Vaccination greatly reduces disease, disability, death and inequity worldwide.

In low-income countries, infectious diseases still account for a large proportion of deaths, highlighting health inequities largely caused by economic differences. Vaccination can cut health-care costs and reduce these inequities. Disease control, elimination or eradication can save billions of US dollars for communities and countries.

Efficacy and safety of a live attenuated, cold-adapted influenza vaccine, trivalent against culture-confirmed influenza in young children in Asia.

Background: This study was designed to evaluate the efficacy and safety of cold-adapted influenza vaccine, trivalent (CAIV-T) against culture-confirmed influenza in children 12 to <36 months of age during 2 consecutive influenza seasons at multiple sites in Asia.

Methods: In year 1, 3174 children 12 to <36 months of age were randomized to receive 2 doses of CAIV-T (n = 1900) or placebo (n = 1274) intranasally > or =28 days apart. In year 2, 2947 subjects were rerandomized to receive 1 dose of CAIV-T or placebo.

Nocardia pneumonia with empyema thoracis in a healthy neonate: a case report.

A 40-day-old male infant presented with fever and non-productive cough for 3 weeks, tachypnea and dyspnea 5 days before admission. The chest radiograph and computed tomographic (CT) scan revealed right lung consolidation with pleural effusion. Pleural tapping showed frank pus that grew Nocardia asteroides.

Immunogenicity and safety of two doses of a paediatric hepatitis A vaccine in thai children: comparison of three vaccination schedules.

As fewer children in Thailand are exposed to hepatitis A virus (HAV) and so do not have seroprotective anti-HAV antibodies, they are becoming an important source of HAV transmission. A flexible HAV vaccination schedule would facilitate incorporation of the vaccine into existing immunization programmes, and we compared the immunogenicity and safety of three HAV immunization schedules. An open, randomized, clinical trial was carried out in which healthy children were given a primary dose of the inactivated hepatitis A vaccine, Avaxim 80 paediatric, with a booster dose 6, 12 or 18 months later.

Protective efficacy of hepatitis B vaccine without HBIG in infants of HBeAg-positive carrier mothers in Thailand.

The primary objective of this study was to estimate the efficacy of a recombinant hepatitis B vaccine (H-B-VAXII) in preventing chronic hepatitis B infection when given alone without concomitant hepatitis B immune globulin (HBIG) to healthy Thai infants born of HBeAg-positive carrier mothers. The infants received a 0.5 ml (5 micro g HBsAg) intramuscular injection of H-B-VAXII either at birth, 1, and 6 months of age (Schedule A) or at birth, 1, 2, and 12 months of age (Schedule B).

Effect of climatic factors and population density on varicella zoster virus epidemiology within a tropical country.

Blood samples were collected from healthy subjects, aged 9 months-29 years in urban and rural communities from 4 distinct regions in Thailand, to determine the seroprevalence rate of varicella-zoster virus (VZV) antibody and its relationship with demographic, climatic, and socioeconomic factors. The overall seroprevalence rate was 52.8% and increased from 15.

Epidemiology of invasive meningococcal disease in 13 government hospitals in Thailand, 1994-1999.

This study was conducted to elucidate the magnitude of problem and the clinical course of invasive meningococcal infection from 13 government hospitals in Thailand between 1994 and 1999. Thirty-six strains of Neisseria meningitidis were isolated from 16 blood and 24 cerebrospinal fluid specimens; 4 patients had positive culture in both blood and CSF. Of the 16 strains, 9 (56.

A review of Hib epidemiology in Asia.

Meningitis due to an invasive Haemophilus influenzae type b (Hib) infection, has been previously perceived to be relatively uncommon in Asia. However, the incidence of disease and its impact may have been underestimated. In addition to a lack of microbiological facilities in some hospitals, difficulties in culturing the organism and the widespread use of antibiotics may have hidden the true incidence of the disease in some countries.

Update on value of the anion gap in clinical diagnosis and laboratory evaluation.

Anion gap (AG) is a calculated value commonly used in clinical practice. It approximates the difference between the concentration of unmeasured anions (UA) and unmeasured cations (UC) in serum. At present, the reference range of anion gap has been lowered from 8-16 to 3-11 mmol/l because of the changes in technique for measuring electrolyte.

Safety and immunogenicity of combined or associated administration of PRP-T vaccine with diphtheria, tetanus and pertussis vaccine in Thai children.

To assess whether the combination of a diphtheria, tetanus and pertussis vaccine with a Haemophilus influenzae type b conjugate vaccine (PRP-T) had any effect on immunogenicity or safety compared with separate administration of the vaccines, 158 infants were randomized to receive the vaccines either in association or as a combination at 2, 4, and 6 months of age. A total of 126 infants (59 associated, 67 combination) completed the three-dose regimen and were analysed for immunogenicity and safety. With respect to safety, there were no significant differences between the two groups.

