ABSTRACT
Objetivo: Evaluar el impacto de la indicación ministerial de la vacunación contra Influenza a lactantes sanos entre 6 y 24 meses iniciada en el año 2006. Material y método: Revisión retrospectiva de fichas clínicas de pacientes hospitalizados por infección respiratoria causada por virus Influenza entre enero 2004 y diciembre 2007 en el Hospital Roberto del Río. Todos los casos fueron confirmados mediante inmunofluorescencia viral positiva para Influenza A o B. Resultados: De un total de 224 pacientes, 122 corresponden al período prevacuna (años 2004-2005) y 102 al postvacuna (años 2006-2007). La tasa de hospitalización fue similar para todos los años estudiados. Durante el período postvacuna recibieron vacunación solo 4 de los 102 pacientes, el 68 por ciento de los no vacunados se encontraban al momento de la campaña ministerial fuera del rango etario con indicación de vacunación. El 70 por ciento de los hospitalizados corresponden a pacientes menores de 2 años en ambos grupos. No se registró diferencia estadísticamente significativa en sexo, días de hospitalización, requerimientos de oxígeno, ingreso a UCI ni necesidad de ventilación mecánica invasiva. Un 75 por ciento de los hospitalizados corresponde a pacientes sin comorbilidad. Se evidencia un cambio en el patrón estacional de las infecciones por Influenza luego de la introducción de la vacuna manteniéndose éstas presentes a lo largo de todo el año. Conclusiones: No existe una disminución en la tasa de hospitalización ni cambios en las características clínicas de los pacientes hospitalizados luego de la introducción de la vacuna. Si se evidencia un cambio en la distribución estacional con un aplanamiento de la curva a diferencia de la clásica presentación en brote descrita en la literatura y observada en nuestro país previo a esta medida.
Objective: To evaluate the impact of the ministerial statement of vaccination against influenza in healthy infants in the age group of 6 and 24 months since 2006. Material and Methods: Retrospective review of medical records of patients hospitalized due to respiratory infection caused by influenza virus between January 2004 and December 2007 at the Hospital Roberto del Río. All cases were confirmed by positive immunofluorescence for influenza virus A or B. Results: Of a total of 224 patients, 122 are from the pre-vaccination period (2004-2005) and 102 from post vaccination period (2006-2007). The hospitalization rate was similar during the study time course. During the post vaccination period only 4 of 102 patients received vaccination, meanwhile 68 percent of them were out of age requirements for the vaccination ministerial campaign. 70 percent of hospitalized patients are younger than 2 years in both groups. There were not significant differences in sex, hospital stay, oxygen requirements, ICU admission or in the need of invasive mechanical ventilation. 75 percent of hospitalized patients did not exhibit comorbility. These results show a change in the seasonal pattern of influenza infections after the vaccine introduction that remains all over the years. Conclusions: There is not a decrease in the hospitalization rate or a change in the clinical characteristics of hospitalized patients after the vaccine introduction. There is a clear change in the seasonal distribution with a curve flattening, unlike the classic outbreak presentation described in literature and observed in our country prior to this program.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Hospitalization/statistics & numerical data , Influenza Vaccines/administration & dosage , Chile , Age and Sex Distribution , Respiratory Tract Diseases/epidemiology , Respiratory Tract Diseases/therapy , Retrospective Studies , Evaluation of Results of Preventive Actions , Length of Stay , Intensive Care Units/statistics & numerical data , Seasons , Severity of Illness IndexABSTRACT
Background: The clinical assessment of asthma control is fundamental to evaluate the results of treatment. The Asthma Control Test (ACT) is a questionnaire with five scored items, that differentiates between a well controlled or uncontrolled asthma. It has a Spanish version and has been applied in different countries. Aim: To assess asthma control using the ACT and compare it with the clinical assessment of specialists in a group of pediatric patients. Material and methods: The ACT was applied to 220 adolescents aged 12 to 17 years, 54 percent males, with persistent asthma, attended at a respiratory disease unit of a pediatric hospital. The concordance between ACT results and the assessment of specialists was also evaluated. Results: According to ACT and specialists, asthma was controlled in 54 percent and 63 percent of patients, respectively. There was a weak concordance between ACT and specialists assessment (Kappa index: 0.27; 95 percent confidence intervals: 0.14-0.4). The degree of asthma control decreased along with increasing severity of the disease ( percentz = 10.128, p =0.001). Conclusions: Half of the evaluated asthmatic adolescents do not have an adequate control of their disease. Severity of the disease is inversely related to the degree of control