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Öğe Effectiveness of a new bioequivalent formulation of oseltamivir (Enfluvir ®) on 2010-2011 seasonal influenza viruses: An open phase IV study(2012) Ceyhan M.; Karadag Oncel E.; Badur S.; Ciblak M.A.; Alhan E.; Celik U.S.; Kurugol Z.; Saz E.U.; Ozsurekci Y.; Celik M.; Parlakay A.O.Objective: The aim of this multicenter prospective study was to evaluate the efficacy of a new bioequivalent formulation of oseltamivir for the treatment of influenza A, influenza B, and H1N1 during the 2010-2011 influenza season. Methods: We compared the symptoms and signs of 300 pediatric patients presenting to three university hospitals with an influenza-like illness between January and March 2011. Nasal swab specimens were collected from all children and tested by reverse-transcription polymerase chain reaction (RT-PCR) for influenza viruses. After randomization, half of the participants were prescribed oseltamivir, while the other half were observed conservatively. Forty patients who were followed-up for influenza prior to the study were also included in the evaluation. Results: Influenza was confirmed by RT-PCR in 129 children, 71 of whom were prescribed oseltamivir. The durations of the symptoms fever, cough, nasal congestion, and rhinorrhea were significantly shorter for patients who were treated with oseltamivir compared with untreated patients (. p<. 0.002 for all symptoms). Early initiation of oseltamivir therapy (within 48. h of the onset of symptoms) was associated with more favorable outcomes and an earlier recovery than in patients for whom treatment was delayed (beyond 48. h). Thirty-seven patients (28.7%) had H1N1, 44 (34.1%) had influenza A, 46 (35.7%) had influenza B, one (0.8%) had H1N1 plus influenza A, and one (0.8%) had influenza A plus influenza B viruses. In the comparison of the duration of symptoms according to the different virus types, a statistically significant difference was only observed in patients with influenza B who had a longer duration of cough (. p<. 0.001), nasal congestion (. p<. 0.001), and rhinorrhea (. p<. 0.001). Conclusions: Oseltamivir is an effective treatment for the management of seasonal influenza and H1N1, and should be initiated immediately without waiting for laboratory confirmation of diagnosis. © 2012 International Society for Infectious Diseases.Öğe Hepatitis A seroprevalence in a random sample of the Turkish population by simultaneous EPI cluster and comparison with surveys in Turkey(Turkish Journal of Pediatrics, 2002) Kanra G.; Tezcan S.; Badur S.; Turkish National Study Team; Alp H.; Bulut A.; Şükrü C.; Çan C.; Dağbaşı N.; Dündar C.; Egemen A.; Eskiocak M.; Evliyaoğlu N.; Güraksın A.; Mocan H.; Öztürk F.; Saka G.; Sıdal M.; Ulukol B.; Tanyer G.; Taş M.A.; Velicangil O.; Yazıaoğlu M.This study was conducted to determine the hepatitis A virus (HAV) seroprevalence in nine provinces representative of Turkey as a whole. These provinces are representative of the country's geographical location, and demographic, economic and social characteristics. In each province, sample sizes were determined using published data on HAV seroprevalence, and sample sizes for each province and for the cluster were calculated for each group of subjects under the age of 30 for seroprevalence estimates within a 95% confidence interval. The samples were selected by a cluster method, and the planned recruitment was a total of 4,800 subjects, including 600 subjects each from five large provinces (Istanbul, Ankara, Izmir, Adana, Diyarbakir) and 450 subjects from each of the remaining four provinces (Samsun, Erzurum, Trabzon, Edirne). These numbers were distributed in accordance with the percentages for age groups in five-year increments starting from age five for the population under the age of 30 living in the rural and urban areas in each province. This study of 4,462 subjects under the age of 30 in nine provinces of Turkey identified an overall HAV seroprevalence rate of 71.3%. The distribution of HAV seroprevalences by age showed a steady increase from one year of age from 42.7% to 91.1% at 25-29 years of age. HAV seroprevalence was slightly higher in female subjects (73%) than in male subjects (69.3%). By educational status, seroprevalences were comparable except in young children under age six. Seroprevalence was notably higher in large families with six and more members (80.1%) than in small families with five or fewer members (66.7%). According to our study results, 50% of Tarkish children are seropositive for HAV by the age of 10 years. We believe the date support the need for a routine primary immunization policy in Turkey and the development of effective prophylactic programs after possible exposure. Consequently, an immunization policy can be developed for each region according to its epidemiological conditions. © 2002, Turkish Journal of Pediatrics. All rights reserved.