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5. Factors Influencing Vaccine Receipt During a 2018 Pediatric Typhoid Conjugate Vaccine Campaign in Navi Mumbai, India.

Author

Borhade, Priyanka, LeBoa, Christopher, Jayaprasad, Niniya, Date, Kashmira, Haldar, Pradeep, Harvey, Pauline, Shimpi, Rahul, Qian An, Chenhua Zhang, Horng, Lily, Fagerli, Kirsten, Yewale, Vijay N., Daruwalla, Savita, Dharmapalan, Dhanya, Gavhane, Jeetendra, Joshi, Shrikrishna, Rai, Rajesh, Rathod, Varsha, Shetty, Keertana, and Warrier, Divyalatha S.

Published
2024
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6. The respiratory route of transmission of virulent polioviruses.

Author

John, T. Jacob, Dharmapalan, Dhanya, Steinglass, Robert, and Hirschhorn, Norbert

Subjects
*POLIOMYELITIS vaccines, *ORAL vaccines, *POLIO, *AGE distribution, *POLIOVIRUS
Abstract

Aims: The route of transmission of wild and circulating vaccine-derived polioviruses remains controversial, between respiratory and faecal-oral, and we aim to identify the most plausible one to settle the controversy. Methods: We explored available epidemiological clues and evidence in support of either route in order to arrive at an evidence-based conclusion. Results: Historically the original concept was respiratory transmission based on epidemiological features of age distribution, which was later revised to faecal-oral as the rationale for popularising the live attenuated oral polio vaccine in preference to the inactivated poliovirus vaccine. Through epidemiological logic, we find no evidence for the faecal-oral route from available studies and observations, but all available information supports the respiratory route. Conclusions: The route is respiratory, not faecal-oral. The global polio eradication initiative assumed it was faecal-oral – and its gargantuan efforts based on this assumption have failed in two ways: eradication remains pending and circulating vaccine-derived polioviruses have seeded widely. With clarity on the route of transmission the choice of vaccine is also clear – it can only be the inactivated poliovirus vaccine. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Intestinal mucosal immunity is unimportant for polio eradication: the failure of oral polio vaccination.

Author

John, T. Jacob, Dharmapalan, Dhanya, and Hirschhorn, Norbert

Subjects
*POLIO, *VACCINATION, *INTESTINES, *ORAL vaccines, *IMMUNITY
Abstract

To explore if intestinal immunity induced by infection with live viruses in the oral poliovirus vaccine (OPV) is essential, necessary or even helpful in interrupting transmission of wild poliovirus (WPV) for global polio eradication. We reviewed the biology of virus-host interactions in WPV infection and its alterations by OPV-induced immunity for direct evidence of the usefulness of intestinal immunity. We also explored indirect evidence by way of the effect of the inactivated poliovirus vaccine (IPV) on the biology and on transmission dynamics of WPV. Immunity, systemic and intestinal, induced by infection with WPV or vaccine viruses, does not prevent re-infection with WPV or vaccine viruses respectively, when exposed. Such re-infected hosts shed virus in the throat and in faeces and are sources of further transmission. Immunity protects against polio paralysis-hence reinfection always remain asymptommatic and silent. Vaccine virus-induced intestinal immunity is not necessary for polio eradication. The continued and intensive vaccination efforts using OPV under the assumption of its superiority over IPV have resulted in the well-known undesirable effects, namely vaccine associated paralytic polio and the emergence of de-attenuated circulating vaccine-derived polioviruses, in addition to the delay in completing global WPV eradication. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries

