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1.
Vaccine ; 42(24): 126077, 2024 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-38960788

RESUMO

BACKGROUND: India aims to eliminate rubella and congenital rubella syndrome (CRS) by 2023. We conducted serosurveys among pregnant women to monitor the trend of rubella immunity and estimate the CRS burden in India following a nationwide measles and rubella vaccination campaign. METHODS: We surveyed pregnant women at 13 sentinel sites across India from Aug to Oct 2022 to estimate seroprevalence of rubella IgG antibodies. Using age-specific seroprevalence data from serosurveys conducted during 2017/2019 (prior to and during the vaccination campaign) and 2022 surveys (after the vaccination campaign), we developed force of infection (FOI) models and estimated incidence and burden of CRS. RESULTS: In 2022, rubella seroprevalence was 85.2% (95% CI: 84.0, 86.2). Among 10 sites which participated in both rounds of serosurveys, the seroprevalence was not different between the two periods (pooled prevalence during 2017/2019: 83.5%, 95% CI: 82.1, 84.8; prevalence during 2022: 85.1%, 95% CI: 83.8, 86.3). The estimated annual incidence of CRS during 2017/2019 in India was 218.3 (95% CI: 209.7, 226.5) per 100, 000 livebirths, resulting in 47,120 (95% CI: 45,260, 48,875) cases of CRS every year. After measles-rubella (MR) vaccination campaign, the estimated incidence of CRS declined to 5.3 (95% CI: 0, 21.2) per 100,000 livebirths, resulting in 1141 (95% CI: 0, 4,569) cases of CRS during the post MR-vaccination campaign period. CONCLUSION: The incidence of CRS in India has substantially decreased following the nationwide MR vaccination campaign. About 15% of women in childbearing age in India lack immunity to rubella and hence susceptible to rubella infection. Since there are no routine rubella vaccination opportunities for this age group under the national immunization program, it is imperative to maintain high rates of rubella vaccination among children to prevent rubella virus exposure among women of childbearing age susceptible for rubella.


Assuntos
Anticorpos Antivirais , Síndrome da Rubéola Congênita , Vacina contra Rubéola , Rubéola (Sarampo Alemão) , Humanos , Feminino , Índia/epidemiologia , Síndrome da Rubéola Congênita/epidemiologia , Síndrome da Rubéola Congênita/prevenção & controle , Estudos Soroepidemiológicos , Gravidez , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/prevenção & controle , Rubéola (Sarampo Alemão)/imunologia , Adulto , Adulto Jovem , Adolescente , Anticorpos Antivirais/sangue , Incidência , Vacina contra Rubéola/imunologia , Vacina contra Rubéola/administração & dosagem , Programas de Imunização , Prevalência , Imunoglobulina G/sangue , Vacinação , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/imunologia , Complicações Infecciosas na Gravidez/prevenção & controle , Vírus da Rubéola/imunologia
2.
Artigo em Português | PAHO-IRIS | ID: phr-59903

RESUMO

A Organização Pan-Americana da Saúde (OPAS) publica o Boletim de Imunização quatro vezes por ano em inglês, francês, português e espanhol. Seu objetivo é facilitar o intercâmbio de ideias e informações sobre programas de imunização na Região das Américas e fora dela. Ele é publicado desde 1979 em inglês e espanhol, com versões em francês e português iniciadas em 2001 e 2019, respectivamente. A edição de marzo de 2024 do Boletim de Imunização aborda os seguintes tópicos: Terceira Reunião Anual da Comissão Regional de Monitoramento e Reverificação da Eliminação do Sarampo, Rubéola e Síndrome da Rubéola Congênita; O Grupo Técnico Assessor da OPAS sobre Doenças Imunopreveníveis fornece recomendações regionais sobre as vacinas contra a dengue e o vírus sincicial respiratório e publica uma declaração sobre os esforços atuais de vacinação contra a COVID-19; Definição do caminho a seguir: reflexões sobre a Iniciativa da OPAS de Eliminação de Doenças Transmissíveis e orientações para o futuro; Rumo à eliminação de doenças associadas à infecção pelo papilomavírus humano no Caribe francês: implementação de uma campanha geral de vacinação nas escolas a partir de outubro de 2023; Metodologia e ferramenta de monitoramento do desempenho do Programa Ampliado de Imunização para a Região das Américas; Vigilância sentinela de rotavírus em menores de 5 anos na Região das Américas; Vigilância sentinela de casos de pneumonia e meningite bacteriana em menores de 5 anos na Região das Américas; Oficina de elaboração de textos e artigos científicos na área de saúde em Bogotá, Colômbia; Classificação final dos casos na Região das Américas, 2022; Sistema de informação de imunização e qualidade dos dados; Curso virtual de autoaprendizagem Ferramentas de monitoramento de intervenções integradas em saúde pública. Vacinação e desparasitação de geo-helmintíases; e Fortalecimento da gestão dos dados de imunização.


