In this slideset, Professor Shabir Madhi, WAidid board member, analyses the trends in global and sub-Saharan Africa under-5 childhood mortality, to then demonstrate the contribution of new childhood vaccines in reducing under-5/neonatal morbidity and mortality by vaccination.
To learn more, visit www.waidid.org!
IFPMA Geneva Pharma Forum on 9 May 2014
Bringing Psoriasis into the Light
Presentation of Kim kjoeller, Senior Vice President
Global Development, Leo Pharma
A recent Presentation at National Annual Review Meeting of Core Group Polio Project (CGPP) -USAID funded project, ADRA India: implementing agency with technical support from CORE Secretariat
Dr. Luke Nkinsi's "Africa matters" presentation on Ebola Outbreak in West Africa and Maternal & Children Health Challenges in Sub-Saharan Africa at Seattle Rainier Beach Public Library - December 5 2014
IFPMA Geneva Pharma Forum on 9 May 2014
Bringing Psoriasis into the Light
Presentation of Kim kjoeller, Senior Vice President
Global Development, Leo Pharma
A recent Presentation at National Annual Review Meeting of Core Group Polio Project (CGPP) -USAID funded project, ADRA India: implementing agency with technical support from CORE Secretariat
Dr. Luke Nkinsi's "Africa matters" presentation on Ebola Outbreak in West Africa and Maternal & Children Health Challenges in Sub-Saharan Africa at Seattle Rainier Beach Public Library - December 5 2014
Risk Assessment of Mycotoxins in Stored Maize Grains from NigeriaFrancois Stepman
12-14 September 2017. Ghent, Belgium. 1st MYCOKEY International Conference.
M. C. Adetunji1, O. O. Atanda1, and C. N. Ezekiel2
1Department of Biological Sciences, McPherson University, Seriki Sotayo, Ogun State, Nigeria
2Department of Microbiology, Babcock University, Ilishan Remo, Ogun State, Nigeria
THE SOCIO-ECONOMIC IMPACT OF MYCOTOXIN CONTAMINATION IN AFRICAFrancois Stepman
12-14 September 2017. Ghent, Belgium. 1st MYCOKEY International Conference.
THE SOCIO-ECONOMIC IMPACT OF MYCOTOXIN CONTAMINATION IN AFRICAPatrick Njobeh* and Adekoya Ifeoluwa Dept of Biotechnology and Food Technology Faculty of Science, University of Johannesburg, South Africa
ILRI in Zambia and sub-Saharan Africa: Food safety, zoonoses and animal healthILRI
Presentation by Theo Knight-Jones at a Zambia Department of Agriculture and Veterinary Services planning workshop on milk testing and certification in Zambia, Monze, Zambia, 18-19 June 2015.
2017 Fall Armyworm (FAW) in Africa and the Nuru International ReponseCasey Harrison
Nuru International projects in Kenya and Ethiopia identified FAW in maize fields across our operating areas from March-June 2017. The impact varied across districts, but in many cases the damage caused was severe, and Nuru implemented a rapid response plan to address the threat. This presentation outlines the context around FAW in Africa and Ethiopia with specific actions and future actions that will be taken to control FAW in 2017-18.
Presentation by ECOWAS, FAO, CILSS and CABI, 3 December 2018
Detected for the first time in West Africa at the beginning of 2016, the fall armyworm mainly attacks maize but it can also attack rice and sorghum, as well as cotton and some vegetables. This joint presentation highlights the nature and extent of the problem and showcases some ongoing interventions to tackle the threat.
KCR features in the newest Pharma Voice, June 2017, top industry publication. Andrzej Piotrowski, MD, Ph.D., Medical Monitor at KCR, commented on malaria treatment and research.
John McDermott
POLICY SEMINAR
CGIAR COVID-19 Hub Seminar: COVID-19 and Implications for One Health Research
Co-Organized by CGIAR COVID-19 Hub and IFPRI
MAY 4, 2021 - 09:30 AM TO 11:00 AM EDT
Food Security in Nigeria: Impetus for Growth and DevelopmentPremier Publishers
One of the most important and crucial debates in the world today is how to provide sufficient food for over seven billion people in the world. In 2019, 690 million people were suffering from hunger globally while about 135 million people in 55 countries and territories were suffering from acute food insecurity with Africa accounting for 73 million of this figure. Food insecurity is one of the major challenges of most African governments occasioned by an increasing number of people living in extreme poverty, high-level corruption, incidences of conflicts/terrorism, low level of human capital and unfavorable climate change in the region. Nigeria has the highest number of people living in extreme poverty globally. The Global Food Security Index (GFSI) rank of Nigeria has been on the increase since 2013 while it was ranked 94th among 113 countries in 2019. Nigeria is facing the challenge of food insecurity, especially in the northeastern and north-central states where conflicts/insurgency, kidnapping, armed banditry, cattle rustling and weather extremes are aggravating the food insecurity situation. This paper therefore recommends that the Nigerian government should redouble efforts aimed at improving food production and processing activities to ensure food security across the states and also boost exports.
