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- Ali, Mohammad, et al.
(författare)
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Vaccine Protection of Bangladeshi infants and young children against cholera: implications for vaccine deployment and person-to-person transmission.
- 2008
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Ingår i: The Pediatric infectious disease journal. - 0891-3668. ; 27:1, s. 33-7
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUND: Killed oral cholera vaccines are internationally licensed for older children and adults, but not for infants and young children. We investigated whether mass immunization of older children and adults can confer herd protection to children too young to be vaccinated. METHODS: We analyzed the first year of surveillance of an individually randomized, placebo-controlled trial of killed oral cholera vaccines in 89,596 older Bangladeshi children and adult women. Vaccine herd protection of children less than 2 years of age, who were too young to participate in the trial, was evaluated by determining whether the incidence of cholera during the first year of follow-up of this age group was lower in residential clusters with higher levels of vaccine coverage than in clusters with lower levels of vaccine coverage. RESULTS: Vaccine coverage of the targeted population ranged from 4% to 65% in different clusters. The incidence (cases per 1000) of cholera among children less than 2 years of age ranged from 18.9 in clusters in the lowest quintile of vaccine coverage to 8.6 in clusters in the highest quintile (P = 0.004 for the inverse association between vaccine coverage and risk of cholera) Vaccine coverage of adult women (relative risk of cholera = 0.95 for each percent increase in vaccine coverage; 95% confidence interval: 0.92-0.99; P < 0.01), but not of older children, was independently associated with a lower risk of cholera in children less than 2 years of age. CONCLUSIONS: Vaccination of older age groups was associated with protection of children too young to be vaccinated. The pronounced herd protection of young children associated with vaccination of adult women suggests that adult women may play a prominent role in the transmission of cholera to young children in this setting.
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- Rosenberg, Molly, et al.
(författare)
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Relationship Between Community-Level Alcohol Outlet Accessibility and Individual-Level Herpes Simplex Virus Type 2 Infection Among Young Women in South Africa
- 2015
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Ingår i: Sexually Transmitted Diseases. - 0148-5717 .- 1537-4521. ; 42:5, s. 259-265
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Tidskriftsartikel (refereegranskat)abstract
- Background: Exposure to alcohol outlets may influence sexual health outcomes at the individual and community levels. Visiting alcohol outlets facilitates alcohol consumption and exposes patrons to a risky environment and network of potential partners, whereas the presence of alcohol outlets in the community may shift social acceptance of riskier behavior. We hypothesize that living in communities with more alcohol outlets is associated with increased sexual risk. Methods: We performed a cross-sectional analysis in a sample of 2174 South African schoolgirls (ages 13-21 years) living across 24 villages in the rural Agincourt subdistrict, underpinned by long-term health and sociodemographic surveillance. To examine the association between number of alcohol outlets in village of residence and individual-level prevalent herpes simplex virus type 2 (HSV-2) infection, we used generalized estimating equations with logit links, adjusting for individual-and villagelevel covariates. Results: The median number of alcohol outlets per village was 3 (range, 0-7). Herpes simplex virus type 2 prevalence increased from villages with no outlets (1.4%[95% confidence interval, 0.2-12.1]), to villages with 1 to 4 outlets (4.5% [3.7-5.5]), and to villages with more than 4 outlets (6.3% [5.6, 7.1]). An increase of 1 alcohol outlet per village was associated with an 11% increase in the odds of HSV-2 infection (adjusted odds ratio [95% confidence interval], 1.11 [0.98-1.25]). Conclusions: Living in villages with more alcohol outlets was associated with increased prevalence of HSV-2 infection in young women. Structural interventions and sexual health screenings targeting villages with extensive alcohol outlet environments could help prevent the spread of sexually transmitted infections.
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- Rosenberg, Molly, et al.
(författare)
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Relationship between school dropout and teen pregnancy among rural South African young women
- 2015
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 44:3, s. 928-936
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sexual activity may be less likely to occur during periods of school enrolment because of the structured and supervised environment provided, the education obtained and the safer peer networks encountered while enrolled. We examined whether school enrolment was associated with teen pregnancy in South Africa. Methods: Using longitudinal demographic surveillance data from the rural Agincourt sub-district, we reconstructed the school enrolment status from 2000 through 2011 for 15 457 young women aged 12-18 years and linked them to the estimated conception date for each pregnancy during this time. We examined the effect of time-varying school enrolment on teen pregnancy using a Cox proportional hazard model, adjusting for: age; calendar year; household socioeconomic status; household size; and gender, educational attainment and employment of household head. A secondary analysis compared the incidence of pregnancy among school enrolees by calendar time: school term vs school holiday. Results: School enrolment was associated with lower teen pregnancy rates [adjusted hazard ratio (95% confidence interval): 0.57 (0.50, 0.65)]. This association was robust to potential misclassification of school enrolment. For those enrolled in school, pregnancy occurred less commonly during school term than during school holidays [incidence rate ratio (95% confidence interval): 0.90 (0.78, 1.04)]. Conclusions: Young women who drop out of school may be at higher risk for teen pregnancy and could likely benefit from receipt of accessible and high quality sexual health services. Preventive interventions designed to keep young women in school or addressing the underlying causes of dropout may also help reduce the incidence of teen pregnancy.
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| 5. |
- Rosenberg, Molly, et al.
(författare)
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The Relationship between Alcohol Outlets, HIV Risk Behavior, and HSV-2 Infection among South African Young Women : A Cross-Sectional Study
- 2015
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Alcohol consumption has a disinhibiting effect that may make sexual risk behaviors and disease transmission more likely. The characteristics of alcohol- serving outlets (e.g. music, dim lights, lack of condoms) may further encourage risky sexual activity. We hypothesize that frequenting alcohol outlets will be associated with HIV risk.Methods: In a sample of 2,533 school- attending young women in rural South Africa, we performed a cross- sectional analysis to examine the association between frequency of alcohol outlet visits in the last six months and four outcomes related to HIV risk: number of sex partners in the last three months, unprotected sex acts in the last three months, transactional sex with most recent partner, and HSV- 2 infection. We also tested for interaction by alcohol consumption.Results: Visiting alcohol outlets was associated with having more sex partners [adjusted odds ratio (aOR), one versus zero partners (95% confidence interval (CI)): 1.51 (1.21, 1.88)], more unprotected sex acts [aOR, one versus zero acts ( 95% CI): 2.28 ( 1.52, 3.42)], higher levels of transactional sex [aOR ( 95% CI): 1.63 ( 1.03, 2.59)], and HSV-2 infection [aOR ( 95% CI): 1.30 ( 0.88, 1.91)]. In combination with exposure to alcohol consumption, visits to alcohol outlets were more strongly associated with all four outcomes than with either risk factor alone. Statistical evidence of interaction between alcohol outlet visits and alcohol consumption was observed for all outcomes except transactional sex.Conclusions: Frequenting alcohol outlets was associated with increased sexual risk in rural South African young women, especially when they consumed alcohol. Sexual health interventions targeted at alcohol outlets may effectively reach adolescents at high risk for sexually transmitted infections like HIV and HSV-2.
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