Author

Irwin, Adam, Akula, Akhila, Bamford, Alasdair, Chang, Amanda, da Silva, Andre, Whitelaw, Andrew, Dramowski, Angela, Vasudevan, Anil Kumar, Sharma, Anita, Justicia, Antonio, Chikkappa, Ashok, Slowinska-Jarzabek, Barbara, Rippberger, Bianca, Zhao, Changan, Tersigni, Chiara, Cheng, Chinglan, Harkensee, Christian, Jing, Chuamei, Zhu, Chunmei, Li, Chunyan, Tagliabue, Claudia, Epalza, Cristina, Jacqueline, Daglish, Tian, Daiyin, Jinka, Dasaratha, Gkentzi, Despoina, Dharmapalan, Dhanya, Benadof, Dona, Papadimitriou, Eleni, Iosifidis, Elias, Roilides, Emmanuel, Yarci, Erbu, Majda-Stanisławska, Ewa, Gowin, Ewelina, Chappell, Faye, Torres, Federico Martinon, Collett-White, Francis, Liu, Gang, Lu, Gen, Syrogiannopoulos, George, Pitsava, Georgia, Alvarez-Uria, Gerardo, Renk, Hana, Mahmood, Hana, Saxen, Harri, Finlayson, Heather, Green, Helen, Rabie, Helena, Kandraju, Hemasree, Zhang, Hong, Okokon, Ita, Cross, Jack, Herberg, Jethro, Li, Jianping, Zhang, Jiaosheng, Deng, Jikui, Liu, Jing, Qian, Jing, Yang, Jinhong, Sicińska, Joanna, Hübner, Johannes, Fukuoka, Kahoru, Yao, Kaihu, Cheung, Kaman, Ojeda, Karla, Kaffe, Katerina, Kreitmeyer, Katharina, Doerholt, Katja, Grimwood, Keith, Ledoare, Kirsty, Vazouras, Konstantinos, Shen, Kunling, Tang, Lanfang, Zhang, Lehai, Lin, Li, Ashkenazi-Hoffnung, Liat, Wu, Lijuan, Wang, Lijun, Teston, Lilian, Galli, Luisa, Speirs, Lynne, Tsolia, Maria, Hufnagel, Markus, Knuf, Markus, Duse, Marzia, Ding, Mingjie, Rozic, Mojca, Premru, Mueller, O'Connell, Natasha, Rieber, Nikolaus, Spyridis, Nikos, Tunga, Onkaraiah, Conejo, Pablo Rojo, McMaster, Paddy, Lumbiganon, Pagakrong, Pansa, Paola, D'Argenio, Patrizia, Moriarty, Paul, Nikolic, Petra, Wang, Ping, Paopongsawan, Pongsatorn, Cao, Qing, Deng, Qiulian, Laxminarayan, Ramanan, Kanithi, Ravishankar, Jimenez, Rodolfo, Cao, Sancheng, Singh, Sanjeev, Rees, Sarah, Praveen, Saroey, Kekomaki, Satu, Hackett, Scott, Ashkenazi, Shai, Chang, Si Min, Drysdale, Simon, Koning, Sonia, Subramanian, Sreeram, Murki, Srinivas, Vergnano, Stefania, Gandra, Sumanth, Esposito, Susanna, Anugulruengkitt, Suvaporn, Puthanakit, Thanyawee, Behrends, Uta, Papaevangelous, Vana, Jian, Victoria, Li, Wei, Zhao, Wei, Wang, Wei, Zhang, Wenshuang, Mu, Xiaoping, Dong, Xiaoyie, Jiang, Xiyuan, Chen, Xu, Wang, Yi, Zheng, Yuejie, Horikoshi, Yuho, Aboderin, Aaron, Olayinka, Adebola, Dedeic-Ljubovic, Amela, McCorry, Ann, Enimil, Anthony, Neubert, Antje, solano, antonio, Pignatari, Antonio, Poojary, Aruna, Kambaralieva, Baktygul, McCullagh, Bernadette, Carevi, Biljana, Van Herendael, Bruno, Gormley, Cairine, Carvajal, Camila, Ramírez, Carlos, Fitzgerald, David, Sabuda, Deana, Konopnicki, Deborah, Lacej, Denada, Pierard, Denis, Rios, Edgar, Marshall, Emily, Firre, Eric, van Elzakker, Erika, Shaqiri, Erjona, Darwish Elhajji, Feras, Gawrys, Gerard, Markovic, Goran, Kunsihima, Hiroyuki, Chen, Hui Hiong, Sviestina, Inese, Pristas, Irina, Hoxha, Iris, Korinteli, Irma, Mareković, Ivana, Soltani, Jafar, Labarca, Jaime, AlSalman, Jameela, Horvatic, Jasminka, Frimpong, Juliet Ampomah, Pagava, Karaman, Kei, Kasahara, Okinaka, Keiji, Iregbu, Kenneth, Ghazaryan, Lilit, Raka, Lul, Gessner-Wharton, Mallory, Aldeyab, Mamoon, Cooper, Mandelin, del Castillo, Marcelo, Hojman, Martin, Hudson, Melissa, Alshehri, Mohamed, Ling, Moi Lin, Greer, Nickie, Oduyebo, Oyinlola, Buijtels, Patricia, TEROL BARRERO, PEDRO, Zarb, Peter, Schelstraete, PEtra, Nwajiobi-Princewill, Princewill Ifeanyi Philip, Khanna, Priya, Quiros, Rodolfo, Simovic, Sanja, Thompson, Sarah, Chan, Si Min, Burokiene, Sigita, Rachina, Svetlana, Usonis, Vytautas, Cornistein, Wanda, Holemans, Xavier, Gu, Yoshiaki, Brothers, Adam, Hersh, Adam, Fernandez, Alfred, Tribble, Alison, Hurst, Amanda, Green, Andrea, Hammer, Benjamin, Lee, Betty P, Kuzmic, Brenik, Shapiro, Craig, Boge, Craig, Haslam, David, Berman, David, Naeem, Fouzia, Johnson, George, Schwenk, Hayden, Orr, Hillary, Maples, Holly, Olsen, Jared, Gerber, Jeffrey, Girotto, Jennifer, Zweiner, Jennifer, Goldman, Jennifer, Gillon, Jessica, Tansmore, Jessica, Manaloor, John, Courter, Joshua, Mongkolrattanothai, Kanokporn, Patel, Karisma, Merkel, Kathryn, Namtu, Katie, Flett, Kelly, Lee, Kelly, Nichols, Kristen, Klein, Kristin, Handy, Lori, Castagnini, Luis, Mazade, Marc, Heger, Margaret, Fernandez, Marisol, Chang, Michael, Crawford, Michelle, Nelson, Miranda, Bennett, Nicholas, Jaggi, Preeti, Hamdy, Rana, Banerjee, Ritu, Olivero, Rosemary, Patel, Sameer, Arnold, Sandra, Ogrin, Sara, Jones, Sarah, Parker, Sarah, Kubes, Sarah, Hymes, Saul, Weissman, Scott, Chan, Shannon, Henderson, Sheryl, Metjian, Talene, Hsia, Yingfen, Lee, Brian R, Versporten, Ann, Yang, Yonghong, Bielicki, Julia, Jackson, Charlotte, Newland, Jason, Goossens, Herman, Magrini, Nicola, and Sharland, Mike

