Assessing the Quality of Life of Dogs with Inflammatory Bowel Disease and Their Owners.

The aim of the study was to assess the quality of life (QoL) of dogs with inflammatory bowel disease (IBD) and the impact on the life and relationship of the owner. An online questionnaire based on a Likert scale score (1-10) was designed to assess items related to dog QoL, owner QoL, and the owner-dog relationship. Responses from 110 dog owners (30 with IBD and 80 healthy dogs) were included in the study. IBD dogs had significantly lower overall QoL (p < 0.001), health (p < 0.0001), and level of activity (p = 0.049). Owners of dogs with IBD reported lower overall QoL (p < 0.001). The scores for how their dog's QoL might affect their own QoL (p = 0.028), how much their dog limited their social life, leisure time, or daily activities (p = 0.015), and how often they felt burdened by caring for their dog (p = 0.006) were significantly higher in the IBD group when compared to the healthy group. In addition, IBD dog owners were more likely to see their dogs as children (p = 0.0004). IBD has a negative impact on affected dogs and their owners regardless of the severity of the disease.

Prevalence and characteristics of methicillin-resistant Staphylococcus aureus in pigs and pig workers in Tenerife, Spain.

Methicillin-resistant Staphylococcus aureus (MRSA) strains belonging to sequence type (ST) 398 are being reported with increasing frequency in Europe and other countries. This MRSA type has been isolated from colonized and infected animals and humans. The aim of this study was to determine the prevalence of nasal MRSA carriage in pigs and pig workers. A total of 300 pigs from 15 different farms were sampled in the slaughterhouse of Tenerife. A total of 54 pig workers were screened for MRSA: 20 belonged to farms whose pigs had been sampled and 34 to the slaughterhouse. The percentage of positive samples of MRSA in pigs was 85.7%. The overall prevalence of nasal MRSA carriage in pig workers was 9.3%. All MRSA isolates from pigs and humans belonged to one clonal group showing multilocus sequence type (MLST) 398. Two types of Staphylococcal Chromosome Cassette (SCCmec) were found, IV and V. In conclusion, the prevalence of MRSA in nasal samples from pigs and pig workers in Tenerife was high. We therefore consider it essential to deepen epidemiological study of this strain of animal origin, as well as to increase surveillance and control measures at all stages of the food chain.

ASSESSMENT OF OCCUPATIONAL EXPOSURE IN THE MAIN PAEDIATRIC INTERVENTIONAL RADIOLOGY PROCEDURES.

The aim of this study is to evaluate the personal dose equivalent Hp(10) in the most frequent (non-cardiac) paediatric interventional radiology (PIR) procedures: central venous catheters (CVC), hepatic/biliary and sclerotherapy interventions. i2 active solid-state dosemeters placed over the lead apron were used to monitor the exposure of three interventional radiologists over 18 months. A database was created to register all procedures performed by each radiologist (including the type of procedure and the kerma-area product, PKA). The mean Hp(10) per procedure for CVC, sclerotherapy and hepatic/biliary interventions was respectively 0.01 ± 0.01 mSv, 0.18 ± 0.13 mSv and 0.12 ± 0.06 mSv (k = 2). A similar value of Hp(10)/PKA was found despite the type of procedure or the patient weight (~10 µSv/Gy·cm2). There was high variability among individual interventions, probably due to the variable level of complexity, which led to uncertainties in the measurements' mean higher than those associated with the dosemeter's angular and energy dependence. i2 therefore proved suitable for monitoring Hp(10) in PIR procedures.

[Accessibility plan: can offer a higher quality for a lower cost?]. / ¿Se puede ofrecer una mayor calidad a un menor coste? Proyecto-plan de accesibilidad.

