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1.  Pneumococcal polysaccharide vaccine at 12 months of age produces functional immune responses 
Infections with Streptococcus pneumoniae (pneumococcus) are a cause of significant child mortality in the world. Pneumococcal glycoconjugate vaccines are expensive and provide limited serotype coverage. The 23-valent pneumococcal polysaccharide vaccine (Pneumovax®) may provide wider serotype coverage but is reported to be weakly immunogenic in children under 2 years of age. We have previously reported that Pneumovax® administered to healthy 12 month old Fijian infants elicits significant serotype-specific IgG responses. However, the functional capacity of these responses in 12 month old infants is not known.
To assess the functional, serotype-specific immune response of 12 month old infants following immunization with Pneumovax®.
Functional responses of 12 month old infants were assessed using the opsonophagocytic and antibody avidity assay against 8 serotypes and 23 serotypes, respectively.
71% of infants produced strong opsonophagocytic activity against 4 of 8 serotypes and 30% produced high avidity serotype-specific IgG antibodies to 10 of 23 serotypes at 2 weeks post- Pneumovax®. Responses were protective for most serotypes that cause disease in western countries while responses to most of the epidemiologically relevant serotypes for developing countries were low.
This is the first comprehensive study evaluating the functional antibody response to Pneumovax® in 12-month old infants. Pneumovax® induced functional antibody responses to several serotypes causing disease in Western countries but induced poorer responses to serotypes that are responsible for the majority of disease in developing countries. Pneumovax® may be of benefit in some populations but further studies are required before this can be recommended in developing countries.
PMCID: PMC3318993  PMID: 22305678
pneumococcal polysaccharide vaccine; antibody; opsonophagocytosis; avidity; function; serotype; Pneumovax®; 23vPPV
2.  Health seeking behavior for cervical cancer in Ethiopia: a qualitative study 
Although cervical cancer is a leading cause of cancer related morbidity and mortality among women in Ethiopia, there is lack of information regarding the perception of the community about the disease.
Focus group discussions were conducted with men, women, and community leaders in the rural settings of Jimma Zone southwest Ethiopia and in the capital city, Addis Ababa. Data were captured using voice recorders, and field notes were transcribed verbatim from the local languages into English language. Key categories and thematic frameworks were identified using the health belief model as a framework, and presented in narratives using the respondents own words as an illustration.
Participants had very low awareness of cervical cancer. However, once the symptoms were explained, participants had a high perception of the severity of the disease. The etiology of cervical cancer was thought to be due to breaching social taboos or undertaking unacceptable behaviors. As a result, the perceived benefits of modern treatment were very low, and various barriers to seeking any type of treatment were identified, including limited awareness and access to appropriate health services. Women with cervical cancer were excluded from society and received poor emotional support. Moreover, the aforementioned factors all caused delays in seeking any health care. Traditional remedies were the most preferred treatment option for early stage of the disease. However, as most cases presented late, treatment options were ineffective, resulting in an iterative pattern of health seeking behavior and alternated between traditional remedies and modern treatment methods.
Lack of awareness and health seeking behavior for cervical cancer was common due to misconceptions about the cause of the disease. Profound social consequences and exclusion were common. Access to services for diagnosis and treatment were poor for a variety of psycho-social, and health system reasons. Prior to the introduction or scale up of cervical cancer prevention programs, socio-cultural barriers and health service related factors that influence health seeking behavior must be addressed through appropriate community level behavior change communications.
PMCID: PMC3544623  PMID: 23273140
Cervical cancer; Health seeking behavior; Ethiopia
3.  Effect of Pneumococcal Vaccination on Nasopharyngeal Carriage of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus in Fijian Children 
Journal of Clinical Microbiology  2012;50(3):1034-1038.
The 7-valent pneumococcal conjugate vaccine (PCV7) reduces carriage of vaccine type Streptococcus pneumoniae but leads to replacement by nonvaccine serotypes and may affect carriage of other respiratory pathogens. We investigated nasopharyngeal carriage of S. pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus in Fijian infants participating in a pneumococcal vaccine trial using quantitative PCR. Vaccination did not affect pathogen carriage rates or densities, whereas significant differences between the two major ethnic groups were observed.
PMCID: PMC3295152  PMID: 22170924
4.  Infants aged 12 months can mount adequate serotype-specific IgG responses to pneumococcal polysaccharide vaccine 
Capsule Summary
This is the first study examining serotype-specific IgG responses following immunization with the polysaccharide vaccine Pneumovax® in infants aged 12 months in the absence of prior pneumococcal conjugate vaccine priming.
PMCID: PMC2917627  PMID: 20584544
Pneumococcal; immunogenicity; antibody; antigen specific immune response; children; infants
5.  Molecular Epidemiology of Streptococcus pneumoniae Serogroup 6 Isolates from Fijian Children, Including Newly Identified Serotypes 6C and 6D▿  
Journal of Clinical Microbiology  2010;48(11):4298-4300.
Multilocus sequence typing (MLST) was applied to all unique serotype 6C and 6D isolates and a random selection of serotype 6B and 6A isolates from nasopharyngeal swabs from Fijian children enrolled in a recent vaccine trial. The results suggest that Fijian serotype 6D has arisen independently from both serotypes 6A/C and 6B.
PMCID: PMC3020807  PMID: 20810769
6.  Comparison of Citrated Human Blood, Citrated Sheep Blood, and Defibrinated Sheep Blood Mueller-Hinton Agar Preparations for Antimicrobial Susceptibility Testing of Streptococcus pneumoniae Isolates ▿  
Journal of Clinical Microbiology  2010;48(10):3770-3772.
The use of Mueller-Hinton agar supplemented with citrated human or citrated sheep blood was compared with the use of routinely used Mueller-Hinton agar supplemented with defibrinated sheep blood for antimicrobial susceptibility testing of Streptococcus pneumoniae. The alternate supplements were found to be unsatisfactory, particularly for testing resistant isolates, and therefore are not recommended.
PMCID: PMC2953122  PMID: 20668133

Results 1-6 (6)