Journal of Infection and Public Health最新文献

{"title":"Prevalence of acquired resistance to antiretrovirals in children and adolescents living with HIV under clinical follow-up at the Roosevelt Hospital in Guatemala","authors":"S. Alonso ,&nbsp;E. Salazar ,&nbsp;N. Gálvez ,&nbsp;J. Navas ,&nbsp;C. Quintana ,&nbsp;N. Orózco ,&nbsp;L. Prieto ,&nbsp;M.L. Navarro ,&nbsp;S. Guillén ,&nbsp;J.M. Gómez-Alba ,&nbsp;C. Medina-Sánchez ,&nbsp;J. Juarez ,&nbsp;A. Holguín","doi":"10.1016/j.jiph.2025.102827","DOIUrl":"10.1016/j.jiph.2025.102827","url":null,"abstract":"<div><h3>Background</h3><div>Insufficient HIV drug resistance (HIVDR) monitoring in Central America has resulted in widespread circulation of HIV-strains with drug resistance mutations (DRM), compromising antiretroviral therapy (ART). This study aimed to assess the first HIVDR data and DRM patterns in the only HIV-infected pediatric population with resistance information in Guatemala.</div></div><div><h3>Methods</h3><div>All HIV-1 infected children and adolescents tested for HIVDR between 2013 and 2021 at Roosevelt Hospital (Guatemala) were retrospectively selected. Their first HIV-1 protease and/or partial retrotranscriptase sequence, when available, was recovered to detect acquired DRMs to three antiretroviral families, and predict resistance to 20 antiretrovirals using the Stanford HIVdb Algorithmv9.5. We compared results with previously recorded DRM data from clinical files. The HIV infecting variant was characterized by phylogeny in those with available sequence.</div></div><div><h3>Results</h3><div>Ninety-nine children/adolescents were selected, most perinatally-infected (93 %) and without neonatal prophylaxis (92.3 %). The 66 with available sequences harbored HIV-1 subtype B. At first DRM genotyping, all had detectable viral loads (&gt;40cp/ml), 58.6 % experienced virological failure (&gt;1,000cp/ml) despite prior antiretroviral exposure (100 % to NRTI, 77.8 % to NNRTI, 32.3 % to PI and 4 % to INSTI). Most (77.9 %) experienced delayed HIV diagnostic. Half received ART within the first month post-diagnosis. Seventy-nine (79.8%) harbored viruses with DRM: 61 (61.6%) to NRTIs, 70 (70.7%) to NNRTIs and 6 (6.3%) to PIs (major DRMs). Half (52.5 %) presented dual resistance (NRTI+NNRTI) and 5.3 % triple (NRTI+NNRTI+PI). The most frequent DRM to NRTIs were M184V/I/M (47.5 %), to NNRTI K103N/R (48.5 %), and to PIs M46I/L/V (5.3 %). Most (88.4 %) carried PI-susceptible viruses.</div></div><div><h3>Conclusion</h3><div>This study updates HIVDR and HIV-1 variant data in Guatemala, offering the first resistance insights for HIV-infected children and adolescents, showing than PI and INSTI-based regimens may enhance HIV management in this vulnerable pediatric group. Periodic HIVDR monitoring is crucial to control the HIV epidemic in Guatemala.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102827"},"PeriodicalIF":4.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare infantile sepsis and meningitis caused by Pasteurella multocida: A case report","authors":"Ming-ming Ni ,&nbsp;Wen-xin Lin ,&nbsp;Yang Li ,&nbsp;Jin-chun Qiu ,&nbsp;Chun-feng Wu","doi":"10.1016/j.jiph.2025.102822","DOIUrl":"10.1016/j.jiph.2025.102822","url":null,"abstract":"<div><div>This case report highlights a rare instance of <em>Pasteurella multocida</em> meningitis in a 2-month-old infant, complicated by subdural empyema. The pathogen was identified using next-generation sequencing (NGS), despite negative bacterial cultures, underscoring the diagnostic challenges. The strain was predicted to be resistant to meropenem and ampicillin, necessitating a tailored treatment approach. The strain was likely transmitted through a neighbor's dog, emphasizing the complexity of <em>P. multocida</em> transmission. This case underscores the importance of advanced diagnostic techniques and personalized therapy for managing rare, antibiotic-resistant infections.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102822"},"PeriodicalIF":4.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world pathogen diagnosis in critically ill infected children: A retrospective study using metagenomic next-generation sequencing with different enrichment strategies","authors":"Huili Shen ,&nbsp;Xiaolei Zhang ,&nbsp;Junfeng Xu ,&nbsp;Weike Ma ,&nbsp;Weiming Chen ,&nbsp;Yixue Wang ,&nbsp;Caiyan Zhang ,&nbsp;Panpan Fan ,&nbsp;Xuemei Zhu ,&nbsp;Liming He ,&nbsp;Huiyuan Yan ,&nbsp;Meili Shen ,&nbsp;Guoping Lu ,&nbsp;Gangfeng Yan","doi":"10.1016/j.jiph.2025.102823","DOIUrl":"10.1016/j.jiph.2025.102823","url":null,"abstract":"<div><h3>Background</h3><div>Study on the clinical pathogen diagnosis in large cohort of critically ill children using metagenomic next-generation sequencing (mNGS) with different enrichment strategies has been limited.