Incidence of Hepatitis A in Argentina after vaccination.

In Argentina, the annual incidence rate of reported hepatitis A disease ranged from 70.5 to 173.8 per 100,000 during 1995-2004. A single dose universal hepatitis A immunization program aimed at children aged 12 months was started in June 2005. The aim was to observe the impact of universal vaccination against hepatitis A in Argentina. A longitudinal analysis of hepatitis A rates reported in Argentina since 1995 to the National Notifiable Diseases Surveillance System (SINAVE). Incidence rates in 2007 were compared with those for the prevaccination baseline period (1998-2002), overall and by age group and geographical regions. Overall vaccine coverage in Argentina was 95% in 2006 for the single dose. After initiating the program, a sharp decrease in disease rates was observed. The annual incidence of 10.2 per 100,000 during 2007 represents 88.0% reduction with respect to the average incidence rate for the period 1998-2002 (P < 0.001). For children aged 1 year, an 83.1% reduction in disease was observed in 2007, compared with the baseline period (P < 0.001). Furthermore, a sharp decline was also observed in all other age groups 87.1% [2-4 years], 88.7% [5-9 years], 83.6% [10-14 years], 78.8% [15-49 years], 20.7% [>50 years]. Also important reductions were observed in all Argentinian regions. Following the implementation of universal hepatitis vaccination with a single dose to children at 12 months of age, hepatitis A rates have declined substantially in Argentina. Monitoring is needed to verify that vaccination continues to proceed and that low rates are sustained.

Poisson regression in mapping cancer mortality.

The aim of this study was to map standardized mortality ratios (SMRs) of specific cancers in Argentina and to examine some ecological relationships using Poisson regression, Poisson regression with frailties, and empirical Bayes estimates. Mortality data for lung cancer, nonmelanoma skin cancer, melanoma, and stomach cancer were obtained from national registers for the period 1989-1993. Overcrowding and unsatisfied basic needs (UBN) were used as indicators of socioeconomic status and people working permanently on farms as an indicator of rural activity. Empirical Bayes estimates provided a good solution for mapping rare causes of cancer when random fluctuations of observed deaths are important, as in the case of nonmelanoma skin cancer (NMSC) and melanoma. In the case of lung and stomach cancers the main improvement was the attenuation of confidence intervals. Lung cancer rates (males and females) were higher in jurisdictions with better socioeconomic status. When the variable UBN was categorized in tertiles (<20, 20-27, and 28% and higher) the rate ratios of lung cancer in men fell to 0.82 IC 95% (0. 78-0.85) in those with UNB index among 20-27% with respect to the reference level and to 0.56 IC 95% (0.54-0.59) in those with more than 28%. In contrast, stomach cancer rates were associated with worse economic conditions. NMSC and melanoma showed different patterns. The former was associated with working on farms, while the latter was not. Neither NMSC nor melanoma was increased in areas affected by Antarctica's ozone hole. Research appears to be warranted to further investigate associations of lung cancer with smoking and behavior in women living in southern Argentinean provinces. Public education must continue to promote personal responsibility in the intervention process to reduce the morbidity and mortality associated with cancers, such as lung and skin cancer, which are partially avoidable through behavioral changes.

[Prevalence of cardiovascular risk factors in first year university students]. / Prevalencia de factores de riesgo cardiovascular en ingresantes universitarios.

The prevalence of cardiovascular risk factors and their relation to a self-reported family history of disease was examined in 3,357 first year university students of Mar del Plata University (Argentine). The prevalence of family disease was 27.5% for hypercholesterolemia, 42.1% for hypertension, 26.9% for diabetes mellitus, 27.2% for obesity and 42.1% for cardiovascular disease. The percentual of 80.7% of the population surveyed showed at least one of these diseases in their previous family history. The prevalence of hypertension (systolic blood pressure levels > or = 140 mmHg) or/and diastolic blood pressure levels > or = 90 mmHg) was 7.0%. Hypertension was related to Body Mass Index (BMI), male sex and age. The percentual of 14.4% presented hypercholesterolemia (> or = 210 mg/dl), which was associated with age, BMI and family history of obesity and hypercholesterolemia. Nine hundred and eleven subjects (27.1%) were smokers. Differences related to sex were not found. Smoking was positively related to age and the career they had chosen. The examination detected one hundred and twenty-three (3.7%) students with cardiac problems. This was associated with a family history of cardiovascular disease. Preventive measures were suggested.