Use of an immunotherapeutic vaccine to treat a life-threatening human arteritic infection caused by Pythium insidiosum.

A 14-year-old Thai boy presented because of a history of headache, mandibular swelling, and facial nerve palsy. A microorganism identified as Pythium insidiosum was cultured from the mandibular abscesses. Despite treatment with amphotericin B, iodides, ketoconazole, and surgery, the infection progressed.

Hepatitis B virus strains in Thailand: genomic variants in chronic carriers.

Genetic heterogeneity of the hepatitis B virus (HBV) has been shown to influence the serological pattern and clinical picture in HBV infection. Thailand has a high transmission rate of HBV, but the molecular epidemiology of HBV strains circulating in this region was hitherto unknown. In this study, the HBV strains from 34 Thai HBsAg-positive patients were investigated.

Treatment of acute bacterial diarrhea: a multicenter international trial comparing placebo with fleroxacin given as a single dose or once daily for 3 days.

This study was designed to test the efficacy of 400 mg fleroxacin given orally as a single dose or once daily for 3 days against acute bacterial diarrhea. A group of 508 adults with acute diarrhea were entered into a randomized, double-blind, placebo-controlled, multicenter trial. Patients were examined and asked about numbers of liquid stools daily for 3 days and at 5 days after start of treatment.

Response to antimicrobial therapy for shigellosis in Thailand.

Shigella species have been one of the most common causes of acute diarrhea in Bangkok, Thailand. The incidence of shigellosis increased steadily from 1984 to 1988. The majority of Shigella species isolated from specimens from patients with acute diarrhea in Bangkok in 1988 were resistant to both ampicillin and trimethoprim-sulfamethoxazole (TMP-SMZ).

Serotypes of Escherichia coli that hybridized with DNA probes for genes encoding Shiga-like toxin I, Shiga-like toxin II, and serogroup O157 enterhemorrhagic E. coli fimbriae isolated from adults with diarrhea in Thailand.

Escherichia coli strains isolated from adults with diarrhea in Bangkok, Thailand, were examined for hybridization with DNA probes for genes that code for Shiga-like toxin (SLT)-I, SLT-II, and serogroup O157 enterhemorrhagic E. coli (EHEC) fimbriae. Seven isolates that hybridized with the SLT-I, SLT-II, and O157 EHEC fimbria probes and produced verocytotoxin (VT; group A) were isolated from two patients with diarrhea.

Hybridization of Escherichia coli producing Shiga-like toxin I, Shiga-like toxin II, and a variant of Shiga-like toxin II with synthetic oligonucleotide probes.

Synthetic oligonucleotides, constructed from the nucleotide sequences of genes coding for the A subunit of Shiga-like toxin (SLT) I and the B subunit of SLT-II, were used as probes at different degrees of stringency to identify Escherichia coli producing different types of SLTs. At 45 degrees C, the A-I oligonucleotide probe hybridized with E. coli producing SLT-I, SLT-II, and variant of SLT-II (SLT-IIv).

Predictors for extraintestinal infection in Salmonella enteritis in Thailand.

To identify the risks and predictors for extraintestinal Salmonella infection (ETI) in infants and children with nontyphoidal Salmonella enteritis, we performed a retrospective review of 326 infants and children with diarrhea and rectal swab cultures positive for nontyphoidal Salmonella enteritis seen at Ramathibodi Hospital between 1981 and 1983. Nineteen patients had bacteremia. The overall rate of bacteremia was 5.

Effect of recent antibacterial agents against bacteria causing diarrhoea.

The susceptibility of 424 bacterial isolates causing diarrhoea were tested by agar dilution technique on Mueller-Hinton Agar against amoxicillin, ampicillin, ceftriaxone, chloramphenicol, co-trimoxazole, ciprofloxacin, doxycycline, norfloxacin and ofloxacin. The bacterial species included were Aeromonas hydrophila, Edwardsiella tarda, Pleisomonas shigelloides, Salmonella spp., Shigella spp.

Consequences of diarrhoeal disease on the pharmacokinetics of norfloxacin.

The pharmacokinetics of 400 mg norfloxacin administered orally were studied in 19 patients both during the acute phase of bacterial gastroenteritis and during convalescence, after normalization of bowel movements. The peak serum concentrations, total area under the serum concentration curve, rate of elimination and serum half-life in the beta-phase were all similar during the acute phase of the disease as well as after normalization of the intestinal function. The only difference was that the time to peak concentrations was longer (p less than 0.

Norfloxacin versus co-trimoxazole in the treatment of acute bacterial diarrhoea: a placebo controlled study.

The bacteriological and clinical efficacy of norfloxacin 400 mg b.i.d.

Consequences of treatment of gastrointestinal infections.

Diarrhoeal disease is a common problem in developing countries. As a result of recent advances in diagnostic methodology, the causative agents can now be identified in most cases of acute diarrhoeal diseases. Enteric bacterial pathogens are the common cause of gastroenteritis in developing countries.