Published
2019
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15. Association of Empiric Antibiotic Regimen Discordance With 30-Day Mortality in Neonatal and Pediatric Bloodstream Infection—A Global Retrospective Cohort Study

Author

Cook, Aislinn, Hsia, Yingfen, Russell, Neal, Sharland, Mike, Cheung, Kaman, Grimwood, Keith, Cross, Jack, Cotrim da Cunha, Denise, Magalhães, Gloria Regina, Renk, Hanna, Hindocha, Avni, McMaster, Paddy, Okomo, Uduak, Darboe, Saffiatou, Alvarez-Uria, Gerardo, Jinka, Dasaratha R., Murki, Srinivas, Kandraju, Hemasree, Dharmapalan, Dhanya, Esposito, Susanna, Bianchini, Sonia, Fukuoka, Kahoru, Aizawa, Yuta, Jimenez-Juarez, Rodolfo Norberto, Ojeda-Diezbarroso, Karla, Pirš, Mateja, Rožič, Mojca, Anugulruengkitt, Suvaporn, Jantarabenjakul, Watsamon, Cheng, Ching-Lan, Jian, Bai-Xiu, Spyridakis, Evangelos, Zaoutis, Theoklis, and Bielicki, Julia

Published
2021
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16. Population structure and antimicrobial resistance patterns of Salmonella Typhi and Paratyphi A amid a phased municipal vaccination campaign in Navi Mumbai, India