OBJECTIVES: Redirect demand pathology severity level IV-V of the hospital emergency room (ED) to the Primary Health Care (AP) reference, increase in technical consultation and assess the effectiveness of the proposed Accessibility Plan (PA). Improving the quality of care offered, lowering the cost to achieve it. DESIGN: Quality research study conducted in January-2010 data collected throughout 2009, and compare them versus those obtained in 2008. SETTING AND PARTICIPANTS: Population allocated to the ABS Sagrada Familia (23,265 users). MEASUREMENTS: Beneficiaries in HUS AP and population due to specialized care, population scheduled diagnostic and therapeutic procedures (radiology, laboratory echo-doppler, cryosurgery ...), total annual visits, attendance, repetition,... RESULTS: Increased 86.5% of emergency radiographs in AP (avoiding lead to ED), 7.4% fewer referrals to the emergency; implantation circuit urgent analytical (laboratory of HUS not collapsed) 13.6% fewer referrals to vascular surgery (the Eco-Doppler), 5.92% less analytical (thank Cardio-Check), 297 fewer referrals to dermatology (for cryotherapy), 9.65% less refe- rrals to psychiatry (through group workshops mental health), decreased frequency (1.4%) and recurrence (2.3%) over 2007, 23.9% of referrals to ED pathology avoided level IV-V served in AP; save ∈ 57,335 on 2007. CONCLUSIONS: Programs that includes the PA has proven its effectiveness, having offered improved quality and user satisfaction, spending economic decline, to be addressed and resolved in AP visits to level IV-V ED.

Role of correlated noise in textural features extraction.

Predictive models of tumor response based on heterogeneity metrics in medical images, such as textural features, are highly suggestive. However, the demonstrated sensitivity of these features to noise does affect the model being developed. An in-depth analysis of the noise influence on the extraction of texture features was performed based on the assumption that an improvement in information quality can also enhance the predictive model. A heuristic approach was used that recognizes from the beginning that the noise has its own texture and it was analysed how it affects the quantitative signal data. A simple procedure to obtain noise image estimation is shown; one which makes it possible to extract the noise-texture features at each observation. The distance measured between the textural features in signal and estimated noise images allows us to determine the features affected in each observation by the noise and, for example, to exclude some of them from the model. A demonstration was carried out using synthetic images applying realistic noise models found in medical images. Drawn conclusions were applied to a public cohort of clinical images obtained using FDG-PET to show how the predictive model could be improved. A gain in the area under the receiver operating characteristic curve between 10 and 20% when noise texture information is used was shown. An improvement between 20 and 30% can be appreciated in the estimated model quality.

Occupational doses to the eye lens in pediatric and adult noncardiac interventional radiology procedures.

PURPOSE: To assess occupational lens exposure in a mixed interventional radiology department, comparing pediatric and adult procedures. To analyze the correlation between the lens dose and the doses measured at the chest and collar level and the kerma-area product (PKA ). METHODS: For 17 months, three radiologists performing both pediatric and adult interventions were monitored by means of 14 dosimeters per worker: 12 single-point optically stimulated luminescent (OSL) dosimeters calibrated in terms of Hp (0.07) were placed on the inside and outside of two pairs of lead glasses, one for pediatric procedures and one for adult interventions; another whole-body OSL dosimeter calibrated in terms of Hp (10) was placed over the thyroid shield; finally, an additional active solid-state dosimeter, also calibrated for Hp (10), was worn on the chest, over the apron. Furthermore, a database was created to register the demographic and dosimetric data of the procedures, as well as the name of the radiologist acting as first operator. RESULTS: For the three radiologists, who performed 276-338 procedures/year (20% pediatric), cumulative annual doses to the left bare eye exceeded 20 mSv (21-61 mSv). Considering the glasses' protection, annual doses exceeded 6 mSv (13-48 mSv) for both eyes. No important differences were observed in lens dose per procedure between pediatric and adult interventions (0.16 vs 0.18, 0.12 vs 0.09, and 0.07 vs 0.07 mSv), although lens dose per PKA was 4.1-4.5 times higher in pediatrics (5.8 vs 1.3, 3.3 vs 0.8, and 2.6 vs 0.6 µSv/Gy·cm2 ) despite a similar use of the ceiling-suspended screen. Lens doses were highly correlated with collar readings (with Pearson coefficients [r] ranging from 0.86 to 0.98) and with chest readings (with r ranging from 0.75 to 0.93). However, slopes of the linear regressions varied greatly among radiologists. CONCLUSIONS: There is real risk of exceeding the occupational dose limit to the eye lens in mixed interventional radiology rooms if radiation protection tools are not used properly. Regular monitoring of the lens dose is recommended, given lens exposure might easily exceed 6 mSv/yr. Using a collar dosimeter for this purpose might be suitable if it is preceded by an individualized regression analysis. The same radiation protection measures should be applied to interventional radiologists regardless of whether they are treating pediatric or adult patients.