Assuntos
Imunização , Vacinação , Imunidade , Dengue , COVID-19
3.
Artigo em Espanhol | PAHO-IRIS | ID: phr-59794

RESUMO

La Organización Panamericana de la Salud (OPS) publica cuatro veces al año el Boletín de Inmunización en español, francés, inglés y portugués. Su propósito es facilitar el intercambio de ideas e información sobre los programas de inmunización en la Región de las Américas y más allá. Se publica desde 1979 en inglés y español, con versiones en francés y portugués a partir de 2001 y 2019, respectivamente. El número de marzo del 2024 del Boletín de Inmunización abarca los siguientes temas: Tercera reunión anual de la Comisión Regional de Monitoreo y Reverificación de la Eliminación del Sarampión, la Rubéola y el Síndrome de Rubeola Congénita; El Grupo Técnico Asesor de la OPS sobre Enfermedades Prevenibles por Vacunación ofrece recomendaciones sobre las vacunas contra el dengue y el virus respiratorio sincitial a nivel regional y emite una declaración referente a los esfuerzos continuos de vacunación contra la COVID-19; Trazando el camino a seguir: reflexiones sobre la Iniciativa para la Eliminación de Enfermedades Transmisibles de la OPS y orientaciones futuras; Hacia la eliminación de las enfermedades debidas al virus del papiloma humano en el Caribe francés: puesta en marcha de una campaña de vacunación masiva en las escuelas a partir de octubre del 2023; Metodología y herramienta de monitoreo del desempeño del Program Ampliado de Inmunización para la Región de las Américas; Vigilancia centinela de rotavirus en los menores de 5 años en la Región de las Américas; Vigilancia centinela de neumonías y meningitis bacterianas en menores de 5 años de edad en las Américas; Taller de Elaboración de textos y artículos científicos en el ámbito de la salud en Bogotá (Colombia); Clasificación final de casos en la Región de las Américas, 2022; El sistema de información de inmunización y la calidad de los datos; Curso virtual de autoaprendizaje “Herramientas para el monitoreo de intervenciones integradas en salud pública. Vacunación y desparasitación para las geohelmintiasis”; y Fortalecer la gestión de los datos de inmunizaciones.


Assuntos
Imunização , Vacinação , Dengue , COVID-19
4.
Vaccine ; 42(20): 125982, 2024 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-38811269

RESUMO

Rubella infection during pregnancy can result in miscarriage or infants with a constellation of birth defects known as congenital rubella syndrome (CRS). When coverage is inadequate, rubella vaccination can increase CRS cases by increasing the average age of infection. Thus, the World Health Organisation recommends that countries introducing rubella vaccine be able to vaccinate at least 80% of each birth cohort. Previous studies have focused on national-level analyses and have overlooked sub-national variation in introduction risk. We characterised the sub-national heterogeneity in rubella transmission within Nigeria and modelled local rubella vaccine introduction under different scenarios to refine the set of conditions and strategies required for safe rubella vaccine use. Across Nigeria, the basic reproduction number ranged from 2.6 to 6.2. Consequently, the conditions for safe vaccination varied across states with low-risk areas requiring coverage levels well below 80 %. In high-risk settings, inadequate routine coverage needed to be supplemented by campaigns that allowed for gradual improvements in vaccination coverage over time. Understanding local heterogeneities in both short-term and long-term epidemic dynamics can permit earlier nationwide introduction of rubella vaccination and identify sub-national areas suitable for program monitoring, program improvement and campaign support.


