human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Invasive pneumococcal disease is a major cause of death in HIV-infected children . The objective of the study was to assess the quantitative antibody response to the seven pneumococcal serotypes of heptavalent pneumococcal conjugate vaccine in a group of HIV-infected children . METHODS Study comprising 40 HIV-infected children aged between 2 and 9 years followed up in a specialized outpatient clinic in São Paulo , Brazil , between 2002 and 2003 .  Enzyme immunoassay ( ELISA ) was used to measure IgG antibody titers against pneumococcus capsule . Antibodies were measured immediately before and 1 month after the second dose of the vaccine . Two response criteria were used : IgG titers > or=1.3 microg/mL in the post-immunization serology and an increase of at least 4or=-fold in post- compared to pre-immunization serology . RESULTS For the first criterion ( > or=1.3 microg/mL ) , 26 ( 65 % ) children had serological response to the vaccine , 12 ( 30 % ) showed post-immunization IgG titers of at least 1.3 microg/mL for all seven serotypes studied . For the second criterion studied ( > or=4-fold increase in post- compared to pre-immunization titers for four serotypes or more ) , serological response was seen in 15 ( 37.5 % ) children . CONCLUSIONS Overall response to the heptavalent pneumococcal conjugate vaccine was adequate , showing a statistically significant increase in the post-immunization geometric mean titers for the seven serotypes studied The safety and immunogenicity of the 10-valent pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine ( PHiD-CV , Synflorix ™ ) were assessed in 240 healthy Chilean children r and omized to receive 3 doses of PHiD-CV ( PHiD-CV group ) or hepatitis A vaccine ( HAV control group ) at 2 - 4 - 6 months of age . All were offered 1 HAV dose at 12 months ( outside study ) . The PHiD-CV group received a second HAV dose at 18 - 21 months and PHiD-CV booster at 20 - 23 months . The HAV control group received 2 PHiD-CV catch-up doses at 18 - 21 and 20 - 23 months . Adverse events were recorded and pneumococcal antibody responses and opsonophagocytic activity ( OPA ) were measured . Both PHiD-CV vaccination schedules were well tolerated and immunogenic against the pneumococcal vaccine serotypes and protein D. The reactogenicity of PHiD-CV primary , booster and catch-up doses was in line with previous PHiD-CV studies , although generally higher than with HAV . For each vaccine serotype , the percentage of subjects with antibody concentrations ≥0.2 µg/ml ( GSK 's 22F-inhibition ELISA ) was at least 93.2 % following 3 PHiD-CV primary doses and at least 97.4 % post-booster ; percentages with OPA titers ≥8 were at least 91.7 % post-booster . After 2-dose catch-up , at least 94.3 % of children had antibody concentrations ≥0.2 µg/ml against each serotype except 6B ( 84.3 % ) ; at least 95.2 % had OPA titers ≥8 except against serotypes 1 , 5 and 6B . In conclusion , the safety profiles of 2 PHiD-CV vaccination schedules ( 3-dose primary plus booster and 2-dose catch-up ) were in line with previous studies and PHiD-CV was immunogenic for all 10 vaccine serotypes and protein OBJECTIVE The objective of this prospect i ve study was to investigate the status of acute respiratory tract infections caused by Haemophilus influenzae and Streptococcus pneumoniae in tsunami disaster evacuation camps . METHODS  Nasopharyngeal swabs  ( NP ) of 324 internally displaced persons ( IDP ) in 3 different tsunami disaster evacuation camps of Sri Lanka were collected between March 18th and 20th , 2005 , and analyzed for MIC , beta-lactamase production , serotypes , PCR and pulsed-field gel electrophoresis ( PFGE ) . RESULTS Many IDP had respiratory symptoms and the prevalence of cough and /or sputum was 84 % , 70.5 % and 64.7 % in the three camps . Twenty-one H. influenzae from 20 IDP and 25 S. pneumoniae from 22 IDP were isolated from the NP . All H. influenzae isolates were nontypeable , and 5 were beta-lactamase producing . Seventeen pneumococci were susceptible , 5 showed intermediate resistance and 3 were fully resistant to penicillin G. Molecular analysis showed the 21 H. influenzae strains had 13 PFGE patterns and 25 pneumococci had 16 PFGE patterns . All 4 different PFGE patterns of H. influenzae strains were detected in a few IDP in camps 1 and 3 , and 5 different PFGE patterns of serotype 3 , 22A , 9A , 10A and 11A pneumococci were detected in a few IDP in camps 1 and 3 . CONCLUSION Our data indicate acute respiratory tract infections caused by