Importance: Access to healthy and affordable foods may play a role in reducing inflammation and in healthy pulmonary immune system development.
Objective: To investigate the association between residing in a low-income and low-food-access (LILA) neighbourhood and risk of childhood asthma. A positive association was hypothesised.
Background: Characterization of US sociodemographic disparities in air pollution respiratory effects has often been limited by lack of participant diversity, geography, exposure characterization, and small sample size.
Methods: We included 34 sites comprising 23,234 children (born 1981-2021) from the Environmental influences on Child Health Outcomes (ECHO) Program with data on asthma diagnosis until age 10 (182,008 person-years). Predicted annual exposure to fine particulate matter (1988-2021), nitrogen dioxide (2000-2016), and ground ozone (2000-2016) were assigned based on residential histories.
Background: Pneumonia is the leading infectious cause of death in children under 5 years of age in low- and middle-income countries (LMICs), with most deaths among infants. In children with pneumonia, aspiration events have been implicated in fatalities; however, physiological data on normative infant feeding patterns and validated techniques for detecting dysphagia and aspiration risk in LMICs are lacking. We aimed to establish a baseline of normative physiological and behavioural feeding-related variables in healthy, well, breastfeeding infants in Malawi to begin developing dysphagia risk scoring tools for infants with severe pneumonia.
View Article and Find Full Text PDFJ Allergy Clin Immunol
September 2025
Background: Environmental exposures and social determinants likely influence specific childhood asthma phenotypes.
Objective: We hypothesized that the Child Opportunity Index (COI) at birth, measuring multiple neighborhood opportunities, influences incidence rates (IRs) for asthma with recurrent exacerbations (ARE).
Methods: We tested for COI associations with ARE IRs in 15,877 children born between 1990 and 2018 in the ECHO (Environmental Influences on Child Health Outcomes) program.
California passed Senate Bill 277 in 2015, eliminating nonmedical exemptions to school immunization requirements. California elementary school personnel who worked with parents on meeting school immunization requirements were surveyed in 2022. Of the 122 survey respondents, half (50 %) were school principals, 11 % were registrars, 9 % were health clerks, and 7 % were nurses.
View Article and Find Full Text PDFObjective: To identify knowledge, attitudes, and beliefs (KABs) associated with COVID-19 vaccination intentions and assess the impact of vaccine-promoting messages on vaccination intentions.
Methods: Our nationally representative survey measured KABs of COVID-19 vaccination and incorporated a randomized experiment to assess the impact of different framing messages for a video encouraging vaccination intentions among unvaccinated adults in the US. Multivariable multinomial logistic regression models were fitted to investigate the relationships of KABs, trust in public health authorities (PHAs), and vaccine confidence with vaccination intentions.
A recommendation from healthcare personnel (HCP) is a strong predictor of vaccination. This study aimed to measure how HCP vaccine attitudes and recommendations changed during the COVID-19 pandemic. HCP were surveyed in January 2023 using a double opt-in network panel.
View Article and Find Full Text PDFVaccines (Basel)
November 2023
Few analyses of COVID-19 vaccine attitudes also cover routine vaccines or focus on parents. In this cross-sectional study, we surveyed US adults in September 2022, immediately following the authorization of updated bivalent COVID-19 boosters for adults but before their authorization for children. The vaccine attitudes of parents were compared to other adults.
View Article and Find Full Text PDF[This corrects the article DOI: 10.3389/fpubh.2023.
View Article and Find Full Text PDFBackground: Pulse oximeters are not routinely available in outpatient clinics in low- and middle-income countries. We derived clinical scores to identify hypoxemic child pneumonia.
Methods: This was a retrospective pooled analysis of two outpatient datasets of 3-35 month olds with World Health Organization (WHO)-defined pneumonia in Bangladesh and Malawi.
Background: Resilience in vaccination demand is ever more critical as the COVID-19 pandemic has increased our understanding of the importance of vaccines on health and well-being. Yet timid demand for COVID-19 vaccines where available and reduced uptake of routine immunizations globally further raise the urgent need to build vaccination resilience. We demonstrate the complexity of vaccination demand and resilience in a framework where relevant dimensions are intertwined, fluid, and contextual.
View Article and Find Full Text PDFIntroduction: Vaccine hesitancy is a global health threat undermining control of many vaccine-preventable diseases. Patient-level education has largely been ineffective in reducing vaccine concerns and increasing vaccine uptake. We built and evaluated a personalized vaccine risk communication website called in English, Spanish and French (Canadian) for vaccines across the lifespan.