Assuntos
Programas de Imunização , Vacina contra Rubéola , Rubéola (Sarampo Alemão) , Cobertura Vacinal , Humanos , Nigéria/epidemiologia , Vacina contra Rubéola/administração & dosagem , Vacina contra Rubéola/imunologia , Rubéola (Sarampo Alemão)/prevenção & controle , Rubéola (Sarampo Alemão)/epidemiologia , Feminino , Cobertura Vacinal/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Gravidez , Demografia , Lactente , Adolescente , Síndrome da Rubéola Congênita/prevenção & controle , Síndrome da Rubéola Congênita/epidemiologia , Masculino , Adulto Jovem , Adulto
5.
Hum Vaccin Immunother ; 20(1): 2334917, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38584121

RESUMO

Rubella is a major cause of congenital defects, and the presence of rubella infection in a pregnant woman may lead to fetal death or congenital defects known as congenital rubella syndrome(CRS). Since China has not yet established a national CRS surveillance system, the true incidence cannot be determined. To understand the disease burden and epidemiological characteristics of CRS cases in China, the article reports the first case of CRS in Quzhou, China, and conducts a retrospective analysis of related cases that have been reported in China over the past decade. Because the availability of rubella-containing vaccines (RCV) was not widespread in China before 2008, women of childbearing age born before 2008 are generally unvaccinated against RCV. Due to the lack of routine CRS monitoring and screening, CRS is underreported in China. Vaccination of nonimmune women of childbearing age with RCV and establishing a sensitive and timely case-based CRS surveillance system can accelerate the elimination of rubella and CRS.


Assuntos
Síndrome da Rubéola Congênita , Rubéola (Sarampo Alemão) , Gravidez , Humanos , Feminino , Lactente , Síndrome da Rubéola Congênita/epidemiologia , Síndrome da Rubéola Congênita/prevenção & controle , Estudos Retrospectivos , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/prevenção & controle , Vacina contra Rubéola , Vírus da Rubéola
6.
Int J Infect Dis ; 144: 107053, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38641317

RESUMO

BACKGROUND: Vietnam continues to have measles and rubella outbreaks following supplementary immunization activities (SIA) and routine immunization despite both having high reported coverage. To evaluate immunization activities, age-specific immunity against measles and rubella, and the number of averted Congenital Rubella Syndrome (CRS) cases, must be estimated. METHODS: Dried blood spots were collected from 2091 randomly selected individuals aged 1-39 years. Measles and rubella virus-specific immunoglobulin G (IgG) were measured by enzyme immunoassay. Results were considered positive at ≥120 mIU/mL for measles and ≥10 IU/mL for rubella. The number of CRS cases averted by immunization since 2014 were estimated using mathematical modelling. RESULTS: Overall IgG seroprevalence was 99.7% (95%CI: 99.2-99.9) for measles and 83.6% (95%CI: 79.3-87.1) for rubella. Rubella IgG seroprevalence was higher among age groups targeted in the SIA than in non-targeted young adults (95.4% [95%CI: 92.9-97.0] vs 72.4% [95%CI: 63.1-80.1]; P < 0.001). The estimated number of CRS cases averted in 2019 by immunization activities since 2014 ranged from 126 (95%CI: 0-460) to 883 (95%CI: 0-2271) depending on the assumed postvaccination reduction in the force of infection. CONCLUSIONS: The results suggest the SIA was effective, while young adults born before 1998 who remain unprotected for rubella require further vaccination.


Assuntos
Anticorpos Antivirais , Imunoglobulina G , Sarampo , Rubéola (Sarampo Alemão) , Humanos , Imunoglobulina G/sangue , Sarampo/epidemiologia , Sarampo/prevenção & controle , Sarampo/imunologia , Adolescente , Pré-Escolar , Criança , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/imunologia , Rubéola (Sarampo Alemão)/prevenção & controle , Adulto , Masculino , Estudos Soroepidemiológicos , Feminino , Adulto Jovem , Lactente , Anticorpos Antivirais/sangue , Modelos Teóricos , Vacina contra Rubéola/imunologia , Vacina contra Rubéola/administração & dosagem , Vírus da Rubéola/imunologia , Prevalência , Vacina contra Sarampo/imunologia , Vacina contra Sarampo/administração & dosagem , Fatores Etários , Vacinação , Programas de Imunização , Síndrome da Rubéola Congênita/epidemiologia , Síndrome da Rubéola Congênita/prevenção & controle , Síndrome da Rubéola Congênita/imunologia
8.
Washington, D.C.; PAHO; 2024-03-25. (PAHO/CIM/24-0007).
em Inglês | PAHO-IRIS | ID: phr-59382

RESUMO

The Thirty-Seventh Managers’ Meeting of the Caribbean Expanded Program on Immunization was held on 30–31 October 2023 at the Best Western Belize Plus Biltmore Plaza in Belize City, Belize. Sixty-five participants convened from 22 countries and territories of the British West Indies and the Dutch Caribbean. Participants included representatives from the ministries of health, Caribbean Public Health Agency, Caribbean Community, and Pan American Health Organization/World Health Organization (PAHO/WHO). The overall objective of the meeting was to analyze and review the achievements and challenges of 2022, with a view to reversing the gains that were lost over the two years since. In addition, the event provided an occasion to share experiences relating to the immunization program and to plan 2024 activities.