Tracking the uptake and trajectory of covid 19 vaccination coverage in 15 wes...MuhammedAfolabi1
Delighted to share our latest work on COVID-19 vaccination coverage and trajectory in the 15 West African countries that constitute the Economic Community of West African States (ECOWAS). Using publicly available, country-level COVID-19 vaccination data, we provided unique insights into the uptake trends of COVID-19 vaccines in the 15 West African countries. Based on the vaccination rates in the ECOWAS region 90 days after commencing COVID-19 vaccinations, we provided a projection of the trajectory and speed of vaccination needed to achieve a COVID-19 vaccination coverage rate of at least 60% of the total ECOWAS population, needed to achieve the population-level immunity to end the acute phase of the pandemic. After three months of the deployment of COVID-19 vaccines across the ECOWAS countries, only 0.27% of the sub-region’s total population had been fully vaccinated. If the ECOWAS countries follow this trajectory, the sub-region will have less than 1.6% of the total population fully vaccinated after 18 months of vaccine deployment. Our projection shows that to achieve a COVID-19 vaccination coverage of at least 60% of the total population in the ECOWAS sub-region after 9, 12 and 18 months of vaccine deployment; the speed of vaccination must be increased to 10, 7 and 4 times the current trajectory, respectively.
The BMJ issued a press release to underscore the significance of our findings, given that low COVID uptake promotes the emergence of new variants. With the recent emergence of the Omicron variant and how it is changing our lives globally, our study supports the findings that vaccine equity is not just for African countries alone, as COVID-19 will not be over until it's over everywhere
Presented to the British High Commission, British Council and the Royal Moroccan Science Council at the Mediterranean Space of Technology and Innovation (MSTI) event held in Rabat, Morocco, this presentation highlight the data innovation ecosystem in the UK.
Risk Assessment of Mycotoxins in Stored Maize Grains from NigeriaFrancois Stepman
12-14 September 2017. Ghent, Belgium. 1st MYCOKEY International Conference.
M. C. Adetunji1, O. O. Atanda1, and C. N. Ezekiel2
1Department of Biological Sciences, McPherson University, Seriki Sotayo, Ogun State, Nigeria
2Department of Microbiology, Babcock University, Ilishan Remo, Ogun State, Nigeria
THE SOCIO-ECONOMIC IMPACT OF MYCOTOXIN CONTAMINATION IN AFRICAFrancois Stepman
12-14 September 2017. Ghent, Belgium. 1st MYCOKEY International Conference.
THE SOCIO-ECONOMIC IMPACT OF MYCOTOXIN CONTAMINATION IN AFRICAPatrick Njobeh* and Adekoya Ifeoluwa Dept of Biotechnology and Food Technology Faculty of Science, University of Johannesburg, South Africa
ILRI in Zambia and sub-Saharan Africa: Food safety, zoonoses and animal healthILRI
Presentation by Theo Knight-Jones at a Zambia Department of Agriculture and Veterinary Services planning workshop on milk testing and certification in Zambia, Monze, Zambia, 18-19 June 2015.
2017 Fall Armyworm (FAW) in Africa and the Nuru International ReponseCasey Harrison
Nuru International projects in Kenya and Ethiopia identified FAW in maize fields across our operating areas from March-June 2017. The impact varied across districts, but in many cases the damage caused was severe, and Nuru implemented a rapid response plan to address the threat. This presentation outlines the context around FAW in Africa and Ethiopia with specific actions and future actions that will be taken to control FAW in 2017-18.
Presentation by ECOWAS, FAO, CILSS and CABI, 3 December 2018
Detected for the first time in West Africa at the beginning of 2016, the fall armyworm mainly attacks maize but it can also attack rice and sorghum, as well as cotton and some vegetables. This joint presentation highlights the nature and extent of the problem and showcases some ongoing interventions to tackle the threat.
KCR features in the newest Pharma Voice, June 2017, top industry publication. Andrzej Piotrowski, MD, Ph.D., Medical Monitor at KCR, commented on malaria treatment and research.
John McDermott
POLICY SEMINAR
CGIAR COVID-19 Hub Seminar: COVID-19 and Implications for One Health Research
Co-Organized by CGIAR COVID-19 Hub and IFPRI
MAY 4, 2021 - 09:30 AM TO 11:00 AM EDT
Food Security in Nigeria: Impetus for Growth and DevelopmentPremier Publishers
One of the most important and crucial debates in the world today is how to provide sufficient food for over seven billion people in the world. In 2019, 690 million people were suffering from hunger globally while about 135 million people in 55 countries and territories were suffering from acute food insecurity with Africa accounting for 73 million of this figure. Food insecurity is one of the major challenges of most African governments occasioned by an increasing number of people living in extreme poverty, high-level corruption, incidences of conflicts/terrorism, low level of human capital and unfavorable climate change in the region. Nigeria has the highest number of people living in extreme poverty globally. The Global Food Security Index (GFSI) rank of Nigeria has been on the increase since 2013 while it was ranked 94th among 113 countries in 2019. Nigeria is facing the challenge of food insecurity, especially in the northeastern and north-central states where conflicts/insurgency, kidnapping, armed banditry, cattle rustling and weather extremes are aggravating the food insecurity situation. This paper therefore recommends that the Nigerian government should redouble efforts aimed at improving food production and processing activities to ensure food security across the states and also boost exports.
