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and risk factors of kidney damage in children after hematopoietic stem cell transplantation
Katarzyna Gąsowska
Serbia
Serbia
The objective of this report is to address the knowledge gaps for the first and second priority challenges and thereby contribute to the evidence-based policymaking on the labor supply and gender equality agendas. Specifically, the report explores the key labor market gender challenges such as occupational segregation (looking at segregation of current occupations and educational specializations) and the parenthood penalty (looking at differences in labor force participation, employment, and earnings for women and men with no children, 1 child, 2 or more children), using the nationally-representative individual-level Labor Force Survey (LFS) data in 2006-2016. The novelty of this study is that an LFS-based analysis that applies a conventional methodology of occupational segregation indicators and earnings regressions and decompositions in chapters two through four is complemented by an original analysis of job seeker profiles in chapter five, scraped from the largest online job portal in Moldova in June 2018, to examine the role of gender in labor market aspirations and expectations of young job seekers. Even though the third priority challenge (entrepreneurship) is also linked to the labor market and there are substantial disparities in the success rate of setting up a business as well as in the size and nature of businesses that Moldovan women and men lead (World Bank, 2014a), this report does not address the issue of entrepreneurship in detail due to LFS data containing only a very small sample of non-agricultural employers (either women or men) and very few relevant variables on this topic. Another limitation of this report is that it does not study the impact of international labor migration and remittances on labor market outcomes of remaining household members and other social and economic indicators in Moldova. Besedina and Levin (2016) and Stratan et al. (2013) find that migration and remittances are associated with lower labor force participation rates of remaining household members (who are more likely to be female, compared to households without migrants)and higher incidence of part-time employment as remittance recipients rationally reduce their labor effort. To answer the question whether migration and remittances contribute to gender inequalities in the Moldovan labor market, including gender gaps in labor force participation, employment and earnings, other data and further research are needed. Finally, the report contributes to the literature about the supply side of the Moldovan labor market whereas it draws on the findings of other studies on the labor demand developments. According to World Bank (2016b, c), rapid economic growth in recent years in Moldova was not accompanied by job creation, net job losses have taken place in most sectors and across regions, and only some categories of workers (predominantly skilled older male workers in urban areas) were able to benefit from access to higher-paying jobs in productivity increasing firms. The report is intended for technically-inclined readers from government agencies, think tanks and researchers active in gender and labor market domains. The Executive summary summarizes the findings of the analysis in non-technical language for the general public and policy makers. Annex one provides technical details on which methodology and data are used for the analysis. (Moldova)
The present output was carried out under the reimbursable advisory services (RAS) agreement concluded for the development of plans for the de-institutionalization of children deprived of parental care and their transfer to community-based care, between the world bank and the national authority for the protection of children’s rights and adoption (AMPDCA), on may 12, 2016. the agreement covers the technical assistance for the ANPDCA project development of the plan for the deinstitutionalization of children in residential care and their transition to community-based care – code SIPOCA 2, funded by the European social fund under the operational program for administrative capacity. Between May-October 2018, the world bank team collected and analyzed the data needed to prepare the sixth output under the agreement (output 6). This report is a continuation of the first five outputs, already submitted to the ANPDCA (in March, June and December 