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Weekly Digest: Hib vaccine linked with better health & cognition in Indian children; Mass antibiotic distribution reduces child mortality in Africa; M&E framework for Global Action Plan on AMR.

Weekly Digest: Hib vaccine linked with better health & cognition in Indian children; Mass antibiotic distribution reduces child mortality in Africa; M&E framework for Global Action Plan on AMR.

Hib vaccine linked with better health, cognition, and schooling outcomes in Indian children.  In a study published in the Annals of the New York Academy of Sciences, researchers at CDDEP, the University of California, Riverside and Harvard T.H. Chan School of Public Health investigated the associations between Hib vaccination status and anthropometric, cognitive, and schooling outcomes among 1,824 Hib-vaccinated and unvaccinated Indian children. Propensity score matching was used to control for systematic differences between the two groups. The study found that at ages 11-12 years, Hib-vaccinated children had significantly higher height-for-age Z scores (an increase of 0.25, P <0.001), significantly higher English and Mathematics test scores (an increase of 4.09 and 4.78 percentage points, P <0.001), and higher schooling attainment (0.16 more grades, P <0.05) than matched Hib-unvaccinated children. [NYAS, CDDEP]

Mass antibiotic distribution linked to reduced childhood mortality in Africa. The MORDOR I trial (Macrolides Oraux pour Réduire les Décès avec un Oeil sur la Résistance) in Niger previously found that a twice-yearly mass distribution of azithromycin among children 1 to 59 months old decreased childhood mortality by 18 percent compared to placebo. In a follow-up study, the MORDOR II trial, findings showed no significant difference in mortality among intervention communities who continued receiving azithromycin for the third year compared to the first two years. The researchers hypothesized that if azithromycin resistance was rising, the reduction in childhood mortality rates would wane. [NEJM]

WHO, FAO and OIE release M&E framework for Global Action Plan on AMR. Jointly launched by the tripartite group of the World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO), and the World Organization for Animal Health (OIE) in 2015, the Global Action Plan on Antimicrobial Resistance (AMR) now has a framework for monitoring and evaluation (M&E). The framework introduces a set of core indicators that take into account intra-country variations in AMR rates and its drivers. [WHO]

Infant antibiotic use associated with childhood asthma. Researchers at Vanderbilt University recruited 152,622 Medicare-enrolled children in Tennessee in a study to assess the impact of infant antibiotic use on childhood asthma. They found that antibiotic use during infancy is associated with a 20 percent increase in odds of childhood asthma per prescription filled. Infants prescribed only broad-spectrum antibiotics had higher odds of developing childhood asthma compared to those who were prescribed only narrow-spectrum antibiotics (aOR: 1.10). [CID]

WHO estimates global STI prevalence and incidence. According to a 2016 global estimate by the World Health Organization (WHO), more than a million new sexually transmitted infections (STI) are diagnosed every day. WHO researchers generated prevalence and incidence estimates on chlamydia, gonorrhea, trichomoniasis, and syphilis using 130 prevalence studies and data from the Spectrum-STI database. Global prevalence estimates were 3.8 percent and 2.7 percent for chlamydia, 0.9 percent and 0.7 percent for gonorrhea, and 5.3 percent and 0.6 percent for trichomoniasis, for women and men respectively. Syphilis rates were 0.5 percent for both genders.  The researchers estimated 376.4 million incident diagnoses of the 4 STIs in 2016. [WHO]

Novel oral poliovirus vaccine shows success in healthy adults. Researchers from the University of Antwerp and partners evaluated the safety and immunogenicity of two novel monovalent oral type-2 poliovirus (OPV2) vaccine candidates which aim to decrease the risk of vaccine-derived poliovirus outbreaks. Both vaccine candidates provided immunogenicity to the healthy adults, and no serious adverse events occurred. Vaccine virus shedding occurred in 100 percent of participants who received vaccine candidate 1 and stopped after a median of 23 days following administration. Shedding occurred in 87 percent of participants who received vaccine candidate 2 and stopped after a median period of 12 days. [The Lancet]

Meningitis screening in advanced HIV patients found cost-effective. HIV-positive adults with a CD4 count of <200 cells/ml in Tanzania and Zambia were randomly assigned to either cryptococcal meningitis screening along with community-based adherence support or to the standard of care. Results found that the incremental cost-effectiveness ratio (health service care cost per life-year saved) for the intervention group compared to the standard of care was $70 (2017 USD) for participants with a CD4 count of 200 cells/ml or less and $91 for participants with a CD4 count of <100 cells/ml. The cryptococcal meningitis screening and community-based adherence support are cost-effective among advanced HIV patients in low-resource communities. [CID]

Power outages linked to reduced use of maternal health services in India. Combining data from the 2015–2016 India Demographic Health Survey with reports of electricity outages, researchers at Wilfrid Laurier University in Ontario, Canada investigated the association between power outages and the utilization of maternal health services in Maharashtra State, India. Results found an average of 8.5 electricity interruptions per month, which is associated with a 2.08 percent lower likelihood of mothers delivering in an institution. Power outage and frequency were also associated with slightly lower odds in skilled birth attendance (OR= 0.97, 0.99). [BMJ Global Health]

Pharmaceutical companies hamper efforts to curb AMR in livestock. The New York Times has shed light on Elanco’s “Pig Zero” campaign, which urged farmers to administer antibiotics to healthy animals to avoid outbreaks. Other drugmakers are also guilty of promoting aggressive use of their own antibiotic cocktails. Although there has been some progress in limiting the use of antibiotics in livestock since the 2017 introduction of the FDA’s ban on the use of medically important antibiotics to fatten livestock, a greater commitment of the industry is required to combat excessive antibiotic administration in animals in the face of an increasing global demand for meat. [NYTimes]

FDA votes in favor of investigational treatment for drug-resistant TB. Earlier this month, the US Food and Drug Administration (FDA) Antimicrobial Drugs Advisory Committee voted in favor of the safety and effectiveness of a new treatment for extensively drug-resistant (XDR) and non-responsive multidrug-resistant tuberculosis (MDR TB). Pretomanid, the anti-TB drug developed by the non-profit drug developer, TB Alliance, is part of an investigational oral combination therapy consisting of bedaquiline, pretomanid, and linezolid. [TB Alliance]

CDDEP Awards in Antimicrobial Resistance. CDDEP Awards in Antimicrobial Resistance will sponsor two individuals for the best-accepted abstracts addressing AMR in low- or middle-income countries for the 19th International Congress on Infectious Diseases (ICID). The awards consist of reimbursement of travel, accommodation, and registration expenses for the 19th ICID in Kuala Lumpur, February 20-23, 2020. Submit your abstract addressing AMR in LMICs by Oct. 25, 2019. [ICID]

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