Accelerating measles and rubella elimination through research and innovation - Findings from the Measles & Rubella Initiative research prioritization process, 2016.

The Measles & Rubella Initiative (M&RI) identified five key strategies to achieve measles and rubella elimination, including research and innovation to support cost-effective operations and improve vaccination and diagnostic tools. In 2016, the M&RI Research and Innovation Working Group (R&IWG) completed a research prioritization process to identify key research questions and update the global research agenda. The R&IWG reviewed meeting reports and strategic planning documents and solicited programmatic inputs from vaccination experts at the program operational level through a web survey, to identify previous research priorities and new research questions.

Research priorities for accelerating progress toward measles and rubella elimination identified by a cross-sectional web-based survey.

Background: In 2012, the World Health Assembly endorsed the Global Vaccine Action Plan (GVAP) that set a target to eliminate measles and rubella in five of the six World Health Organization (WHO) regions by 2020. Significant progress has been made toward achieving this goal through intensive efforts by countries and Measles & Rubella Initiative (M&RI) partners. Accelerating progress will require evidence-based approaches to improve implementation of the core strategies in the Global Measles and Rubella Strategic Plan.

Measles and rubella elimination: learning from polio eradication and moving forward with a diagonal approach.

In 1988, an estimated 350,000 children were paralyzed by polio and 125 countries reported polio cases, the World Health Assembly passed a resolution to achieve polio eradication by 2000, and the Global Polio Eradication Initiative (GPEI) was established as a partnership focused on eradication. Today, following eradication efforts, polio cases have decreased >99% and eradication of all three types of wild polioviruses is approaching. However, since polio resources substantially support disease surveillance and other health programs, losing polio assets could reverse progress toward achieving Global Vaccine Action Plan goals.

Prevalence of asymptomatic poliovirus infection in older children and adults in northern India: analysis of contact and enhanced community surveillance, 2009.

Background: In 2009, enhanced poliovirus surveillance was established in polio-endemic areas of Uttar Pradesh and Bihar, India, to assess poliovirus infection in older individuals.

Methods: In Uttar Pradesh, stool specimens from asymptomatic household and neighborhood contacts of patients with laboratory-confirmed polio were tested for polioviruses. In Bihar, in community-based surveillance, children and adults from 250 randomly selected households in the Kosi River area provided stool and pharyngeal swab samples that were tested for polioviruses.

Hepatitis A and hepatitis B infection prevalence and associated risk factors in men who have sex with men, Bangkok, 2006-2008.

Despite the availability of safe and effective vaccines, little is known about prevalence and risk factors for hepatitis A (HAV) and hepatitis B virus (HBV) infection among Thai men who have sex with men. The prevalence of HAV and HBV infection among men who have sex with men cohort in Bangkok was assessed. Baseline blood specimens were drawn and demographic and behavioral data were collected.

Prevalence of hepatitis B, tetanus, hepatitis A, human immunodeficiency virus and feasibility of vaccine delivery among injecting drug users in Bangkok, Thailand, 2003-2005.

Objectives: To estimate the prevalence of hepatitis B virus (HBV), tetanus, hepatitis A virus (HAV) and human immunodeficiency virus (HIV) in injecting drug users (IDUs), risk factors associated with infection and the feasibility of HBV vaccine delivery in HBV seronegatives.

Methods: Cross-sectional seroprevalence survey of 1535 IDUs recruited from 17 Bangkok Metropolitan Administration (BMA) methadone clinics and HBV vaccination of seronegatives.

Results: Prevalence of antibody to HBV, tetanus, HAV and HIV was 87.

Long-term capacity-building in public health emergency preparedness in Thailand--short report.

Thailand's long-term commitment to public health workforce capacity-building and its health infrastructure were key components in its successful response to the December 26, 2004 tsunami disaster. Surveillance and Rapid Response Teams, comprising fellows and staff from the Field Epidemiology Training Programme of Thailand, in collaboration with staff from the Thailand Ministry of Public Health---U.S Centers for Disease Control and Prevention and the World Health Organization, enabled a rapid and an effective public health response.

Public health informatics: improving and transforming public health in the information age.

Development of effective public health information systems requires understanding public health informatics (PHI), the systematic application of information and computer science and technology to public health practice, research, and learning. PHI is distinguished from other informatics specialties by its focus on prevention in populations, use of a wide range of interventions to achieve its goals, and the constraints of operating in a governmental context. The current need for PHI arises from dramatic improvements in information technology, new pressures on the public health system, and changes in medical care delivery.

Factors associated with non-disclosure of HIV infection status of new mothers in Bangkok.

The objective of this study was to estimate HIV disclosure rates and identify factors that predict non-disclosure in Thai women who tested HIV positive during pregnancy or at delivery. This was a cohort study evaluating the implementation of prevention of mother-to-child HIV transmission programs at two Bangkok hospitals in 1999-2003. All HIV-infected women who delivered during the study period were enrollment eligible.

Support for immunization registries among parents of vaccinated and unvaccinated school-aged children: a case control study.

Background: Immunizations have reduced childhood vaccine preventable disease incidence by 98-100%. Continued vaccine preventable disease control depends on high immunization coverage. Immunization registries help ensure high coverage by recording childhood immunizations administered, generating reminders when immunizations are due, calculating immunization coverage and identifying pockets needing immunization services, and improving vaccine safety by reducing over-immunization and providing data for post-licensure vaccine safety studies.

