While increasing immunization coverage is a complex structural an

While increasing immunization coverage is a complex structural and behavioral process, financial incentives may improve routine immunization coverage in developing countries. Food/medicine coupon incentives increased immunization coverage in our low-income communities. Governments could use the strategy of economic incentives to target the poorest areas that have constantly selleck chemicals shown slow progress despite continuous efforts. The authors would like to thank Ismat Lotia for her assistance in data management and Waseem Akbar for ensuring the smooth running of the study. “

risk types of Human Papillomavirus (HPV) have been proved to be the etiologic agents of cervical cancer [1], which ranks as the second most frequent cancer in women all over the world. Among all HPV types, HPV 16 and HPV 18 are two of the most prevalent types in cervical cancer worldwide. However, the distribution of other HPV types varies in different regions. In Asia, HPV 58 is the third most prevalent type in cervical cancer [2], especially in China, where the prevalence of HPV 58 is as high as 7.2% [3]. Besides, in South America and Oceania, the prevalence

of HPV 58 in high-grade lesions patients are 8.4% and 10.4%, respectively, which makes HPV58 as the second most prevalent type in those patients [4]. HPV58 is also the second most common type in both high-grade lesions and low-grade lesions in Central America BYL719 manufacturer and Asia [2] and [4]. The major capsid protein (L1) of HPV can self-assemble into virus-like particles (VLPs) [5] and [6]. L1 VLPs are highly immunogenic and are considered to be an ideal candidate for prophylactic vaccines. However, the neutralizing antibodies induced by L1 VLPs are predominantly type specific with the exception of the closely related types (about 85% L1 amino acid identity) which have weak cross-reactivities [7], [8], [9], [10], [11], [12] and [13]. Furthermore, vaccination with VLPs or virions derived from one animal Papillomavirus type does not protect against experimental infections from different animal types [14], [15] and [16]. Currently licensed HPV 16/18/6/11 quadrivalent

and HPV 16/18 bivalent HPV L1 VLPs vaccines contained two most prevalent types in cervical ever cancer (HPV 16 and 18). The clinical trials of HPV 16/18 bivalent vaccine showed that this vaccine could partially protect against incident infection with HPV 45 and 31, but the vaccine efficacy against HPV 58 was very low [17] and [18]. Analysis of HPV 16/18/6/11 quadrivalent vaccine showed that it only had a 27% efficacy in preventing CIN 1–3 associated with nonvaccine types [19]. Thus, it is of great importance to develop prophylactic vaccines containing HPV 58 to meet the demands of HPV 58 prevalent regions. Many reports demonstrated that immunization with multiple antigens could induce immune interference [20], [21], [22], [23], [24], [25], [26], [27], [28] and [29].

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