Tracking the uptake and trajectory of covid 19 vaccination coverage in 15 wes...MuhammedAfolabi1
Delighted to share our latest work on COVID-19 vaccination coverage and trajectory in the 15 West African countries that constitute the Economic Community of West African States (ECOWAS). Using publicly available, country-level COVID-19 vaccination data, we provided unique insights into the uptake trends of COVID-19 vaccines in the 15 West African countries. Based on the vaccination rates in the ECOWAS region 90 days after commencing COVID-19 vaccinations, we provided a projection of the trajectory and speed of vaccination needed to achieve a COVID-19 vaccination coverage rate of at least 60% of the total ECOWAS population, needed to achieve the population-level immunity to end the acute phase of the pandemic. After three months of the deployment of COVID-19 vaccines across the ECOWAS countries, only 0.27% of the sub-region’s total population had been fully vaccinated. If the ECOWAS countries follow this trajectory, the sub-region will have less than 1.6% of the total population fully vaccinated after 18 months of vaccine deployment. Our projection shows that to achieve a COVID-19 vaccination coverage of at least 60% of the total population in the ECOWAS sub-region after 9, 12 and 18 months of vaccine deployment; the speed of vaccination must be increased to 10, 7 and 4 times the current trajectory, respectively.
The BMJ issued a press release to underscore the significance of our findings, given that low COVID uptake promotes the emergence of new variants. With the recent emergence of the Omicron variant and how it is changing our lives globally, our study supports the findings that vaccine equity is not just for African countries alone, as COVID-19 will not be over until it's over everywhere
Presented to the British High Commission, British Council and the Royal Moroccan Science Council at the Mediterranean Space of Technology and Innovation (MSTI) event held in Rabat, Morocco, this presentation highlight the data innovation ecosystem in the UK.
Determinants Of Visual Outcomes After Small Incision Cataract Surgery In Pati...Dr. Jagannath Boramani
Authors : Presenting author- Dr. Kumud Jeswani Co authors: Dr. Kuldeep Dole, Dr. Shruti Shah, Dr. Nilesh Kakade. PMBA ‘S H .V . Desai Eye Hospital, PUNE.
Repair of incisional hernia! A anatomical and technical challenge.KETAN VAGHOLKAR
Incisional hernia is the most challenging problem in abdominal surgery. Open method provides the most sound and longlasting cure to the problem. The recurrence rate with a well done open technique is very low.
Revista se faz para o leitor. Esta é daquelas verdades tão simples quanto muitas vezes ignoradas. Muitos projetos editoriais naufragam porque as revistas foram criadas a partir do desejo do editor de “fazer jornalismo” e de ter um veículo para “se expressar”, esquecendo-se completamente do leitor.
Ofsted inspection: Putting learning first conference January 2017Ofsted
Sean Harford, Director, Education, gave this presentation at the conference in Ilminster, Somerset on Wednesday 18 January 2017. It covers headline messages about Ofsted inspection and debunks Ofsted myths.
The PPT gives overview of PEI, global updates on PEI, Polio end game strategy and eradication timelines, polio legacy and link with Health Systems strengthening and relevant health programes etc. The PPT was presented at National Annual Review Meeting held for 2 days in Mussoorie for Core Group of Polio Project (CGPP) -a USAID funded polio eradication initiatives. ADRA India is one of the lead implementing agency for CGPP since 2004 and it has worked for nearly 15 years in polio across states in India.
Am looking for writers CPP is 250 to 300.Contact [email prot.docxnettletondevon
Am looking for writers CPP is 250 to 300.
Contact [email protected], Send your sample papers and contact numbers
Part I
Health-related
Millennium Development Goals
12
3 WHO Child Growth Standards. Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and
development. WHO Multicentre Growth Reference Study Group. Geneva, World Health Organization, 2006, page 312.
www.who.int/childgrowth/publications/en/
Summary of status and trends
With only five years remaining to 2015, there are signs of progress in many countries in achieving the
health-related Millennium Development Goals (MDGs). In other countries, progress has been limited
because of conflict, poor governance, economic or humanitarian crises, and lack of resources. The
effects of the global food, energy, financial and economic crises on health are still unfolding, and action
is needed to protect the health spending of governments and donors alike.
Undernutrition is an underlying cause in about one third of all child deaths. Over the past year,
rising food prices coupled with falling incomes have increased the risk of malnutrition, especially
among children. Although the percentage of children under 5 years of age who are underweight
(compared to the WHO Child Growth Standards3) declined globally from 25% in 1990 to 18% in
2005, subsequent progress has been uneven. In some countries, the prevalence of undernutrition has
increased, and worldwide stunted growth still affected about 186 million children under 5 years of age
in 2005.
