Bordetella pertussis: Vaccine Coverage and Immune Status among Children Under Five Years Old in Sana’a City, Yemen

Aims: This study was made to evaluate the immune response to pertussis among children under five years old by measuring the level of circulating Immunoglobulin G (IgG) antibodies against pertussis toxin (IgG-PT) after immunization with the primary series of DPT (DPT1-3)and then determining the coverage rates of universal childhood vaccines.Study Design:Cross-sectional laboratory study.Place and Duration of Study:Department of Medical Microbiology and Clinical Immunology, Faculty of Medicine and Health Sciences, Sana’a University, between June and October 2010.Methodology:A total of 345 children were randomly selected and investigated for universal childhood vaccination coverage rates; of these, 273 children who had received 3 full doses of DPT were studied for their pertussis immunological status. Blood samples were collected from the latter group and then tested for levels of IgG-PT by ELISA method. For assessment IgG-PT levels more than 24 units/ml were considered protected against pertussis. Data were analyzed according to Original Research Article gender and age groups. Results:The coverage rate of pertussis vaccine was 79.1%; only 71.4% of vaccinated children responded to the vaccinewith mean level of 33 U/ml. A statistically significant difference was observed with respect to sero-protective IgG-PT between males and females (63.8% and 84.8% respectively, with χ2=15, p=0.0001). Also, a statistically significant difference was observed with respect to sero-protective IgG-PT in different age groups, with older children (>48 months) having a higher rate of antibodies than younger (13-24 months) (90% and 59.1% respectively, with χ2=3.87, p=.04). Conclusion:We conclude that a considerable proportion of vaccinated children with a normal immune status were not serologically immune to pertussis. They remain to be reconsidered for either revaccination or booster doses due to lack of or inadequate response. Also, the rates of vaccine coverage for the main universal childhood vaccines are low.

Evaluación del uso en adultos de cuatro vacunas: una encuesta poblacional en Argentina / Assessment of the use in adults of four vaccines: a population survey in Argentina

La vacunación es una de las estrategias más efectivas para la prevención de enfermedades. Argentina inició la transición de la vacunación del niño a la de la familia, incorporando la vacunación del adulto. Una de las dificultades con este último grupo es determinar el porcentaje de utilización (PU) de las vacunas. Con el objetivo de caracterizar el PU de las vacunas en adultos en Argentina, la Encuesta Nacional de Factores de Riesgo que realizó el Ministerio de Salud de la Nación en 2013 incluyó un módulo de vacunación. El diseño muestral fue estratificado y multietápico. Fueron encuestadas 32 365 personas >18 años sobre el uso de cuatro vacunas incluidas en el Calendario Nacional de Vacunación: hepatitis B, tétanos, influenza y neumococo. Se consideró toda la población encuestada para tétanos y hepatitis B y ciertos grupos en riesgo para influenza y neumococo, de acuerdo con las recomendaciones. El PU varió según las vacunas analizadas: tétanos 49.8%, hepatitis B 21.7%, influenza 51.6% y neumococo 16.2%. Las principales fuentes de información sobre vacunas del adulto fueron, en primer lugar los medios públicos de comunicación (televisión, internet, etc.), y en segundo lugar el personal de salud (70.8% y 27.9%, respectivamente). Se concluye que la encuesta es una herramienta útil para evaluar el uso de vacunas por adultos, identificar poblaciones con baja cobertura, así como para planificar e implementar estrategias para mejorar la cobertura.

Vaccination is one of the most effective strategies for disease prevention. Argentina initiated the transition from child vaccination to family vaccination through the incorporation of an adult schedule. One of the difficulties with this last group is to assess the percentage of use (PU) of the vaccines. With the aim of determining the PU of adult vaccines in Argentina, a vaccination module was included in the National Survey of Risk Factors carried out in 2013 by the National Ministry of Health. The sampling had a stratified multistage design. A total of 32 365 people = 18 year-old were surveyed about the use of four vaccines included in the National Vaccination Calendar: hepatitis B, tetanus, influenza, and pneumococcus. The entire population was surveyed for tetanus and hepatitis B while certain groups at risk were evaluated for influenza and pneumococcus, according to current recommendations. PU varied according to the vaccine analyzed: tetanus 49.8%, hepatitis B 21.7%, influenza 51.6% and pneumococcus 16.2%. The main information sources on adult vaccination were media (television, internet, etc.) followed by health personnel (70.8% and 27.9%, respectively). The survey is a suitable tool to assess the use of vaccines by adults, identify low coverage populations, and to plan and implement strategies to improve coverage.