Assuntos
Imunização , Programas de Imunização , Vacinas , Sarampo , Rubéola (Sarampo Alemão) , Síndrome da Rubéola Congênita , Poliomielite
9.
MMWR Morb Mortal Wkly Rep ; 73(8): 162-167, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38421933

RESUMO

Rubella virus is a leading cause of vaccine-preventable birth defects. Infection during pregnancy can result in miscarriage, fetal death, stillbirth, or a constellation of birth defects, including cataracts, deafness, heart defects, and developmental delay, known as congenital rubella syndrome (CRS). A single dose of rubella-containing vaccine can provide lifelong protection against rubella. The Global Vaccine Action Plan 2011-2020 included a target to achieve elimination of rubella in at least five of the six World Health Organization (WHO) regions by 2020, and rubella elimination is a critical goal of the Immunization Agenda 2030. This report updates a previous report and describes progress toward rubella and CRS elimination during 2012-2022. During 2012-2022, among 194 WHO countries, the number that included rubella-containing vaccine (RCV) in their immunization schedules increased from 132 (68%) to 175 (90%) and the percentage of the world's infants vaccinated against rubella increased from 40% to 68%. Reported rubella cases declined 81%, from 93,816 in 2012 to 17,407 in 2022. Verification of rubella elimination was achieved in 98 (51%) of 194 countries by 2022, an increase from 84 (43%) countries in 2019. Despite significant progress in the introduction of RCV into routine immunization programs worldwide, approximately 25 million infants annually still do not have access to RCV. Nevertheless, even in complex settings, the increasing number of countries that have achieved and sustained rubella elimination demonstrates progress toward global rubella elimination.


Assuntos
Síndrome da Rubéola Congênita , Rubéola (Sarampo Alemão) , Lactente , Gravidez , Feminino , Humanos , Síndrome da Rubéola Congênita/epidemiologia , Síndrome da Rubéola Congênita/prevenção & controle , Saúde Global , Vigilância da População , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/prevenção & controle , Vacina contra Rubéola
10.
BMC Pediatr ; 24(1): 31, 2024 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-38200453

RESUMO

BACKGROUND: Following rubella virus control, the most important cause of congenital infections is human cytomegalovirus (HCMV). Congenital CMV (cCMV) may happen both in primary and non-primary maternal infections. The present study aimed to screen cCMV in symptomatic newborns suspected of congenital rubella syndrome (CRS) in Iran. METHODS: Out of 1629 collected infants' serum samples suspected of CRS but negative for rubella IgM, 524 samples were selected regarding cCMV complications. These samples were divided into two age groups: 1- one month and younger, 2- older than 1 month up to one year. Anti-HCMV IgM detection was performed on these serums. Then HCMV IgG avidity assay and HCMV DNA detection were carried out on all samples with positive and borderline results in IgM detection. RESULTS: Herein, 3.67% of symptomatic infants aged one month and younger had positive and borderline HCMV IgM, 12.5% of which had a low avidity index (AI). HCMV IgM detection rate among symptomatic infants older than one month to one year was 14.5%. Identified genotypes in this study were gB-1(63.63%), gB2 (18.18%), and gB3 (18.18%), respectively. CONCLUSIONS: This comprehensive study was performed on serum samples of symptomatic infants clinically suspected of cCMV from all over Iran. There was a good correlation between serology findings and PCR.


