ABSTRACT
INTRODUCTION: Mexico was the country to initiate massive vaccination with heptavalent pneumococcal conjugate vaccine (PCV-7) in children. There is no information regarding pneumococcal invasive disease (PID) in children before and after implementation of PCV-7 in Mexico or elsewhere in Latin America. METHODOLOGY: During October 2005 to September 2010, active surveillance for pediatric PID was initiated at Tijuana General Hospital. Only culture-confirmed cases from sterile fluids were included in the study. Serotype identification was also performed. RESULTS: Twenty-eight pediatric PID cases were confirmed. Streptococcus pneumoniae was the main cause of pleural empyema (n = 13). It was also the second most common cause of confirmed bacterial meningitis (n = 10), followed by Neisseria meningitidis (n = ?), and the only cause of otomastoiditis with bacterial isolation (n = 5). Vaccine-associated serotypes decreased from 54% before PCV-7 introduction to the vaccination schedule, to only 5.6% after PCV-7 implementation. Serotypes 19A and 7F (47% and 33% respectively were predominant following PCV-7 vaccination. CONCLUSIONS: Serotype substitution in PID is present in the northern border of Mexico following PCV-7 vaccination in children.
Subject(s)
Pneumococcal Infections/epidemiology , Pneumococcal Infections/microbiology , Pneumococcal Vaccines/administration & dosage , Pneumococcal Vaccines/immunology , Streptococcus pneumoniae/classification , Streptococcus pneumoniae/isolation & purification , Adolescent , Child , Child, Preschool , Empyema/epidemiology , Empyema/microbiology , Heptavalent Pneumococcal Conjugate Vaccine , Hospitals, Pediatric , Humans , Infant , Male , Mastoiditis/epidemiology , Mastoiditis/microbiology , Meningitis, Bacterial/epidemiology , Meningitis, Bacterial/microbiology , Mexico/epidemiology , SerotypingABSTRACT
We reviewed confirmed cases of pediatric invasive meningococcal disease in Tijuana, Mexico, and San Diego County, California, USA, during 2005-2008. The overall incidence and fatality rate observed in Tijuana were similar to those found in the US, and serogroup distribution suggests that most cases in Tijuana are vaccine preventable.
Subject(s)
Meningococcal Infections/epidemiology , Neisseria meningitidis, Serogroup C/classification , Neisseria meningitidis/classification , Population Surveillance/methods , Adolescent , Age Distribution , California/epidemiology , Child , Child, Preschool , Humans , Incidence , Infant , Infant, Newborn , Meningococcal Infections/microbiology , Meningococcal Infections/prevention & control , Mexico/epidemiology , Neisseria meningitidis, Serogroup C/isolation & purification , Risk Factors , United States/epidemiologyABSTRACT
Because there is little routine tuberculosis (TB) screening in Mexico, the prevalence of latent TB infection (LTBI) is unknown. In the context of an increasing HIV epidemic in Tijuana, Mexico, understanding prevalence of LTBI to anticipate emergence of increased LTBI reactivation is critical. Therefore, we recruited injection drug users, noninjection drug users, female sex workers, and homeless persons for a study involving risk assessment, rapid HIV testing, and TB screening. Of 503 participants, the overall prevalences of TB infection, HIV infection, and TB/HIV co-infection were 57%, 4.2%, and 2.2%, respectively; no significant differences by risk group (p>0.05) were observed. Two participants had TB (prevalence 398/100,000). Incarceration in Mexico (odds ratio [OR] 2.28), age (OR 1.03 per year), and years lived in Tijuana (OR 1.02 per year) were independently associated with TB infection (p<0.05). Frequent LTBI in marginalized persons may lead to increases in TB as HIV spreads.