Globally, child mortality continues to fall. In 2008, the total annual number of deaths in children
under 5 years old fell to 8.8 million – down by 30% from the 12.4 million estimated in 1990.
Mortality in children under 5 years old in 2008 was estimated at 65 per 1000 live births, which is
a 27% reduction from 90 per 1000 live births in 1990 (Figure 1). Recent encouraging trends also
indicate an acceleration of the rate of decline in all regions since 2000 (Table 1).
WHO region 1990–1999 2000–2008
African Region 0.9 1.8
Region of the Americas 4.2 4.6
South-East Asia Region 2.5 3.8
European Region 3.6 5.6
Eastern Mediterranean Region 1.5 1.7
Western Pacific Region 2.5 5.7
GLOBAL 1.2 2.3
Table 1: Average annual rate of decline (%) in mortality in children under 5 years old –
1990–1999 and 2000–2008
13
Despite these encouraging trends, regional and national averages mask considerable inequities.
The greatest reductions in child mortality have been recorded among the wealthiest households and
in urban areas. Concerted efforts will be needed to achieve the MDG target of a 67% reduction from
1990 levels by the year 2015, especially in countries facing economic crises or conflicts. Low-income
countries would need to increase their annual average rate of decline from 1.9% to 10.9% in order to
achieve the target. Reducing child mortality increasingly depen.
Role of vaccines and child health - Professor Shabir MadhiWAidid
"Role of vaccines in making the world a better place for children" - Slideset by professor Madhi (WAidid Board Member) presented at the 2015 World Congress of Nephrology, held in Cape Town from March 13-17 2015.
Find more on www.waidid.org
David K. Robinson, Ph. D.Vice President, BiologicsHead and Executive Director, Biologics and Vaccines CMC RegulatoryMerck & Co, Inc.
Presenting on behalf of the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA)WCBP CASS, Washington DC, USAJanuary 2014
AIDSTAR-One Increasing Access to Prevention of Mother-to-Child Transmission S...AIDSTAROne
This technical report discusses the many services needed throughout the prevention of mother-to-child transmission (PMTCT) and infant care services continuum and identifies potential barriers to service coverage, access, and utilization. AIDSTAR-One provides examples of evidence-based and emerging practices to mitigate these barriers.
www.aidstar-one.com/focus_areas/pmtct/resources/report/increasing_access_to_pmtct_services
09 CeoMeeting- Session 4- Medicines for MalariaMLSCF
Session 4: Health & Wellness
Title: The Changing Face Of Healthcare:
Where Are The Opportunities?
Special Speaker: Dr Chris Hentschel, Medicines for Malaria Venture
Three months after the start of the COVID-19 pandemic in Wuhan (China), the African response could be labelled as impressive. Many lessons were learnt by African countries from Ebola epidemic which hit West Africa (2014-2016). Industrial resiliency (mask production at scale), Technological innovations (PCR test local production, machine learning and robotics) and Genomic Prowess (Genome sequence of COVID-19 virus) ; all showed Africa is ready to be part of the global solution to COVID-19. Yet, only 3 clinical trials for vaccine and medicine against the virus were ongoing across the continent at the time of this presentation. The presentation also discusses some of the public health and industrial strategies to build even more resiliency in the continent beyond the pandemic.
In light of the global health crisis, Imperial College Healthcare Club to host the second webinar discussion around Africa’s healthcare system resilience to COVID-19. We are honored to be joined by Dr. Kaouthar Lbiati, who are both currently working on the continent’s response to the pandemic.The event will be a discussion, where the speakers will be presenting their work as well as their views and perspectives around the Healthcare crisis in Africa.
The webinar will focus on :
1. How the healthcare actors based in Africa have been crucial in responding to the pandemic.
3. How the long-term consequences of this crisis can bring major changes in Africa.
Kaouthar Lbiati (MD, MSc) will be emphasising on the wider scope of the healthcare policy & industry and explore the strategies on both that Africa as a continent could
establish to build resilience.
Sharing from USAID:
The U.S. Agency for International Development (USAID) is pleased to announce the release of its “Annual Progress Report to Congress: Global Health Programs FY 2014.” The report presents a summary of USAID’s key global health accomplishments during the previous fiscal year. From improving children’s nutrition to supporting antiretroviral treatment for millions of individuals, USAID programs had a great impact in 2014.