various types of H. influenzae and S. pneumoniae appear to have been prevalent , some of which were potentially transmitted from person to person in tsunami disaster evacuation camps Objective The WHO aims for 90 % coverage of the Exp and ed Program on Immunization ( EPI ) , which in Guinea-Bissau included BCG vaccine at birth , three doses of diphtheria−tetanus−pertussis vaccine ( DTP ) and oral polio vaccine ( OPV ) at 6 , 10 and 14 weeks and measles vaccine ( MV ) at 9 months when this study was conducted . The WHO assesses coverage by 12 months of age . The sequence of vaccines may have an effect on child mortality , but is not considered in official statistics or assessment s of programme performance . We assessed vaccination coverage and frequency of out-of-sequence vaccinations by 12 and 24 months of age . Design Observational cohort study . Setting and participants The B and i m Health Project 's ( BHP ) rural Health and Demographic Surveillance site covers 258 r and omly selected villages in all regions of Guinea-Bissau . Villages are visited biannually and vaccination cards inspected to ascertain vaccination status . Between 2003 and 2009 vaccination status by 12 months of age was assessed for 5806 children aged 12–23 months ; vaccination status by 24 months of age was assessed for 3792 children aged 24–35 months . Outcome measures Coverage of EPI vaccinations and frequency of out-of-sequence vaccinations . Results Half of 12-month-old children and 65 % of 24-month-old children had completed all EPI vaccinations . Many children received vaccines out of sequence : by 12 months of age 54 % of BCG-vaccinated children had received DTP with or before BCG and 28 % of measles-vaccinated children had received DTP with or after MV . By 24 months of age the proportion of out-of-sequence vaccinations was 58 % and 35 % , respectively , for BCG and MV . Conclusions In rural Guinea-Bissau vaccination coverage by 12 months of age was low , but continued to increase beyond 12 months of age . More than half of all children received vaccinations out of sequence . This highlights the need to improve vaccination services Background The impact on carriage and optimal schedule for primary vaccination of older children with 10-valent pneumococcal non-typeable Haemophilus influenzae protein-D conjugate vaccine ( PHiD-CV )  are unknown . Methods 600 Kenyan children aged 12–59 months were vaccinated at days 0 , 60 and 180 in a double-blind r and omized controlled trial according to the following vaccine sequence : Group A : PHiD-CV , PHiD-CV , diphtheria/tetanus/acellular pertussis vaccine ( DTaP ) ; Group B : PHiD-CV , DTaP , PHiD-CV ; Group C : hepatitis A vaccine ( HAV ) , DTaP , HAV . Nasopharyngeal carriage of Streptococcus pneumoniae was measured at five timepoints . In 375 subjects , serotype-specific responses were measured by 22F-inhibition ELISA and opsonophagocytic killing assays ( OPA ) one month after vaccination . Results Following one dose of PHiD-CV , > 90 % of recipients developed IgG≥0.35 µg/mL to serotypes 1 , 4 , 5 , 7F , 9V and 18C and OPA≥8 to serotypes 4 , 7F , 9V , 18C , 23F . After a second dose > 90 % of recipients had IgG≥0.35 µg/mL to all vaccine serotypes and OPA≥8 to all vaccine serotypes except 1 and 6B . At day 180 , carriage of vaccine-type pneumococci was 21 % in recipients of two doses of PHiD-CV ( Group A ) compared to 31 % in controls ( p = 0.04 ) . Fever after dose 1 was reported by 41 % of PHiD-CV recipients compared to 26 % of HAV recipients ( p<0.001 ) . Other local and systemic adverse experiences were similar between groups . Conclusions Vaccination of children aged 12–59 months with two doses of PHiD-CV two to six months apart was immunogenic , reduced vaccine-type pneumococcal carriage and was well-tolerated . Administration of PHiD-CV would be expected to provide effective protection against vaccine-type disease . Trial Registration Clinical Trials.gov Background A recent trial with PCV-7 in a rural Gambian community showed reduced vaccine-type pneumococcal carriage in fully vaccinated compared with control communities . We measured pneumococcal polysaccharide antibody concentrations in this trial to underst and further the mechanisms underlying the observed changes . Methods A single-blind , cluster-r and omized ( by village ) trial was conducted in 21 Gambian villages . In 11 villages , all residents received PCV-7 ( Vaccine group ) ; in 10 control villages only children < 30 months old or those born during the study received PCV-7 .  