Assuntos
Infecções por Citomegalovirus , Síndrome da Rubéola Congênita , Recém-Nascido , Lactente , Humanos , Síndrome da Rubéola Congênita/diagnóstico , Estudos Transversais , Irã (Geográfico)/epidemiologia , Infecções por Citomegalovirus/diagnóstico , Anticorpos Antivirais , Imunoglobulina M
11.
Lancet Glob Health ; 12(2): e217-e225, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38245112

RESUMO

BACKGROUND: Hearing loss affects approximately 1·6 billion individuals worldwide. Many cases are preventable. We aimed to estimate the annual number of new hearing loss cases that could be attributed to meningitis, otitis media, congenital rubella syndrome, cytomegalovirus, and ototoxic medications, specifically aminoglycosides, platinum-based chemotherapeutics, and antimalarials. METHODS: We used a targeted and a rapid systematic literature review to calculate yearly global incidences of each cause of hearing loss. We estimated the prevalence of hearing loss for each presumed cause. For each cause, we calculated the global number of yearly hearing loss cases associated with the exposure by multiplying the estimated exposed population by the prevalence of hearing loss associated with the exposure, accounting for mortality when warranted. FINDINGS: An estimated 257·3 million people per year are exposed to these preventable causes of hearing loss, leading to an estimated 33·8 million new cases of hearing loss worldwide per year. Most hearing loss cases were among those with exposure to ototoxic medications (19·6 million [range 12·6 million-27·9 million] from short-course aminoglycoside therapy and 12·3 million from antimalarials). We estimated that 818 000 cases of hearing loss were caused by otitis media, 346 000 by meningitis, 114 000 by cytomegalovirus, and 59 000 by congenital rubella syndrome. INTERPRETATION: The global burden of preventable hearing loss is large. Hearing loss that is attributable to disease sequelae or ototoxic medications contributes substantially to the global burden of hearing loss. Prevention of these conditions should be a global health priority. FUNDING: The US National Institute on Deafness and Other Communication Disorders and the US National Institute on Aging.


Assuntos
Antimaláricos , Perda Auditiva , Meningite , Otite Média , Síndrome da Rubéola Congênita , Humanos , Perda Auditiva/epidemiologia , Perda Auditiva/prevenção & controle
12.
Graefes Arch Clin Exp Ophthalmol ; 262(3): 777-788, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37878037

RESUMO

PURPOSE: To evaluate the clinical characteristics of congenital rubella retinopathy (CRR) with modern fundus imaging. METHODS: Single-center case series. Eleven patients (2005-2020) at the Emory Eye Center with known or presumed CRR. Trained image readers reviewed fundus imaging (color fundus photography, widefield pseudocolor imaging, near-infrared reflectance imaging, autofluorescence imaging, and spectral-domain optical coherence tomography) for pre-specified features suggestive of CRR. RESULTS: Eleven patients with confirmed (63.6%) or presumed (36.3%) CRR were identified. All were female with median (range) age of 53 (35-67) years. Six (54.5%) were born during the 1964-1965 United States rubella epidemic. All had congenital hearing loss. Two (18.2%) had a congenital heart defect. Eleven (50.0%) eyes had salt-and-pepper retinal pigmentary changes. Twenty-two eyes (100.0%) had irregularly distributed regions of speckled hypoautofluorescence. One eye (4.5%) had a presumed macular neovascularization. CONCLUSION: Modern fundus imaging demonstrates characteristic features of CRR, even when pigmentary changes are not readily apparent on examination. Widefield autofluorescence findings of irregularly distributed speckled hypoautofluorescence are particularly revealing. This series of newly diagnosed adults with CRR may represent the milder end of the phenotypic spectrum of this condition, highlighting imaging findings that may aid in diagnostically challenging cases of CRR.


Assuntos
Infecções Oculares Virais , Doenças Retinianas , Retinite , Síndrome da Rubéola Congênita , Rubéola (Sarampo Alemão) , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Masculino , Doenças Retinianas/diagnóstico , Síndrome da Rubéola Congênita/diagnóstico , Fundo de Olho , Rubéola (Sarampo Alemão)/diagnóstico
13.
J AAPOS ; 28(1): 103791, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37939916