Local diagnostic reference levels for paediatric non-cardiac interventional radiology procedures.

PURPOSE: To establish local diagnostic reference levels (DRLs) for non-cardiac interventional procedures in paediatrics. METHODS: The type of procedure, the patient's weight and age and dose-related data from 279 interventions was recorded in a database completed by interventional radiologists, radiographers and technicians of the Medical Physics department. These procedures were classified into 14 categories and 6 weight ranges. Local DRLs were proposed for those ranges in which a sample of at least 15 patients could be gathered and were calculated as the third quartile (Q3) of the air kerma-area product (PKA) values. The Q3 of the fluoroscopy time (FT) and number of digital subtraction angiography (DSA) images were also obtained. Finally, the correlation between PKA and weight was analysed. RESULTS: Local DRLs are proposed for three types of procedures: hepatic/biliary interventions (5-15 kg, 1304 cGy·cm2; 15-30 kg, 2121 cGy·cm2), sclerotherapy procedures (15-30 kg, 704 cGy·cm2; 30-50 kg, 4049 cGy·cm2; 50-80 kg, 3734 cGy·cm2) and central venous catheter (CVC) procedures (5-15 kg, 84 cGy·cm2). Hepatic/biliary interventions showed a moderate correlation (r = 0.61), while sclerotherapy procedures presented a poor correlation (r = 0.34) between PKA and weight, possibly due to the PKA dependence on the complexity level. Regarding CVC procedures, a clearly higher correlation was found when the fluoroscopy PKA value was normalised to the FT (r = 0.85 vs r = 0.35). CONCLUSIONS: The results support the feasibility of establishing DRLs for the most common procedures (sclerotherapy, hepatic/biliary and CVC interventions) despite the small number of paediatric interventions.

Changes in body mass of expectant male cotton-top tamarins (Saguinus oedipus).

It has been noted that expectant cotton-top tamarin males in captivity experience a body mass increase during the last months of their mates' pregnancies, and this has been explained as being a male physiological response. We studied the body mass of 4 inexperienced and 4 experienced expectant males, and we expected to observe a larger body mass increase among the experienced ones since they undergo multiple hormonal changes in comparison to inexperienced expectant males. However, while inexperienced expectant males gained body mass during months 4-6 of the pregnancy period by a mean +/-SD of 5.4 +/- 3.1% (i.e. 29 +/- 17 g), the experienced ones did not (mean +/- SD of months 4-6, 0.5 +/- 1.7%, i.e. 5 +/- 12 g). The results suggest that other factors, such as behavioural communication between pairs and feeding and resting behaviour, should be studied in order to clarify the basis of this body mass increase.

[Trends in preventive drug prescription in the Primary Care District of Seville [2000-2003]]. / Tendencias en la prescripción de fármacos preventivos en el distrito de atención primaria de Sevilla (2000-2003).

