1) The PSERENADE project analyzed surveillance data from over 50 sites in 34 countries to assess the impact of PCV10 and PCV13 introduction on pneumococcal meningitis incidence globally in children under 5 years old and adults 18 years and older.
2) For both age groups, PCV10 and PCV13 significantly reduced meningitis caused by serotypes covered by the vaccines, with almost elimination in children under 5 years old within 5 years. Herd protection was observed in adults as well.
3) PCV13 significantly reduced meningitis from additional serotypes it covers compared to PCV10, though serotype 19A increased with PCV10 and serotype 3 trends were unclear
Prospects for GBS prevention - current candidates & removing barriers to licensure of a GBS vaccine for pregnant women globally
https://www.meningitis.org/mrf-conference-2017
Preparedness for and response to meningococcal outbreaks: preliminary results of a Canadian Immunization Research Network (CIRN) randomized controlled trial of two schedules of 4CMenB vaccine in adolescents and young adults.
https://www.meningitis.org/mrf-conference-2017
Efficacy differences between PCV10 and PCV13 - Slideset by Professors Esposit...WAidid
This slideset edited by Professors Esposito, Palmu, De Wals and Sanders for the Second WAidid Congress present some studies that compare in different countries (including Finland, Sweden, Quebec and the Netherlands) efficacy differences between PCV10 and PCV13.
To learn more please visit www.waidid.org
Prospects for GBS prevention - current candidates & removing barriers to licensure of a GBS vaccine for pregnant women globally
https://www.meningitis.org/mrf-conference-2017
Preparedness for and response to meningococcal outbreaks: preliminary results of a Canadian Immunization Research Network (CIRN) randomized controlled trial of two schedules of 4CMenB vaccine in adolescents and young adults.
https://www.meningitis.org/mrf-conference-2017
Efficacy differences between PCV10 and PCV13 - Slideset by Professors Esposit...WAidid
This slideset edited by Professors Esposito, Palmu, De Wals and Sanders for the Second WAidid Congress present some studies that compare in different countries (including Finland, Sweden, Quebec and the Netherlands) efficacy differences between PCV10 and PCV13.
To learn more please visit www.waidid.org
Presentation by Camelia Savulescu during the ESCAIDE 2016 parallel session on Vaccine-preventable diseases (2) on 29 November 2016 in Stockholm, Sweden
TB and Bangladesh - Threats and Way Forward.pptxMdNadimReza1
TB and Bangladesh - Threats and Way Forward. Describes the overall TB situation in Bangladesh in 2023 based on evidence. It also describes the challenges, diagnostic options, and also way forwards in the management of TB in Bangladesh.
National Childhood Flu Immunisation Programme 2017-18 - training for healthca...Public Health England
This training slide set about the National Flu vaccination programme 2017-2018 is intended for healthcare practitioners and includes detailed information on:
• the background of the programme
• vaccine handling, administration and constituents
• eligibility and resource
For additional guidance on delivering the programme please visit https://www.gov.uk/government/collections/annual-flu-programme
Big Data Analysis Suggests COVID Vaccination Increases Excess Mortality Of ...sdateam0
Explaination of Paper
Sakura, Ken. 2024. “Big Data Analysis Suggests COVID Vaccination Increases Excess Mortality of Highly Vaccinated North Temperate Zone and North Frigid Zone Countries.” OSF Preprints. April 8. doi:10.31219/osf.io/zv6j8.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
1. Yangyupei Yang on behalf of the PSERENADE team*
November 2021
November 2021
1
Changes in Pneumococcal Meningitis Incidence
Following Introduction of PCV10 and PCV13:
Results from the Global PSERENADE Project
*The PSERENADE Team includes the Hopkins Core Team &
investigators in over 50 surveillance sites and at the WHO.
2. PSERENADE Project: Background & Methods
• Pneumococcal conjugate vaccines (PCV10 and PCV13)
have been introduced into infant immunization
programs of 147 countries
• We assessed the impact of PCV10/PCV13 introduction
on pneumococcal meningitis incidence globally in
children <5 years and adults ≥18 years
November, 2021
2
Number included in analysis:
Sites: PCV13 = 32 PCV10 = 14
Countries: PCV13 = 22 PCV10 = 12
N Cases: <5 years: 13,391 ≥18 years: 36,322
Methods
• Countries shared IPD surveillance data
• Meningitis cases = pneumococcus detected in cerebral
spinal fluid (CSF)
• Modeled each site’s change in meningitis incidence
after PCV introduction and averaged across sites
(Bayesian multi-level Poisson regression)
Stratified by: age group, PCV10 vs PCV13, and the
amount of PCV7 impact prior to PCV10/13
introduction
PCV not used
PCV used, data unavailable or ineligible for analysis
Included in PCV10 site analysis
Included in PCV13 site analysis
Mixed PCV10/13
3. Change in pneumococcal meningitis: PCV10 serotypes
CONFIDENTAL: Do Not Circulate
Children < 5 years Adults ≥ 18 years
PCV10/13
Intro
PCV10/13
Intro
Key messages: Meningitis caused by serotypes in PCV10 by year 5:
• <5 years -- Almost eliminated in most sites
• ≥18 years – large herd effect but took longer and heterogeneous across sites
Incidence
Rate
Ratio
79-99%
declines
Year since PCV10/13 introduction
74-99%
declines
44-92%
declines
43-74%
declines
November, 2021
1.0=Pre-PCV Rate
Serotypes
1,
5,
and
7F
PCV7
Serotypes
4. Change in pneumococcal meningitis: PCV13 (non-10) Types
Incidence
Rate
Ratio
Year since PCV10/13 introduction
Children < 5 years Adults ≥ 18 years
PCV10/13
Intro
PCV10/13
Intro
48-96% decline
80-99% decline
PCV13: 78-93%
decline
PCV10: 4-9 fold
increase
Key messages
•Evidence of cross
protection against 6A for
PCV10
•19A was reduced at
PCV13 sites, but
increased at PCV10 sites
•No clear trends in
Serotype 3 for either
product
PCV10: 5-8 fold
increase
PCV13: 10-53%
decline
November, 2021
Serotype
3
Serotype
19A
Serotype
6A
5. Change in pneumococcal meningitis: Non-PCV13 Types
5
Incidence
Rate
Ratio
Year since PCV10/13 introduction
Children < 5 years Adults ≥ 18 years
2.2-3.2 fold
increase
PCV10/13
Intro
PCV10/13
Intro
N=1 N=1
1.3-2.3 fold
increase
November, 2021
A single high HIV-prevalence site
with concurrent non-vaccine
interventions, including ART
Key messages
Non-PCV13 serotypes:
• Increased in both age groups; both PCV10 and PCV13
• Increase peaked by year 5
6. Change in all pneumococcal meningitis
6
Year since PCV10/13 introduction
Key messages
For both PCV10 and PCV13 sites, the net impact on all
pneumococcal meningitis by year 5 was a reduction in all ages:
• children <5 years – reduced about 50-70%
• Adults ≥18y years – reduced by about 25-36% (most sites)
Incidence
Rate
Ratio
PCV10/13
Intro
1.0=Pre-PCV Rate
52-71% decline
Children < 5 years Adults ≥ 18 years
PCV10/13
Intro
8-36% decline
November, 2021