As the largest investor in global health, USAID is leading efforts to improve and save lives worldwide. In partnership with countries, non-governmental organizations, the faith-based community, and the private sector, the Agency is reaching people with the greatest need in the most remote areas. USAID works to further President Barack Obama’s vision to end extreme poverty through its ongoing contributions to ending preventable child and maternal deaths, creating an AIDS-free generation and protecting communities from infectious diseases.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Progress, Challenges and Opportunities for Vaccines to Reduce Under-5 Childhood Mortality - prof. Shabir Madhi
1. National Institute for Communicable Diseases &
University of Witwatersrand, South Africa
Respiratory and Meningeal Pathogens Research Unit,
& DST/NRF: Vaccine Preventable Diseases
Shabir A. Madhi
Progress, Challenges and
Opportunities for Vaccines to
Reduce Under-5 Childhood Mortality
2. ● Institution received research grants from GSK, Pfizer and Novartis
● Honoraria for speaking from GSK, Pfizer, Abbott and Sanofi
Pasteur
● Investigator in clinical vaccine trials for GSK, Wyeth, Novartis,
Medimmune and Sanofi Pasteur
● Consultant/member of advisory boards for GSK, Pfizer, Merck
and Novartis
Disclosure
3. Overview
● Trends in Global and sub-Saharan Africa under-5
childhood mortality.
● Recent contribution and challenges of childhood
vaccines in reducing under-5 mortality.
● Potential of new childhood vaccines in reducing
under-5 mortality.
● New horizons in reducing under-5/neonatal
morbidity and mortality by vaccination.
4. Overview
● Trends in Global and sub-Saharan Africa under-5
childhood mortality.
● Recent contribution and challenges of childhood
vaccines in reducing under-5 mortality.
● Potential of new childhood vaccines in reducing
under-5 mortality.
● New horizons in reducing under-5/neonatal
morbidity and mortality by vaccination.
5. Global Trends in Under-5 Childhood Deaths, 2000 to 2010
• Reduction in all-cause under-5 mortality from 9.629 to 7.622 million between 2000 to 2010.
• 3.55 million deaths occurred in Africa in 2010
Liu L et al. Lancet 2012; 379: 2151-61
6. Global Causes of Under-5 Childhood Deaths in 2013
Liu L et al. Lancet 2015; 385: 430-440
• Under-5 mortality declined to 6.3 million in 2013.
• 51.8% (3.275 million) died due to infectious causes.
• 44% (2.76 million) died during neonatal period.
7. Liu L et al. Lancet 2015; 385: 430-440
Causes of Under-5 Childhood Deaths in Sub-Saharan
Africa in 2013
2013: Sub-Saharan Africa: 25% of global under-5 births
50% of under-5 childhood deaths
8. Estimated Annual Rate of Reduction by Cause at
the Global Level between 2000 to 2013
Target of 4.4% year on year decline was required to achieve MDG4 Goal
of Reducing Under-5 Mortality by Two-thirds Between 1990 and 2015.
Liu L et al. Lancet 2015; 385: 430-440
9. Global Cause-Specific Mortality on 2030 Within the
Achievement Scenario by Comparison with Cause-
Specific Mortality in 2013.
Liu L et al. Lancet 2015; 385: 430-440
• 4.4 million childhood deaths still expected in 2030.
Sub-saharan Africa (2030):
● 33% of births globally in 2030 vs. 25% in 2015
● 60% of under-5 deaths in 2030 vs. 50% in 2015
10. Overview
● Trends in Global and sub-Saharan Africa under-5
childhood mortality.
● Recent contribution and challenges of childhood
vaccines in reducing under-5 mortality.
● Potential of new childhood vaccines in reducing
under-5 mortality.
● New horizons in reducing under-5/neonatal
morbidity and mortality by vaccination.
11. Percentage of deaths (2.5 million) from vaccine-preventable
diseases (VPDs) among children <5 years worldwide, 2002
OtherVPDs
1%(25000)
MMWR; 2006: 55:511-5 &WHO. 2004: Global Immunization Data
Over 50% of VPDs in under-5 children in 2002 due to diseases for which
vaccine available since the 1930s-early 90s.
12. Progress and Challenges Toward Measles
Elimination
Source: http://www.immunize.org/photos/polio-measles.asp
13. Measles Containing Vaccine Coverage By WHO Region,
1980-2011; Global Coverage At 84% In 2011
Source: WHO/UNICEF coverage estimates 1980-2011
193 WHO Member States. Date of slide: 2 Nov 2012
14. Estimated measles deaths in 2000 and 2010
10 100
48 600
139 300 measles deaths in 2010
Simons E et al. Lancet 2012; 379: 2173-78
74% decrease in global measles deaths between 2000 to 2010.
Target: 90% reduction in measles mortality by 2010 compared to 2000.
85%26%
76%1
78%
78%
1 Per cent reduction in 2010 compared to 2000
15. 13.8 Million Measles Deaths Averted Globally between
2000 to 2012.
Simons E et al. Lancet 2012; 379: 2173-78
During 2000-2012:
77% decrease in incidence
78% decline in deaths
16. ARE WE ON TRACK TO REACH OUR GVAP COVERAGE GOALS ?
Global Immunization 1980-2015 and projections to reach 90% global coverage goals
in 2020 - MCV1 coverage
0
20
40
60
80
100
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
%coverage
Global African American Eastern Mediterranean
European South East Asian Western Pacific
Source: WHO/UNICEF coverage estimates 2015 revision. July 2016
Immunization Vaccines and Biologicals, (IVB), World Health Organization.