Author

da Silva, Kesia Esther, primary, Date, Kashmira, additional, Hirani, Nilma, additional, LeBoa, Christopher, additional, Jayaprasad, Niniya, additional, Borhade, Priyanka, additional, Warren, Joshua, additional, Shimpi, Rahul, additional, Hoffman, Seth A., additional, Mikoleit, Matthew, additional, Bhatnagar, Pankaj, additional, Cao, Yanjia, additional, Haldar, Pradeep, additional, Harvey, Pauline, additional, Zhang, Chenhua, additional, Daruwalla, Savita, additional, Dharmapalan, Dhanya, additional, Gavhane, Jeetendra, additional, Joshi, Shrikrishna, additional, Rai, Rajesh, additional, Rathod, Varsha, additional, Shetty, Keertana, additional, Warrier, Divyalatha S., additional, Yadav, Shalini, additional, Chakraborty, Debjit, additional, Bahl, Sunil, additional, Katkar, Arun, additional, Kunwar, Abhishek, additional, Yewale, Vijay, additional, Dutta, Shanta, additional, Luby, Stephen P., additional, and Andrews, Jason R., additional

Published
2023
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18. Fighting the hidden pandemic of antimicrobial resistance in paediatrics: recommendations from the International Pediatric Association

Author

Pana, Zoi Dorothea, primary, El-Shabrawi, Mortada, additional, Sultan, Muhammad Ashraf, additional, Murray, Thomas, additional, Alam, Anggraini, additional, Yewale, Vijay, additional, Dharmapalan, Dhanya, additional, Klein, Jonanthan D, additional, Haddad, Joseph, additional, Thacker, Naveen, additional, Pulungan, Aman B, additional, and Hadjipanayis, Adamos, additional

Published
2023
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26. Programmatic Effectiveness of a Pediatric Typhoid Conjugate Vaccine Campaign in Navi Mumbai, India.

Author

Hoffman, Seth A, LeBoa, Christopher, Date, Kashmira, Haldar, Pradeep, Harvey, Pauline, Shimpi, Rahul, An, Qian, Zhang, Chenhua, Jayaprasad, Niniya, Horng, Lily, Fagerli, Kirsten, Borhade, Priyanka, Daruwalla, Savita, Dharmapalan, Dhanya, Gavhane, Jeetendra, Joshi, Shrikrishna, Rai, Rajesh, Rathod, Varsha, Shetty, Keertana, and Warrier, Divyalatha S

Subjects
BLOOD, PUBLIC health surveillance, HOSPITALS, CLUSTER sampling, IMMUNIZATION, EVALUATION of human services programs, CELL culture, CONFIDENCE intervals, PEDIATRICS, WORLD health, TYPHOID fever, MEDICAL protocols, GOVERNMENT programs, DESCRIPTIVE statistics, RESEARCH funding, TYPHOID vaccines, STATISTICAL sampling, LOGISTIC regression analysis, HEALTH promotion, LONGITUDINAL method
Abstract

Background The World Health Organization recommends vaccines for prevention and control of typhoid fever, especially where antimicrobial-resistant typhoid circulates. In 2018, the Navi Mumbai Municipal Corporation (NMMC) implemented a typhoid conjugate vaccine (TCV) campaign. The campaign targeted all children aged 9 months through 14 years within NMMC boundaries (approximately 320 000 children) over 2 vaccination phases. The phase 1 campaign occurred from 14 July 2018 through 25 August 2018 (71% coverage, approximately 113 420 children). We evaluated the phase 1 campaign's programmatic effectiveness in reducing typhoid cases at the community level. Methods We established prospective, blood culture–based surveillance at 6 hospitals in Navi Mumbai and offered blood cultures to children who presented with fever ≥3 days. We used a cluster-randomized (by administrative boundary) test-negative design to estimate the effectiveness of the vaccination campaign on pediatric typhoid cases. We matched test-positive, culture-confirmed typhoid cases with up to 3 test-negative, culture-negative controls by age and date of blood culture and assessed community vaccine campaign phase as an exposure using conditional logistic regression. Results Between 1 September 2018 and 31 March 2021, we identified 81 typhoid cases and matched these with 238 controls. Cases were 0.44 times as likely to live in vaccine campaign communities (programmatic effectiveness, 56%; 95% confidence interval [CI], 25% to 74%; P =.002). Cases aged ≥5 years were 0.37 times as likely (95% CI,.19 to.70; P =.002) and cases during the first year of surveillance were 0.30 times as likely (95% CI,.14 to.64; P =.002) to live in vaccine campaign communities. Conclusions Our findings support the use of TCV mass vaccination campaigns as effective population-based tools to combat typhoid fever. [ABSTRACT FROM AUTHOR]

