RESUMO
BACKGROUND AND OBJECTIVE: The 7-valent pneumococcal conjugate vaccine (PCV7) has been commercialized in Spain since June 2001. We aim to evaluate the impact of this vaccine in the incidence of invasive pneumococcal disease (IPD) in Navarre. POPULATION AND METHOD: The laboratories of microbiology of Navarre declare all the isolations of Streptococcus pneumoniae in samples of normally sterile corporal fluids. We analyzed the incidence of IPD in children younger than 5 years between weeks 41 of 2000 and 40 of 2005. RESULTS: The doses of PCV7 sold up to 2005 would provide a cover of 27% in children younger than 5 years, having assumed 4 dose schedules. In the 5 seasons, 103 cases of IPD were diagnosed. From the 2 first seasons (2000-2002) to the last one (2004-2005) a reduction of 69% in the incidence rate of IPD caused by vaccine serotypes was observed (from 33 to 10 cases by 100,000 children under 5 years; p = 0.003). Between those same periods the incidence of IPD caused by non-vaccine serotypes increased a 36% (from 42 to 57 by 100,000; p = 0.405). The global incidence of IPD diminished a 12% (from 77 to 67 by 100,000; p = 0.689). The percentage of cases that had received PCV7 increased until 45% in season 2004-2005 (p < 0.001). The meningitis and bacteraemic pneumonias supposed 42% of the IPD, without significant changes during the period (p = 0.442). CONCLUSIONS: Since the PCV7 was marketed the pattern of serotypes has changed, but the expected reduction in the total IPD incidence has not been achieved.
Assuntos
Vacinas Meningocócicas , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas , Pré-Escolar , Vacina Pneumocócica Conjugada Heptavalente , Humanos , Incidência , Lactente , Infecções Pneumocócicas/epidemiologia , Espanha/epidemiologiaRESUMO
Fundamento y objetivo: Desde junio de 2001 se comercializa en España la vacuna neumocócica conjugada heptavalente (VNC7v). Nuestro objetivo ha sido evaluar su impacto en la incidencia de enfermedad neumocócica invasiva (ENI) en Navarra. Población y método: Los laboratorios de microbiología de Navarra declaran todos los aislamientos de neumococo en muestras de fluidos corporales normalmente estériles. Analizamos la incidencia de ENI en niños menores de 5 años entre las semanas 41 de 2000 y 40 de 2005. Resultados: Las dosis de VNC7v vendidas hasta 2005 permitirían alcanzar una cobertura del 27% en menores de 5 años, suponiendo 4 dosis por niño. Entre las 5 temporadas se diagnosticaron 103 casos de ENI. Comparando la incidencia de ENI en las 2 primeras temporadas (2000-2002) con la última (2004-2005), se observa un descenso del 69% en la tasa por serotipos vacunales (de 33 a 10 casos por 100.000 menores de 5 años; p = 0,003). Entre esos mismos períodos, la incidencia de ENI por serotipos no vacunales aumentó un 36% (de 42 a 57 por 100.000; p = 0,405). La incidencia global de ENI disminuyó un 12% (de 77 a 67 por 100.000; p = 0,689). El porcentaje de casos que habían recibido VNC7v aumentó hasta el 45% en la temporada 2004-2005 (p < 0,001). Las meningitis y neumonías bacteriémicas supusieron el 42% de las ENI, sin cambios significativos durante el período (p = 0,442). Conclusiones: Tras la comercialización de la VNC7v ha cambiado el patrón de serotipos, pero no se ha conseguido el descenso esperado de la incidencia global de ENI
Background and objective: The 7-valent pneumococcal conjugate vaccine (PCV7) has been commercialized in Spain since June 2001. We aim to evaluate the impact of this vaccine in the incidence of invasive pneumococcal disease (IPD) in Navarre. Population and method: The laboratories of microbiology of Navarre declare all the isolations of Streptococcus pneumoniae in samples of normally sterile corporal fluids. We analyzed the incidence of IPD in children younger than 5 years between weeks 41 of 2000 and 40 of 2005. Results: The doses of PCV7 sold up to 2005 would provide a cover of 27% in children younger than 5 years, having assumed 4 dose schedules. In the 5 seasons, 103 cases of IPD were diagnosed. From the 2 first seasons (2000-2002) to the last one (2004-2005) a reduction of 69% in the incidence rate of IPD caused by vaccine serotypes was observed (from 33 to 10 cases by 100,000 children under 5 years; p = 0.003). Between those same periods the incidence of IPD caused by non-vaccine serotypes increased a 36% (from 42 to 57 by 100,000; p = 0.405). The global incidence of IPD diminished a 12% (from 77 to 67 by 100,000; p = 0.689). The percentage of cases that had received PCV7 increased until 45% in season 2004-2005 (p < 0.001). The meningitis and bacteraemic pneumonias supposed 42% of the IPD, without significant changes during the period (p = 0.442). Conclusions: Since the PCV7 was marketed the pattern of serotypes has changed, but the expected reduction in the total IPD incidence has not been achieved