OBJECTIVES: To describe trends in prescription rates for biphosphonates, raloxifene, calcitonin, statins and hormone replacement therapy (HRT) between 2000 and 2003 and to assess the impact of mass media information on the interruption of the Women's Health Initiative trial on HRT prescription rates. METHODOLOGY: We performed a descriptive, ecological study, with time (month) as the observation unit. Monthly rates of bisphosphonate, calcitonin, raloxifene, statins and HRT prescription, in defined daily doses per 1000 persons, were measured in the population assigned to 249 family physicians in 27 health centers in Seville. Trend graphs and time series analysis were carried out. RESULTS AND DISCUSSION: The prescription of preventive drugs has tended to increase between 2000 and 2003. The HRT prescription rate has decreased since the interruption of the Women's Health Initiative trial.

[Impact of systematic vaccination with the antimeningococcal C conjugated vaccine in a health area in Andalusia]. / Enfermedad meningocócica e impacto de la vacunación sistemática con la vacuna conjugada antimeningocócica C en un área sanitaria de andalucía.

BACKGROUND: A retrospective longitudinal study of population incidence was made to assess the effectiveness of meningococcal serogroup C conjugate vaccine, after its mass introduction in children in the geographic area of a health district, measuring its population impact, and we have studied the state of the meningococcal disease. METHODS: Vaccine coverage in children born between 1991 and 2001, and rates of incidence in declared cases of meningococcal disease in seven epidemiological seasons (1997/98 to 2003/04) were calculated. The impact of vaccination against serogroup C meningitis was assessed comparing the average annual rates of previous and later seasons to the vaccination campaigns in population younger and older than 10, using the Fisher exact test. RESULTS: In all the study period, 109 cases of meningococcal disease were declared, of which 50 were of serogroup C meningococcal disease. Starting from 2000/2001 season the incidence of serogroup C disease decreased in the population below 10. In this age group, the annual average rate of post-vaccine seasons decreases in respect to pre-vaccine (from 8.2 to 2.0 per 100,000 inhabitants) showing a statistically significant difference. In the population above 10 years, this incidence reduction was not observed. In the study period, no case of vaccine failure was declared. CONCLUSIONS: The absence of vaccine failure and the impact observed on the incidence of serogroup C meningococcal disease in children under 10 suggests the effectiveness of this new conjugate vaccine, together with suitable vaccination conditions (vaccination schedule, high catch-up, etc.) which are developing in our health district.

Descriptive analysis of antibiotic-resistant patterns of methicillin-resistant Staphylococcus aureus (MRSA) st398 isolated from healthy swine.

BACKGROUND: Livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) such as the MRSA ST398 strain has spread all over the world and the most worrying aspect of this fact appears to be its capacity to easily spread to humans. The excessive use of antibiotics has made swine a reservoir of MRSA. The aim of the present study was to determine the antibiotic resistance profile of MRSA samples isolated from healthy swine of the island of Tenerife (Spain). METHODS: A total of 256 MRSA isolates from swine samples and five MRSA isolates from pig worker samples were investigated for MRSA antibiotic resistant patterns. RESULTS: Analysis of the susceptibility status of MRSA pig isolates revealed that 39 isolates were resistant to one antibiotic, 71 isolates were resistant to two antibiotics and 96 isolates were resistant to three or more antibiotics. SCCmec typing revealed the presence of types IV and V. Isolates having SCCmec IV had an increased resistance to the antimicrobial agents tested than those having SCCmec V. We observed significant differences when comparing the most common resistance patterns and SCCmec type. CONCLUSIONS: MRSA isolated from humans showed similar resistance to those isolated from pigs, excepting erythromycin, since all the workers' isolates were sensitive to this antibiotic. The evolution of new MRSA clones has emphasized the need for infection control practices in animals and humans in close contact.

Asymmetry in facial expression of emotions by chimpanzees.

