). From these we extrapolated the influenza mortality burden for all 193 countries of the world, including the 28 countries of the EU, using a multiple imputation approach. To study the effect of vaccination programs, we obtained data from the EU-funded VENICE project regarding the percentage of persons over 65 who were vaccinated in each country; the data ranged from 2% to 82% between the 21 countries which provided estimates for the 2006/07 reference season. RESULTS: We estimated that an average of 27,600 (range 16,200-39,000) respiratory deaths were associated with seasonal influenza in the 28 EU countries per winter; 88% were among people 65 years and older, and the rates of mortality in this age group were roughly 35 times higher compared with those <65 years. Estimates varied considerably across the EU; for example, rates in the elderly ranged from 21.6 (12.5-35.1) per 100,000 in Portugal to 36.5 (16.4-62.5) in Luxembourg, a difference of nearly 70%. We were unable to find a negative correlation between vaccination coverage rates and influenza-associated mortality estimates in the elderly. CONCLUSION: Our EU estimate of influenza-associated respiratory mortality is broadly consistent with the ECDC estimate. More research is needed to explain the observed variation in mortality across the EU, and on possible bias that could explain the unexpected lack of mortality benefits associated with European elderly influenza vaccination programs.

The global response to infectious diseases has seen a renewed interest in the use of community engagement to support research and relief efforts. From a perspective rooted in the social sciences, the concept of vulnerability offers an especially useful analytical frame for pursuing community engagement in a variety of contexts. However, few have closely examined the concept of vulnerability in community engagement efforts, leading to a need to better understand the various theories that underline the connections between the two. This literature review searched four databases (covering a total of 537 papers), resulting in 15 studies that analyze community engagement using a framing of vulnerability, broadly defined, in the context of an infectious disease, prioritizing historical and structural context and the many ways of constituting communities. The review identified historical and structural factors such as trust in the health system, history of political marginalization, various forms of racism and discrimination, and other aspects of vulnerability that are part and parcel of the main challenges faced by communities. The review found that studies using vulnerability within community engagement share some important characteristics (e.g., focus on local history and structural factors) and identified a few theoretical avenues from the social sciences which integrate a vulnerability-informed approach in community engagement. Finally, the review proposes an approach that brings together the concepts of vulnerability and community engagement, prioritizing participation, empowerment, and intersectoral collaboration.

Background : Seasonal influenza concerns the worldwide population every year, whilst pandemic influenza is an unpredictable threat. Due to an important socioeconomic impact, mitigation measures must be specified. Governments elaborate vaccination policy based on scientific evidence. However, this process is, in general, not transparent. Objectives : To study the decision-making process related to the influenza vaccination policy, identifying the actors involved, the decisions made and describing the information used by type and level of importance. Methods : Six major databases were searched in seven languages, without time limit, using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to three established criteria. Selected articles were analysed and compared against a checklist for context, stakeholders and evidence. Results : 111 articles were retrieved since the 1990s, most of them (40%) were conducted in the USA. The decision-making process mainly concerned vaccination strategies (53%) and pandemic preparedness (28%). Stakeholders were identified at an institutional, production and consumer level. Evidence used by policy-makers was similar (e.g. logistics of vaccines), but the factors influencing were different (e.g. social conditions). Conclusion : Considering the imminent risk of socio-economic disruption and media pressure, the pandemic threat needs to be integrated into an analysis of decision making processes regarding seasonal influenza vaccination.

Background : Seasonal influenza concerns the worldwide population every year, whilst pandemic influenza is an unpredictable threat. Due to an important socioeconomic impact, mitigation measures must be specified. Governments elaborate vaccination policy based on scientific evidence. However, this process is, in general, not transparent. Objectives : To study the decision-making process related to the influenza vaccination policy, identifying the actors involved, the decisions made and describing the information used by type and level of importance. Methods : Six major databases were searched in seven languages, without time limit, using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to three established criteria. Selected articles were analysed and compared against a checklist for context, stakeholders and evidence. Results : 111 articles were retrieved since the 1990s, most of them (40%) were conducted in the USA. The decision-making process mainly concerned vaccination strategies (53%) and pandemic preparedness (28%). Stakeholders were identified at an institutional, production and consumer level. Evidence used by policy-makers was similar (e.g. logistics of vaccines), but the factors influencing were different (e.g. social conditions). Conclusion : Considering the imminent risk of socio-economic disruption and media pressure, the pandemic threat needs to be integrated into an analysis of decision making processes regarding seasonal influenza vaccination.