View Article and Find Full Text PDF(1) Background: Periodic resurgences in COVID-19 due to more contagious variants highlight the need to increase coverage of booster doses. (2) Methods: Our September 2022 nationally representative survey of US adults measured COVID-19 vaccination status, intentions, attitudes, values, and confidence in information sources. (3) Findings: Although 85% of the weighted sample reported receiving at least one dose of a COVID-19 vaccine, only 63% reported being up-to-date on COVID-19 vaccines (e.
View Article and Find Full Text PDFBackground: Hypoxaemic pneumonia mortality risk in low-income and middle-income countries is high in children who have been hospitalised, but unknown among outpatient children. We sought to establish the outpatient burden, mortality risk, and prognostic accuracy of death from hypoxaemia in children with suspected pneumonia in Bangladesh.
Methods: We conducted a prospective community-based cohort study encompassing three upazila (subdistrict) health complex catchment areas in Sylhet, Bangladesh.
Background: Descriptive epidemiological data on incidence rates (IRs) of asthma with recurrent exacerbations (ARE) are sparse.
Objectives: This study hypothesized that IRs for ARE would vary by time, geography, age, and race and ethnicity, irrespective of parental asthma history.
Methods: The investigators leveraged data from 17,246 children born after 1990 enrolled in 59 US with 1 Puerto Rican cohort in the Environmental Influences on Child Health Outcomes (ECHO) consortium to estimate IRs for ARE.
Background: Increasing vaccine coverage remains the best way to control the COVID-19 pandemic. Healthcare personnel (HCP) have long been the most credible and frequently used source of vaccine information for the public, and an HCP recommendation is a strong predictor of vaccination.
Methods: A survey of HCP was conducted in September 2021 via a double opt-in network panel.
In October 2021, Emergency Use Authorization of Coronavirus Disease 2019 (COVID-19) vaccines was granted for children aged 5-11. To ensure vaccine uptake in children upon approval, California will implement a state-wide executive order mandating COVID-19 vaccination for school children following full US FDA approval. This study uses survey data collected between November 6th, 2020 and December 14th, 2020 (n = 2091) to identify how sociodemographic characteristics and attitudes towards childhood vaccines among California parents were associated with their intentions to vaccinate their child against COVID-19.
View Article and Find Full Text PDFBackground: In response to reports of thrombosis with thrombocytopenia syndrome (TTS) post-vaccination, the Johnson & Johnson (J&J) vaccine was paused and then restarted in April 2021. Our objective was to assess whether this pause adversely impacted vaccine confidence.
Methods: Two large internet-based surveys were conducted in the US among adults to measure knowledge, attitudes and perceptions of the J&J vaccine pause and rates of vaccine hesitancy among unvaccinated persons before, during and after the pause.
Background: WHO defines hypoxaemia, a low peripheral arterial oxyhaemoglobin saturation (SpO), as <90%. Although hypoxaemia is an important risk factor for mortality of children with respiratory infections, the optimal SpO threshold for defining hypoxaemia is uncertain in low-income and middle-income countries (LMICs). We derived a SpO threshold for hypoxaemia from well children in Bangladesh residing at low altitude.
View Article and Find Full Text PDFBackground: Pneumococcal conjugate vaccine (PCV) effectiveness against radiographic pneumonia in South Asia is unknown. Bangladesh introduced PCV10 in 2015 using a three dose primary series (3 + 0). We sought to measure PCV10 effectiveness for two or more vaccine doses on radiographic pneumonia among vaccine-eligible children in rural Bangladesh.
View Article and Find Full Text PDFBMJ Open Respir Res
April 2020
Introduction: To evaluate WHO chest radiograph interpretation processes during a pneumococcal vaccine effectiveness study of children aged 3-35 months with suspected pneumonia in Sylhet, Bangladesh.
Methods: Eight physicians masked to all data were standardised to WHO methodology and interpreted chest radiographs between 2015 and 2017. Each radiograph was randomly assigned to two primary readers.
Gates Open Res
April 2018
The study examines the impact of the introduction of 10-valent Pneumococcal Conjugate Vaccine (PCV10) into Bangladesh's national vaccine program. PCV10 is administered to children under 1 year-old; the scheduled ages of administration are at 6, 10, and 18 weeks. The study is conducted in ~770,000 population containing ~90,000 <5 children in Sylhet, Bangladesh and has five objectives: 1) To collect data on community-based pre-PCV incidence rates of invasive pneumococcal diseases (IPD) in 0-59 month-old children in Sylhet, Bangladesh; 2) To evaluate the effectiveness of PCV10 introduction on Vaccine Type (VT) IPD in 3-59 month-old children using an incident case-control study design.
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