Asymmetries in human facial expressions have long been documented and traditionally interpreted as evidence of brain laterality in emotional behavior. Recent findings in nonhuman primates suggest that this hemispheric specialization for emotional behavior may have precursors in primate evolution. In this study, we present the first data collected on our closest living relative, the chimpanzee. Objective measures (hemimouth length and area) and subjective measures (human judgements of chimeric stimuli) indicate that chimpanzees' facial expressions are asymmetric, with a greater involvement of the left side of the face in the production of emotional responses. No effect of expression type (positive versus negative) on facial asymmetry was found. Thus, chimpanzees, like humans and some other nonhuman primates, show a right hemisphere specialization for facial expression of emotions.

Functional asymmetry of emotions in primates: new findings in chimpanzees.

In the past 15 years, there have been a number of studies conducted on asymmetries in the perception and production of facial expressions in human and non-human primates as a means of inferring hemispheric specialization for emotions. We review these studies to assess continuity and discontinuity between species in these emotional processes. We further present new data on asymmetries in the production of facial expressions in a sample of captive chimpanzees. Objective measures (hemimouth length and area) and subjective measures (human judgement's of chimeric stimuli) indicate that chimpanzees' facial expressions are asymmetric, with a greater involvement of the left side of the face (right hemisphere) in the production of emotional responses. Left hemimouth was bigger than the right in the facial expressions of pant-hooting, play, and silent bared-teeth (p < 0.05) and it extended laterally more than the right in the categories of pant-hooting, silent bared-teeth, and scream face (p < 0.05). Human judges also reported that the left side of the faces was emotionally more intense in the case of the play and silent bared-teeth categories (p < 0.01). Thus, chimpanzees, like humans and some other non-human primates, show a right hemisphere specialization for facial expression of emotions, which suggests that this functional asymmetry is homologous in all these species.

Asymmetries in postural control and locomotion in chimpanzees (Pan troglodytes).

Posture and locomotion are two of the most primitive and basic motor manifestations of an organism's behavior. Although the restrictions they impose on other motor functions are evident, few studies have considered the possibility of asymmetries in these behaviors in human and nonhuman primates, and how they might impact other asymmetries at higher functional levels. The aim of the current study was to explore in a group of 10 chimpanzees at the Madrid Zoo-Aquarium the degree of asymmetry in four behaviors related to locomotion (walking, ascending, descending, and brachiating) and four behaviors associated with posture (sitting, lying, hanging, and changing postures). Few subjects showed individual preferences, but significant trends in the group for some of the behaviors were found, including right-hand use when initiating quadruped walking, and left-hand use when descending and hanging. Some significant correlations also emerged: a negative one between walking and descending, and a positive one between walking and brachiating and between sitting and changing postures. No correlations were found between locomotor and postural modes. Although we cannot make generalizations on the population level at this time, these findings highlight the importance of considering postural and locomotion factors when studying motor asymmetries in primates.

Effect of the enclosure on carriers' body weight loss in the cotton-top tamarin (Saguinus oedipus).

Infant carrying in cotton-top tamarins is a costly activity that results in weight loss by the fathers and helpers. However, to date, measures of carrying costs have been obtained in small indoor enclosures. We studied body weight changes in adult and subadult individuals from eight large groups (n > 5) for 9 weeks after the birth of infants. Four groups were housed in large indoor/outdoor enclosures (42 m(2) x 3.3 m high), and four were housed in small indoor enclosures (12 m(2) x 2.4 m high). All of the individuals were weighed regularly at least three times a week. Reproductive males lost more weight in the big indoor/outdoor enclosures (mean=6.51%) than in the small indoor ones, as did male adult helpers (mean=5.59%) and female adult helpers (mean=4.4%). Still-growing subadult individuals also lost weight in the big indoor/outdoor enclosures (mean=3.17%), although the differences did not reach significance (P=0.07). These results support the hypothesis that cotton-top tamarins living in more natural settings experience higher weight loss than those housed under less-natural conditions.

Human assessment of chimpanzee facial asymmetry.

