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Query: UMLS:C0043167 (pertussis)
 19,595 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The Indian government set up an integrated child development services (ICDS) scheme in 1974, the object of which was to provide health care that would reduce mortality, morbidity, malnutrition, and preventable disease among India's 228 million children (according to the 1971 Census) under the age of 14. The paper describes what this program consists in and summarizes its achievements in one area from July 1976 to December 1977. These have been: 80% of the children in the age group 0-6 immunized against diphtheria, pertussis, tetanus, tuberculosis, and smallpox; 60% of expectant mothers immunized against tetanus; 40% of the children and 30% of the mothers have received Foliper tablets, supplied to prevent nutritional anemia; 60% of the children have received 1 dose of vitamin A in oil and 40% have received their second; and, finally, 82% of the children have received a health checkup and 70% of the expectant mothers have received antenatal checkups. In addition, 20 indigenous dais have been trained and 20 more are presently undergoing training.
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PMID:Integrated child development services (I.C.D.S.) scheme. A new approach to (maternal and child health) services. Its activities in Orissa. 45 21

A retrospective study was carried out to determine the effect of common childhood infectious diseases on the hemoglobin level of a cohort of Alaskan Eskimo children born between 1960 and 1962. Hemoglobin and health records were available on 308 children between 6-11 and 12-17 months of age. Additional records were available on 187 of these children at 18-23 months of age. Episodes of chickenpox, measles, pertussis, and lower respiratory infections were reviewed. Between 38 and 50% of infants between 6 and 23 months of age had hemoglobin levels below 11.0 g/dl. The mean hemoglobin level of infants 6-11 and 12-17 months of age decreased with increasing number of total infectious episodes occurring within the 3 months before hemoglobin measurement. This trend was not apparent for infants in the 18-23 months age interval nor were low hemoglobins predictive of illness during the 3 months after the hemoglobin determination. At the 6-11 and 12-17 month age interval the number of lower respiratory infectious were most significantly associated with a decreased hemoglobin value. These observations are consistent with more recent reports that document iron deficiency anemia among children with antecedent infections and again emphasize the role of infection in the development and maintenance of anemia in children about 1 year of age.
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PMID:Associations of early childhood infections and reduced hemoglobin levels in a historic cohort of Alaska Native infants. 227 96

A 2.5-year-old boy with congenital pure red cell aplasia (PRCA) became unresponsive to conventional prednisone (2 mg/kg) treatment following a febrile period related to diphtheria-pertussis-tetanus (DPT) immunization and required transfusions. Following an administration of high-dose intravenous methylprednisolone, his bone marrow and hematological findings were completely normalized and continued so for 18 months after initiation and 9.5 months after discontinuation of the treatment. When his anemia relapsed, following an upper respiratory infection, he was again found refractory to conventional prednisone administration but responded promptly to intravenous bolus methylprednisolone treatment.
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PMID:High-dose intravenous corticosteroid for a patient with Diamond-Blackfan syndrome refractory to classical prednisone treatment. 642 86

In March 1992, March 1993, and June 1994, an international expert advisory committee oversaw a systematic and comprehensive review of potential interventions for preventing pneumonia among children aged less than 5 living in developing countries. The World Health Organization's Programme for the Control of Acute Respiratory Infections (ARIs) and the London School of Hygiene and Tropical Medicine conducted the review. There were 28 individual intervention areas identified among six broad intervention groups. Immunization comprises one of the six broad intervention categories. Specific immunization interventions include increased coverage of measles and pertussis and new vaccines for Pneumococcus, H. influenza B, respiratory syncytial virus, and other viral vaccines. Improving nutrition interventions revolve around breast feeding, low birth weight, malnutrition, vitamin A, severe anemia, and other micronutrients (e.g., zinc). The broad intervention category of reducing environmental pollution encompasses indoor air pollution, environmental tobacco smoke, and outdoor air pollution. Severely malnourished children, high risk neonates, ARI (upper tract), helminths, and wheezing fall under the case management and chemoprophylaxis intervention category. Crowding, direct transmission, and HIV are addressed in the category of reducing transmission of pathogens. The category of improving child care practices includes care-seeking, avoiding chilling, other child care practices, maternal education, and child spacing. The specialists conducted modeling to determine the potential impact of various interventions. It showed that the potential impact of an intervention increases independently with the pre-intervention prevalence of the risk category, with the size of the associated relative risk, and with the reduction in risk-category prevalence achieved by the intervention. Modeling will be used to compare the potential impacts of ARI preventive approaches with the impact achievable with the case management strategy.
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PMID:Potential interventions for the prevention of childhood pneumonia in developing countries: a systematic review. 890 73