</div></div><div><h3>Methods</h3><div>763 samples were enrolled and we summarized the clinical pathogen diagnosis and compared the performance between mNGS and clinical microbial tests (CMTs) in different sample types, as well as between shotgun-based (S-mNGS) and hybrid capture-based mNGS (C-mNGS).</div></div><div><h3>Results</h3><div>A total of 93 clinical diagnosed pathogens were identified from763 samples with suspected infections, with a positive rate of 60.16 %. Respiratory specimens had the highest positive rate (90.73 %, 235/259), while the lowest was cerebrospinal fluid (26.94 %, 59/219). mNGS showed higher sensitivity (90.85 % vs. 83.66 %, P = 0.001), specificity (77.30 % vs. 67.43 %, P = 0.007), positive predictive value (PPV, 85.80 % vs. 79.50 %, P = 0.01), negative predictive value (NPV, 84.84 % vs. 73.21 %, P &lt; 0.001), and accuracy (85.45 % vs. 77.20 %, P &lt; 0.001) than CMTs. The corrected true positive rate of mNGS was higher than CMTs (83.88 % vs. 75.60 %, P = 0.002), and its advantage in virus detection was more obvious (OR=1.39, 95 %CI: 1.08–1.78, P = 0.010). S-mNGS and C-mNGS shown significantly higher sensitivity and accuracy than CMTs. However, the total true positive rate between S-mNGS and C-mNGS were close (83.15 % vs. 85.00 %, P = 0.600). According to the mNGS results, the adjusted pathogen diagnosis rate was 45.48 % (417/763), and the adjusted anti-infection strategy ratio was 42.86 % (327/763).</div></div><div><h3>Conclusions</h3><div>mNGS provided an efficient pathogen diagnosis method for critically ill children with suspected infection. Different enrichment strategies of mNGS can play their respective advantages in clinical practice.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102823"},"PeriodicalIF":4.7,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superspreading potential of SARS-CoV-2 across multiple infection generations","authors":"Hee Kyoung Kim ,&nbsp;Jun-Sik Lim ,&nbsp;Seonghui Cho ,&nbsp;Eun Woo Lee ,&nbsp;Minje Lee ,&nbsp;Dong Wook Kim ,&nbsp;Kyungnam Kim ,&nbsp;Achangwa Chiara ,&nbsp;Sang-Eun Lee ,&nbsp;Sukhyun Ryu","doi":"10.1016/j.jiph.2025.102808","DOIUrl":"10.1016/j.jiph.2025.102808","url":null,"abstract":"<div><h3>Background</h3><div>Early during the coronavirus disease 2019 pandemic, the first patients to be identified as the source of infection in the clustered outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were labeled superspreaders in South Korea. However, the extent to which superspreading potential varies across different infection generations remains unclear. This study aims to estimate SARS-CoV-2 superspreading potentials across different infection generations from the largest clustered outbreak of the SARS-CoV-2 wild type in Seoul, South Korea, 2020.</div></div><div><h3>Methods</h3><div>We retrieved the infector–infectee line list data on an outbreak occurred between May 6 and June 5, 2020. To evaluate the superspreading potential (<span><math><mi>k</mi></math></span>), we fitted the offspring distributions that had been acquired by counting the number of observed secondary infections for each case and each generation into negative binomial distributions.</div></div><div><h3>Results</h3><div>The outbreak yielded a <span><math><mi>k</mi></math></span> value of 0.18 (95 % confidence interval [CI]: 0.13–0.27) and similar superspreading potentials across the different infection generations. Regarding the superspreading potential in each generation (i.e., individuals’ heterogeneity across different generations), <span><math><mi>k</mi></math></span> was estimated to be 0.27 (95 % CI: 0.15–0.51), 0.14 (0.03–0.23), 0.10 (0.01–0.17), 0.55 (0.12–5.80 ×10⁵), and 0.19 (0.07–0.73) for the first, second, third, fourth, and fifth or more generations, respectively.</div></div><div><h3>Conclusions</h3><div>Our findings revealed no significant variations in the superspreading potential of SARS-CoV-2 across cases from different infection generations in the clustered outbreak. Assessing superspreading potential during the epidemic is necessary to refine epidemic modeling and enhance public health understanding of the transmission dynamic of epidemics.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102808"},"PeriodicalIF":4.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional and national burden of echinococcosis in 204 countries and territories from 1990 to 2021: A systematic analysis based on the Global Burden of Disease Study 2021","authors":"Talaiti Tuergan ,&nbsp;Aimitaji Abulaiti ,&nbsp;Alimu Tulahong ,&nbsp;Ruiqing Zhang ,&nbsp;Yingmei Shao ,&nbsp;Tuerganaili Aji","doi":"10.1016/j.jiph.2025.102810","DOIUrl":"10.1016/j.jiph.2025.102810","url":null,"abstract":"<div><h3>Background</h3><div>Echinococcosis, a neglected zoonotic helminthic disease, poses a significant health and economic burden globally. The study aimed to systematically analyze the burden of echinococcosis from 1990 to 2021. This study described incidence, prevalence, deaths, and disability-adjusted life years (DALYs) lost due to echinococcosis, explored trends in disease burden over time, identified high-burden regions and countries, and evaluated the contribution of various age and sex groups to the overall burden.