In this study, facial asymmetry in chimpanzees was assessed using a technique that has traditionally been implemented in human studies. Image composites made of each half of chimpanzees' facial expressions were presented to humans with and without chimpanzee experience. The group of subjects with chimpanzee experience considered composites made of the left side of the chimpanzee faces as the most emotionally intense for the emotional categories of play, silent bared-teeth, scream face, and a neutral category. On the other hand, left-left composites were not consistently judged by subjects with and without chimpanzee experience as the most similar to the whole original face, which might be explained as the result of an attentional bias in the human observers towards the right side of the chimpanzee expressions. Furthermore, responses given by subjects with and without chimpanzee experience were highly correlated, which indicates that the two groups of humans perceived the chimpanzee facial expressions in a similar fashion. The finding of left-sided asymmetries in these chimpanzees' facial expressions suggests a right hemisphere asymmetry in the production of emotions in this species and it is consistent with results reported in human and other nonhuman primates.

¿Se puede ofrecer una mayor calidad a un menor coste? / Accessibility plan: can offer a higher quality for a lower cost?

Objetivos. Redireccionar la demanda de patología de gravedad nivel IV-V de los Servicios de Urgencias Hospitalarios (SUH) hacia la Atención Primaria (AP) de referencia, aumentar la tecnificación en la consulta y valorar la efectividad del proyecto Plan de Accesibilidad (PA). Mejorar la calidad asistencial ofertada, disminuyendo el coste económico para lograrla. Diseño. Estudio de investigación de calidad realizado en 2010 de datos recogidos durante todo 2009, y comparativa de estos versus los obtenidos en 2008. Emplazamiento y participantes. Población de referencia asignada al ABS Sagrada Familia (23.265 usuarios). Mediciones principales. Población atendida en SUH y AP; derivada a atención especializada; programada en procesos diagnósticos y terapéuticos (radiología, laboratorio, eco-doppler, crioterapia...); visitas totales anuales, frecuentación-reiteración,... Resultados. Aumento del 86,5% de radiografías urgentes realizadas en AP (evitando derivar al SUH); 7,4% menos derivaciones a urgencias; implantación del circuito de analíticas urgentes (descolapsando el laboratorio del SUH); 13,6% menos derivaciones a cirugía vascular (por el Eco-Doppler); 5,92% menos de analíticas (gracias al Cardio-Check); 297 derivaciones menos a dermatología (por la crioterapia); 9,65% menos de derivaciones a psiquiatría (gracias a talleres grupales de salud mental); disminución de frecuentación (1,4%) y reiteración (2,3%) respecto 2007; 23,9% de derivaciones evitadas al SUH por patología nivel IV-V atendida en AP; ahorro de 57.335 € en relación a 2007. Conclusiones. Los programas que incluye el PA han demostrado su eficacia; habiendo mejorado la calidad ofertada y satisfacción del usuario, y reduciendo el gasto económico; disminuyendo también, al ser atendidas y resueltas en AP, las visitas de nivel IV-V al SUH (AU)

Objectives. Redirect demand pathology severity level IV-V of the hospital emergency room (ED) to the Primary Health Care (AP) reference, increase in technical consultation and assess the effectiveness of the proposed Accessibility Plan (PA). Improving the quality of care offered, lowering the cost to achieve it. Design. Quality research study conducted in January-2010 data collected throughout 2009, and compare them versus those obtained in 2008. Setting and participants. Population allocated to the ABS Sagrada Familia (23,265 users). Measurements. Beneficiaries in HUS AP and population due to specialized care, population scheduled diagnostic and therapeutic procedures (radiology, laboratory, echo-doppler, cryosurgery ...), total annual visits, attendance, repetition,... Results. Increased 86.5% of emergency radiographs in AP (avoiding lead to ED), 7.4% fewer referrals to the emergency; implantation circuit urgent analytical (laboratory of HUS not collapsed) 13.6% fewer referrals to vascular surgery (the Eco-Doppler), 5.92% less analytical (thank Cardio-Check), 297 fewer referrals to dermatology (for cryotherapy), 9.65% less referrals to psychiatry (through group workshops mental health), decreased frequency (1.4%) and recurrence (2.3%) over 2007, 23.9% of referrals to ED pathology avoided level IV-V served in AP; save € 57,335 on 2007. Conclusions. Programs that includes the PA has proven its effectiveness, having offered improved quality and user satisfaction, spending economic decline, to be addressed and resolved in AP, visits to level IV-V ED(AU)

