August 23, 2018
MRSA colonization increases risk of subsequent infection during and after hospitalization. A study of data from 2008 to 2015 from the US Department of Veterans Affairs followed nearly one million patients who were screened for colonization with methicillin-resistant Staphylococcus aureus (MRSA) when admitted and at several points during hospitalization. Patients were then followed and tested at 30, 90, 180, and 365 days after discharge to determine their risk of MRSA infection. The researchers found that 8% of patients were colonized, and of those colonized 1.5% had a subsequent infection, while only 0.6% of those not colonized became infected. A substantial portion of infections occurred after hospital discharge. [Clinical Infectious Diseases]
Improved malaria vector control with newer dual-treated nets. A trial in Burkina Faso demonstrated that nets treated with two insecticides with different modes of action provided better malaria protection for young children (2.0 infections occurred per child-year with standard nets, compared to 1.5 infections per child-year with dual-treated nets). In those using dual-treated nets, the number of estimated infectious bites was significantly lower, and the children had lower rates of anemia. The results suggest that wide distribution of these newer dual-treated nets could reduce morbidity and mortality from malaria. [Lancet, Commentary]
WHO update on MERS finds continued risk of transmission in healthcare settings and travel. The latest World Health Organization (WHO) update on the Middle East respiratory syndrome-coronavirus (MERS-CoV) found that overall there have been no changes in the epidemiology, transmission patterns, or clinical presentations of MERS patients. The virus continues to remain a zoonotic illness that enters the human population via direct or indirect contact with infected dromedary camels in the Arabian Peninsula. Limited, non-sustained human-to-human transmission, mainly in health care settings, continues to occur in Saudi Arabia. The risk of export via travel remains significant as symptoms of MERS-CoV infection are non-specific and global awareness about MERS-CoV among medical personnel is low. [WHO]
Tdap vaccination for pregnant women does not increase risk of autism. A study published in the journal Pediatrics assessed prenatal vaccination of pregnant women with the tetanus, diphtheria, acellular pertussis (Tdap) vaccine and autism spectrum disorder (ASD) risk in their children. The study included 81,993 children and found that 1.5 percent of children whose mothers were vaccinated with Tdap had a diagnosis of ASD, while 1.8 percent of children whose mothers were not vaccinated had a diagnosis of ASD. This compares to the estimated prevalence of ASD among 8-year-old children in the United States of 1.7 percent. [Pediatrics]
Poor medical conditions in Malawi threaten the lives of infants. In a feature discussing neonatal conditions in the country, the first ever Malawian neonatologist tells a journalist of the agonizing reality of babies in his hospital’s neonatal ward. About 15 of every 200 babies admitted are diagnosed with sepsis. Hospitals in Malawi face increased regularity of sepsis with more than half of cases resistant to available antibiotics. As a result of the poor conditions in hospitals and the lack of basic hygienic necessities, women often avoid coming into the hospitals even in the event of serious complications. [BMJ]
Billion dollar implications of substandard medication in low- and middle-income countries. An analysis of the prevalence and economic burden of poor-quality medications has been published in a review article, with data showing an overall 13.6% of medications in low- and middle-income countries to be substandard. In Africa, the percentage was as high as 18.7%. The economic impact of poor quality or falsified medications ranges from US$10 billion to US$200 billion, depending largely on market size. Researchers call for a standardized method of regulating pharmaceuticals including the use of global networks for surveillance. [JAMA Network]
Barriers to increasing routine vaccination coverage in Pakistan require multifaceted strategies. A survey of 8,400 households in southern Pakistan found the majority of children under one were either non-vaccinated (23%) or had incomplete vaccination status (46%), despite government efforts to expand routine vaccination coverage. The study, published in Vaccine, found that caregivers often cited lack of awareness of the importance for vaccination, a fear of vaccine reactions, distance from immunization centers, and interruptions in vaccine supplies as major barriers to complying with vaccination schedules. Combined, these factors suggest the need for a multipronged strategy to improve uptake of vaccination services in Pakistan, which has one of the world’s largest birth cohorts and faces high rates of under-five child mortality, due in part to vaccine-preventable illnesses. [Vaccine]
Introduction of rotavirus vaccine results in significant decline in infant mortality. A recent study shows that including the rotavirus vaccine in Malawi’s immunization program has reduced diarrhea-related infant death by 34%. Rotavirus is the leading cause of diarrheal disease in infants and young children in African and Asian countries. Malawi’s strong immunization program and implementation is, in part, responsible for the success of the program. The results support the WHO recommendation to include rotavirus vaccines in immunization programs for low- and middle-income countries. [EurekAlert, University of Liverpool, The Lancet: Global Health]
DRIVE-AB: innovative incentives for sustainable antibiotic use. Innovative Medicines Initiative recently completed a three-year project, DRIVE-AB, which aimed to develop business models to increase antibiotic development and disincentivize antibiotic resistance. A recent article described three strategies to reward: first, to divorce unit sales from the innovation reward in an effort to keep prices low; second, to strike a balance between prices that are low enough to encourage rampant misuse and prices that are high enough to make necessary pharmaceuticals inaccessible; and third, to limit marketing that creates a false belief of need for particular medicines. [Journal of Law, Medicine, and Ethics]
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