2017 and June, September 2018), this being the last output under this agreement. output 6 incorporates the ideas and comments formulated during eight regional consultation seminars (one per each region of the country), organized in July 2018 by the national authority for child protection and adoption (ANPDCA), attended by over 400 representatives of county and local authorities, as well as NGOs from this field. Output 6 are (i) Analysis of the survey of families of institutionalized children living in source communities, (ii) identification of children exposed to the risk of separation in at least 30 source communities, (iii) 30 plans for the development of preventative services in rural source communities, (iv) a plan for the monitoring and evaluation of closing Residential Centers, and (v) a dissemination report presenting the results of the RAS (Romania)
Abstract Background COVID-19 pandemic modified trends of infant bronchiolitis, leading cause of emergency room (ER) attendance in infants in high income countries, primarily due to Respiratory Syncytial Virus. Understanding recent pandemic-related epidemiological shifts could inform affordable prevention efforts to improve sustainability and coverage of prophylactic treatments beyond maternal vaccines and infant monoclonal antibodies. Methods We estimated incidence rates (IR) of bronchiolitis ER presentations in 0-6month olds in 2012-2023 in a region-wide cohort of almost 1 million births using administrative health data from Lombardy, Italy. To assess potential contributors, we investigated direct and indirect COVID-19-related factors, including disease severity, shape of the epidemic peak, parental health seeking behaviour and vaccine coverage. We estimated COVID-19 maternal vaccination associations using mothers-infants data linkages and multivariable-adjusted logistic regression. Findings Compared to pre-pandemic levels, IRs doubled in 2021-2023 (from 2 to ≥ 4/100 person-time). The surge could not be explained by changes in infant age at ER visit, clinical severity or in the shape of the epidemic peak. Adjusted models showed little support for a role of infant routine or maternal COVID-19 vaccination on bronchiolitis episodes (respectively hazard ratio 1.09, 95%CI: 0.98–1.22 and odds ratio 0.91, 95%CI: 0.76–1.09). Interpretation The post-pandemic increase in infant bronchiolitis is likely driven by multiple epidemiological changes rather than a single factor. As maternal RSV vaccination and infant RSV monoclonal antibodies are introduced and scale up, identifying these mechanisms will be critical to maximise their public health impact, inform complementary prevention strategies, and improve preparedness for future RSV epidemics.
Valeria Nazzari, Albert Navarro Gallinad, Laura Ghirardi et al.
Objectives. To compare childhood vaccination coverage in Albania, Montenegro, North Macedonia, and Serbia and assess divergence between DTP3 and later measles-containing vaccine coverage during 2019-2023. Material and methods. A retrospective comparative ecological time-trend study used WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) for DTP3, MCV1, and MCV2. Annual trends, change from the 2019 baseline to the lowest value in 2020-2021, subsequent change to 2023, and the DTP3-MCV1 difference were described. The DTP3-MCV1 difference was defined as an ecological indicator of divergence between early infant-series vaccination and later measles-vaccination contact, not as an individual dropout measure. No inferential modeling was performed because only five annual observations per indicator were available. Results. Albania maintained DTP3 coverage at 97% in 2023, while its DTP3-MCV1 difference widened from 4 to 14 percentage points. Montenegro had persistently low coverage across the selected indicators and a 57-point DTP3-MCV1 difference in 2023. North Macedonia narrowed this difference from 17 to 13 points, while Serbia narrowed it from 10 to 9 points and returned MCV2 to its 2019 value. No country reached at least 95% for both measles doses in 2023. Conclusions. DTP3 and MCV1 followed different country-level patterns during 2019-2023. Albania maintained high DTP3 coverage but showed widening DTP3-MCV1 divergence, whereas North Macedonia and Serbia showed partial narrowing, and Montenegro retained a very wide difference. These findings are descriptive and hypothesis-generating; the DTP3-MCV1 comparison is ecological and should not be interpreted as individual dropout, continuity, or causality.