A case-control study was undertaken in Basrah Maternity and Children Hospital, Iraq. We studied 148 children who were admitted to hospital with severe pneumonia according to the World Health Organization (WHO) criteria and the controls were 250 children attending the out-patient department for non-severe respiratory infections. Significant risk factors were younger age (2-6 months), low parental education, smoking at home, prematurity, weaning from breast milk at < 6 months, a negative history of diphtheria, pertussis and tetanus vaccination, anaemia and malnutrition.
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PMID:Risk factors for severe pneumonia in children in Basrah. 1144 32

The Lady Dufferin Fund, founded in 1885 in India, had by 1940 established 400 hospitals to alleviate diseases and mortality related to childbirth. After independence 2328 community health centers and 21254 primary health centers were created in the country. During 1974-94 more than 131,000 subcenters were set up and about 620,000 auxiliary nurse midwives (ANMs) had been trained. The Ministry of Health introduced four health prevention schemes in 1969: 1) immunization of children against diphtheria, pertussis, and tetanus; 2) immunization of pregnant women against tetanus; 3) prophylaxis of mothers and children against nutritional anemia; and 4) prophylaxis of children against blindness caused by vitamin A deficiency. As a result, infant mortality declined from 146/1000 live births to 74/1000 in 1993; but maternal mortality still stayed around 4-5/1000. In 1993 an estimated 117,356 maternal deaths occurred out of a total of 26,057,000 births, equalling 4.5 deaths per 1000 live births. The main causes of maternal deaths are hemorrhage, anemia, abortion, toxemia, and puerperal sepsis. Only about 411 first referral units in community health centers are functioning properly. Prenatal care of mothers includes the administration of tetanus toxoid and iron-folic acid tablets. However, the prenatal coverage reached only about 50% of mothers; and the coverage was only 21.4% in Bihar, 23.8% in Nagaland, 29.3% in Rajasthan, and 29.6% in Uttar Pradesh. In these areas administrative inefficiency is widespread with nonavailability of essential drugs for malaria, infections, sepsis, dysentery, and colds. During 1992-93 the rate of hospital deliveries ranged from 6.1% in Nagaland to 88.4% in Kerala, with a national average of only 25.6%. 71% of deliveries in rural areas and 30% in urban areas were conducted by untrained assistants. Although there are 450 ANM training schools in the country, the level of training has deteriorated. The major causes of infant deaths are respiratory infections and diarrhea, responsible for 13.5% and 6.9% of mortality, respectively. Severe malnutrition and inadequate vaccination are other major causes of child deaths and morbidity.
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PMID:Maternal and child health in India: a critical review. 1229 Sep 61

The World Health Organisation recommends vitamin A supplementation (VAS) to children aged 6 months to 5 years in low-income countries, and for logistic reasons, this has been linked to routine childhood immunizations. Observational studies suggest that VAS given with diphtheria-tetanus-pertussis (DTP) vaccine may increase mortality from non-targeted diseases. We investigated the non-targeted effect of pretreatment with VAS and DTP vaccine in a murine model of experimental cerebral malaria. Our a priori hypothesis was that VAS/DTP would aggravate the infection. We found that the effect of VAS and DTP depended on pathogenesis; VAS/DTP tended to increase parasitaemia and significantly depressed cytokine responses in mice, which developed cerebral malaria, but this was not seen in mice dying of anaemia. The divergent effect according to pathogenesis may help elucidate why VAS has divergent effects on different diseases in humans. Our results support the hypothesis that immunological effects of VAS/DTP may have detrimental implications for disease outcomes.
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PMID:Simultaneous administration of vitamin A and DTP vaccine modulates the immune response in a murine cerebral malaria model. 2088 15

We present a case report of a small boy with cystic fibrosis complicated by pertussis and pneumothorax. The child had not been vaccinated against Bordetella pertussis due to the failure to thrive and was infected with the bacterium at the age of 4 months. The course of the disease was severe, with respiratory distress and spontaneous pneumothorax. The diagnosis of pertussis was serologically confirmed. A suspicion for cystic fibrosis increased after an unusually prolonged course of the disease and a history of the failure to thrive. A comprehensive diagnostic procedure revealed Pseudomonas aeruginosa respiratory infection, anemia, pancreatic insufficiency, a positive sweat test and the presence of two CFTR gene mutations. The patient, treated with comprehensive cystic fibrosis therapy, recovered from acute respiratory illness and started to thrive soon.
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PMID:[Pertussis in a 4-month-old infant with unrecognized cystic fibrosis]. 2338 10

