Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective

Background

Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events.

Methodology/Principal Findings

Electronic databases and grey literature were searched and records were screened against eligibility criteria. Data extraction and risk of bias assessments were performed in duplicate. Results were synthesised narratively and meta-analyses were conducted where feasible. Heterogeneity was assessed using I² and publication bias was assessed using Begg''s funnel plot and Egger''s regression test. Many of the 209 eligible studies included an unclear or high risk of bias. Meta-analyses showed a significant effect of preventing influenza-like illness (odds ratio [OR] = 0.23; 95% confidence interval [CI] = 0.16–0.34; p<0.001) and laboratory confirmed influenza infection (OR = 0.15; 95% CI = 0.03–0.63; p = 0.01) through vaccinating immunocompromised patie nts compared to placebo or unvaccinated controls. We found no difference in the odds of influenza-like illness compared to vaccinated immunocompetent controls. The pooled odds of seroconversion were lower in vaccinated patients compared to immunocompetent controls for seasonal influenza A(H1N1), A(H3N2) and B. A similar trend was identified for seroprotection. Meta-analyses of seroconversion showed higher odds in vaccinated patients compared to placebo or unvaccinated controls, although this reached significance for influenza B only. Publication bias was not detected and narrative synthesis supported our findings. No consistent evidence of safety concerns was identified.

Conclusions/Significance

Infection prevention and control strategies should recommend vaccinating immunocompromised patients. Potential for bias and confounding and the presence of heterogeneity mean the evidence reviewed is generally weak, although the directions of effects are consistent. Areas for further research are identified.     

Factors affecting ever-married men's contraceptive knowledge and use in Nigeria

African men play important roles in the decisions about family life, including fertility and family planning. However, fertility and family planning research and programmes have ignored their roles in the past, focusing only on women's behaviours. Since the 1994 International Conference on Population and Development (ICPD), interest in men's involvement in reproductive health has increased. Unfortunately, data on their knowledge and use of contraception are generally scanty. This paper examines knowledge and use of contraception among ever-married men in Nigeria. A total of 1451 ever-married men aged 18-55 were interviewed in Imo and Ondo States, Nigeria. The findings reveal that men's level of contraceptive knowledge is high in the study areas. About 90% knew at least one method of family planning. Furthermore, the level of contraceptive use among married men is such that men could participate in family planning activities if there were adequate programmes to involve them. Men in the sample areas were found not only to support their spouses' use of contraceptives, but were actually using condoms to delay or prevent pregnancy. Age, education, place of residence, number of living children and being counselled for family planning were identified as key factors determining contraceptive knowledge and use among married men in the study areas. To ensure increased participation of men in family planning, programmes must be designed to educate them on the need for family size limitation and involve them in service delivery, even if only to their male counterparts.     

Transformation associated with catecholase in Dioscorea alata during storage

The Michaelis constant of catecholase in 3 cultivars of Dioscorea alata was determined. Oxidative browning was related to the activity of the enzyme in the yams. Inhibition by cysteine was competitive, while 2-mercaptoethanol caused an uncompetitive type of inhibition. On DEAE column chromatography a minor peak preceded the major peak in the fresh yam while a minor peak was eluted after the major peak in the stored yam.     

Influence of proteinuria on vascular disease,blood pressure,and lipoproteins in insulin dependent diabetes mellitus.

Patients with insulin dependent diabetes mellitus who develop proteinuria may die prematurely, whereas those who do not develop this complication have a comparatively normal life span. The excess mortality in diabetics with proteinuria is from cardiovascular as well as renal disease, but the reason is unclear. Risk factors for vascular disease were therefore assessed in 22 insulin dependent diabetics with proteinuria, but not renal failure, who were matched for sex, age, duration of diabetes, and glycated haemoglobin (HbA1) values with a similar number who had normal urinary albumin excretion rates. Macrovascular disease (ischaemic heart disease and peripheral vascular disease) was present in 10 patients with proteinuria but in only three with normal albumin excretion rates, and proliferative retinopathy was detected in 11 and four patients in the two groups. There was no significant excess of smokers in the group with proteinuria. Blood pressure was, however, higher in the patients with proteinuria--mean systolic pressure 161 (SD 18) mm Hg compared with 135 (19) mm Hg (95% confidence interval of difference between means 15 to 38 mm Hg); mean diastolic pressure 90 (SD 12) mm Hg compared with 79 (15) mm Hg (confidence interval 3 to 19 mm Hg). The concentration of serum high density lipoprotein (HDL) cholesterol isolated by precipitation was lower in the patients with proteinuria (confidence interval 0.02 to 0.41 mmol/l). Their concentration of HDL2 cholesterol isolated by ultracentrifugation was also decreased (confidence interval 0.02 to 0.40 mmol/l), whereas HDL3 cholesterol tended to be increased (confidence interval -0.01 to 0.23 mmol/l). There was also a trend for serum cholesterol concentrations to be higher in the presence of proteinuria (confidence interval -0.39 to 1.20 mmol/l). The aggregation of risk factors for atherosclerosis in insulin dependent diabetes mellitus complicated by proteinuria helps to explain the increased prevalence of ischaemic heart disease and peripheral vascular disease reported in these patients. Early renal disease in insulin dependent diabetes may have an important role in hypertension and altered lipoprotein metabolism.     