Zhinzela Qyli
ABSTRACT Importance Nirsevimab, a monoclonal antibody against RSV, was implemented in France in September 2023. Recently, rare resistance-associated substitutions were described in RSV but the effectiveness according to lineages remains unclear. Objective We aimed to estimate the effectiveness of nirsevimab against hospitalization for RSV bronchiolitis according to RSV lineages. Design We conducted a multicenter test-negative case-control study from October 15, 2023 to March 15, 2025. Setting This study was based on data from three national multicentric prospective studies. The 12 participating centers were secondary or tertiary hospital with a pediatric department located in France. Participants We included all children younger than 12 months who were hospitalized for RSV bronchiolitis in one of the participating centers in France during the two first RSV epidemic seasons following the implementation of nirsevimab (from October 15, 2023 to February 29, 2024, and from October 10, 2024 to March 15, 2025). Main outcomes and measures The main outcome of the study was the RSV test result of bronchiolitis cases. RSV whole-genome sequencing was performed using a tiled amplicon approach covering the complete viral genome, as previously described in the POLYRES studies. We estimated the effectiveness of nirsevimab by a multivariable logistic regression model adjusted for potential confounders. We estimated the adjusted risk of immunization failure for each lineage by calculating relative odds ratio to a reference lineage. A range of sensitivity analyses were conducted. Results We included 3019 infants with bronchiolitis among which 2273 had a positive RSV test (case patients) and 746 had a negative RSV test (control patients). Overall, 373/2273 (16.4%) case patients were immunized by nirsevimab versus 423/746 (56.7%) control patients. The adjusted effectiveness of nirsevimab against hospitalization for bronchiolitis was 88.4% (95% CI, 84.5–91.4) with RSV-B and 79.4% (95% CI, 73.7–83.8) with RSV-A. The risk of immunization failure was 3.2-fold (95% CI 1.8–5.7) higher for lineages derived from A.D.3 than for lineages derived from B.D.4.1. Conclusion and relevance In this multicentric case-control study, we observed that nirsevimab effectiveness was variable across RSV lineages, with a lower effectiveness against A.D.3 lineages compare to others. Further surveillance is needed to confirm these findings and assess their implication on RSV lineages epidemiology as nirsevimab use expands. KEYPOINT Question Does the effectiveness of nirsevimab against hospitalization for RSV-bronchiolitis change based on the RSV lineages? Findings In this case-control test negative design study that include 3019 infants, the effectiveness of nirsevimab against hospitalization for bronchiolitis was significantly higher with RSV-B than with RSV-A. Specifically, we found a 3.2-fold risk of immunization failure with lineages derived from A.D.3 than with lineages with highest effectiveness. Meaning This study suggest that nirsevimab effectiveness varies substantially across RSV lineages, with lineages derived from A.D.3 less susceptible to nirsevimab. This highlight the importance of molecular and clinical surveillance over the coming years of wide nirsevimab use.
Mathieu Barbier, Corinne Lévy, Robert Cohen et al.
Abstract Respiratory syncytial virus (RSV) is a leading cause of infant morbidity and hospitalisation in the UK. Postnatal monoclonal antibody (mAb) immunisation can protect infants, but implementation depends on parental acceptance. We surveyed 12,326 UK parents of children under 18 years in August–September 2024, measuring intent to accept a hypothetical RSV mAb injection for an infant if free through the National Health Service. We estimated national and sub-national intent using multilevel regression and poststratification aligned to UK census data, assessed socio-demographic and behavioural determinants, and embedded an online randomised controlled trial in which a control arm received no additional timing or disease-burden information and six intervention arms varied this information. Estimated national RSV mAb intent was high, with 88.8% leaning towards or definitively intending to immunise, although only 54.0% expressed firm intent. Intent was slightly lower in urban areas, especially London, and among older parents, those born outside the UK, and some ethnic minority groups. Belief in vaccine safety, importance, and trust in health workers were strong positive predictors of intent. Information that the mAb would be administered shortly after birth reduced post-exposure intent relative to control, highlighting the importance of timing, framing, and communication for equitable uptake across groups.
J. Happenhofer, M. Carreno, Alexandre de Figueiredo
The cultural emphasis on mothers' individual responsibility and choice regarding their children's health is often considered a key factor behind vaccine hesitancy, especially among the middle class in Western countries. Drawing on qualitative interviews with vaccine-hesitant Russian mothers, this article broadens this discussion in two ways. First, it shifts the focus from women as autonomous decision-makers to examining how they share vaccination-related responsibilities with other family members. Second, it situates these dynamics within Russian healthcare and childcare-institutional settings where neoliberal trends coexist with socialist legacies and strong state control. The study shows that beneath the surface of responsibilised and seemingly individualistic mothering lies a network of care and familial commitment that frames vaccination decision-making. This is particularly relevant for institutional contexts that promote individual health responsibility without consistently supporting it, thereby fuelling parental distrust in vaccinations and making family involvement essential for navigating volatile welfare environments.
Ekaterina Borozdina
