Association between contextual factors and coverage of the Acwy meningococcal vaccine, after three years of its overdue, in the vaccination calendar of adolescents in the state of Minas Gerais, Brazil: global space regressions.

The objective of the study was to analyze the spatial distribution of vaccination coverage of bacterial meningitis vaccine: A, C, W and Y (menacwy) and identify the association between socioeconomic and social environment factors with menacwy vaccine coverage among adolescents in the state of Minas Gerais (MG), Brazil. This is an ecological, mixed study, conducted with secondary data from the 853 municipalities of the State of MG, Brazil, from 2020 to 2022, provided by the information system of the National Immunization Program. For spatial statistical analysis, spatial dependence and the presence of spatial clusters formed by municipalities with high and low vaccination coverage of Menacwy were evaluated. In the year 2021, MG presented the largest vaccination coverage (60.58%) since the introduction of the Menacwy vaccine by the PNI. Regarding the analysis of global regressions, it is observed that for the year 2020, as the MG Index of Social Responsibility-Health increased and MG Index of Social Responsibility-Public Security increased, increased the vaccination coverage of the municipalities of the Menacwy vaccine. Finally, compared to 2021, similar association was observed in relation to the proportion of the population served by the Family Health Strategy of the municipalities of the state of MG and per capita spending on education activities: as this indicator increased, with increased coverage of the Vaccine of the Menacwy vaccine of the state municipalities. They reinforce the importance of assessing the quality-of-care management and health surveillance system, professional training, and damage reduction to populations, especially adolescents.

Situação epidemiológica das meningites em Minas Gerais, 1990 a 2006: incidência, etiologia, letalidade e critério diagnóstico / Epidemiological features on meningitis in Minas Gerais, Brazil, 1990-2006: incidence and case fatality rates, diagnostic criteria

A meningite é um problema de saúde pública complexo em razão da sua multicausalidade de natureza infecciosa cuja prevenção e controle exigem estratégias diversas. Objetivo: analisar características epidemiológicas e a qualidade diagnóstica da meningite em Minas Gerais. Método: realizou-se estudo descritivo das meningites emMinas Gerais no período de 1990 a 2006, notificadas à Secretaria de Estado de Saúde e registradas no Sistema de Informação de Agravos de Notificação. Foram analisadas incidência e letalidade por etiologia e faixa etária, critério diagnóstico, com destaque para a doença meningocócica (DM). Resultados: predominou a meningite de etiologia bacteriana, média de 47, seguida da meningite virótica, média de 30 . Dentre as bacterianas, o maior número de casos deveu-se à Neisseria meningitidis, seguido pelo Streptococcus pneumoniae e Haemophilus influenzae. A partir de 1999, a incidência das meningites bacterianas e das não especificadas vêm decaindo, porém a letalidade apresentou aumento. Após 2001, ocorreu diminuição também da incidência da meningite presumivelmente viral. A incidência foi maior na faixa etária menor de cinco anos e a letalidade maior no menor de um ano e após 50 anos de idade. A DM foi diagnosticada principalmente por bacterioscopia e clínica (54) e as outras etiologias pela citoquímica e clínica em 70 dos casos. Esta deficiência no diagnóstico reflete-se na baixa sorogrupagem dos casos de DM, com identificação de 25 a 30. A redução na incidência e o aumento da letalidade das meningites podem ser devidos à subnotificação que, somada à deficiência no diagnóstico etiológico, torna prioritário o aprimoramentodas ações de vigilância e melhoria da rede assistencial e laboratorial de Minas Gerais.

Meningitis is a complex public health problem by virtue of its multiple infectious causes that demand many prevention and control strategies. Objective: To analyze epidemiologic aspects and the diagnostic efficacy of meningitis in Minas Gerais in the period between 1990 and 2006. Method: A descriptive study of meningitis was carried out based on the cases notified tothe State Office of Health and registered in the Diseases of Mandatory Notification Surveillance System – SINAN. Cases were analyzed regarding incidence, case fatality rates per etiologyand per age group and diagnostic criteria, with an emphasis on meningococcal disease (MD).Results: Bacterial meningitis, with an average of 47, was observed to be predominant, followed by viral meningitis, with an average of 30. Among bacterial etiologies, the most frequent agent was found to be Neisseria meningitides, followed by Streptococcus pneumoniae. From the year of 1999, the incidence of bacterial and non-specified meningitis decreased, but lethality increased. After 2001, the incidence of presumed viral meningitis incidence began to decrease. The highestincidence was found in the age group of less than 5 years, and lethality was highest in the age ranges below oneand above 50 years. MD was diagnosed mainly by means of bacterioscopy and clinical findings (54 of the cases),while the other etiologies were diagnosed with citochemistry and clinical findings in 70 of the cases. This diagnostic deficiency reflects on a low serogrouping of MD cases, withan identification rate of 25-30. The observed decrease in incidence and increase in the lethality of meningitis may be due to undernotification, which, in addition to the deficiency in etiological diagnosis, stresses the need for prioritizing improvements in surveillance actions and in the health care network of the state of Minas Gerais.