Health Risk Assessment of Exposure to Metals in a Nigerian Water Supply

This article reports the health risk associated with chronic intake of metals in the municipal water supplies of Eleyele and neighboring towns in the Ibadan metropolitan area of Nigeria. A total of 42 composite samples, consisting of treated water from the water treatment facility and residential areas receiving personal-use water (i.e., tap water) directly from the facility, as well as raw water from the treatment facility's water supply dam were sampled twice every month for 7 months. Concentrations of the metals were determined by atomic absorption spectrophotometry. Among the metals studied, Cd, Co, Cr, and Pb were detected at concentrations higher than maximum regulatory limits. Cd, Co, Cr, and Pb concentrations in treated water at the treatment facility ranged from 0.08–0.10, 0.14–0.16, 0.04–0.22 and 0.07–0.36 mg L^?1, respectively, while personal-use water ranged from 0.08–0.11, 0.15–0.29, 0.02–0.29, and 0.12–0.65 mg L¹, respectively. Likewise, concentrations of the metals at the dam ranged from 0.06–0.08, 0.17–0.20, 0.13–0.37, and 0.03–0.15 mg L¹, respectively. It is estimated that exposure to the metals in the water supply results in oncological and non-oncological systemic health risks higher than is generally acceptable for drinking water.     

Characterization and antioxidant ability of potential probiotic lactic acid bacteria in ogi liquor and lemon juice-ogi liquor

Purpose

Ogi is an indigenous edible fermented cereal slurry but the steep liquor is usually wasted or administered as therapeutic to suppress certain illnesses. The combination of lemon juice and ogi steep liquor (OSL) is known to possess bioactive metabolites.

Method

This study evaluated potential probiotic lactic acid bacteria (LAB) in different OSL (Zea mays, Sorghum bicolor, and Pennisetum glaucum L.) and lemon juice-ogi steep liquor (LJOSL) based on low pH, bile and lysozyme tolerances, hydrophobicity and auto-aggregation, antibiotic, cholesterol removal, exopolysaccharide production, β-galactosidase, and antimicrobial and hemolytic activities using standard methods. Presumptive LAB were sequenced and assayed for radical scavenging using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and lipid peroxidation inhibitory (LPI) tests.

Results

Presumptive LAB counts were higher in maize OSL (0 h:5.09 log CFU/ml) and combined cereal OSL (24–48 h:7.65 and 7.72 log CFU/ml) but decreased in all steep liquors at 72 h, except in millet OSL (7.72 log CFU/ml). A total of 120 LAB isolates were randomly selected. Based on pH and bile tolerances, 14 isolates were comparable to reference strains. All these isolates demonstrated probiotics properties except for three that did not show γ-hemolysis. Sequenced LAB isolates were identified as Lactobacillus plantarum, Lactobacillus fermentum, Pediococcus pentosaceus, and Weissella cibara. DPPH activities of LAB gradually increased during fermentation with the highest activity of DPPH (58.77%) and LPI (57.94%) activity in L. plantarum. Strong correlations were found between DPPH and LPI in all the selected isolates.

Conclusion

The antioxidant property of probiotic LAB in OSL and LJOSL could contribute to its therapeutic nature.

     

Can it be all more simple? Manufacturing aflatoxin biocontrol products using dry spores of atoxigenic isolates of Aspergillus flavus as active ingredients

Aflatoxin contamination of staple crops, commonly occurring in warm areas, negatively impacts human and animal health, and hampers trade and economic development. The fungus Aspergillus flavus is the major aflatoxin producer. However, not all A. flavus genotypes produce aflatoxins. Effective aflatoxin control is achieved using biocontrol products containing spores of atoxigenic A. flavus. In Africa, various biocontrol products under the tradename Aflasafe are available. Private and public sector licensees manufacture Aflasafe using spores freshly produced in laboratories adjacent to their factories. BAMTAARE, the licensee in Senegal, had difficulties to obtain laboratory equipment during its first year of production. To overcome this, a process was developed in Ibadan, Nigeria, for producing high-quality dry spores. Viability and stability of the dry spores were tested and conformed to set standards. In 2019, BAMTAARE manufactured Aflasafe SN01 using dry spores produced in Ibadan and sent via courier and 19 000 ha of groundnut and maize in Senegal and The Gambia were treated. Biocontrol manufactured with dry spores was as effective as biocontrol manufactured with freshly produced spores. Treated crops contained safe and significantly (P < 0.05) less aflatoxin than untreated crops. The dry spore innovation will make biocontrol manufacturing cost-efficient in several African countries.