</div></div><div><h3>Methods</h3><div>First, numbers and age-standardized rates of incidence, prevalence, deaths, and DALYs were assessed globally and by sub-types in 2021. Furthermore, the temporal trend of the disease burden was explored by the linear regression model from 1990 to 2021. Moreover, the age-period-cohort (APC) model and Bayesian age-period-cohort (BAPC) model were used to predict the future disease burden from 2022 to 2046. The Autoregressive Integrated Moving Average (ARIMA) model and the Exponential smoothing (ES) model were used for sensitivity analysis. To further delve into the factors driving changes in the disease burden between 1990 and 2021, decomposition analyses were conducted. Finally, frontier analysis was employed to assess the correlation between disease burden and sociodemographic development.</div></div><div><h3>Results</h3><div>Exposure to Echinococcosis contributed to 148521 incidence, 633404 prevalence, 1364 deaths, and 105072 DALYs globally in 2021. Younger and middle-aged adults were high-risk populations. Lower socio-demographic index (SDI) regions were high-risk areas. The disease burden varied considerably across the GBD regions and the countries. From 1990–2021, the number of incidence and prevalence cases increased. The predicted results showed that the incidence and prevalence for both genders would still increase from 2022 to 2046. Countries or regions with a higher SDI have greater burden improvement potential.</div></div><div><h3>Conclusion</h3><div>In conclusion, Echinococcosis has threatened public health globally. More proactive and effective strategic measures should be developed after considering global-specific circumstances.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102810"},"PeriodicalIF":4.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144099086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic diversity and antimicrobial resistance of clinical Klebsiella pneumoniae isolates: An ISSR-PCR analysis","authors":"Poonamrani Mishra ,&nbsp;Debasish Sahoo ,&nbsp;Mahesh Chandra Sahu","doi":"10.1016/j.jiph.2025.102813","DOIUrl":"10.1016/j.jiph.2025.102813","url":null,"abstract":"<div><h3>Background</h3><div><em>Klebsiella pneumoniae</em> is a major nosocomial pathogen associated with severe infections and increasing antimicrobial resistance. The study aimed to investigate the genetic diversity of <em>K. pneumoniae</em> clinical isolates using Inter Simple Sequence Repeat (ISSR) primers to assess strain differentiation and evolutionary relationships.</div></div><div><h3>Methods</h3><div>A total of 144 <em>K. pneumoniae</em> isolates were obtained from clinical samples in a tertiary care hospital. Standard microbiological and biochemical techniques were used for bacterial identification. Antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method. Genomic DNA was extracted, and ISSR-PCR was conducted using 19 primers to analyze genetic diversity. Banding patterns were scored, and genetic relationships were determined using Jaccard's coefficient and the Unweighted Pair Group Method with Arithmetic Mean (UPGMA) to construct a phylogenetic dendrogram. Principal Component Analysis (PCA) was also applied to assess variability among isolates.</div></div><div><h3>Results</h3><div>The antibiotic resistance profile revealed a high prevalence of multidrug-resistant (MDR) <em>K. pneumoniae</em>, with resistance to beta-lactams, aminoglycosides, and fluoroquinolones. ISSR-PCR analysis exhibited significant genetic polymorphism, with ISSR 1, ISSR 7, and ISSR 15 generating the highest number of bands. The resolving power of ISSR 11 and ISSR 14 was the highest (0.889 and 0.867), indicating their efficacy in distinguishing closely related strains. Phylogenetic analysis clustered the isolates into two major groups, suggesting genetic heterogeneity. PCA further confirmed genetic variability, with distinct clusters forming among isolates.</div></div><div><h3>Conclusion</h3><div>The study underscores the genetic diversity of <em>K. pneumoniae</em> isolates and the utility of ISSR markers in bacterial typing. The high prevalence of MDR strains highlights the urgent need for enhanced molecular surveillance and infection control strategies. ISSR-PCR offers a cost-effective alternative for epidemiological studies, though integration with whole-genome sequencing could provide deeper insights into resistance mechanisms.