Subjects over the age of 30 months resident in vaccine villages received a single dose of PCV-7 whilst those in control villages received a single dose of a serogroup C meningococcal conjugate vaccine .  Serum antibody concentrations against specific pneumococcal polysaccharides were measured in approximately 200 age-stratified subjects before , 4–6 , 12 and 24 months following vaccination . Results Baseline pneumococcal antibody concentrations were generally high and increased with age up to 10 years . One dose of PCV-7 increased geometric mean antibody concentrations ( GMC ) in vaccinated versus control villages for vaccine serotypes 6B and 18C , and 4 and 18C , in the young ( under 5 years ) and older age groups ( 5 + years ) respectively . There were significantly higher proportions of subjects in the vaccinated than in the control communities with an antibody concentration believed to protect against carriage ( > 5.0 µg/mL ) for all but serotype 9V of the PCV-7 serotypes in the older group , but not in the younger age group . Conclusion Higher antibodies in vaccinated communities provide an explanation for the lower pneumococcal carriage rates in fully vaccinated compared to control communities . Trial Registration Controlled-Trials.com IS RCT N51695599 51695599 Background A village-r and omized trial of a seven-valent pneumococcal-conjugate-vaccine ( PCV-7 ) conducted in rural Gambia showed a decrease of vaccine-type ( VT ) and a non-significant increase in non-vaccine-type ( NVT ) nasopharyngeal carriage of pneumococci two years after vaccination . Here , we report findings four years after vaccination . Methods PCV-7 was given to all children below 30 months of age enrolled in the trial and to those born during its course in all study villages . Villages were r and omized ( older children and adults ) to receive  PCV-7 ( wholly vaccinated villages ) or  serogroup-C-meningococcal-conjugate-vaccine  ( partly vaccinated villages ) . Cross-sectional surveys ( CSS ) to collect nasopharyngeal swabs were conducted before and at various intervals after vaccination . Sixteen of these r and omized villages ( 8 wholly vaccinated and 8 partly vaccinated ) participated in a CSS conducted four years after vaccination started . Results Four years after vaccination , the prevalence of VT pneumococcal carriage was 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Invasive pneumococcal disease is a major cause of death in HIV-infected children . The objective of the study was to assess the quantitative antibody response to the seven pneumococcal serotypes of heptavalent pneumococcal conjugate vaccine in a group of HIV-infected children . METHODS Study comprising 40 HIV-infected children aged between 2 and 9 years followed up in a specialized outpatient clinic in São Paulo , Brazil , between 2002 and 2003 .  Enzyme immunoassay ( ELISA ) was used to measure IgG antibody titers against pneumococcus capsule . Antibodies were measured immediately before and 1 month after the second dose of the vaccine . Two response criteria were used : IgG titers > or=1.3 microg/mL in the post-immunization serology and an increase of at least 4or=-fold in post- compared to pre-immunization serology . RESULTS For the first criterion ( > or=1.3 microg/mL ) , 26 ( 65 % ) children had serological response to the vaccine , 12 ( 30 % ) showed post-immunization IgG titers of at least 1.3 microg/mL for all seven serotypes studied . For the second criterion studied ( > or=4-fold increase in post- compared to pre-immunization titers for four serotypes or more ) , serological response was seen in 15 ( 37.5 % ) children . CONCLUSIONS Overall response to the heptavalent pneumococcal conjugate vaccine was adequate , showing a statistically significant increase in the post-immunization geometric mean titers for the seven serotypes studied The safety and immunogenicity of the 10-valent pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine ( PHiD-CV , Synflorix ™ ) were assessed in 240 healthy Chilean children r and omized to receive 3 doses of PHiD-CV ( PHiD-CV group ) or hepatitis A vaccine ( HAV control group ) at 2 - 4 - 6 months of age . All were offered 1 HAV dose at 12 months ( outside study ) . The PHiD-CV group received a second HAV dose at 18 - 21 months and PHiD-CV booster at 20 - 23 months . The HAV control group received 2 PHiD-CV catch-up doses at 18 - 21 and 20 - 23 months . Adverse events were recorded and pneumococcal antibody responses and opsonophagocytic activity ( OPA ) were measured . Both PHiD-CV vaccination schedules were well tolerated and immunogenic against the pneumococcal vaccine