RESUMO

PURPOSE: To investigate the dysmorphic facial features in congenital rubella syndrome (CRS) and describe their associations with ocular and systemic features. METHODS: The medical records of children diagnosed with CRS between 2016 and 2021 were retrospectively reviewed for ocular and systemic features. CRS was diagnosed either on the basis of positive serology for rubella antibodies or with the classic triad of congenital cataract, sensorineural hearing loss, and congenital heart defect. Children with photographic documentation of the face were analyzed independently by three experienced investigators for facial dysmorphic features (triangular face, microcephaly, broad forehead, low anterior hairline, whorl on the anterior hairline, prominent nose, micrognathia). The dysmorphic feature was recorded as present only when at least two of the three examiners confirmed its existence. RESULTS: CRS was diagnosed in 237 children: mean age at presentation, 5.45 ± 4.5 years; 126 males (53%); bilateral cataract, 176 (75%). Positive serology for rubella antibodies was noted in 153 children (65%). Photographic record of facial features was documented in 127 (54%). The most common dysmorphic facial feature was wide forehead (82 [65%]), followed by low anterior hairline with whorl (41 [32%]). However, microcornea (P = 0.9801), cataract (P = 0.8342), pupillary sphincter atrophy (P = 0.7421), and salt and pepper retinopathy (P = 0.8803) were not significantly associated with the presence of facial dysmorphism. Congenital heart disease was significantly associated with facial dysmorphism (P = 0.0308). Sensorineural hearing loss was not associated with the presence of facial dysmorphism (P = 0.8463). CONCLUSIONS: Facial dysmorphism is common in children with CRS, but it was not predictive of the presence of ocular manifestations of CRS in this cohort.


Assuntos
Catarata , Doenças da Córnea , Perda Auditiva Neurossensorial , Síndrome da Rubéola Congênita , Criança , Masculino , Humanos , Lactente , Pré-Escolar , Síndrome da Rubéola Congênita/complicações , Síndrome da Rubéola Congênita/diagnóstico , Estudos Retrospectivos , Catarata/congênito , Doenças da Córnea/complicações , Perda Auditiva Neurossensorial/diagnóstico , Pupila
14.
Acta Medica Philippina ; : 58-63, 2024.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-1016683

RESUMO

Background and Objective@#The Philippines does not have a national congenital rubella syndrome (CRS) surveillance or registry. Regular monitoring of CRS cases in hospitals, including in a Philippine tertiary hospital, helped in the past to provide clinico-epidemiologic data on CRS. This study aimed to continue providing clinico-epidemiologic data on CRS cases seen in the Philippine tertiary hospital from 2009-2012 and 2019-2022 and compare the cases seen from said timelines.@*Methods@#A cross-sectional study was used, employing chart review of patients newly diagnosed with CRS from 2009-2012 and 2019-2022 in the Department of Ophthalmology and Visual Sciences at the Philippine tertiary hospital.@*Results@#Forty-two patients newly diagnosed with CRS from 2009-2012 and 2019-2022 were included. Only 14 (33%) were serologically-confirmed cases (albeit qualitatively). Median age (first and third interquartile ranges) at consult was 1 year (0.4, 2.5). Twenty-four (57%) patients had maternal history of rashes and/or fever. Trimester of pregnancy when mother became symptomatic was not significantly correlated with chief complaint (p=0.20) and numbers of ophthalmic (p=0.68) and systemic manifestations (p=0.32). Cataract was the most common ophthalmic manifestation present in 40 (95%) patients. Twenty-six (62%) patients had other associated systemic findings of which hearing loss was the most common. Only 29 of 40 patients with cataract underwent lensectomy, with 23 patients having poor visual prognosis prior to surgery (5 with nystagmus alone, 10 with nystagmus and strabismus, and 8 with strabismus alone). @*Discussion@#Using ophthalmic manifestations as primary indicator, this study provided an update on the CRS cases in the country. Laboratory confirmation remains a challenge in diagnosing CRS as the tests are costly and not widely available. There was increase from 2009-2012 compared to 2019-2022 in number of patients who underwent surgical treatment for cataract but visual outcomes were suboptimal due to delay in consultation. Although there was a decrease in number of CRS cases seen in the Philippine tertiary hospital, this cannot be attributed to increased rubella-containing vaccine (RCV) coverage alone. @*Conclusion@#Provision of data from individual hospital-based studies similar to this highlights the need for a national CRS surveillance system or registry. This can better gauge the burden of CRS and identify the gap in RCV coverage.


