RESUMEN
OBJECTIVE: Estimate the effectiveness of the monovalent rotavirus vaccine in preventing the need to hospitalize children under 2 years old for acute diarrheal disease in five Colombian cities. METHODS: A population survey was conducted based on a probability sample of children over 2 months and under 24 months of age in five Colombian cities (Barranquilla, Bogotá, Cali, Cartagena, and Riohacha) over the period from August through October 2010. The vaccine had been introduced in the Expanded Program on Immunization in January 2009. Rotavirus vaccination coverage was estimated by age group; the cumulative incidence of hospitalization for severe diarrhea was determined; and the magnitude of correlation between vaccination with one or two doses of rotavirus vaccine and hospitalization for diarrhea was calculated using the age-adjusted probability ratio (PR) and other epidemiologically significant factors. Effectiveness of the vaccine was estimated using the expression 1-PR. RESULTS: Coverage with a single dose of the rotavirus vaccine was 87.3%. During the 12 months prior to the survey, 1 453 of the children under 24 months old in the study areas (43.2%) had presented with diarrhea, and of these, 174 (5.2%) had been hospitalized for this cause. The effectiveness of two doses of the vaccine in preventing hospitalization for severe diarrhea was 68% (CI 95% = 55%-77%). CONCLUSIONS: In Colombia, rotavirus vaccination protects against hospitalization for diarrhea due to any cause. The use of cross-sectional surveys appeared to be adequate for rapid evaluation of an immunization program's effectiveness with a new vaccine.
Asunto(s)
Infecciones por Rotavirus/prevención & control , Vacunas contra Rotavirus , Preescolar , Colombia , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Evaluación de Programas y Proyectos de Salud , Infecciones por Rotavirus/epidemiologíaRESUMEN
OBJECTIVE: A study was carried out in Bogota aimed at estimating the burden of disease associated with human papillomavirus infection (HPV) and the potentially avoidable percentage due to using new vaccines. METHODS: A literature review was combined with analysing surveillance system data and disease cost evaluation. RESULTS: After adjusting for underreporting and misclassification, it was estimated that 322 deaths from cervical cancer occur annually in Bogota (corresponding to 676 new cases). This would cause the loss of 15 years of life for each 1,000 women per year (most occurring amongst women aged 40 to 69). In addition to cervical cancer, there would be around 6,084 cases of high-grade and 22,984 low-grade cervical lesions yearly. The disease's yearly cost would amount to around 7 million dollars. Important weaknesses were found in the clinical management of women suffering from cervical lesions. CONCLUSION: Strengthening cervical cancer prevention programmes in Bogota would lead to saving a significant number of deaths, cases of cancer and the costs associated with HPV infection. Introducing an anti-HPV vaccine may be considered, but only as part of a more widespread preventative strategy and provided that more affordable prices have been found.
Asunto(s)
Costo de Enfermedad , Infecciones por Papillomavirus/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Colombia , Costos y Análisis de Costo , Femenino , Humanos , Persona de Mediana Edad , Salud Urbana , Adulto JovenRESUMEN
OBJETIVO: Estimar la efectividad de la vacuna monovalente antirrotavírica para prevenir la hospitalización por enfermedad diarreica aguda en niños menores de 2 años en cinco ciudades de Colombia. MÉTODOS: Se realizó una encuesta poblacional sobre una muestra probabilística de niños mayores de 2 meses y menores de 24 meses de edad en cinco ciudades de Colombia (Barranquilla, Bogotá, Cali, Cartagena y Riohacha) en el período de agosto a octubre de 2010. La vacuna fue introducida en el Programa Ampliado de Inmunizaciones en enero de 2009. Se estimaron las coberturas de vacunación contra rotavirus por grupos de edad y la incidencia acumulada de hospitalización por diarrea severa, y se evaluó la magnitud de la asociación entre la vacunación con una o dos dosis de vacuna antirrotavírica y la hospitalización por diarrea, utilizando la razón de probabilidades (RP) ajustada por edad y otros factores de importancia epidemiológica. La efectividad de la vacunación se estimó usando la expresión 1 - RP. RESULTADOS: La cobertura de vacunación con una dosis de vacuna fue de 87,3%. En los 12 meses previos a la encuesta 43,2% (1 453 niños) de menores de 24 meses presentaron diarrea, y de ellos, 5,2% (174 niños) fueron hospitalizados por esta causa. La efectividad de dos dosis de vacuna antirrotavírica para prevenir la hospitalización por diarrea severa fue de 68% (intervalo de confianza de 95%: 55%-77%). CONCLUSIONES: La vacunación contra rotavirus en Colombia protege contra la hospitalización por diarrea por cualquier causa. El uso de encuestas transversales se mostró adecuado para evaluar rápidamente la efectividad de un programa de vacunación con una nueva vacuna.