Background : Seasonal influenza concerns the worldwide population every year, whilst pandemic influenza is an unpredictable threat. Due to an important socioeconomic impact, mitigation measures must be specified. Governments elaborate vaccination policy based on scientific evidence. However, this process is, in general, not transparent. Objectives : To study the decision-making process related to the influenza vaccination policy, identifying the actors involved, the decisions made and describing the information used by type and level of importance. Methods : Six major databases were searched in seven languages, without time limit, using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to three established criteria. Selected articles were analysed and compared against a checklist for context, stakeholders and evidence. Results : 111 articles were retrieved since the 1990s, most of them (40%) were conducted in the USA. The decision-making process mainly concerned vaccination strategies (53%) and pandemic preparedness (28%). Stakeholders were identified at an institutional, production and consumer level. Evidence used by policy-makers was similar (e.g. logistics of vaccines), but the factors influencing were different (e.g. social conditions). Conclusion : Considering the imminent risk of socio-economic disruption and media pressure, the pandemic threat needs to be integrated into an analysis of decision making processes regarding seasonal influenza vaccination.

Background : Seasonal influenza concerns the worldwide population every year, whilst pandemic influenza is an unpredictable threat. Due to an important socioeconomic impact, mitigation measures must be specified. Governments elaborate vaccination policy based on scientific evidence. However, this process is, in general, not transparent. Objectives : To study the decision-making process related to the influenza vaccination policy, identifying the actors involved, the decisions made and describing the information used by type and level of importance. Methods : Six major databases were searched in seven languages, without time limit, using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to three established criteria. Selected articles were analysed and compared against a checklist for context, stakeholders and evidence. Results : 111 articles were retrieved since the 1990s, most of them (40%) were conducted in the USA. The decision-making process mainly concerned vaccination strategies (53%) and pandemic preparedness (28%). Stakeholders were identified at an institutional, production and consumer level. Evidence used by policy-makers was similar (e.g. logistics of vaccines), but the factors influencing were different (e.g. social conditions). Conclusion : Considering the imminent risk of socio-economic disruption and media pressure, the pandemic threat needs to be integrated into an analysis of decision making processes regarding seasonal influenza vaccination.

Background : Seasonal influenza concerns the worldwide population every year, whilst pandemic influenza is an unpredictable threat. Due to an important socioeconomic impact, mitigation measures must be specified. Governments elaborate vaccination policy based on scientific evidence. However, this process is, in general, not transparent. Objectives : To study the decision-making process related to the influenza vaccination policy, identifying the actors involved, the decisions made and describing the information used by type and level of importance. Methods : Six major databases were searched in seven languages, without time limit, using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to three established criteria. Selected articles were analysed and compared against a checklist for context, stakeholders and evidence. Results : 111 articles were retrieved since the 1990s, most of them (40%) were conducted in the USA. The decision-making process mainly concerned vaccination strategies (53%) and pandemic preparedness (28%). Stakeholders were identified at an institutional, production and consumer level. Evidence used by policy-makers was similar (e.g. logistics of vaccines), but the factors influencing were different (e.g. social conditions). Conclusion : Considering the imminent risk of socio-economic disruption and media pressure, the pandemic threat needs to be integrated into an analysis of decision making processes regarding seasonal influenza vaccination.

Background : Seasonal influenza concerns the worldwide population every year, whilst pandemic influenza is an unpredictable threat. Due to an important socioeconomic impact, mitigation measures must be specified. Governments elaborate vaccination policy based on scientific evidence. However, this process is, in general, not transparent. Objectives : To study the decision-making process related to the influenza vaccination policy, identifying the actors involved, the decisions made and describing the information used by type and level of importance. Methods : Six major databases were searched in seven languages, without time limit, using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to three established criteria. Selected articles were analysed and compared against a checklist for context, stakeholders and evidence. Results : 111 articles were retrieved since the 1990s, most of them (40%) were conducted in the USA. The decision-making process mainly concerned vaccination strategies (53%) and pandemic preparedness (28%). Stakeholders were identified at an institutional, production and consumer level. Evidence used by policy-makers was similar (e.g. logistics of vaccines), but the factors influencing were different (e.g. social conditions). Conclusion : Considering the imminent risk of socio-economic disruption and media pressure, the pandemic threat needs to be integrated into an analysis of decision making processes regarding seasonal influenza vaccination.

