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Typhoid fever commonly affects young children in endemic areas and antibiotic resistance is increasing (in a large epidemic in Tajikistan in 1996–98 over 90% of the organisms were multidrug resistant and 82% were ciprofloxacin resistant). The development of an effective conjugate vaccine could, therefore, hardly come at a more opportune time. In Vietnam (New England Journal of Medicine2001; 344:1263–9, see also editorial Ibid: 1322–3) a randomised, placebo-controlled trial included over 11 000 children aged 2–5 years. Two doses of the vaccine (Vi capsular polysaccharide antigen conjugated with a non–toxic recombinantPseudomonas aeruginosa exotoxin A) provided 91.5% protection against blood culture confirmed typhoid fever. In all children tested, the second dose of the vaccine caused at least a tenfold increase in antibody titre.
Anxiety disorders are said to be the most common kind of psychiatric disorder to affect children but the best way of treating them is uncertain. In a placebo controlled trial at five US academic centres (New England Journal of Medicine2001;344:1279–85, see also editorial, Ibid: 1326–7) a clinically significant response to 8 weeks of treatment occurred in 76% of 6–17 year old children randomised to fluvoxamine (a selective serotonin-reuptake inhibitor) and 29% of controls. The editorialist, though, suggests that cognitive behavioural therapy could be the best initial treatment.
A multicentre trial involving 12–33 month old …