Background: Iron deficiency may impair adaptive immunity and is common among African infants at time of vaccination. Whether iron deficiency impairs vaccine response and whether iron supplementation improves humoral vaccine response is uncertain. Methods: We performed two studies in southern coastal Kenya. In a birth cohort study, we followed infants to age 18 mo and assessed whether anemia or iron deficiency at time of vaccination predicted vaccine response to three-valent oral polio, diphtheria-tetanus-whole cell pertussis-Haemophilus influenzae type b vaccine, ten-valent pneumococcal-conjugate vaccine and measles vaccine. Primary outcomes were anti-vaccine-IgG and seroconversion at age 24 wk and 18 mo. In a randomized trial cohort follow-up, children received a micronutrient powder (MNP) with 5 mg iron daily or a MNP without iron for 4 mo starting at age 7.5 mo and received measles vaccine at 9 and 18 mo; primary outcomes were anti-measles IgG, seroconversion and avidity at age 11.5 mo and 4.5 y. Findings: In the birth cohort study, 573 infants were enrolled and 303 completed the study. Controlling for sex, birthweight, anthropometric indices and maternal antibodies, hemoglobin at time of vaccination was the strongest positive predictor of: (A) anti-diphtheria and anti-pertussis-IgG at 24 wk (p = 0.0071, p = 0.0339) and 18 mo (p = 0.0182, p = 0.0360); (B) anti-pertussis filamentous hemagglutinin-IgG at 24 wk (p = 0.0423); and (C) anti-pneumococcus 19 IgG at 18 mo (p = 0.0129). Anemia and serum transferrin receptor at time of vaccination were the strongest predictors of seroconversion against diphtheria (p = 0.0484, p = 0.0439) and pneumococcus 19 at 18 mo (p = 0.0199, p = 0.0327). In the randomized trial, 155 infants were recruited, 127 and 88 were assessed at age 11.5 mo and 4.5 y. Compared to infants that did not receive iron, those who received iron at time of vaccination had higher anti-measles-IgG (p = 0.0415), seroconversion (p = 0.0531) and IgG avidity (p = 0.0425) at 11.5 mo. Interpretation: In Kenyan infants, anemia and iron deficiency at time of vaccination predict decreased response to diphtheria, pertussis and pneumococcal vaccines. Primary response to measles vaccine may be increased by iron supplementation at time of vaccination. These findings argue that correction of iron deficiency during early infancy may improve vaccine response.
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PMID:Iron Deficiency Anemia at Time of Vaccination Predicts Decreased Vaccine Response and Iron Supplementation at Time of Vaccination Increases Humoral Vaccine Response: A Birth Cohort Study and a Randomized Trial Follow-Up Study in Kenyan Infants. 3275 50

Iron-deficiency anemia (IDA) affects many infants in low- and middle-income countries (LMICs) and may impair cognitive development and adaptive immunity. Effective interventions to improve iron intakes for infants in LMICs are urgently needed. However, absorption of oral iron fortificants and supplements is low, usually <10%, and most of the iron passes into the colon unabsorbed. In randomized controlled trials, provision of iron to infants in LMICs adversely affects their gut microbiome and increases pathogenic Escherichia coli, gut inflammation, and diarrhea. To minimize these detrimental effects of iron, it is important to provide the lowest effective dosage and maximize fractional iron absorption. Prebiotic galacto-oligosaccharides and apo-lactoferrin may prove useful in iron formulations in LMICs because they increase absorption of fortificant iron and at the same time may mitigate the adverse effects of unabsorbed iron on the infant gut. Providing well-absorbed iron early in infancy may improve immune function. Recent data from a Kenyan birth cohort suggest IDA at the time of infant vaccination impairs the response to diphtheria, pertussis, and pneumococcus vaccines. A randomized trial follow-up study reported that providing iron to Kenyan infants at the time of measles vaccination increased antimeasles immunoglobulin G (IgG), seroconversion, and IgG avidity. Because IDA is so common among infants in LMICs and because the vaccine-preventable disease burden is so high, even if IDA only modestly reduces immunogenicity of vaccines, its prevention could have major benefits.
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PMID:Global look at nutritional and functional iron deficiency in infancy. 3327 51


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