The Global Influenza Initiative (GII)is a global expert group that aims to raise acceptance and uptake of influenza vaccines globally and provides recommendations and strategies to address challenges at local, national, regional, and global levels. This article provides a consolidated estimation of disease burden in Latin America, currently lacking in published literature, and delivers the GII recommendations specific to Latin America that provide guidance to combat existing vaccination challenges. While many countries worldwide, especially in the tropics and subtropics, do not have a seasonal influenza policy, 90% of Latin American countries have a seasonal influenza policy in place. Local governments in the Latin American countries and The Pan American Health Organization's Technical Advisory Group on Vaccine-preventable Diseases play a major role in improving the vaccination coverage and reducing the overall disease burden. Influenza seasonality poses the biggest challenge in deciding on optimal timing for vaccination in Latin America, as in temperate climates seasonal influenza activity peaks during the winter months (November–February and May–October)in the northern and southern hemispheres, respectively, while in the tropics and subtropical regions it usually occurs throughout the year, but especially during the rainy season. Besides this, vaccine mismatch with circulating strains, misconception concerning influenza vaccine effectiveness, and poor disease and vaccine awareness among the public are also key challenges that need to be overcome. Standardization of clinical case definitions is important across all Latin American countries. Surveillance (mostly passive)has improved substantially in the Latin American countries over the past decade, but more is still required to better understand the disease burden and help inform policies.

Respiratory syncytial virus (RSV) is a common cause of acute lower respiratory tract infections and hospitalisations among young children and is globally responsible for many deaths in young children, especially in infants aged <6 months. Furthermore, RSV is a common cause of severe respiratory disease and hospitalisation among older adults. The development of new candidate vaccines and monoclonal antibodies highlights the need for reliable surveillance of RSV. In the European Union (EU), no up-to-date general recommendations on RSV surveillance are currently available. Based on outcomes of a workshop with 29 European experts in the field of RSV virology, epidemiology and public health, we provide recommendations for developing a feasible and sustainable national surveillance strategy for RSV that will enable harmonisation and data comparison at the European level. We discuss three surveillance components: active sentinel community surveillance, active sentinel hospital surveillance and passive laboratory surveillance, using the EU acute respiratory infection and World Health Organization (WHO) extended severe acute respiratory infection case definitions. Furthermore, we recommend the use of quantitative reverse transcriptase PCR-based assays as the standard detection method for RSV and virus genetic characterisation, if possible, to monitor genetic evolution. These guidelines provide a basis for good quality, feasible and affordable surveillance of RSV. Harmonisation of surveillance standards at the European and global level will contribute to the wider availability of national level RSV surveillance data for regional and global analysis, and for estimation of RSV burden and the impact of future immunisation programmes.

Respiratory syncytial virus (RSV) is a common cause of acute lower respiratory tract infections and hospitalisations among young children and is globally responsible for many deaths in young children, especially in infants aged <6 months. Furthermore, RSV is a common cause of severe respiratory disease and hospitalisation among older adults. The development of new candidate vaccines and monoclonal antibodies highlights the need for reliable surveillance of RSV. In the European Union (EU), no up-to-date general recommendations on RSV surveillance are currently available. Based on outcomes of a workshop with 29 European experts in the field of RSV virology, epidemiology and public health, we provide recommendations for developing a feasible and sustainable national surveillance strategy for RSV that will enable harmonisation and data comparison at the European level. We discuss three surveillance components: active sentinel community surveillance, active sentinel hospital surveillance and passive laboratory surveillance, using the EU acute respiratory infection and World Health Organization (WHO) extended severe acute respiratory infection case definitions. Furthermore, we recommend the use of quantitative reverse transcriptase PCR-based assays as the standard detection method for RSV and virus genetic characterisation, if possible, to monitor genetic evolution. These guidelines provide a basis for good quality, feasible and affordable surveillance of RSV. Harmonisation of surveillance standards at the European and global level will contribute to the wider availability of national level RSV surveillance data for regional and global analysis, and for estimation of RSV burden and the impact of future immunisation programmes.