First name
Ramona
Last name
Cordero

Title

Impact of 13-Valent Pneumococcal Conjugate Vaccine on Nasopharyngeal Carriage Rates of Streptococcus pneumoniae in a Rural Community in the Dominican Republic.

Year of Publication

2021

Number of Pages

S237-S247

Date Published

2021 Sep 01

ISSN Number

1537-6613

Abstract

<p><strong>BACKGROUND: </strong>Invasive pneumococcal disease (IPD) leads to thousands of pediatric deaths annually. Pneumococcal colonization precedes IPD. In 2013, the Dominican Republic introduced the 13-valent pneumococcal conjugate vaccine (PCV13) into its routine infant immunization program, with doses at ages 2, 4, and 12 months. Prevalence of pneumococcal nasopharyngeal colonization was evaluated post-PCV13 introduction.</p>

<p><strong>METHODS: </strong>A prospective cohort study of 125 children aged 2-35 months was conducted in a rural Dominican Republic community November 2016 through July 2017. Nasopharyngeal swabs and clinical and vaccination data were collected at enrollment and 4-6 months later. Serotypes included in PCV13 were defined as vaccine-type. Colonization rates and serotype distribution were compared at baseline and follow-up, and the association between colonization and vaccination status among the entire cohort was evaluated at each time point.</p>

<p><strong>RESULTS: </strong>Of 125 children enrolled, 118 (94%) completed follow-up. Overall and vaccine-type pneumococcal colonization rates were 62% and 25%, respectively, at baseline and 60% and 28% at follow-up. Among children age-eligible for 3 doses, 50% and 51% were fully vaccinated at baseline and follow-up, respectively. At baseline assessment, children up-to-date for age for PCV13 were less likely to be colonized with vaccine-type pneumococci than children not up-to-date, and the same was found for fully vaccinated children (3 doses) compared to those not fully vaccinated (odds ratios [ORs], 0.38 [95% confidence interval {CI}, .18-.79], and 0.14 [95% CI, .04-.45], respectively). The same associations were not found at follow-up assessment.</p>

<p><strong>CONCLUSIONS: </strong>Three years post -PCV13 introduction, vaccine-type colonization rates remained high. Low vaccination coverage for 3 PCV13 doses may have contributed. The protective effect of PCV13 on vaccine-type carriage suggests an increase in PCV13 coverage could lead to substantial declines in pneumococcal vaccine-type carriage.</p>

DOI

10.1093/infdis/jiab172

Alternate Title

J Infect Dis

PMID

34469551

Title

Effectiveness of Deworming with Single-Dose Albendazole for Preschool-Aged Children in the Dominican Republic.

Year of Publication

2021

Number of Pages

2333794X211002949

Date Published

2021

ISSN Number

2333-794X

Abstract

<p><em>Background</em>. The World Health Organization recommends biannual deworming with single-dose albendazole for all children over 1 year in regions where soil-transmitted helminths (STH) are endemic. There are limited data from the Dominican Republic (DR) on the effectiveness of deworming programs.&nbsp;<em>Methods</em>. Between January and June 2019, we enrolled 63 preschool-aged children at a community clinic in the DR. Participants received albendazole at enrollment. Stool samples were collected and examined for parasites at enrollment, 2 to 4 and 12 to 16 weeks post-albendazole. Caregivers were surveyed on home hygiene practices and children's symptoms.&nbsp;<em>Findings</em>. At enrollment, 1 or more parasites were noted in 89% of samples.&nbsp;<em>Ascaris lumbricoides</em>&nbsp;(68%) was the most common species, followed by&nbsp;<em>Entamoeba histolytica</em>&nbsp;(35%) and&nbsp;<em>Giardia intestinalis</em>&nbsp;(8%). Two-to-four weeks post-albendazole, fewer than half of those with&nbsp;<em>A. lumbricoides</em>&nbsp;infections at baseline had cleared the infection. STH symptoms significantly improved between enrollment and 2 to 4 weeks. By 12 to 16 weeks after treatment,&nbsp;<em>A. lumbricoides</em>&nbsp;infections were as high as baseline.&nbsp;<em>Interpretation</em>. Although limited by size and available technology, our study contributes data on STH in the DR. Single-dose deworming with albendazole did not reduce&nbsp;<em>Ascaris lumbricoides</em>&nbsp;infections in our sample. As STH are the most common neglected tropical diseases and negatively impact children's health globally, further studies on both effective deworming programs and interventions to prevent STH are needed.</p>

DOI

10.1177/2333794X211002949

Alternate Title

Glob Pediatr Health

PMID

33796636

Title

Caregiver Strengths, Attitudes, and Concerns About Reading and Child Development in the Dominican Republic.

Year of Publication

2020

Number of Pages

2333794X20942661

Date Published

2020

ISSN Number

2333-794X

Abstract

<p><strong>Background.</strong> Parents' beliefs about and engagement in reading aloud to young children and other positive parenting practices have been associated with early childhood development (ECD) and later achievement. <strong>Aim.</strong> This exploratory study sought to assess parental attitudes and self-reported practices regarding ECD in a rural, low-income community in the Dominican Republic with many risk factors for ECD delays, including high rates of poverty, iron-deficiency anemia, and malnutrition. <strong>Methods.</strong> We used the Parent Reading Belief Inventory and open-ended questions to evaluate parental beliefs regarding reading, self-efficacy in promoting child development, current positive parenting practices, and parents' concerns about the development of their 0- to 5-year-old children in Consuelo, Dominican Republic. We explored associations between demographic factors and strength of positive parenting beliefs and practices. <strong>Results.</strong> Overall participants had positive attitudes toward reading and their own importance in promoting their children's development. Participants with at least some high school education had significantly higher Parent Reading Belief Inventory scores ( = .03) than those with less formal education. Participants reported frequently singing, talking, and playing with their children, but less frequently reading with them. Few participants had access to reading materials for young children. Parental interest in programs to support ECD was high. Parents raised concerns about their children's behavior, personal and educational attainment, and early literacy. <strong>Conclusion.</strong> Children whose parents have less formal education may benefit most from interventions to promote beliefs and practices likely to improve ECD. In this community, there is high interest in learning more about ECD.</p>

DOI

10.1177/2333794X20942661

Alternate Title

Glob Pediatr Health

PMID

32743027

Title

Evaluation of iron intake in preschool children in a setting with high anemia burden.

Year of Publication

2020

Date Published

2020 Jan 24

ISSN Number

1876-3405

Abstract

<p><strong>BACKGROUND: </strong>Iron deficiency anemia affects millions of children worldwide. Iron intake assessments can inform targeted interventions.</p>

<p><strong>METHODS: </strong>This cross-sectional study describes diet and hemoglobin levels of children 1-5&nbsp;y of age in a resource-limited setting in the Dominican Republic. The study team performed meal observations and measurements, dietary questionnaires, and point-of-care hemoglobin testing.</p>

<p><strong>RESULTS: </strong>Iron intake and bioavailability were low, with liberal estimates indicating that not more than 40% of subjects consumed the recommended daily allowance for iron. Forty of 80 children had anemia, with 23% demonstrating moderate or severe anemia.</p>

<p><strong>CONCLUSIONS: </strong>Poor observed iron intake likely contributes to the high prevalence of anemia in this population.</p>

DOI

10.1093/inthealth/ihz106

Alternate Title

Int Health

PMID

31974577

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