Prevalence of National Responsiveness to HBV Vaccine After 22 Years of Iranian Expanded Program on Immunization (EPI): A Systematic Review and Meta-Analysis Study

Context:

Hepatitis B Virus expanded program on immunization (EPI) started on 1993 in Iran. Most surveys have assessed the level of response to vaccine by measuring the titers of anti-HBs. This meta- analysis aimed to summarize the Iranian published data on the rate of vaccine-responders versus non-responders. Moreover, the impact of variables such as age, gender, type of vaccine, etc. on the levels of responsiveness was evaluated.

Evidence Acquisition:

All published papers on this topic in Iranian and international journals with affiliation of “Iran” were reviewed using standard keywords up to 2014. We included our study to healthy participants with no previous HBV infection and who had already received a complete course of HB vaccine. The estimated prevalence and 95% confidence intervals in 28 eligible articles for HBV vaccine responders (anti-HBs > 10 IU/mL) and non-responders (10 <) were analyzed by random effect method due to between-study heterogeneity.

Results:

The age of subjects was between 6 months and 15 years old. Overall, 5991 (51.5%) were male and 4571 (48.5%) females. Overall, 80% were responders to vaccine versus 20% nonresponders. With increase in age, the number of responders to vaccine decreased significantly (P = 0.001). There was no strong difference between responders versus nonresponders to vaccine for gender, types of vaccine, ethnicity and living area.

Conclusions:

The results arose from this meta-analysis highlighted the safety of vaccine and its effectiveness in stimulating immune response of vaccines, despite being different in generation, manufacturers and types. Moreover, there was no substantial difference between Iranian and other international investigations in the rate of nonresponsiveness to HBV vaccine.     

Mise en place d’un home-programme numérique et mesure de son observance dans le cadre de la prise en charge kinésithérapique d’un patient atteint de paralysie cérébrale — Étude de cas

IntroductionInternships in a professional environment, school holidays, lockdowns… As a physiotherapist, ensuring care continuity of teenagers and young adults with Cerebral Palsy (CP), within medico-social structures, requires permanent adaptability to avoid any lasting period with no activities of physical therapy.MethodThis work is a case study using a digital home program (smartphone app) of goal-oriented exercises and carried out during a transitional downtime of an eight-week physiotherapy care.ResultsThe compliance achieved by the subject is equal to 75% over the entire period.ConclusionHome-program, with specific environmental factors associated with personally favoring factors, was a way for the therapist to ensure continuity during a period of transitional interruption of physiotherapy management.