Résumé
The national immunization coverage in Thailand for all types of vaccine has been steadily increasing since 1978, when the EPI was formally launched. The coverage in 1987 was 96% for BCG, 75% for DPT, 74% for OPV, and 60% for TT. Measles vaccine, which started only in late 1984, had the lowest coverage, 51%, in 1987. During the period 1982-1987, the drop-out rates between the first and third dose of DPT and OPV decreased dramatically from 69% to 13% and from 42% to 13% respectively. Sampling surveys of immunization coverage showed higher coverage for DPT and OPV than those from reporting in all regions, especially in the capital city which has a high concentration of the private health sector. Only the northeastern region had less coverage from surveys than from reporting. Following the launch of EPI, the disease incidence demonstrated a clearly downward trend for diphtheria, poliomyelitis, and measles, while in the case of pertussis and neonatal tetanus, slower of still fluctuating declines were observed. The reported age-specific incidences per 100,000 population in 1986 for children 0-4 years were as follows: 4 for diphtheria, 0.9 for poliomyelities, 180 for measles, 14 for pertussis, and 10 for tetanus.
Sujets)
Contrôle des maladies transmissibles/méthodes , Études d'évaluation comme sujet , Humains , Immunisation , Monitorage immunologique , Services de médecine préventive/organisation et administration , Thaïlande , VaccinationRésumé
A significant proportion of the illness and death of diarrhoeal diseases in the developing world is estimated to be due to the diarrhoea associated with measles. During February 1983-January 1984 a prospective study of measles in a hospital in Northeastern Thailand was conducted. A total of 550 cases of measles were studied. Diarrhoea was the most frequent complication of measles, occurring in 233 cases (42.4%). The largest proportion (46.2%) of cases with diarrhoea occurred in May-July. Children with measles aged 6-11 months had the highest frequency of diarrhoea (65.7%). Cases aged 1 year and 0-5 months had diarrhoea rates of 60% and 57% respectively. The proportion of measles cases with diarrhoea decreased with increasing age. Only 9.1% (9/99) of stools sent for bacteriological culture were positive. In three of these Shigella spp. were isolated. The rest were non-typhoid Salmonella (2), enteropathogenic Escherichia coli (2), Vibrio cholera (1), and Vibrio parahaemolyticus (1). Other complications among measles cases were pneumonia in 168 (30.5%), otitis media in 28 (5.1%), convulsion in 13 (2.4%), croup in 9 (1.6%), encephalitis in 4 (0.7%), and sepsis in 1 (0.2%). Seven cases (1.3%) died, 4 from pneumonia, 2 from encephalitis, and 1 from sepsis.