Assuntos
Masculino , Feminino , Lactente , Pré-Escolar , Humanos , Infecções Pneumocócicas/epidemiologia , Meningite Pneumocócica/epidemiologia , Vacinas Pneumocócicas/farmacocinética , Streptococcus pneumoniae/patogenicidade , Monitoramento Epidemiológico , Controle de Doenças Transmissíveis/tendênciasRESUMO
Fundamento y objetivo: La hipertrofia ventricular izquierda (HVI) es la enfermedad cardíaca más frecuente en hipertensos. El objetivo es conocer la prevalencia de HVI en población hipertensa de larga evolución tratada en el ámbito de atención primaria (AP), así como su perfil epidemiológico. Pacientes y método: Estudio descriptivo, transversal y multicéntrico, de 915 hipertensos que acudieron consecutivamente a consultas de AP y llevaban más de 5 años en tratamiento farmacológico. Se midió la presión arterial y se realizó anamnesis y registro de datos electrocardiográficos y bioquímicos. Se evaluó la HVI según criterios de Cornell y/o Sokolow-Lyon. Resultados: La población estudiada (el 63% mujeres) tiene una media de edad de 68,7 años; el 31,6% son diabéticos y el 37,5% tiene la presión arterial controlada. El 30,5% presenta criterios electrocardiográficos de HVI, con mayor prevalencia en mujeres; asimismo, las mujeres con HVI tienen una edad más avanzada. El 30% tiene antecedentes de enfermedad cardiovascular y la prevalencia de insuficiencia cardíaca es mayor en pacientes con HVI. El 54% está en politerapia antihipertensiva y no hay diferencias significativas en el tratamiento de los pacientes con y sin HVI. El 77% de los pacientes con HVI cumplen únicamente el criterio de Cornell; el 12%, sólo el de Sokolow-Lyon y el 11%, ambos criterios. Los pacientes que sólo tienen positividad para el criterio de Cornell se caracterizan por predominio del sexo femenino y mayor prevalencia de obesidad. Conclusiones: La prevalencia de HVI, valorada mediante criterios electrocardiográficos, es elevada en hipertensos de larga evolución, especialmente en mujeres. Es preciso insistir en la realización periódica de electrocardiogramas en hipertensos e incrementar el esfuerzo terapéutico
Background and objective: Left ventricular hypertrophy (LVH) is the most frequent manifestation of cardiac damage in hypertension. The objective of this study was to evaluate the prevalence of LVH in hypertensive patients of long evolution at Primary Care (PC) and to describe their epidemiological profile. Patients and method: 915 hypertensive patients treated for more than 5 years with antihypertensive drugs, who were atended in a consecutive way by de PC physicians, were evaluated in a multicentral and descriptive study. Clinical evaluation data together with electrocardiographic (EKG) and laboratory results were recorded. LVH was assessed by the Cornell and/or Sokolow-Lyon criteria. Results: Study population was characterized by a mean age of 68.7 years, 63% women, 31.6% diabetics, and 37.5% presented controlled blood pressure levels. 30.5% of them presented LVH criteria on EKG, being more prevalent among women, and on the other hand, women with LVH were of a greater age. 30% of patients presented history of cardiovascular disease and heart failure was more frequent among those with LVH. 54% were polymedicated with blood pressure lowering drugs, however there were no differences between groups of patients with and without LVH regarding their treatment. The Cornell criterion and the Sokolow-Lyon criterion alone were presented in a 77% and 12% of patients, respectively, and 11% of them were positive for both criteria. Patients with positivity for only the Cornell criterion were characterized by a greater prevalence of women and obesity. Conclusions: The prevalence of LVH assessed by EKG criteria is high among hypertensive population of long evolution. A greater effort is needed to guarantee a periodic EKG performance in hypertensive patients together with a therapeutic strategy improvement