194 WHO Member States. Date of slide: 26 July 2016
18. Percentage of children under one year age who received
measles vaccine, by household wealth quintile and region
Percent
Source: UNICEF. Pneumonia and Diarrhoea. June 2012. Available: www.childinfo.org/publications
• Need to focus immunization efforts on reaching out to the poorest quintile,
who are also disadvantaged to access to curative health services
19. Global Immunization 1980-2015, DTP3 coverage
global coverage at 86% in 2015
21
2426
39
45
49
52
56
64
68
76
727070
73737271727272737375767879808284858585858586
0
20
40
60
80
100
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
%coverage
Global African American Eastern Mediterranean
European South East Asian Western Pacific
Source: WHO/UNICEF coverage estimates 2015 revision. July 2016
Immunization Vaccines and Biologicals, (IVB), World Health Organization.
194 WHO Member States. Date of slide: 16 July 2016.
20. 19.4 million infants not immunized (DTP3), 2015
African
American
Eastern Mediterranean
European
South East Asian
Western Pacific
Source: WHO/UNICEF coverage estimates 2015 revision. July 2016 / United Nations, Population Division. The
World Population Prospects - the 2015 revision". New York, 2015.
Immunization Vaccines and Biologicals, (IVB), World Health Organization.
194 WHO Member States. Date of slide: 28 July 2016.
22. Progress in Polio Eradication,
Estimated and Reported Polio Cases, 1985-2015
Source: WHO/Polio database, Aug 2016
194 WHO Member States.
0
100
200
300
400
Number(thousands)
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Reported Estimated
1988: WHA Resolution to
Eradicate Polio
2000: Original Target Date for
Interruption of Transmission
Reported cases: 2 971
Estimated cases: 3 500
1999: WHA Resolution to
accelerate polio eradication
activities
2015: Reported
wild poliovirus
cases: 74
23. Polio Eradication Progress, 1988 – 2015
Source: WHO/POLIO database, as of Aug 2016
The boundaries and names shown and the designations used on this map do not imply the expression of
any opinion whatsoever on the part of the World Health Organization concerning the legal status of any
country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or
boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full
agreement.
WHO 2016. All rights reserved
Certified polio-free regions (126 countries)
Endemic with wild poliovirus ( 2 countries)
Not certified but non-endemic (65 countries)
24. Global estimates of burden of deaths due to H. influenzae
type b in children younger than 5 years; 2000
Watts JP, et al. Lancet 2009; 374:903=11
• Hib caused 8.13 (7.33-13.2) million serious illnesses worldwide in 2000
• Hib caused 371 000 (247 000-527 000) deaths in 2000
Africa: 181 000
(126 000-251 000)
Americas: 8 400
(5200-11700)
SE Asia: 75 300
(53 000-109 900)
Western Pacific: 17 600
(12 400-25 600)
Europe: 6 500
(4 600-9 500)
Eastern Mediterranean
41 600
(29 300-60 700)
25. Proportion of countries, by income-group, that have
introduced Hib conjugate vaccine into immunization
programs
Source: UNICEF. Pneumonia and Diarrhoea. June 2012. Available: www.childinfo.org/publications
PercentcountriesinwhichHibCV
introduced
26. Overview
● Trends in Global and sub-Saharan Africa under-5
childhood mortality.
● Recent contribution and challenges of childhood
vaccines in reducing under-5 mortality.
● Potential of new childhood vaccines in reducing
under-5 mortality.
● New horizons in reducing under-5/neonatal
morbidity and mortality by vaccination.
27. Substantial Experience in last 15 years with
New Vaccine Introduction to EPI
Malaria
(≈ 2015)
Maternal
Tetanus
(1983)
1920-1939: 1 vaccine
1940-1959: 3 vaccines
1960-1979: 4 vaccines
1980-1999: 3 vaccines
2000-2019: > 12 vaccines
Rabies
(1880’s)
1974: EPI
(BCG, OPV, DTP, Measles)
DTP+HepB+Hib
(Pentavalent)
(1998)
Courtesy Kate O’Brien. IVAC, JHU
28. Global Causes of Under-5 Childhood Deaths in 2013
(n=6.3 million)
Liu L et al. Lancet 2015; 385: 430-440
29. Overview
● Trends in Global and sub-Saharan Africa under-5
childhood mortality.
● Recent contribution and challenges of childhood
vaccines in reducing under-5 mortality.
● Potential of new childhood vaccines in reducing
under-5 mortality.
● New horizons in reducing under-5/neonatal
morbidity and mortality by vaccination.
30.