Enfermedad meningocócica e impacto de la vacunación sistemática con la vacuna conjugada antimeningocócica C en un área sanitaria de Andalucía / Impact of systematic vaccination with the antimeningococcal C conjugated vaccine in a health area in Andalusia

Fundamento: En la Comunidad Autónoma de Andalucía,comenzó en julio de 2000 la vacunación con vacuna conjugada antimeningocócicaC de todos los niños nacidos con posterioridad al 1 deenero de 1995, y en septiembre de 2001 se amplíó a los nacidos a partirdel 1 de enero de 1991, esto es, hasta los 10 años de edad. El objetivode este trabajo es valorar la efectividad de esta vacuna tras suintroducción masiva en los niños del área geográfica de un distritosanitario, midiendo su impacto.Métodos: Mediante un estudio longitudinal retrospectivo deincidencia poblacional se calculan las coberturas vacunales de losniños nacidos entre los años 1991 y 2001 y las tasas de incidencia delos casos declarados de enfermedad meningocócica en siete temporadasepidemiológicas (1997/98 a 2003/04). El impacto de la vacunaciónfrente a la meningitis del serogrupo C se calcula comparandolas tasas promedios anuales de las temporadas previas y posterioresa las campañas de vacunación en la población menor y mayor de 10años, utilizando el test exacto de Fisher.Resultados: En el periodo de estudio se declararon 109 casos deenfermedad meningocócica, de los que 50 eran de meningitis C. Apartir de la temporada 2000-2001 descendió la incidencia de meningitisC en los niños menores de 10 años. En este grupo de edad seencuentran diferencias significativas entre las tasas promedio anualde las temporadas prevacunales y postvacunales (de 8,2 a 2,0 por100.000 habitantes). En la población mayor de 10 años no se observaeste descenso en la incidencia. En el periodo de estudio no se hadeclarado ningún caso de fallo vacunal.Conclusiones: La ausencia de fallos vacunales y la disminuciónde la incidencia de enfermedad meningocócica C en los niños menoresde 10 años sugiere la buena efectividad de esta nueva vacuna conjugadafrente al meningococo C

Background: A retrospective longitudinal study of populationincidence was made to assess the effectiveness of meningococcalserogroup C conjugate vaccine, after its mass introduction in childrenin the geographic area of a health district, measuring its populationimpact, and we have studied the state of the meningococcaldisease.Methods: Vaccine coverage in children born between 1991 and2001, and rates of incidence in declared cases of meningococcaldisease in seven epidemiological seasons (1997/98 to 2003/04) werecalculated. The impact of vaccination against serogroup C meningitiswas assessed comparing the average annual rates of previous andlater seasons to the vaccination campaigns in population youngerand older than 10, using the Fisher exact test.Results: In all the study period, 109 cases of meningococcaldisease were declared, of which 50 were of serogroup C meningococcaldisease. Starting from 2000/2001 season the incidence ofserogroup C disease decreased in the population below 10. In thisage group, the annual average rate of post-vaccine seasons decreasesin respect to pre-vaccine (from 8.2 to 2.0 per 100,000 inhabitants)showing a statistically significant difference. In the population above10 years, this incidence reduction was not observed. In the studyperiod, no case of vaccine failure was declared.Conclusions: The absence of vaccine failure and the impactobserved on the incidence of serogroup C meningococcal disease inchildren under 10 suggests the effectiveness of this new conjugatevaccine, together with suitable vaccination conditions (vaccinationschedule, high catch-up, etc.) which are developing in our health district