Published
2023
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32. Dermatology

Author

Thomas, Jayakar, primary, Kumar, Parimalam, additional, Dharmapalan, Dhanya, additional, and Kumar, D, additional

Published
2014
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33. Radiology

Author

Chavhan, Govind, primary, Dharmapalan, Dhanya, additional, and Hattangadi, Nameet, additional

Published
2014
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34. Immunization

Author

Dharmapalan, Dhanya, primary, Agrawal, Rohit, additional, Shah, Himani, additional, and Mehta, Pravin, additional

Published
2014
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36. Surgery

Author

Parikh, Ketan, primary and Dharmapalan, Dhanya, additional

Published
2014
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37. Newborn

Author

Jain, Naveen, primary, Thakre, Rhishikesh, additional, and Dharmapalan, Dhanya, additional

Published
2014
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38. Nutrition

Author

Shah, Dheeraj, primary, Dharmapalan, Dhanya, additional, and Kaushik, Jaya, additional

Published
2014
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39. Poisoning

Author

Ramachandran, P, primary, Dharmapalan, Dhanya, additional, and Rajakumar, PS, additional

Published
2014
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46. Preoperative successful thrombectomy and thrombolysis of acute extensive splanchnic venous system and TIPSS thrombosis in a child with Budd‐Chiari syndrome—Creating a window to enable living donor liver transplantation

Author

Sonavane, Amey, primary, Raut, Vikram, additional, Marar, Shaji, additional, Sawant, Ambreen, additional, Shah, Ketul, additional, Raj, Amruth, additional, Thorat, Ashok, additional, Chaksota, Harshit, additional, Bagde, Abhijit, additional, Verma, Rahul, additional, Dharmapalan, Dhanya, additional, Vasanth, Suresh, additional, Nagral, Aabha, additional, Mirza, Darius, additional, and Yewale, Vijay, additional

Published
2020
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48. Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries

Author

Hsia, Yingfen, Lee, Brian R, Versporten, Ann, Yang, Yonghong, Bielicki, Julia, Jackson, Charlotte, Newland, Jason, Goossens, Herman, Magrini, Nicola, Sharland, Mike, Irwin, Adam, Akula, Akhila, Bamford, Alasdair, Chang, Amanda, da Silva, Andre, Whitelaw, Andrew, Dramowski, Angela, Vasudevan, Anil Kumar, Sharma, Anita, Justicia, Antonio, Chikkappa, Ashok, Slowinska-Jarzabek, Barbara, Rippberger, Bianca, Zhao, Changan, Tersigni, Chiara, Cheng, Chinglan, Harkensee, Christian, Jing, Chuamei, Zhu, Chunmei, Li, Chunyan, Tagliabue, Claudia, Epalza, Cristina, Jacqueline, Daglish, Tian, Daiyin, Jinka, Dasaratha, Gkentzi, Despoina, Dharmapalan, Dhanya, Benadof, Dona, Papadimitriou, Eleni, Iosifidis, Elias, Roilides, Emmanuel, Yarci, Erbu, Majda-Stanisławska, Ewa, Gowin, Ewelina, Chappell, Faye, Torres, Federico Martinon, Collett-White, Francis, Liu, Gang, Lu, Gen, Syrogiannopoulos, George, Pitsava, Georgia, Alvarez-Uria, Gerardo, Renk, Hana, Mahmood, Hana, Saxen, Harri, Finlayson, Heather, Green, Helen, Rabie, Helena, Kandraju, Hemasree, Zhang, Hong, Okokon, Ita, Cross, Jack, Herberg, Jethro, Li, Jianping, Zhang, Jiaosheng, Deng, Jikui, Liu, Jing, Qian, Jing, Yang, Jinhong, Sicińska, Joanna, Hübner, Johannes, Fukuoka, Kahoru, Yao, Kaihu, Cheung, Kaman, Ojeda, Karla, Kaffe, Katerina, Kreitmeyer, Katharina, Doerholt, Katja, Grimwood, Keith, Ledoare, Kirsty, Vazouras, Konstantinos, Shen, Kunling, Tang, Lanfang, Zhang, Lehai, Lin, Li, Ashkenazi-Hoffnung, Liat, Wu, Lijuan, Wang, Lijun, Teston, Lilian, Galli, Luisa, Speirs, Lynne, Tsolia, Maria, Hufnagel, Markus, Knuf, Markus, Duse, Marzia, Ding, Mingjie, Rozic, Mojca, Premru, Mueller, O'Connell, Natasha, Rieber, Nikolaus, Spyridis, Nikos, Tunga, Onkaraiah, Conejo, Pablo Rojo, McMaster, Paddy, Lumbiganon, Pagakrong, Pansa, Paola, D'Argenio, Patrizia, Moriarty, Paul, Nikolic, Petra, Wang, Ping, Paopongsawan, Pongsatorn, Cao, Qing, Deng, Qiulian, Laxminarayan, Ramanan, Kanithi, Ravishankar, Jimenez, Rodolfo, Cao, Sancheng, Singh, Sanjeev, Rees, Sarah, Praveen, Saroey, Kekomaki, Satu, Hackett, Scott, Ashkenazi, Shai, Chang, Si Min, Drysdale, Simon, Koning, Sonia, Subramanian, Sreeram, Murki, Srinivas, Vergnano, Stefania, Gandra, Sumanth, Esposito, Susanna, Anugulruengkitt, Suvaporn, Puthanakit, Thanyawee, Behrends, Uta, Papaevangelous, Vana, Jian, Victoria, Li, Wei, Zhao, Wei, Wang, Wei, Zhang, Wenshuang, Mu, Xiaoping, Dong, Xiaoyie, Jiang, Xiyuan, Chen, Xu, Wang, Yi, Zheng, Yuejie, Horikoshi, Yuho, Aboderin, Aaron, Olayinka, Adebola, Dedeic-Ljubovic, Amela, McCorry, Ann, Enimil, Anthony, Neubert, Antje, solano, antonio, Pignatari, Antonio, Poojary, Aruna, Kambaralieva, Baktygul, McCullagh, Bernadette, Carevi, Biljana, Van Herendael, Bruno, Gormley, Cairine, Carvajal, Camila, Ramírez, Carlos, Fitzgerald, David, Sabuda, Deana, Konopnicki, Deborah, Lacej, Denada, Pierard, Denis, Rios, Edgar, Marshall, Emily, Firre, Eric, van Elzakker, Erika, Shaqiri, Erjona, Darwish Elhajji, Feras, Gawrys, Gerard, Markovic, Goran, Kunsihima, Hiroyuki, Chen, Hui Hiong, Sviestina, Inese, Pristas, Irina, Hoxha, Iris, Korinteli, Irma, Mareković, Ivana, Soltani, Jafar, Labarca, Jaime, AlSalman, Jameela, Horvatic, Jasminka, Frimpong, Juliet Ampomah, Pagava, Karaman, Kei, Kasahara, Okinaka, Keiji, Iregbu, Kenneth, Ghazaryan, Lilit, Raka, Lul, Gessner-Wharton, Mallory, Aldeyab, Mamoon, Cooper, Mandelin, del Castillo, Marcelo, Hojman, Martin, Hudson, Melissa, Alshehri, Mohamed, Ling, Moi Lin, Greer, Nickie, Oduyebo, Oyinlola, Buijtels, Patricia, TEROL BARRERO, PEDRO, Zarb, Peter, Schelstraete, Petra, Nwajiobi-Princewill, Princewill Ifeanyi Philip, Khanna, Priya, Quiros, Rodolfo, Simovic, Sanja, Thompson, Sarah, Chan, Si Min, Burokiene, Sigita, Rachina, Svetlana, Usonis, Vytautas, Cornistein, Wanda, Holemans, Xavier, Gu, Yoshiaki, Brothers, Adam, Hersh, Adam, Fernandez, Alfred, Tribble, Alison, Hurst, Amanda, Green, Andrea, Hammer, Benjamin, Lee, Betty P, Kuzmic, Brenik, Shapiro, Craig, Boge, Craig, Haslam, David, Berman, David, Naeem, Fouzia, Johnson, George, Schwenk, Hayden, Orr, Hillary, Maples, Holly, Olsen, Jared, Gerber, Jeffrey, Girotto, Jennifer, Zweiner, Jennifer, Goldman, Jennifer, Gillon, Jessica, Tansmore, Jessica, Manaloor, John, Courter, Joshua, Mongkolrattanothai, Kanokporn, Patel, Karisma, Merkel, Kathryn, Namtu, Katie, Flett, Kelly, Lee, Kelly, Nichols, Kristen, Klein, Kristin, Handy, Lori, Castagnini, Luis, Mazade, Marc, Heger, Margaret, Fernandez, Marisol, Chang, Michael, Crawford, Michelle, Nelson, Miranda, Bennett, Nicholas, Jaggi, Preeti, Hamdy, Rana, Banerjee, Ritu, Olivero, Rosemary, Patel, Sameer, Arnold, Sandra, Ogrin, Sara, Jones, Sarah, Parker, Sarah, Kubes, Sarah, Hymes, Saul, Weissman, Scott, Chan, Shannon, Henderson, Sheryl, Metjian, Talene, GARPEC and Global-PPS networks, on behalf of the, GARPEC Network, Global-PPS Network, Children's Hospital, HUS Children and Adolescents, and Clinicum

