ARCHIVED - Infectious Diseases News Brief - November 9, 2012

Fall in Human Papillomavirus Prevalence Following a National Vaccination Program

Background. In April 2007, Australia became the first country to introduce a national government-funded human papillomavirus (HPV) vaccination program. The researchers evaluated the program's impact on genotype-specific HPV infection prevalence through a repeat survey of women attending clinical services.

Methods. HPV genoprevalence in women aged 18–24 years attending family planning clinics in the prevaccine period (2005–2007) was compared with prevalence among women of the same age group in the postvaccine period (2010–2011). The same recruitment and testing strategies were utilized for both sets of samples, and comparisons were adjusted for potentially confounding variables.

Results. The prevalence of vaccine HPV genotypes (6, 11, 16, and 18) was significantly lower in the postvaccine sample than in the prevaccine sample (6.7% vs 28.7%; P < .001), with lower prevalence observed in both vaccinated and unvaccinated women compared with the prevaccine population (5.0% [adjusted odds ratio, 0.11; 95% confidence interval, 0.06–0.21] and 15.8% [adjusted odds ratio, 0.42; 95% confidence interval, 0.19–0.93], respectively). A slightly lower prevalence of nonvaccine oncogenic HPV genotypes was also found in vaccinated women (30.8% vs 37.6%; adjusted odds ratio, 0.68; 95% confidence interval, 0.46–0.99).

Conclusions. Four years after the commencement of the Australian HPV vaccination program, a substantial decrease in vaccine-targeted genotypes is evident and should, in time, translate into reductions in HPV-related lesions.

Source: The Journal of Infectious Diseases, (2012) 206(11):1645-1651

Influenza and Malaria Coinfection Among Young Children in Western Kenya, 2009–2011

Background. Although children <5 years old in sub-Saharan Africa are vulnerable to both malaria and influenza, little is known about coinfection.

Methods. This retrospective, cross-sectional study in rural western Kenya examined outpatient visits and hospitalizations associated with febrile acute respiratory illness (ARI) during a 2-year period (July 2009–June 2011) in children <5 years old.

Results. Across sites, 45% (149/331) of influenza-positive patients were coinfected with malaria, whereas only 6% (149/2408) of malaria-positive patients were coinfected with influenza. Depending on age, coinfection was present in 4%–8% of outpatient visits and 1%–3% of inpatient admissions for febrile ARI. Children with influenza were less likely than those without to have malaria (risk ratio [RR], 0.57–0.76 across sites and ages), and children with malaria were less likely than those without to have influenza (RR, 0.36–0.63). Among coinfected children aged 24–59 months, hospital length of stay was 2.7 and 2.8 days longer than influenza-only-infected children at the 2 sites, and 1.3 and 3.1 days longer than those with malaria only (all P < .01).

Conclusions. Coinfection with malaria and influenza was uncommon but associated with longer hospitalization than single infections among children 24–59 months of age.

Source: The Journal of Infectious Diseases, (2012) 206(11):1674-1684