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102813"},"PeriodicalIF":4.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Papillomavirus (HPV) prevalence in population younger than 12 years old: A meta-analysis and systematic review","authors":"Mona Sadat Larijani ,&nbsp;Amir Javadi ,&nbsp;Amirabbas Faridpour ,&nbsp;Mohammad Banifazl ,&nbsp;Fatemeh Ashrafian ,&nbsp;Anahita Bavand ,&nbsp;Ladan Moradi ,&nbsp;Amitis Ramezani","doi":"10.1016/j.jiph.2025.102814","DOIUrl":"10.1016/j.jiph.2025.102814","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of HPV in children has been studied in different populations; however, the heterogeneity between the investigations is remarkable, and the total prevalence of HPV infection in this population is not well understood.</div></div><div><h3>Methods</h3><div>The conducted studies on the prevalence of HPV infection in the population &lt; 12 years old were explored and analyzed through a systematic review and meta-analysis approach. The studies which investigated HPV detection in oropharyngeal, nasopharyngeal and/or anogenital samples were included. HPV prevalence, sample type and age were considered as the inclusion criteria for the meta-analysis.</div></div><div><h3>Results</h3><div>Fifteen published studies between 1994 and 2021 with a total number of 2638 children aged from 1 day to 12 years, were analyzed. The total HPV prevalence in this population is estimated to be 14.7 % with the highest rate in kids over 1 year old, accounting for 25.4 %. Furthermore, the type of samples showed that buccal swabs had the highest rate of infection. The ratio of HPV-positive children born to HPV-positive mothers varied from 3 % to 55 % (median: 17.5 %), while this ratio decreased to 0–19.7 % (median 5.55 %) in HPV-positive kids born to HPV-negative mothers.</div></div><div><h3>Conclusion</h3><div>According to the present analysis, the prevalence of HPV in children is relatively high and requires further prospective studies and monitoring HPV acquisition in the young population, specifically in those born to HPV-positive mothers. Follow-up studies to assess the persistency rate of HPV after infancy are needed in order to highlight any possible implications for HPV vaccination programs and policy-making.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102814"},"PeriodicalIF":4.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Particle filtration efficiency of respirators during the COVID-19 pandemic","authors":"Jackson Williams,&nbsp;Lucan Baillie,&nbsp;Wayne Clancy,&nbsp;Travis Dodd,&nbsp;Kelly Tsang,&nbsp;Katie Burns,&nbsp;Lisa Kerr,&nbsp;Amanda Craig","doi":"10.1016/j.jiph.2025.102811","DOIUrl":"10.1016/j.jiph.2025.102811","url":null,"abstract":"<div><h3>Background</h3><div>Respirators are an essential medical device vital to prevent the transmission of airborne illness between persons. This study presents an investigation conducted by the Therapeutic Goods Administration (TGA) into the particle filtration efficiency (PFE) performance of respirators supplied in Australia that were included as medical devices in the Australian Register of Therapeutic Goods (ARTG) throughout the COVID-19 pandemic or supplied to the TGA from other jurisdictions for compliance testing.</div></div><div><h3>Methods</h3><div>A total of 400 real-world batches of respirators were tested against a rapid-screen PFE method developed by the TGA. The TGA analysed a respirator’s ability to meet its claimed filtration efficiency with a statistical power analysis differentiated by the claimed PFE standard, country of manufacture, time of inclusion into the ARTG and respirators with surgical against non-surgical claims.</div></div><div><h3>Findings</h3><div>Of the tested batches of respirators (n = 400), 70 % were compliant with the pre-set compliance criteria. The results indicate statistically significant PFE differences (p &lt; 0.05) between respirators claiming the standards 42 CFR Part 84, AS 1716:2012, GB 19083: 2010 and EN 149:2001+ A1:2009 when tested against respirators claiming GB 2626:2006. There were no observed significant differences between the PFE of surgical and non-surgical respirators (p &gt; 0.05).</div></div><div><h3>Interpretation</h3><div>The findings of this study highlight the importance of ensuring respirators meet their claimed PFE level based on their claimed standard prior to manufacturer release. Further studies should be focussed on investigating the effect of respiratory protection devices and their claimed efficiency in clinical settings such as hospitals against aerosolised particulates using a range of respiratory protection devices.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102811"},"PeriodicalIF":4.