Assuntos
Síndrome da Rubéola Congênita , Retinose Pigmentar
15.
Medicine (Baltimore) ; 102(45): e35709, 2023 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-37960813

RESUMO

OBJECTIVE: To evaluate the effect of rubella elimination publicity and communication project intervention activities on rubella related knowledge attitudes and practices (KAP) on parents of 0 to 2 year old children in Chongqing, and to provide basis for the formulation of rubella elimination strategies and measures. METHOD: We choose 7 townships (streets) of parents of 0 to 2 year old children who live for more than 6 months in Chongqing to investigate the status of rubella knowledge, attitude and practice. Parents' cognition and behavior related to rubella, congenital rubella syndrome (CRS) and rubella component vaccine (RCV) were analyzed and evaluated before and after intervention. RESULTS: 420 people were surveyed before and after the intervention. The awareness rate of rubella prevention knowledge of parents after intervention was significantly higher than that before intervention, with statistical significance (P < .05). After intervention, parents' support rate of "rubella antibody test before pregnancy" and "RCV vaccination for children" were 89.52% and 72.14%, respectively, which were higher than those of parents before intervention (84.05% and 27.38%, P < .05). The RCV timely vaccination rate of children after intervention was 92.78%, which was higher than that of children before intervention (83.90%, P < .05). CONCLUSION: Targeted publicity and communication methods should be adopted for urban and rural areas to create a good publicity atmosphere, popularize rubella and CRS related popular science knowledge, and improve the RCV timely vaccination rate of school-age children and high-risk population.


Assuntos
Síndrome da Rubéola Congênita , Rubéola (Sarampo Alemão) , Gravidez , Feminino , Humanos , Pré-Escolar , Conhecimentos, Atitudes e Prática em Saúde , Rubéola (Sarampo Alemão)/prevenção & controle , Rubéola (Sarampo Alemão)/epidemiologia , Vacina contra Rubéola , Síndrome da Rubéola Congênita/prevenção & controle , Síndrome da Rubéola Congênita/epidemiologia , Pais , China/epidemiologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-37817313

RESUMO

For 30 years the Australian Paediatric Surveillance Unit (APSU) has conducted national surveillance of rare communicable diseases and rare complications of communicable diseases. In this report, we describe the results of thirteen such studies surveyed by the APSU in 2022, including reported case numbers and incidence estimates, demographics, clinical features, management and short-term outcomes. Conditions described are: acute flaccid paralysis (AFP); congenital cytomegalovirus (cCMV); neonatal and infant herpes simplex virus (HSV) infection; perinatal exposure to human immunodeficiency virus (HIV) and paediatric HIV infection; severe complications of influenza; juvenile-onset recurrent respiratory papillomatosis (JoRRP); congenital rubella infection/syndrome; congenital varicella syndrome (CVS) and neonatal varicella infection (NVI); and the new conditions dengue; Q fever; and severe acute hepatitis. In 2022, cases of severe complications of influenza were reported to the APSU for the first time since 2019. This likely reflects the easing of government-mandated restrictions imposed in 2020-2021 to curb the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the re-emergence of a range of infectious diseases. As previously, AFP surveillance by the APSU contributed to Australia achieving a minimum target incidence of one AFP case per 105 children aged less than 15 years. Cases of JoRRP and NVI were reported in 2022. This indicates potential gaps in human papillomavirus (HPV) and varicella vaccination coverage respectively, especially in high-risk groups such as young migrant and refugee women of childbearing age from countries without universal vaccination programs. Paediatric HIV case numbers resulting from mother-to-child-transmission (MTCT) of HIV remain low in Australia due to use of effective intervention strategies. However, there has been an increase in the number of imported cases of HIV in children (mainly perinatally-acquired) from countries with a high HIV prevalence. Without effective vaccines, there has been no decline in the incidence of congenital CMV and neonatal HSV, indicating the importance of early identification and management to reduce morbidity and mortality. The first cases of dengue, Q fever and severe acute hepatitis were received by APSU in 2022, including two cases of acute hepatitis in which aetiology has not been confirmed to date. The APSU has an important ongoing role in monitoring rare childhood infections.


Assuntos
Varicela , Doenças Transmissíveis , Infecções por Citomegalovirus , Dengue , Infecções por HIV , Hepatite , Influenza Humana , Febre Q , Síndrome da Rubéola Congênita , Lactente , Recém-Nascido , Gravidez , Humanos , Feminino , Criança , Infecções por HIV/epidemiologia , Varicela/epidemiologia , Varicela/prevenção & controle , Influenza Humana/epidemiologia , alfa-Fetoproteínas , Austrália/epidemiologia , Transmissão Vertical de Doenças Infecciosas , Doenças Transmissíveis/epidemiologia
19.
Int J Infect Dis ; 137: 149-156, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37690575