Assessment of immunization registry databases as supplemental sources of data to improve ascertainment of vaccination coverage estimates in the national immunization survey.

Objective: To evaluate the use of immunization registry data to supplement missing or incomplete vaccination data reported by immunization providers (referred to as "providers" hereafter) in the National Immunization Survey.

Design: Cross-sectional, random-digit-dialing, telephone survey to measure vaccination coverage among children aged 19 to 35 months in the United States.

Setting: Four sites with mature (with >67% of provider participation in the area) immunization registries.

Assessing immunization registry data completeness in Bexar County, Texas.

Background: Immunization information systems (or registries) are increasingly being used to promote and sustain high levels of vaccination coverage. However, the perception among many providers that registry data are too incomplete to be relied on when making immunization decisions has impeded the acceptance of registries.

Methods: To evaluate registry completeness, immunization coverage levels from the San Antonio Immunization Registry System (SAIRS) were compared with coverage levels derived from immunization records from 77 (37%) of the 210 clinics participating in the Vaccines for Children (VFC) program in 1998, 44 (21%) clinics in 1999, and 10 (5%) clinics in 2000.

Immunization registries: progress and challenges in reaching the 2010 national objective.

Immunization registries are confidential, population-based, computerized information systems that contain data about children's immunizations and have been described as the cornerstone of immunization delivery in the 21st century. Work to ensure the privacy of registry participants and the confidentiality of their information, recruit provider participation, overcome technical and operational challenges, and identify sustainable funding streams has resulted in 24 percent of children less than 6 years of age currently in an immunization registry in the United States. New solutions will be needed before reaching the national health objective of increasing the proportion of children to 95 percent in a fully operational immunization registry by 2010.

A review of state legislation related to immunization registries.

Background: Since the early 1990s, a concerted effort has been made to develop community- and state-based immunization registries. A 1995 survey showed that nine states had laws specifically authorizing immunization registries. This survey was conducted to describe the current status of legislation and policies addressing immunization registries and the sharing of immunization information.

The impact of computer-generated messages on childhood immunization coverage(2)(2).

Introduction: Recent evaluations of computer-generated reminder/recall messages have suggested that they are an inexpensive, labor-saving method of improving office visitation rates of childhood immunization providers. This study assesses the sustained impact of computer-generated messages on immunization coverage during the first two years of life.Design: Randomized, controlled trial.

The impact of computer-generated messages on childhood immunization coverage.

Introduction: Recent evaluations of computer-generated reminder/recall messages have suggested that they are an inexpensive, labor-saving method of improving office visitation rates of childhood immunization providers. This study assesses the sustained impact of computer-generated messages on immunization coverage during the first two years of life.

Design: Randomized, controlled trial.

The effect of diarrhea on oral poliovirus vaccine failure in Brazil.

The effect of diarrhea on oral poliovirus vaccine (OPV) failure was evaluated using data from Brazil, where 728 infants were immunized at birth (OPV1) and approximately 6 (OPV2), 10 (OPV3), and 14 (OPV4) weeks. Recent diarrhea history was significantly associated with increased vaccine failure only after OPV2 for poliovirus types 2 and 3. In multivariate models, controlling for breast feeding, season of vaccine administration (type 3 only), maternal antibody (type 3 only), and immunization campaign exposure (type 3 only) strengthened this effect.

The clinical efficacy of trivalent oral polio vaccine in The Gambia by season of vaccine administration.

An epidemic of poliomyelitis caused by poliovirus type 1 occurred in The Gambia in 1986. To determine if a relationship existed between the failure of trivalent oral poliovirus vaccine (OPV) to prevent poliomyelitis and the season when children were vaccinated, 46 children 1-7 years old with poliomyelitis who had received three card-documented doses of OPV were compared with 260 controls who had also received three card-documented doses. Controls were individually matched with children who had poliomyelitis by age, sex, and residence.

Sequential use of inactivated poliovirus vaccine followed by oral poliovirus vaccine in Oman.

Seroprevalence and geometric mean titers (GMTs) were compared at 6 and 10 months after vaccination with monovalent type 1 oral poliovirus vaccine (OPV) at 6 months and trivalent OPV at 7 and 9 months. Group 1 had received 4 doses of OPV, group 2 OPV at birth and 3 doses of OPV and inactivated poliovirus vaccine (IPV), and group 3 placebo at birth and 3 doses of IPV. A total of 547 infants completed the study.

Effect of target age of supplemental immunization campaigns on poliomyelitis occurrence in China.

The World Health Organization recommends conducting supplemental immunization activities to eradicate poliomyelitis by the year 2000. Although effective in eliminating poliomyelitis from the Americas, supplemental campaigns require substantial resources. To assess differential campaign effectiveness in eliminating this disease, poliomyelitis occurrence was compared in counties in China that targeted children <3 versus <4 years of age.

Poliomyelitis surveillance: the compass for eradication.

Effective disease surveillance is a key strategy of the global polio eradication initiative. In an effort to strengthen the quality of polio surveillance as a prerequisite to achieving and certifying eradication, surveillance assessments were conducted in 28 countries in the World Health Organization African, Eastern Mediterranean, and European Regions from 1992 to 1995 using a standard protocol and evaluation guidelines. Six general recommendations were made: Use surveillance data for public health decision-making and action, improve timeliness of information exchange and dissemination, standardize the data collected, ensure adequate surveillance infrastructure, improve local data analysis, and enhance teamwork among surveillance partners.