A multi-country study of dengue vaccination strategies with Dengvaxia and a future vaccine candidate in three dengue-endemic countries: Vietnam,Thailand, and Colombia

BackgroundThe dengue vaccination era began when Dengvaxia (CYD-TDV) became available in 2016. In addition, several second-generation vaccine candidates are currently in phase 3 trials, suggesting that a broader availability of dengue vaccines may be possible in the near future. Advancing on the recent WHO-SAGE recommendations for the safe and effective use of CYD-TDV at the regional level on average, this study investigates the vaccination impacts and cost-effectiveness of CYD-TDV and of a hypothetical new vaccine candidate (NVC) in a country-specific manner for three endemic countries: Vietnam, Thailand, and Colombia.MethodsThe vaccination impacts of CYD-TDV and NVC were derived by fitting the empirical seroprevalence rates of 9 year olds into an individual-based meta-population transmission model, previously used for the WHO-SAGE working group. The disability-adjusted life years were estimated by applying country-specific parametric values. The cost-effectiveness analyses of four intervention strategies in combination with routine and catch-up campaigns were compared for both vaccines to inform decision makers regarding the most suitable immunization program in each of the three countries.Results and conclusionBoth CYD-TDV and NVC could be cost-effective at the DALY threshold cost of $2000 depending upon vaccination costs. With CYD-TDV, targeting 9 year olds in routine vaccination programs and 10–29 year olds as a one-off catch-up campaign was the most cost-effective strategy in all three countries. With NVC, while the most cost-effective strategy was to vaccinate 9–29 and 9–18 year olds in Vietnam and Thailand respectively, vaccinating younger age cohorts between 1 and 5 years old in Colombia was more cost-effective than other strategies. Given that three countries will soon face decisions regarding whether and how to incorporate CYD-TDV or future dengue vaccines into their budget-constrained national immunization programs, the current study outcomes can be used to help decision makers understand the expected impacts and cost-effectiveness of such vaccines.     

Personality correlates of pro-environmental attitudes

There is considerable scientific interest in the psychological correlates of pro-environmental attitudes and concerns. While much research has focused on demographic and social-psychological characteristics of individuals with pro-environmental attitudes, our study explores the relations between personality traits and pro-environmental behaviours. The study found that Honesty, Agreeableness, Openness, Proactive personality and Pro-environmental attitude predict environmental behaviour. The main implication of the study is the fact that responsible environmental behaviour could be enhanced through programmes focused on the increase of the environmental awareness and the development of a more pro-ecological view.     

Salmonella/rotavirus coinfection in hospitalized children

This study's aim was to analyze the characteristics and severity of acute gastroenteritis related to infection with rotavirus (group R), nontyphoid Salmonella (NTS; group S), and infection with both rotavirus and Salmonella (group B) in children in southern Taiwan in order to improve diagnosis and expedite appropriate management. The medical records of children admitted between October 2002 to September 2008 for acute gastroenteritis related to rotavirus, NTS, or coinfection were collected and analyzed.Among 2040 reviewed medical records, 40 patients were infected with both pathogens, while 501 cases were infected with rotavirus alone and 189 were infected with NTS alone. There were no significant differences between the three groups in terms of age at admission or sex. The age distribution of the reviewed cases revealed that children between the ages of 12–24 months comprised the largest proportion of cases in each group. Higher concentrations of fecal leukocytes and fecal pus cells and longer hospitalizations were observed in group B in comparison with groups S and R (p < 0.05). Clinical severity was significantly higher in groups B and S than group R (p < 0.05). A proportional association was found between the monthly case number of rotavirus infections and the mean monthly temperature difference in southern Taiwan (r = 0.9248; p < 0.0001). In summary, concomitant rotavirus infection with NTS infection did not affect the clinical manifestations of the reviewed patients. Rotavirus infection was less severe in most clinical manifestations, but vomiting was more severe in rotavirus-infected patients. Positive fecal leukocytes and positive fecal pus cells were more frequent during coinfection. There was a strong positive relationship between the incidence of rotavirus gastroenteritis and the mean monthly temperature difference.     

Prognostic factors and survival outcomes of women with uterine leiomyosarcoma: A Turkish Uterine Sarcoma Group Study-003

To assess the clinicopathological features, prognostic factors, and survival rates associated with uterine leiomyosarcoma (uLMS). Databases from 15 participating gynecological oncology centers in Turkey were searched retrospectively for women who had been treated for stage I-IV uLMS between 1996 and 2018. Of 302 consecutive women with uLMS, there were 234 patients with Federation of Gynecology and Obstetrics (FIGO) stage I disease and 68 with FIGO stage II-IV disease. All patients underwent total hysterectomy. Lymphadenectomy was performed in 161 (54.5%) cases. A total of 195 patients received adjuvant treatment. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 42% and 54%, respectively. Presence of lymphovascular space invasion (LVSI), higher degree of nuclear atypia, and absence of lymphadenectomy were negatively correlated with DFS, while LVSI, mitotic count, higher degree of nuclear atypia, FIGO stage II-IV disease, and suboptimal surgery significantly decreased OS. LVSI and higher degree of nuclear atypia appear to be prognostic indicators for uLMS. Lymphadenectomy seems to have a significant effect on DFS but not on OS.