Examen médico preventivo (EMP): coberturas y descripción de factores asociados a su aplicación en la población usuaria del sistema público de salud para la Región Metropolitana / Preventive medical examination (PME): coverage and description of factors associated with its application among the users of the Metropolitan Region public health system

El Examen Médico Preventivo (EMP) se define como un plan periódico de monitoreo y evaluación de la salud a lo largo del ciclo vital, cuyo propósito es reducir la morbi-mortalidad y discapacidad debido a enfermedades o condiciones prevenibles o controlables, así como detectar precozmente factores de riesgo tales como tabaquismo, hipertensión arterial, consumo problemático de alcohol, obesidad y sedentarismo. EMP constituye un derecho para toda la población, es ejecutado en la Red de Atención Primaria de Salud y contempla metas de cobertura sobre la población usuaria del Sistema Público de Salud, cuyo cumplimiento es verificado por el Ministerio de Salud de Chile. OBJETIVO: Describir las coberturas de EMP en adultos de 20 a 64 años, en la Región Metropolitana sobre población usuaria del Sistema Público de Salud e identificar factores asociados a su aplicación. MÉTODO: Se revisan los Registros Estadísticos Mensuales del Ministerio de Salud (REM) de EMP regionales realizados en adultos de 20 a 64 años desde Enero de 2006 a Diciembre de 2008. Se determina número de EMP en adultos realizados a nivel regional y por Servicio de Salud, durante el período estudiado. La Población Beneficiaria del Seguro Público de Salud (FONASA) a nivel regional - y por tanto con derecho a este beneficio - se obtiene a partir de las bases de datos FONASA para el periodo estudiado. Desde los REM, se obtiene además la Población regional Bajo Control del Programa Cardiovascular. Para el cálculo de tasas de cobertura, ésta última población se excluye del denominador a fin de no sobreestimar a la población Beneficiaria. Finalmente, se analiza la relación de EMP con Consulta por Morbilidad y Consulta por Control de Salud en la Red de Atención Primaria regional...

The Preventive Medical Examination (PME) is a periodic health care service provided throughout the life cycle, with the purpose of reducing the morbidity, mortality and disability caused by diseases or conditions that are preventable or controllable, and of detecting risk factors such as smoking, arterial hypertension, alcohol abuse, obesity and physical inactivity. The PME constitutes a right for the whole population, is executed in the Primary Health Care System and has coverage objectives for the population using the Public Health System. The implementation is verified by the Chilean Ministry of Health. OBJECTIVE: To describe the coverage of the PME in adults, ages 20 to 64, carried out in the Metropolitan Region among users of the Public Health System, and to identify factors associated with its use. METHOD: The Ministry of Health’s Monthly Statistic Registers (MSR) of the PMEs carried out in adults, ages 20 to 64, from January of 2006 to December of 2008 were inspected; the number of PMEs in adults carried out in the region and in each territorial Health Service during the study period was ascertained. The corresponding beneficiary population of the Public Health Fund (FONASA) was obtained from the FONASA data bases for the study period. Furthermore, the regional population covered by the Cardiovascular Program was obtained from the MSR. In the calculation of the coverage rates, this last mentioned population was excluded from the denominator in order not to overestimate the beneficiary population. Finally, the relation between the PME and the Medical Consultations in the regional Primary Health Care System was analysed. RESULTS: A total of 788,792 PMEs of adults in the Metropolitan Region was carried out between January 2006 and December 2008. The general PME coverage rate of adults was 11.63 percent; 11.82 percent and 12.65 percent for the years 2006, 2007 and 2008 respectively, with an average coverage of 5.42 percent for men...