serotypes and protein D. The reactogenicity of PHiD-CV primary , booster and catch-up doses was in line with previous PHiD-CV studies , although generally higher than with HAV . For each vaccine serotype , the percentage of subjects with antibody concentrations ≥0.2 µg/ml ( GSK 's 22F-inhibition ELISA ) was at least 93.2 % following 3 PHiD-CV primary doses and at least 97.4 % post-booster ; percentages with OPA titers ≥8 were at least 91.7 % post-booster . After 2-dose catch-up , at least 94.3 % of children had antibody concentrations ≥0.2 µg/ml against each serotype except 6B ( 84.3 % ) ; at least 95.2 % had OPA titers ≥8 except against serotypes 1 , 5 and 6B . In conclusion , the safety profiles of 2 PHiD-CV vaccination schedules ( 3-dose primary plus booster and 2-dose catch-up ) were in line with previous studies and PHiD-CV was immunogenic for all 10 vaccine serotypes and protein OBJECTIVE The objective of this prospect i ve study was to investigate the status of acute respiratory tract infections caused by Haemophilus influenzae and Streptococcus pneumoniae in tsunami disaster evacuation camps . METHODS  Nasopharyngeal swabs  ( NP ) of 324 internally displaced persons ( IDP ) in 3 different tsunami disaster evacuation camps of Sri Lanka were collected between March 18th and 20th , 2005 , and analyzed for MIC , beta-lactamase production , serotypes , PCR and pulsed-field gel electrophoresis ( PFGE ) . RESULTS Many IDP had respiratory symptoms and the prevalence of cough and /or sputum was 84 % , 70.5 % and 64.7 % in the three camps . Twenty-one H. influenzae from 20 IDP and 25 S. pneumoniae from 22 IDP were isolated from the NP . All H. influenzae isolates were nontypeable , and 5 were beta-lactamase producing . Seventeen pneumococci were susceptible , 5 showed intermediate resistance and 3 were fully resistant to penicillin G. Molecular analysis showed the 21 H. influenzae strains had 13 PFGE patterns and 25 pneumococci had 16 PFGE patterns . All 4 different PFGE patterns of H. influenzae strains were detected in a few IDP in camps 1 and 3 , and 5 different PFGE patterns of serotype 3 , 22A , 9A , 10A and 11A pneumococci were detected in a few IDP in camps 1 and 3 . CONCLUSION Our data indicate acute respiratory tract infections caused by various types of H. influenzae and S. pneumoniae appear to have been prevalent , some of which were potentially transmitted from person to person in tsunami disaster evacuation camps Objective The WHO aims for 90 % coverage of the Exp and ed Program on Immunization ( EPI ) , which in Guinea-Bissau included BCG vaccine at birth , three doses of diphtheria−tetanus−pertussis vaccine ( DTP ) and oral polio vaccine ( OPV ) at 6 , 10 and 14 weeks and measles vaccine ( MV ) at 9 months when this study was conducted . The WHO assesses coverage by 12 months of age . The sequence of vaccines may have an effect on child mortality , but is not considered in official statistics or assessment s of programme performance . We assessed vaccination coverage and frequency of out-of-sequence vaccinations by 12 and 24 months of age . Design Observational cohort study . Setting and participants The B and i m Health Project 's ( BHP ) rural Health and Demographic Surveillance site covers 258 r and omly selected villages in all regions of Guinea-Bissau . Villages are visited biannually and vaccination cards inspected to ascertain vaccination status . Between 2003 and 2009 vaccination status by 12 months of age was assessed for 5806 children aged 12–23 months ; vaccination status by 24 months of age was assessed for 3792 children aged 24–35 months . Outcome measures Coverage of EPI vaccinations and frequency of out-of-sequence vaccinations . Results Half of 12-month-old children and 65 % of 24-month-old children had completed all EPI vaccinations . Many children received vaccines out of sequence : by 12 months of age 54 % of BCG-vaccinated children had received DTP with or before BCG and 28 % of measles-vaccinated children had received DTP with or after MV . By 24 months of age the proportion of out-of-sequence vaccinations was 58 % and 35 % , respectively , for BCG and MV . Conclusions In rural Guinea-Bissau vaccination coverage by 12 months of age was low , but continued to increase beyond 12 months of age . More than half of all children received vaccinations out of sequence . This highlights the need to improve vaccination services Background The impact on carriage and optimal schedule for primary vaccination of older children with 10-valent pneumococcal non-typeable Haemophilus influenzae