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Your search keyword '"Elsbeth D. M. Rouers"' showing total 3 results
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3 results on '"Elsbeth D. M. Rouers"'

1. Effect of Palivizumab Prophylaxis on Respiratory Syncytial Virus Infection in Very Preterm Infants in the First Year of Life in The Netherlands

Author

Rutger M. Schepp, Joanna Kaczorowska, Pieter G. M. van Gageldonk, Elsbeth D. M. Rouers, Elisabeth A. M. Sanders, Patricia C. J. Bruijning-Verhagen, and Guy A. M. Berbers

Subjects
RSV prophylaxis, palivizumab effectiveness, very preterm infants, RSV infection rates, gestational age, Medicine
Abstract

Respiratory Syncytial Virus (RSV) poses a severe threat to infants, particularly preterm infants. Palivizumab, the standard preventive prophylaxis, is primarily utilized in high-risk newborns due to its cost. This study assessed palivizumab’s effectiveness in preventing RSV infections in predominantly very preterm infants during their first year of life. Serum samples from a prospective multicentre cohort study in the Netherlands were analyzed to assess RSV infection rates by measuring IgG levels against three RSV proteins: nucleoprotein, pre-fusion, and post-fusion protein. Infants were stratified based on gestational age (GA), distinguishing very preterm (≤32 weeks GA) from moderate/late preterm (>32 to ≤36 weeks GA). In very preterm infants, palivizumab prophylaxis significantly reduced infection rates (18.9% vs. 48.3% in the prophylaxis vs. non-prophylaxis group. Accounting for GA, sex, birth season, and birth weight, the prophylaxis group showed significantly lower infection odds. In infants with >32 to ≤36 weeks GA, the non-prophylaxis group (55.4%) showed infection rates similar to the non-prophylaxis ≤32-week GA group, despite higher maternal antibody levels in the moderate/late preterm infants. In conclusion, palivizumab prophylaxis significantly reduces RSV infection rates in very premature infants. Future research should explore clinical implications and reasons for non-compliance, and compare palivizumab with emerging prophylactics like nirsevimab aiming to optimize RSV prophylaxis and improve preterm infant outcomes.

Published
2023
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2. Acute Gastroenteritis Disease Burden in Infants With Medical Risk Conditions in the Netherlands

Author

Patricia Bruijning-Verhagen, Marc J. M. Bonten, Josephine A P van Dongen, Elsbeth D M Rouers, and Rob Schuurman

Subjects
Microbiology (medical), Diarrhea, Pediatrics, medicine.medical_specialty, burden of disease, medicine.disease_cause, medical risk infants, Severity of Illness Index, Original Studies, Astrovirus, 03 medical and health sciences, Feces, fluids and secretions, 0302 clinical medicine, Cost of Illness, Risk Factors, 030225 pediatrics, Rotavirus, Prevalence, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Disease burden, Netherlands, biology, business.industry, Incidence (epidemiology), Incidence, Infant, biology.organism_classification, Confidence interval, Gastroenteritis, Low birth weight, Infectious Diseases, rotavirus, Medical risk, Pediatrics, Perinatology and Child Health, Acute Disease, Viruses, Norovirus, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, medicine.symptom, business
Abstract

Supplemental Digital Content is available in the text., Background: Infants with medical risk conditions are vulnerable to childhood infections including acute gastroenteritis (AGE). To guide prevention programs, we quantified AGE incidence, severity and virus prevalence among medical risk infants in the Netherlands. Methods: This prospective cohort-study was part of the RIVAR-project recruiting infants with prematurity, low birth weight or severe congenital conditions in 13 hospitals. Follow-up included 18 monthly health questionnaires detailing AGE symptoms and healthcare usage. Parents were also instructed to notify when an infant developed AGE, to collect a stool sample and complete a daily severity score (Modified Vesikari Severity). Stool samples were analyzed by real-time polymerase chain reaction for rotavirus, norovirus, adenovirus and astrovirus. Results: Between November 2014 and October 2017, 631 infants participated during 9125 person-months of observation. In total, 559 episodes were identified. The mean AGE incidence rate was 73.5 per 100 person-years (PY) (95% confidence interval: 67.6–79.9) and increased with age [incidence rate: 48.3 (39.8–58.3) vs. 80.2 (73.0–88.1)/100 PY for ages 1–5 vs. 6–18 months, respectively]. Healthcare was attended for 38.1% (213/559) and 26.8% (68/254) were classified as severe based on the Modified Vesikari Severity. Stool samples were obtained from 254 AGE episodes. Norovirus was identified in 65 (25.6%) and rotavirus in 44 (17.7%). Adenovirus and astrovirus together accounted for 8.3% (N = 21). Severe AGE occurred most frequently in rotavirus positive episodes. Conclusion: The observed AGE incidence, severity and healthcare usage among medical risk infants confirms substantial disease burden. Norovirus and rotavirus are the dominant pathogens and severe episodes occurred most frequently in children with rotavirus infection. AGE prevention in medical risk infants should be prioritized.