31. Death rate of pneumococcal disease in children <5 years
(per 100,000)
0
50
100
150
200
250
300
350
400
450
500
Africa America Eastern
Mediterranean
Europe Southeast Asia Western Pacific
Incidenceratesper100000
100,100 15,100 187,000 43,000Number of deaths: 447,000 33,100
O’Brien K et al. Lancet 2009;374;893–902
90% of the 830 000 pneumococcal deaths
associated with pneumonia
32. Invasive Pneumococcal Disease in South African Children < 2
years age: 2005-2012
>80% reduction in PCV7 serotype IPD in HIV-infected and HIV-uninfected children
within 3 years of vaccine introduction.
Von Gottberg A et al New Eng J Med; 2014. 371 (20): 1889-99.
33. Time Series Analysis of PCV7/13 Against All-Cause
Pneumonia Hospitalization (Soweto) in HIV-uninfected
Children, 2006 to 2014
Izu A et al. ISPPD June 2016
Reduction: 54% (95%CI: 37, 65) Reduction: 32% (95%CI: 10, 48)
Reduction: 13% (95%CI: -23, 37) Reduction: 50% (95%CI: 30, 64)
Reduction compares 2012-2014 vs. 2006-2008
34. PCV and HibCV Vaccine Introduction by
Income Group
http://www.jhsph.edu/research/centers-and-institutes/ivac/resources/PCVImpactGapAnalysis_MAR2016_FINAL_public.pdf
35. PCV Introduction by GAVI and Country Income
Status
http://www.jhsph.edu/research/centers-and-institutes/ivac/resources/PCVImpactGapAnalysis_MAR2016_FINAL_public.pdf
38. Point estimates of Rotarix* and RotaTeq† vaccine
Efficacy in Relation to Country GDP
Nelson EAS & Glass RI, Lancet 2010; 367: 568-9
Possible reasons for lower
efficacy in developing countries
• High maternal antibody titres
• Breastfeeding at vaccination
• Micronutrient deficiencies
• Interfering microorganisms
• HIV and malaria
39. Severe Rotavirus GE Episodes Prevented per 100 children
0
1
2
3
4
5
6
7
8
9
Africa South Africa Malawi
SevererotavirusGEepisodesper100
Placebo
Vaccine
3 episodes
prevented
2.5 episodes
prevented
3.9 episodes
prevented
VE:
61.2% 76.9% 49.5%
(44.0 – 73.2) (56.0 – 88.5) (19.2 – 68.3)
Madhi SA, Cunliffe NA et al. NEJM. 2010; 362: 289-298
40. Number of diarrhea-related deaths among children aged
<59 months in Mexico by age group; July 2002 to May
2009
Richardson V et al. N Eng J Med 2010; 362; 299-305
41%; 95%CI 36 to 47
29%; 95%CI 17 to 39
43. Overview
● Trends in Global and South American under-5
childhood mortality.
● Recent contribution of childhood vaccines in
reducing under-5 mortality.
● Potential of new childhood vaccines in reducing
under-5 mortality:
Malaria vaccine
● New horizons in reducing under-5/neonatal
morbidity and mortality by vaccination.
44. Cause-specific mortality rates in African
Children aged 1-59 months, 2000 to 2010
Liu L et al. Lancet 2012; 379: 2151-61
45. Kaplan-Meyer Survival Plots for RTS,S Malaria
Vaccine; Pooled Data of Phase 2 Data
Severe Malaria Deaths
Bejon P et al. Lancet Infect Dis; 2013; 13: 319-27.
Vaccine Efficacy Varied from 36% (95%CI: 24 to 45) at time of vaccination
to 0% (-38 to 38) after 3 years
46. Changes In Malaria Indicators, Relative to Introduction
or Upscaling of Control Measures in Bioko Island,
Equitorial Guinea
IncidenceofPediatricinpatientmalaria
(per1000children)
Bioko Island, Equitorial GuineaBioko Island, Equitorial Guinea
• IRS: Indoor residual spraying
• ACTs: Artemisinin combination therapies
• LLITNs: Long Lasting Insecticide treated bed nets
O’Meara WP; Lancet Infect Dis; 2010; 10: 545-55
47.
48. The Meningitis Belt in Africa and meningococcal A
Conjugate Vaccine (PsA-TT) rollout 2010-2016.
Novak RT; Lancet Infect Dis; 2012; 12: 757-64
49. Cumulative Curve Rates per 100 000 of Suspected Meningitis
Cases and Deaths; Burkina Faso (1997:2011)
Suspected meningitis
cases
Suspected meningitis
deaths
Novak RT et al. Lancet Infect Dis; 2012; 12: 757-64
50. Proportion of Confirmed Meningitis Cases by Year
Attributable to Different Bacteria; Burkina Faso
Novak RT et al. Lancet Infect Dis; 2012; 12: 757-64
51. Effectiveness of MenAfriVac on Incidence of
meningitis in Chad (2009-2013)
Daugla DM; Lancet 2014; 383: 40-47
94% difference in crude incidence of
meningitis
52. Number of Suspected Meningitis Cases by
Week In Niger: 1 Jan- 30 June 2003 to 2015.
