Thesis (M.S.)--University of Michigan, 1982.

Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

Thesis (Ph. D.)--West Virginia University, 2006. / Title from document title page. Document formatted into pages; contains xii, 128 p. Includes abstract. Includes bibliographical references (p. 75-84).

Thesis (doctoral)--Lund University, 1994. / Added t.p. with thesis statement inserted.

This diploma thesis deals with the issue of vaccination coverage among children. Vaccination in the Czech Republic has a long tradition and represents a very effective protection of children and adults not only against infectious diseases, but also against their consequences. It also prevents the development of infectious diseases. Vaccination is one of the most successful preventive methods that affect the health of individuals and the whole population. Vaccination is also very important for unvaccinated individuals. If the population reaches a high level of vaccination coverage, the spread of infection between vaccinated individuals is interrupted which significantly reduces the risk of transmission of infection to unvaccinated individuals as well. Vaccination thus protects also those who cannot be vaccinated because of illness, decreased immunity or other reasons. Currently, however, there are some opinions which question the usefulness and importance of compulsory vaccination. An increasing number of those who refuse vaccination occur due to the increased accessibility of the Internet and social networks, where we can notice a growing amount of information to the disadvantage of vaccination. The most common reason for refusing vaccination is the belief that some vaccinations are not necessary. The thesis is divided into two main parts - theoretical and practical. The first theoretical chapter contains an introduction to the issue of vaccination. In the following part of my thesis I deal with the system of vaccination in the Czech Republic, its planning, organization and control, and the role of public health protection authorities. The following chapter deals with the importance and division of vaccination and kinds of vaccines. The thesis is also focused on the diseases which are vaccinated against under mandatory vaccination scheme. At present mandatory vaccination in the Czech Republic includes vaccination against diphtheria, tetanus, pertussis, rubella, mumps, measles, transmissible polio, hepatitis B and invasive diseases caused by Haemophilus influenzae type b. Vaccination especially against tick-borne encephalitis, hepatitis A, diseases caused by pneumococci and invasive meningococcal disease is recommended. Last but not least, I also mention contraindications for vaccination and the adverse reactions after the vaccination. In the next chapter of the theoretical part I write about the implementation of vaccination and the control management of vaccination coverage in the Czech Republic. In conclusion of the theoretical part I deal with the issue of vaccination opponents and their reasons for refusing vaccination.

Magister Public Health - MPH / Ethiopia has achieved its target for Millennium Development Goal 4 by recording 69 %reduction in its under-five mortality. The proportion of fully immunized children in Ethiopia has increased from 14 % in 2000 to 24 % in 2011. Though progress has been made, about 3 out of 4 children still remain incompletely immunized. The purpose of this study is to determine the socio-demographic and socioeconomic factors associated with incomplete immunization among children aged 12-23 months in Ethiopia. This study is based on secondary analysis of the 2011 Ethiopia Demographic and Health Survey. Information on 1,889 mothers of children aged 12–23 months were extracted from the children dataset. Records from vaccination cards and mothers’ self-reported data were used to determine vaccine coverage. The association between child immunization status and determinants of non-utilization of immunization services was assessed using bivariate and multivariate analyses. The findings of this study showed that the prevalence of incompletely immunized children is 70.9%. Children of mothers from the poor (AOR = 2.27; 95 % CI: 1.34 – 3.82) wealth quintile were more likely to be incompletely immunized. Children of mothers from Affar (AOR = 15.80; 95 % CI: 7.12 – 35.03), Amhara (AOR = 4.27; 95 %CI: 2.31 – 7.88), Oromiya (AOR = 8.10; 95 % CI: 4.60 – 14.25), Somali (AOR = 4.91;95 % CI: 2.65 – 9.10), Benishangul-Gumuz (AOR = 4.20; 95% CI: 2.34 – 7.57),Southern Nations Nationalities and Peoples’ (AOR = 4.76; 95 % CI: 2.53 – 8.94), Gambela (AOR = 7.75; 95 % CI: 3.68 – 16.30) and Harari (AOR = 3.22; 95 % CI: 1.77 –5.89) regions were more likely to be incompletely immunized. Mothers with inadequate exposure to media (AOR = 1.60; 95% CI: 1.21 – 2.14), who are not aware of community conversation programme (AOR = 1.80; 95% CI: 1.40 – 2.32) and who attended no antenatal care (AOR = 2.21; 95% CI: 1.72 – 2.83) were more likely to have incompletely immunized children. Despite efforts to increase rates of childhood immunization, the proportion of children with incomplete immunization in Ethiopia is considerably high. Therefore, targeted interventions at the identified socio-demographic factors are needed to increase immunization rates.

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MSc (Med), Population-Based Epidemiology, Faculty of Health Sciences, University of the Witwatersrand, 2010

A better understanding of the role of antigen-presenting cells (APCs) in host resistance to malaria is essential to unravel the complex interactions between the host and the parasite. This would improve the design of malaria vaccines. Mycobacterium bovis Bacillus Calmette-Guérin (BCG) has been utilized as a vector to deliver vaccine candidate antigens. We assessed the immunogenicity of a recombinant BCG-expressing (BCG-CS) circumsporozoite protein (CSp) as a malaria vaccine candidate. Immunization of BALB/c mice with BCG-CS augmented the numbers of dendritic cells (DCs) in draining lymph nodes and in the spleen. The activation markers MHC-class-II, CD40, CD80, and CD86 on DCs were significantly upregulated by BCG-CS as compared to wild-type BCG (wt-BCG). In vitro stimulation of bone marrow-derived DCs and macrophages with BCG-CS induced IL-12 and TNF-α production. BCG-CS induced higher phagocytic activity in macrophages as compared to wt-BCG. Finally, BCG-CS induced CSp-specific antibodies and IFN-γ-producing memory cells. Taken together, we found that BCG-CS is highly efficient in activating innate immune responses and could effectively prime the adaptive immune system. Heterologous prime–boost approaches using vectors are optimal strategies to improve a broad and prolonged immunogenicity of malaria vaccines. We have demonstrated in BALB/c mice that priming with a replication-defective human adenovirus serotype 35 (Ad35) vector encoding CSp (Ad35-CS), followed by boosting with BCG-CS, maintained antibody responses and significantly increased levels of long-lived plasma cells (LLPC) and IFN-g-producing cells in response to CSp peptides. The increased number of IFN-g-producing cells induced by the combination of Ad35-CS/BCG-CS and the sustained type 1 antibody profile, together with high levels of LLPCs, may be essential for the development of long-term protective immunity against liver-stage parasites. Fulani and Dogon, two sympatric ethnic groups living in northeastern Mali, are characterized by a marked difference in the susceptibility to P. falciparum malaria. We investigated whether APCs obtained from Fulani and Dogon children exhibited differences in terms of activation status and toll-like receptor (TLR) responses during malaria infection. We observed decreased activation of APCs and markedly suppressed TLR responses in Dogon children as compared to Fulani. These findings suggest that APCs and TLR signaling may be of importance for the protective immunity against malaria observed in the Fulani. In conclusion, this thesis provides new insights that could facilitate a rational design of novel vaccines against malaria. Furthermore, the results elicit some immunological bases of the APC activation underlying the differences in host susceptibility to malaria infections. / At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 1: In Press. Paper 2: Manuscript.

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