RESUMO

OBJECTIVES: Many countries introduced rubella-containing vaccination (RCV) after 2011, following changes in recommended World Health Organization (WHO) vaccination strategies and external support. We evaluated the impact of these introductions. METHODS: We estimated the country-specific, region-specific, and global Congenital Rubella Syndrome (CRS) incidence during 1996-2019 using mathematical modeling, including routine and campaign vaccination coverage and seroprevalence data. RESULTS: In 2019, WHO African and Eastern Mediterranean regions had the highest estimated CRS incidence (64 [95% confidence intervals (CI): 24-123] and 27 [95% CI: 4-67] per 100,000 live births respectively), where nearly half of births occur in countries that have introduced RCV. Other regions, where >95% of births occurred in countries that had introduced RCV, had a low estimated CRS incidence (<1 [95% CI: <1 to 8] and <1 [95% CI: <1 to 12] per 100,000 live births in South-East Asia [SEAR] and the Western Pacific [WPR] respectively, and similarly in Europe and the Americas). The estimated number of CRS births globally declined by approximately two-thirds during 2010-2019, from 100,000 (95% CI: 54,000-166,000) to 32,000 (95% CI: 13,000-60,000), representing a 73% reduction since 1996, largely following RCV introductions in WPR and SEAR, where the greatest reductions occurred. CONCLUSIONS: Further reductions can occur by introducing RCV in remaining countries and maintaining high RCV coverage.


Assuntos
Síndrome da Rubéola Congênita , Rubéola (Sarampo Alemão) , Humanos , Síndrome da Rubéola Congênita/epidemiologia , Síndrome da Rubéola Congênita/prevenção & controle , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/prevenção & controle , Estudos Soroepidemiológicos , Vacinação , Organização Mundial da Saúde , Vacina contra Rubéola
20.
Washington, D.C.; OPS; 2023-09-18. (PAHO/CDE/HT/23-0007).
em Espanhol | PAHO-IRIS | ID: phr-58003

RESUMO

La Organización Panamericana de la Salud (OPS) es un líder reconocido en la eliminación de enfermedades, que trabaja de la mano con los países de la Región y sus asociados con el fin de impulsar los logros en materia de salud pública a nivel regional y mundial. Estos esfuerzos han contribuido a la erradicación de la viruela, la eliminación de la poliomielitis y el tétanos neonatal de la Región de las Américas, la eliminación de la transmisión endémica del sarampión, la rubéola y el síndrome de rubéola congénita, así a como la eliminación de la transmisión maternoinfantil del VIH y la sífilis en ocho países. La Región también ha avanzado de manera considerable hacia la eliminación de la malaria, la lepra, el tracoma, la filariasis linfática, la oncocercosis y la rabia humana transmitida por perros. En septiembre del 2019, el 57.° Consejo Directivo de la OPS aprobó la Iniciativa de la OPS para la Eliminación de Enfermedades, una política innovadora que promueve un enfoque integrado y sostenible encaminado a acelerar el avance de los países hacia la eliminación de las enfermedades transmisibles y otras afecciones relacionadas. La eliminación de enfermedades se basa en la trayectoria eficaz de eliminación de enfermedades en la Región de las Américas y tiene como objetivo catalizar la voluntad política y aprovechar la capacidad técnica necesaria para lograr un futuro sin la carga de 35 enfermedades transmisibles y otras afecciones relacionadas en la Región de las Américas en el 2030 y contribuir al progreso hacia los Objetivos de Desarrollo Sostenible (ODS). Al tiempo que los países se recuperan del impacto de la pandemia de COVID‑19, la OPS reconoció la importancia de convocar al Grupo Consultivo Estratégico y Técnico externo sobre eliminación de enfermedades con el objeto de hacer un balance del nuevo panorama de salud pública y las evoluciones recientes en la eliminación de enfermedades y buscar orientación y recomendaciones sobre temas prioritarios con el fin de respaldar la agenda de eliminación de enfermedades en la Región de las Américas. En el presente informe se presenta un resumen de los procedimientos, conclusiones y recomendaciones de la segunda reunión del Grupo Consultivo Estratégico y Técnico de la OPS sobre eliminación de enfermedades, que tuvo lugar el 29 y 30 de noviembre del 2022.


Assuntos
Erradicação de Doenças , Doenças Transmissíveis , COVID-19 , Sistemas de Saúde , Desenvolvimento Sustentável , América
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