Sidikou F et al. Lancet Infect Dis; 2016
53. Laboratory-confirmed Cases of Meningitis by
Epidemiological Week and Pathogen;
1 Jan 2015- 30 June 2015
Sidikou F et al. Lancet Infect Dis; 2016
54. Overview
● Trends in Global and South American under-5
childhood mortality.
● Recent contribution of childhood vaccines in
reducing under-5 mortality.
● Potential of new childhood vaccines in reducing
under-5 mortality.
● New horizons in reducing under-5 (neonatal)
morbidity and mortality by vaccination.
55. Global Causes of Under-5 Childhood Deaths in 2013
Liu L et al. Lancet 2015; 385: 430-440
• 44% (2.76 million) of under-5 deaths occur during neonatal period.
56. Vaccination of Pregnant Women: An Evolving Paradigm
Shift Aimed at Protection of The Fetus and Young
Infants.
57. Estimated Preterm Birth Rates by Country for
Year 2010
Blencome H, et al. Lancet; 2012; 379: 2162-72
• In 2010 14.9 million (Range 12.3-18.1) born preterm.
• 11.1% of all births born preterm; 5% in Europe to 18% in Africa.
• Only 3 of 65 countries reduced preterm birth rate between 1990-2010.
58. Blencowe et al. Lancet Global Health; 2016; 4: e98-108.
Estimated Country-level Stillbirth Rates, 2015.
59. Potential Benefits of Maternal Immunization (MI)
MI may protect infants <5-mo against
infection-related deaths
MI can have an impact on maternal
morbidity and mortality
MI may also prevent a portion of
infection-related stillbirths (10 – 50%1
of the overall stillbirths)
1. McClure EM, "Stillbirth in Developing Countries: A review of causes, risk factors and prevention strategies" , J. of Matern Fetal Neonatal Med. (2014);
2. WHO-CHERG 2013 ● 4
Global neonatal mortality2
Infection
related
606K
(22%)
Pre-term births
965K
(35%)
Other
1,190K
(43%)
60.
61. Success of Maternal Tetanus Vaccination in Preventing
Neonatal Tetanus Deaths
63. Zaman K; NEJM;
2008
Madhi S; NEJM;
2015
Vaccination of HIV- pregnant women in preventing
Influenza-confirmed illness in their infants <6 months age.
64. Meta-analysis on Effect of Maternal Seasonal
Influenza Vaccination on Preterm Births
Nunes M et al. Am J Perinatology; 2016
Overall (I-squared = 47.4%, p = 0.107)
Adedinsewo et al.
Dodds et al.
Legge et al.
Omer et al.
Nordin et al.
Study
2013
2012
Year
2010-2012
2011
2014
Published
0.87 (0.77, 0.99)
0.83 (0.59, 1.16)
0.84 (0.69, 1.02)
Adjusted Odds
0.75 (0.60, 0.94)
0.83 (0.55, 1.26)
0.97 (0.93, 1.02)
Ratio (95% CI)
0.87 (0.77, 0.99)
0.83 (0.59, 1.16)
0.84 (0.69, 1.02)
Adjusted Odds
0.75 (0.60, 0.94)
0.83 (0.55, 1.26)
0.97 (0.93, 1.02)
Ratio (95% CI)
1.5 .75 1 1.25 1.5 1.75 2
TIV containing or not H1N1 papers not restricted to flu season Preterm
2014
65. Hazard ratio of Stillbirth by Seasonal Influenza
Activity (Australia 2012-2013)
Regan AK et al. Clin Infect Dis; 2016;62(10):1221–7
66. Other Vaccines Currently Recommended or In Clinical
Development For Immunization of Pregnant Women to
Protect Young Infants
● Pertussis vaccine:
80% pertussis deaths occur in infants <2 months age
Recommended in many High-Income countries and studies underway on
LMIC
Group B Streptococcus serotype-specific protein-polysaccharide
conjugate vaccine
Leading cause of neonatal sepsis in high-income and LMIC countries
Phase II studies on trivalent vaccine completed.
Respiratory Syncytial Virus
Leading cause of pneumonia hospitalization globally, with estimated
66,000-240,000 deaths annually.
Multiple vaccine candidates aimed at pregnant women under clinical
development.
67. Conclusions
● Significant advances made since 1990 in reduction of mortality from
polio, measles and neonatal tetanus over relative short periods because
of vaccination.
● Newly licensed vaccine against major pathogens causing diarrhoea
(rotavirus), pneumonia (pneumococcus) and meningitis
(pneumococcus and meningococcus A/B/C/Y/W) have potential of
preventing approximately 650-750 thousand childhood deaths annually.
● Next frontier is targeting vaccination of pregnant women for reducing
death from neonatal and early-infancy vaccine-preventable diseases.
● Full benefit of advances in vaccine development will only be realised
when equity of access addressed between and within countries.
68.
69. Reported Cases of Meningitis in Chad; 1930-2012
Daugla DM; Lancet 2014; 383: 40-47