protein-D conjugate vaccine ( PHiD-CV )  are unknown . Methods 600 Kenyan children aged 12–59 months were vaccinated at days 0 , 60 and 180 in a double-blind r and omized controlled trial according to the following vaccine sequence : Group A : PHiD-CV , PHiD-CV , diphtheria/tetanus/acellular pertussis vaccine ( DTaP ) ; Group B : PHiD-CV , DTaP , PHiD-CV ; Group C : hepatitis A vaccine ( HAV ) , DTaP , HAV . Nasopharyngeal carriage of Streptococcus pneumoniae was measured at five timepoints . In 375 subjects , serotype-specific responses were measured by 22F-inhibition ELISA and opsonophagocytic killing assays ( OPA ) one month after vaccination . Results Following one dose of PHiD-CV , > 90 % of recipients developed IgG≥0.35 µg/mL to serotypes 1 , 4 , 5 , 7F , 9V and 18C and OPA≥8 to serotypes 4 , 7F , 9V , 18C , 23F . After a second dose > 90 % of recipients had IgG≥0.35 µg/mL to all vaccine serotypes and OPA≥8 to all vaccine serotypes except 1 and 6B . At day 180 , carriage of vaccine-type pneumococci was 21 % in recipients of two doses of PHiD-CV ( Group A ) compared to 31 % in controls ( p = 0.04 ) . Fever after dose 1 was reported by 41 % of PHiD-CV recipients compared to 26 % of HAV recipients ( p<0.001 ) . Other local and systemic adverse experiences were similar between groups . Conclusions Vaccination of children aged 12–59 months with two doses of PHiD-CV two to six months apart was immunogenic , reduced vaccine-type pneumococcal carriage and was well-tolerated . Administration of PHiD-CV would be expected to provide effective protection against vaccine-type disease . Trial Registration Clinical Trials.gov Background A recent trial with PCV-7 in a rural Gambian community showed reduced vaccine-type pneumococcal carriage in fully vaccinated compared with control communities . We measured pneumococcal polysaccharide antibody concentrations in this trial to underst and further the mechanisms underlying the observed changes . Methods A single-blind , cluster-r and omized ( by village ) trial was conducted in 21 Gambian villages . In 11 villages , all residents received PCV-7 ( Vaccine group ) ; in 10 control villages only children < 30 months old or those born during the study received PCV-7 .  Subjects over the age of 30 months resident in vaccine villages received a single dose of PCV-7 whilst those in control villages received a single dose of a serogroup C meningococcal conjugate vaccine .  Serum antibody concentrations against specific pneumococcal polysaccharides were measured in approximately 200 age-stratified subjects before , 4–6 , 12 and 24 months following vaccination . Results Baseline pneumococcal antibody concentrations were generally high and increased with age up to 10 years . One dose of PCV-7 increased geometric mean antibody concentrations ( GMC ) in vaccinated versus control villages for vaccine serotypes 6B and 18C , and 4 and 18C , in the young ( under 5 years ) and older age groups ( 5 + years ) respectively . There were significantly higher proportions of subjects in the vaccinated than in the control communities with an antibody concentration believed to protect against carriage ( > 5.0 µg/mL ) for all but serotype 9V of the PCV-7 serotypes in the older group , but not in the younger age group . Conclusion Higher antibodies in vaccinated communities provide an explanation for the lower pneumococcal carriage rates in fully vaccinated compared to control communities . Trial Registration Controlled-Trials.com IS RCT N51695599 51695599 Background A village-r and omized trial of a seven-valent pneumococcal-conjugate-vaccine ( PCV-7 ) conducted in rural Gambia showed a decrease of vaccine-type ( VT ) and a non-significant increase in non-vaccine-type ( NVT ) nasopharyngeal carriage of pneumococci two years after vaccination . Here , we report findings four years after vaccination . Methods PCV-7 was given to all children below 30 months of age enrolled in the trial and to those born during its course in all study villages . Villages were r and omized ( older children and adults ) to receive  PCV-7 ( wholly vaccinated villages ) or  serogroup-C-meningococcal-conjugate-vaccine  ( partly vaccinated villages ) . Cross-sectional surveys ( CSS ) to collect nasopharyngeal swabs were conducted before and at various intervals after vaccination . Sixteen of these r and omized villages ( 8 wholly vaccinated and 8 partly vaccinated ) participated in a CSS conducted four years after vaccination started . Results Four years after vaccination , the prevalence of VT pneumococcal carriage was 
    Output:
    