Öğe Hepatitis B and measles seroprevalence among Turkish children(2005) Kanra G.; Tezcan S.; Badur S.; Alp H.; Bulut A.; Cin S.; Mocan G.; Dagbaşi N.; Dündar C.; Egemen A.; Eskiocak M.; Evliyaog¨lu N.; Güraksin A.; Kara A.; Mocan H.; Özmert E.; Oztürk F.; Saka G.; Sidal M.; Ulukol B.; Tanyer G.; Tas M.A.; Velicangil Ö.; Yazicioglu M.This study was performed to determine hepatitis B and measles seroprevalence among the population under 30 years of age in Turkey. Blood samples of 2,683 subjects from eight provinces of Turkey were studied. Measles IgG was determined by hemagglutinin inhibition method, and hepatitits B surface antigen (HBsAg), anti-hepatitis B surface antibody (anti-HBs) and anti-hepatitis B core antibodies (anti-HBc) were determined by ELISA method. Overall seropositivity for measles was found to be 59.6%. There was a significant difference in seropositivity among provinces. The seropositivity was found to increase with age. The overall seropositivities for HBsAg, anti-HBs and anti-HBc were found to be 5.4%, 17% and 15.1 %, respectively. The seroprevalences differed significantly among provinces. Although seroprevalence for anti-HBs and anti-HBc increased with age, HBsAg seropositivity did not change significantly after one year of age. Seroprevalence was not affected by sex. It was concluded that every effort should be given to vaccinate infants as early as possible for hepatitis B and that the coverage of infancy measles vaccination should be increased with a second dose.Öğe Influenza viruses types in 2010-2011 winter season and effectiveness of oseltamivir treatment [2010-2011 ki{dotless}ş sezonunda görülen İnfluenza virüsü tipleri ve tedavide oseltamivir'in etkinligi](2012) Ceyhan M.; Öncel E.K.; Badur S.; Ciblak M.A.; Alhan E.; Çelik U.S.; Kurugöl Z.; Saz E.U.; Özsürekçi Y.; Çelik M.; Parlakay A.O.Objective: The aim of this multicentric prospective study was to evaluate the efficacy of a new bioequivalent formulation of oseltamivir for the treatment of influenza A, influenza B and H1N1 during the 2010- 2011 influenza season. Materials and Methods: We compared the symptoms and signs of 300 pediatric patients presenting to three University hospitals with an influenza-like illness, between January and March 2011. Nasal swab specimens were collected from all children and tested by reverse-transcription polymerase chain reaction (RT-PCR) for influenza viruses. After randomization, half of the participants were prescribed oseltamivir, while the other half were observed conservatively. Forty patients who were followed-up for influenza prior to the study were also included into the evaluation. Results: Influenza was confirmed by RT-PCR in 129 children, 71 of whom were prescribed oseltamivir. The durations of symptoms such as fever, cough, nasal congestion and rhinorrhea were significantly shorter for patients who were treated with oseltamivir compared with untreated patients (for all symptoms p<0.002). Early initiation of oseltamivir therapy (within 48 hours of the onset of symptoms) was associated with more favorable outcomes and a earlier recovery than in patients for whom treatment was delayed (beyond 48 hours). Thirty-seven patients (28.6%) had H1N1, 44 (34.1%) had influenza A, 46 (35.6%) had influenza B, 1 (0.75%) had H1N1 plus influenza A and 1 (0.75%) had influenza A plus influenza B viruses. In the comparison of the duration of symptoms in different virus types, a statistically significant difference was only observed in patients with influenza B, who had a longer duration of cough (p<0.001), nasal congestion (p<0.001) and rhinorrhea (p<0.001). Conclusion: Oseltamivir is an effective treatment for the management of seasonal influenza and H1N1, and should be initiated immediately without waiting for laboratory confirmation of diagnosis.
