Encouraging medical profes- sionals to recommend ... Microbiology and Immunology Department,. Cairo/EG ... d Cairo University, Medical Microbiology and.
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Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163
and determinants of vaccination in Singaporean children. We describe the results of a survey of knowledge, attitudes and determinants of childhood influenza vaccination. Methods & Materials: In January-March 2016, 332 parents of children aged 6 months to 5 years attending childcare centres completed an online questionnaire. Results: General knowledge about influenza, perceived benefit of vaccination and willingness to vaccinate were high, with few perceived barriers to vaccination. However, only 32% of children had ever received influenza vaccine, and only 15% in the past year. In multivariable analysis, respondents were more likely to have vaccinated their child if: (i) they had a higher willingness to vaccinate (prevalence ratio (PR)=1.58, 95% CI:1.24-2.04 per unit increase in willingness score); (ii) they felt well-informed about influenza vaccine (PR=1.44, 95% CI: 1.04-1.99); (iii) their family regularly received pre-travel influenza vaccine (PR=1.64, 95% CI: 1.19-2.25), (iv) their child’s doctor recommended influenza vaccine (PR=2.47, 95% CI: 1.75-3.48), and (v) they received influenza vaccine information from a general practitioner (PR=1.47, 95% CI: 1.05-2.04). Parents who obtained influenza vaccine information from television were less likely to have vaccinated their child (PR=0.44, 95% CI: 0.23-0.85). Path analysis using structural equation modelling indicated that being recommended vaccination by a child’s doctor increased willingness to vaccinate and self-efficacy (feeling well informed about influenza vaccine). Median willingness-to-pay for a dose of influenza vaccine was SGD30 (interquartile range: SGD20SGD50), and was higher in parents of vaccinated compared with unvaccinated children (SGD45 vs SGD30, p=0.0012). A quarter of respondents were aware that Medisave could be used to pay for influenza vaccination. Conclusion: Knowledge and willingness to vaccinate are high among parents, but there is considerable potential to improve influenza vaccine uptake in children. Encouraging medical professionals to recommend vaccination of eligible children is key. http://dx.doi.org/10.1016/j.ijid.2016.11.265 20.023 Vaccine efficacy of seasonal influenza vaccine programme among Singapore military personnel in 2012–2015 X. Zhao a,∗ , A. Cook a , J.V. Pang b a b
National University of Singapore, Singapore/SG Tan Tock Seng Hospital, Singapore, Singapore/SG
Purpose: All male Singaporeans undertake two years of national service, and since 2009 active servicemen have received annual influenza vaccine. Vaccine efficacy (VE) of the seasonal trivalent influenza vaccine (TIV) was assessed among military personnel in the Singapore Armed Forces (SAF) from November 2012 to the end of 2015. Methods & Materials: Consenting national servicemen who presented with febrile respiratory illness (FRI), which was defined as having fever ≥37.5 ◦ C and cough/sore throat, had their nasal swab samples and clinical data (including vaccination history) collected. All nasal swab samples were sent for laboratory confirmation using RT-PCR. Vaccination status for study participants was assessed if they had vaccination more than 14 days but less than 180 days from the disease onset date. To estimate the crude and adjusted VE, univariate and multivariate logistic models were used respectively. Variables adjusted in the multivariate logistic models were camp groups (recruit camp vs other camps) and interaction between camp groups and individual vaccine history
Results: A total of 4733 observations were collected in the FRI surveillance programme conducted by SAF during the entire study period. The crude VE of TIV was moderate against influenza A(H1N1)pdm09 (VE: 57.7%, 95% confidence interval (CI): 30.6% to 74.2%) and A(H3N2) infections (VE: 52.0%, 95% CI: 39.9% to 61.6%). VE against influenza B infections was markedly lower (VE: 25.8%, 95% CI: 4.8% to 42.2%). Additional multivariate analyses showed that adjusted VE was positively significant against influenza A(H1N1)pdm09 and A(H3N2) infections in both recruit camp and other camps. However, the adjusted VE against influenza B infections was significant in the recruit camp only (VE for recruit camp: 62.8%, 95% CI: 45.4% to 86.9%; VE for other camps: -5.2%, 95% CI: -55.6% to 28.9%). Conclusion: TIV provided a moderate degree of protection against influenza A(H1N1) and A(H3N2), but not against influenza B in non-recruit military camps, which may be due to vaccine mismatch on B strains during that period. Virological surveillance of this fully vaccinated population may herald strain mismatches in the general community, and in this case could suggest the use of the quadrivalent influenza vaccine rather than the trivalent one. http://dx.doi.org/10.1016/j.ijid.2016.11.266 20.026 Viral load and oxidative stress in Egyptian chronic hepatitis C patients B.A.M. El Awady a,∗ , B. Hussein b , E. El-Seidi c , Y. Abou-Hamed d a
Kasr Al Ainy Faculty of Medicine, Medical Microbiology and Immunology Department, Cairo/EG b Central Labs, Ministry of Health, Medical Microbiology and Immunology, Cairo/EG c Cairo University, Department of Medical Microbiology and Immunology, Cairo/EG d Cairo University, Medical Microbiology and Immunology, Cairo/EG Purpose: Hepatitis C virus (HCV) is major cause of viral hepatitis in Egypt. This viral infection frequently does not resolve and chronic HCV carriers may then progress to serious liver diseases. The overproduction of reactive species results in oxidative stress, causing an imbalance in the host. HCV infection is associated with severe alterations of the host redox status, thus playing important roles in the development of HCV-associated liver diseases. Aim: Determination of the presence of any association between chronic HCV infection and the oxidative stress, namely correlating between the HCV viral load and liver enzymes, malondialdehyde (MDA) and catalase (CAT) enzyme in chronic HCV patients. Methods & Materials: Evaluations were done on a total of 150 chronic HCV Egyptian patients, having variable viral loads, in addition to a control group of 50 healthy subjects. HCV antibodies were detected by ELISA and HCV viral load was determined by Real Time PCR. Chemical detection of serum alanine transaminase (ALT), aspartate transaminase (AST), malondialdehyde (MDA) and catalase enzyme was performed. Results: The study revealed that a statistically significant correlation between the liver enzymes and oxidative stress markers has been detected. Moreover, a statistically significant positive correlation existed between MDA and the HCV viral load and a statistically significant negative correlation existed between the catalase enzyme and HCV viral load.
Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163
Conclusion: Oxidative stress is a significant feature of chronic HCV infection. The higher the viral load, the more prominent the oxidative stress markers are. http://dx.doi.org/10.1016/j.ijid.2016.11.267 20.027 Point of care of testing in molecular diagnostics: Evaluation of GeneXpert HCV RNA for diagnosing and monitoring of HCV infection E. Gupta a,∗ , P. Ranjan b , G. Kumar c a
Institute of Liver and Biliary Sciences, Clinical Virology, Delhi/IN b Institute of liver and biliary sciences, clinical virology, Delhi/IN c Institute of liver and biliary sciences, Clinical Research, Delhi/IN Purpose: HCV RNA measurement is essential not only for the confirmation of diagnosis but for the monitoring of antiviral HCV therapy. Nucleic acid testing at the point of care may turn out to be a game changer for HCV diagnosis and treatment monitoring, especially in low income countries, through increased sensitivity, reduced turnaround time, and ease of performance. One such assay GeneXpert (Cepheid) has recently been released. Methods & Materials: Comparative analysis between Xpert HCV RNA and Abbott HCV RNA test for diagnosing of new cases of HCV and monitoring of patients on antivirals was done. The Xpert system is a fully automated real-time PCR device, which combines steps of sample preparation, nucleic acid extraction, amplification and detection of target sequences in one cartridge. Overall, 174 CHC patients were recruited and, one time plasma samples from 154 patients and in 20 patients, plasma samples obtained at specific key decision time points of two types of therapy (baseline, 4 weeks, 12 weeks and 24 weeks) were serially re-tested on Xpert. Results: Genotype 3 was the commonest, seen in 80 (66%) of the cases, genotype 1 in 34(28.3%), genotype 4 in 4(3.3%) and genotype 2 and 5 in 1(0.8%) each. HCV RNA load in the samples ranged from 0 to 6.98 log10 IU/ml, with a median value of 4.69 log10 IU/ml. Overall a very good correlation was seen between the two assays (R2 =0.985), concordance of the results between the assays was seen in 138 samples (89.6%).High and low positive reference standards were tested ten times on Xpert to evaluate the precision and the coefficient of variation was 0.01 for HPC and 0.07 for the LPC. Monitoring of patients on two different regimes of treatment,Interferon and ribavirin (20) and sofosbuvir (20)was done by both the systems at baseline, 4, 12 and 24 weeks. Perfect correlation in the course of therapy at different data point across all genotype was seen. Conclusion: The study demonstrates excellent performances of the Xpert HCV assay in viral load assessment and in treatment course monitoring consistency. Assays are comparable and can be interchanged. http://dx.doi.org/10.1016/j.ijid.2016.11.268
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20.028 A Diagnostic and Epidemiologic Investigation of Acute Febrile Illness (AFI) in Kilombero, Tanzania C.A. Hercik a,∗ , L. Cosmas b , O. Mogeni c , N. Wamola c , W. Kohi d , C. Ochieng c , C. Onyango e , B. Fields f , S. Mfinanga g , J. Montgomery h a
Georgetown University, Microbiology and Immunology, Washington, DC/US b US Centers for Disease Control and Prevention, Division of Global Health Protection, Nairobi/KE c Kenyan Medical Research Institute, Centre for Global Health Research, Nairobi/KE d National Institute of Medical Research, Muhimbili Research Centre, Dar es Salaam/TZ e US centers for Disease Control and Prevention-Kenya, Division of Global Health Protection, Nairobi/KE f US Centers for Disease Control and Prevention, Global disease detection, Nairobi/KE g National Institute for Medical Research, Muhimbili Research Centre, Dar es Salaam/TZ h US Centers for Disease Control and Prevention, International Emerging Infections Program, Nairobi/KE
Purpose: In low-resource settings, empiric case management of febrile illness is fairly routine as a result of limited access to laboratory diagnostics. The use of comprehensive fever syndromic surveillance, with enhanced clinical microbiology, advanced diagnostics and more robust epidemiologic investigation, could enable healthcare providers to offer a differential diagnosis of fever syndrome and more appropriate care and treatment. Methods & Materials: We conducted a year-long exploratory study of fever syndrome among patients presenting to clinical settings with an axillary temperature of >37.5 C and symptomatic onset of