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidimensional challenges in Brazil's decision-making process of vaccines adoption: The case of childhood pneumococcal conjugate vaccines","authors":"Ana Marli Christovam Sartori ,&nbsp;Patrícia Coelho de Soárez ,&nbsp;Hillegonda Maria Dutilh Novaes ,&nbsp;Thayssa Veiga da Fonseca Victer ,&nbsp;Ana Catarina de Melo Araujo ,&nbsp;Greice Madeleine Ikeda do Carmo ,&nbsp;Marcelo Yoshito Wada ,&nbsp;Eder Gatti Fernandes","doi":"10.1016/j.jiph.2025.102812","DOIUrl":"10.1016/j.jiph.2025.102812","url":null,"abstract":"<div><div>The objective of this paper was to examine the process of adopting new vaccines in a middle-income country.</div></div><div><h3>Methods</h3><div>We used an intrinsic explanatory case study to analyze the recent decision-making process of switching 10-valent Pneumococcal Conjugate Vaccine (PCV10) to PCV13 in the Brazilian childhood immunization schedule. We analyzed Conitec (<em>Comissão Nacional de Incorporação de Tecnologias no Sistema Único de Saúde) official documents.</em></div></div><div><h3>Results</h3><div>In November 2022, the Conitec plenary recommended, at first, switching from PCV10 to PCV13, considering PCV13 non-inferiority and similar safety profile to PCV10, the price proposed by Wyeth/Pfizer, below the currently practiced, and the scenario of possible resource savings observed in an economic analysis conducted by Wyeth/Pfizer. In a second meeting, in April 2023, Conitec final decision was not to introduce PCV13 at that moment, based on additional scientific, administrative and technical data presented by the National Immunization Program, mainly epidemiological data showing no recent increase of pneumococcal disease (PD), the need to increase vaccination coverage to better control PD and to implement a sentinel surveillance of vaccine-preventable bacterial diseases with nationwide representation to better evaluate PD burden and serotypes replacement, and the country technological development and self-sufficiency in vaccine production.</div></div><div><h3>Conclusions</h3><div>Our case showed the decision-making process of adopting new vaccines is country-specific and involve many levels of political prioritization and complex technical aspects, and depends on the presence of strong public health institutions.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102812"},"PeriodicalIF":4.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of evolution driven population-wide emergence of mpox: The paradoxic effect of moderate interventions","authors":"F. Nedényi ,&nbsp;J.M. Benke ,&nbsp;M. Szalai ,&nbsp;G. Röst","doi":"10.1016/j.jiph.2025.102799","DOIUrl":"10.1016/j.jiph.2025.102799","url":null,"abstract":"<div><h3>Background</h3><div>The global mpox outbreak in 2022 was declared a public health emergency of international concern. While in non-endemic countries disease spread remained limited mostly to a high risk group, a main public health concern is that through evolution, mpox gains the ability to widely spread in the entire population.</div></div><div><h3>Methods</h3><div>We construct a stochastic epidemiological model of SEIR type, to investigate the spread of mpox primarily propagating within a core population — consisting of MSM individuals having multiple sexual partners — before affecting the general population. We examine how effective various intervention strategies are in preventing this from happening. These non-pharmaceutical interventions include reducing disease transmission in the core population, in the general population, or in both. Our analysis encompasses the optimal timing for these interventions, considering the effects of early versus late intervention and the potential impact of different mutation patterns on disease spread.</div></div><div><h3>Results</h3><div>Our findings highlight that effective early intervention can be achieved with lower intensity, while delayed intervention requires stronger measures. Notably, our results reveal an intriguing phenomenon where moderate intervention could lead to worse outcome than no intervention. This counterintuitive outcome arises because moderate reductions may prolong transmission chains within the core group, leading to more opportunities for the pathogen to acquire mutations resulting in higher transmission potential in the general population.</div></div><div><h3>Conclusions</h3><div>A comprehensive understanding of the role of the core group in disease dynamics and the mutation patterns are crucial for developing tailored and effective public health strategies. The moderate intervention paradox suggests that to minimize the risk of population-wide emergence, it must be ensured that targeted interventions are highly efficient.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102799"},"PeriodicalIF":4.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144137911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}