Published
2020

3. Rotavirus Vaccine Safety and Effectiveness in Infants With High-Risk Medical Conditions

Author

Maaike C van Rossem, Caterina Band, Rob Schuurman, Patricia Bruijning-Verhagen, Jacqueline van der Sluijs, Shannon M Watkins, Marieke A C Hemels, Gijs Th. J. van Well, Dasja Pajkrt, Carin A C M Dassel, Margreet Wessels, Elly A Kleinlugtenbeld, Marlies A. van Houten, Anne A M W van Kempen, Josephine A P van Dongen, Arine M. Vlieger, Gerdien Tramper-Stranders, Obbe F. Norbruis, Louis Bont, Marc J.M. Bonten, Helene G Stas, Elsbeth D M Rouers, MUMC+: MA Kindergeneeskunde (3), Kindergeneeskunde, MUMC+: MA Medische Staf Kindergeneeskunde (9), MUMC+: MA Arts Assistenten Kindergeneeskunde (9), RS: NUTRIM - R1 - Obesity, diabetes and cardiovascular health, Paediatric Infectious Diseases / Rheumatology / Immunology, AII - Infectious diseases, and Amsterdam Reproduction & Development (AR&D)

Subjects
Male, Pediatrics, medicine.medical_specialty, Vaccination Coverage, PREMATURE, Vaccine Efficacy, Netherlands/epidemiology, CHILDREN, medicine.disease_cause, IMMUNOGENICITY, Rotavirus Infections, DISEASE, Congenital Abnormalities, Congenital Abnormalities/epidemiology, Rotavirus, medicine, Humans, Rotavirus Infections/epidemiology, Prospective Studies, Adverse effect, Netherlands, Hospitalization/statistics & numerical data, business.industry, GASTROENTERITIS, Rotavirus Vaccines, Rotavirus Vaccines/administration & dosage, virus diseases, Infant, medicine.disease, EFFICACY, Rotavirus vaccine, Gastroenteritis/epidemiology, Hospitalization, Vaccination, Controlled Before-After Studies, Relative risk, Pediatrics, Perinatology and Child Health, Cohort, Infant, Small for Gestational Age, Small for gestational age, Small for Gestational Age, Female, business, BURDEN, Infant, Premature, Cohort study
Abstract

OBJECTIVES Rotavirus vaccination has 87% to 100% effectiveness against severe rotavirus acute gastroenteritis (AGE) in healthy infants in high-income countries. Little is known whether infants with medical risk conditions (MRCs) are equally protected and if the vaccine is equally well tolerated. We conducted a quasi-experimental prospective multicenter before-after cohort study to assess the vaccine effectiveness (VE) and safety profile of the human rotavirus vaccine (HRV) among MRC infants that required prolonged or frequent postnatal care. METHODS The Netherlands has no national rotavirus immunization program, but HRV was implemented in routine care for MRC infants in 13 Dutch hospitals. Participants in the before and after cohort, HRV unvaccinated and vaccinated, respectively, were followed for occurrence of (rotavirus) AGE. VE of at least 1 dose was estimated by using time-to-event analysis for severe rotavirus AGE. Vaccine-related serious adverse event (AEs) after HRV were retrieved systematically from medical charts. Solicited AEs after vaccinations were prospectively collected and compared between vaccination time points with or without HRV. RESULTS In total, 1482 high-risk infants with MRC were enrolled, including 631 in the before and 851 in the after cohorts; 1302 infants were premature (88.3%), 447 were small for gestational age (30.2%), and 251 had at least 1 congenital disorder (17.0%). VE against severe rotavirus AGE was 30% (95% confidence interval [CI]: −36% to 65%). Overall, the observed number of rotavirus hospitalizations was low and not significantly different between the cohorts (2 and 2, respectively). The rate of vaccine-related serious AE was 0.24 per 100 vaccine doses. The adjusted risk ratio for any AE after HRV vaccination compared with other routine vaccinations was 1.09 (95% CI: 1.05 to 1.12) for concomitant administration and 0.91 (95% CI: 0.81 to 0.99) for single HRV administration. Gastrointestinal AEs were 10% more frequent after HRV. CONCLUSIONS In contrast to previous findings among healthy term infants, in routine use, HRV offered limited protection to vulnerable medical risk infants. HRV is generally well tolerated in this group in single administration, but when coadministered with routine vaccines, it is associated with higher risk of (mostly gastrointestinal) AE. Our study highlights the importance of studying vaccine performance in subgroups of medically vulnerable infants.

Published
2021

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