Subjects
medicine.medical_specialty, Adolescent, medicine.drug_class, 030231 tropical medicine, Antibiotics, MEDLINE, Psychological intervention, CHILDREN, World Health Organization, Pediatrics, Essential medicines, 03 medical and health sciences, Antimicrobial Stewardship, 0302 clinical medicine, Antibiotic resistance, POINT PREVALENCE SURVEY, SURVEILLANCE, Medicine and Health Sciences, Medicine, Antimicrobial stewardship, Humans, 030212 general & internal medicine, Medical prescription, Child, Neonatal sepsis, business.industry, lcsh:Public aspects of medicine, STEWARDSHIP, Infant, Newborn, Infant, lcsh:RA1-1270, General Medicine, medicine.disease, 3142 Public health care science, environmental and occupational health, Drug Utilization, 3. Good health, Anti-Bacterial Agents, QUALITY INDICATORS, Family medicine, Child, Preschool, Health Care Surveys, Human medicine, business, Pharmacy Service, Hospital
Abstract

Summary: Background: Improving the quality of hospital antibiotic use is a major goal of WHO's global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally. We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions. Methods: 1-day point prevalence survey antibiotic prescription data were combined from two independent global networks: the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children and the Global Point Prevalence Survey on Antimicrobial Consumption and Resistance networks. We included hospital inpatients aged younger than 19 years receiving at least one antibiotic on the day of the survey. The WHO AWaRe classification was used to describe overall antibiotic use as assessed by the variation between use of Access, Watch, and Reserve antibiotics, for neonates and children and for the commonest clinical indications. Findings: Of the 23 572 patients included from 56 countries, 18 305 were children (77·7%) and 5267 were neonates (22·3%). Access antibiotic use in children ranged from 7·8% (China) to 61·2% (Slovenia) of all antibiotic prescriptions. The use of Watch antibiotics in children was highest in Iran (77·3%) and lowest in Finland (23·0%). In neonates, Access antibiotic use was highest in Singapore (100·0%) and lowest in China (24·2%). Reserve antibiotic use was low in all countries. Major differences in clinical syndrome-specific patterns of AWaRe antibiotic use in lower respiratory tract infection and neonatal sepsis were observed between WHO regions and countries. Interpretation: There is substantial global variation in the proportion of AWaRe antibiotics used in hospitalised neonates and children. The AWaRe classification could potentially be used as a simple traffic light metric of appropriate antibiotic use. Future efforts should focus on developing and evaluating paediatric antibiotic stewardship programmes on the basis of the AWaRe index. Funding: GARPEC was funded by the PENTA Foundation. GARPEC-China data collection was funded by the Sanming Project of Medicine in Shenzhen (SZSM2015120330). bioMérieux provided unrestricted funding support for the Global-PPS.