OBJECTIVE: Estimate the effectiveness of the monovalent rotavirus vaccine in preventing the need to hospitalize children under 2 years old for acute diarrheal disease in five Colombian cities. METHODS:A population survey was conducted based on a probability sample of children over 2 months and under 24 months of age in five Colombian cities (Barranquilla, Bogotá, Cali, Cartagena, and Riohacha) over the period from August through October 2010. The vaccine had been introduced in the Expanded Program on Immunization in January 2009. Rotavirus vaccination coverage was estimated by age group; the cumulative incidence of hospitalization for severe diarrhea was determined; and the magnitude of correlation between vaccination with one or two doses of rotavirus vaccine and hospitalization for diarrhea was calculated using the age-adjusted probability ratio (PR) and other epidemiologically significant factors. Effectiveness of the vaccine was estimated using the expression 1-PR. RESULTS: Coverage with a single dose of the rotavirus vaccine was 87.3%. During the 12 months prior to the survey, 1 453 of the children under 24 months old in the study areas (43.2%) had presented with diarrhea, and of these, 174 (5.2%) had been hospitalized for this cause. The effectiveness of two doses of the vaccine in preventing hospitalization for severe diarrhea was 68% (CI 95% = 55%−77%). CONCLUSIONS: In Colombia, rotavirus vaccination protects against hospitalization for diarrhea due to any cause. The use of cross-sectional surveys appeared to be adequate for rapid evaluation of an immunization program's effectiveness with a new vaccine.
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Infecciones por Rotavirus/prevención & control , Vacunas contra Rotavirus , Colombia , Estudios Transversales , Evaluación de Programas y Proyectos de Salud , Infecciones por Rotavirus/epidemiologíaRESUMEN
Objetivo Se realizó un estudio en Bogotá para estimar la magnitud de la carga de enfermedad asociada a la infección por el virus del papiloma humano (VPH) y la proporción potencialmente evitable con el uso de vacunas. Materiales y métodos Se combinaron una revisión sistemática de la literatura colombiana sobre infección por VPH, el análisis de datos rutinarios de vigilancia de Bogotá y un análisis de costos de la enfermedad. Resultados Después de corregir por subregistro y mala clasificación en Bogotá se registrarían 322 muertes y 676 casos asociados a cáncer de cuello uterino anualmente. Esto ocasiona la pérdida de 1,5 años de vida por cada 1 000 mujeres al año, la mayoría en mujeres entre los 40 y 69 años. Adicionalmente, se diagnosticarían 6 084 lesiones de cuello uterino de alto grado y 22 984 de bajo grado. El costo de la enfermedad ascendería a 7 millones de dólares anuales aproximadamente. Se encontraron debilidades en el manejo de los casos con displasias o neoplasias cervicales. Conclusión El fortalecimiento de los programas de prevención de cáncer de cuello uterino en Bogotá permitiría disminuir de manera importante el impacto epidemiológico y económico de la infección por VPH en Bogotá. Se podría considerar, adicionalmente, la inclusión de una vacuna contra VPH pero solo incluida dentro de una estrategia integral de control y a un precio que pueda ser sostenible.
Objective A study was carried out in Bogota aimed at estimating the burden of disease associated with human papillomavirus infection (HPV) and the potentially avoidable percentage due to using new vaccines. Methods A literature review was combined with analysing surveillance system data and disease cost evaluation. Results After adjusting for underreporting and misclassification, it was estimated that 322 deaths from cervical cancer occur annually in Bogota (corresponding to 676 new cases). This would cause the loss of 15 years of life for each 1,000 women per year (most occurring amongst women aged 40 to 69). In addition to cervical cancer, there would be around 6,084 cases of high-grade and 22,984 low-grade cervical lesions yearly. The disease's yearly cost would amount to around 7 million dollars. Important weaknesses were found in the clinical management of women suffering from cervical lesions. Conclusion Strengthening cervical cancer prevention programmes in Bogota would lead to saving a significant number of deaths, cases of cancer and the costs associated with HPV infection. Introducing an anti-HPV vaccine may be considered, but only as part of a more widespread preventative strategy and provided that more affordable prices have been found.