Published
2019

49. Partha's Investigations and Interpretations in Pediatric and Adolescent Practice

Author

Parthasarathy, A, Gupta, Alok, Borker, Anupama S, Dharmapalan, Dhanya, R, Remesh Kumar, Parthasarathy, A, Gupta, Alok, Borker, Anupama S, Dharmapalan, Dhanya, and R, Remesh Kumar

Abstract

This book focuses on Partha's investigations and interpretations in pediatric and adolescent practice. It covers basic and essential investigations which have come out of the experts'own rich experience over decades will be of great use to the practicing pediatricians in managing common and uncommon selected cases with the right diagnosis and the right treatment in their day-to-day practice. This book consists of 27 chapters, which include newborn, growth and development, nutrition, immunization, infectious disease, neurology, cardiology, pulmonology, gastroenterology and hepatology, nephrology, urology, hematology, oncology, allergy, rheumatology, endocrinology, genetics, poisoning, intensive care, adolescent medicine, dermatology, ophthalmology, investigations and interpretations in pediatric and adolescent practice, pediatric surgery, neurodevelopmental disorder, learning disability, and world health organization standard investigation. It is with this objective in mind, conceived the idea of coming out with ‘Partha's series of books in Pediatric and Adolescent Practice'viz. Case Scenarios, Frequently Asked Questions, and Management Algorithms in Pediatric and Adolescent Practice. This book is useful for not only amongst the practicing pediatricians, but also amongst postgraduate students and teaching faculties as well.

Published
2019

50. Point prevalence surveys of antimicrobial use among eight neonatal intensive care units in India: 2016

Author

Hsia, Yingfen, Gandra, Sumanth, Alvarez-Uria, Gerardo, Murki, Srinivas, Singh, Sanjeev K., Kanithi, Ravishankar, Jinka, Dasaratha R., Chikkappa, Ashok K., Subramanian, Sreeram, Sharma, Anita, Dharmapalan, Dhanya, Kandraju, Hemasree, Vasudevan , Anil Kumar, Tunga, Onkaraiah, Akula, Akhila, Sharland, Mike, and Laxminarayan, Ramanan

Subjects
0301 basic medicine, Microbiology (medical), Male, NICU, medicine.medical_specialty, 030106 microbiology, Prevalence, India, Meropenem, Drug Prescriptions, Article, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, Intensive care, Intensive Care Units, Neonatal, medicine, Humans, lcsh:RC109-216, 030212 general & internal medicine, Practice Patterns, Physicians', Point prevalence survey, Neonatal sepsis, business.industry, Infant, Newborn, Neonates, Drug Resistance, Microbial, General Medicine, biochemical phenomena, metabolism, and nutrition, medicine.disease, Antimicrobial, Anti-Bacterial Agents, Antimicrobial use, Infectious Diseases, Cross-Sectional Studies, Amikacin, Emergency medicine, Practice Guidelines as Topic, Electronic data, Female, Guideline Adherence, Neonatal Sepsis, business, medicine.drug
Abstract

Highlights • Approximately half (51.6%) of NICU babies received at least one antimicrobial agent. • Amikacin was the most commonly prescribed antimicrobial agent followed by meropenem. • The recommended first-line antimicrobial agents, ampicillin and gentamicin were rarely prescribed for community acquired neonatal sepsis., Background Information about antimicrobial use is scarce and poorly understood among neonatal intensive care units (NICUs) in India. In this study, we describe antimicrobial use in eight NICUs using four point prevalence surveys (PPSs). Methods As part of the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children (GARPEC) study, one-day, cross-sectional, hospital-based PPSs were conducted four times between 1 February 2016 and 28 February 2017 in eight NICUs. Using a standardized web-based electronic data entry form, detailed data were collected for babies on antimicrobials. Results A total of 403 babies were admitted to NICUs across all survey days, and 208 (51.6%) were prescribed one or more antimicrobials. Among 208 babies, 155 (74.5%) were prescribed antimicrobials for treatment of an active infection. Among 155 babies with an active infection, treatment was empiric in 109 (70.3%). Sepsis (108, 49.1%) was the most common reason for prescribing antimicrobials. Amikacin (17%) followed by meropenem (12%) were the two most commonly prescribed antimicrobials. For community-acquired sepsis, piperacillin-tazobactam (17.5%) was the most commonly prescribed drug. A combination of ampicillin and gentamicin was prescribed in only two babies (5%). Conclusions The recommended first-line antimicrobial agents, ampicillin and gentamicin, were rarely prescribed in Indian NICUs for community acquired neonatal sepsis.

Published
2018
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