RESUMO
Thirty-two participants, aged between 3-18 years, born to hepatitis B surface antigen (HBsAg)-positive mothers and vaccinated at birth were analyzed for hepatitis B virus (HBV) infection. Overall, 56% had anti-HB titers ≥10 IU/L; five were positive for antibodies to the core antigen (anti-HBc), and two of these were also positive for HBsAg/DNA. One of the HBsAg/anti-HBc double-negative children presented with an unusual occult infection (HBV DNA-positive). No known vaccine escape mutations were detectable. Our data suggest that the vaccine protected 93.8% of children in this high-risk group against chronic HBV infection. Occult infections should be considered even in countries with low endemicity and high vaccination coverage.
Assuntos
Vacinas contra Hepatite B/imunologia , Vírus da Hepatite B/imunologia , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/epidemiologia , Adolescente , Formação de Anticorpos , Infecções Assintomáticas/epidemiologia , Criança , Pré-Escolar , Cuba/epidemiologia , DNA Viral/sangue , DNA Viral/imunologia , Feminino , Anticorpos Anti-Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/análise , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/isolamento & purificação , Hepatite B Crônica/imunologia , Hepatite B Crônica/prevenção & controle , Humanos , Masculino , Mães , Gravidez , Complicações Infecciosas na Gravidez , VacinaçãoRESUMO
OBJECTIVE: Obtain baseline information on the status of the basic capacities of the health sector at the local, municipal, and provincial levels in order to facilitate identification of priorities and guide public policies that aim to comply with the requirements and capacities established in Annex 1A of the International Health Regulations 2005 (IHR-2005). METHODS: A descriptive cross-sectional study was conducted by application of an instrument of evaluation of basic capacities referring to legal and institutional autonomy, the surveillance and research process, and the response to health emergencies in 36 entities involved in international sanitary control at the local, municipal, and provincial levels in the provinces of Havana, Cienfuegos, and Santiago de Cuba. RESULTS: The polyclinics and provincial centers of health and epidemiology in the three provinces had more than 75% of the basic capacities required. Twelve out of 36 units had implemented 50% of the legal and institutional framework. There was variable availability of routine surveillance and research, whereas the entities in Havana had more than 40% of the basic capacities in the area of events response. CONCLUSIONS: The provinces evaluated have integrated the basic capacities that will allow implementation of IHR-2005 within the period established by the World Health Organization. It is necessary to develop and establish effective action plans to consolidate surveillance as an essential activity of national and international security in terms of public health.
Assuntos
Implementação de Plano de Saúde , Recursos em Saúde/estatística & dados numéricos , Serviços de Saúde/estatística & dados numéricos , Saúde Pública/legislação & jurisprudência , Estudos Transversais , Cuba , Planejamento em Desastres , Fidelidade a Diretrizes , Implementação de Plano de Saúde/legislação & jurisprudência , Política de Saúde , Prioridades em Saúde , Recursos em Saúde/legislação & jurisprudência , Recursos em Saúde/organização & administração , Recursos em Saúde/provisão & distribuição , Serviços de Saúde/provisão & distribuição , Necessidades e Demandas de Serviços de Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Cooperação Internacional , Responsabilidade Legal , Avaliação das Necessidades , Vigilância da População , Autonomia Profissional , Medicina Estatal/organização & administração , Medicina Estatal/estatística & dados numéricos , Organização Mundial da SaúdeRESUMO
Objetivo. Obtener información de línea base sobre el estado de las capacidades básicas delsector salud a nivel local, municipal y provincial, a fin de facilitar la identificación de prioridadesy orientar las políticas públicas dirigidas a garantizar los requisitos y capacidades establecidosen el Anexo 1A del Reglamento Sanitario Internacional de 2005 (RSI-2005).Métodos. Se realizó un estudio descriptivo de corte transversal mediante la aplicación de uninstrumento de evaluación de capacidades básicas referidas a la autonomía legal e institucional,el proceso de vigilancia e investigación y la respuesta frente a emergencias sanitarias en36 entidades involucradas en el control sanitario internacional de los niveles local, municipaly provincial en las provincias de La Habana, Cienfuegos y Santiago de Cuba.Resultados. Los policlínicos y centros provinciales de higiene y epidemiología de las tres provinciascontaban con más del 75% de las capacidades básicas requeridas. Doce de 36 unidadesdisponían del 50% del marco legal e institucional implementado. La vigilancia e investigaciónde rutina presentaron una disponibilidad variable, mientras que las entidades de La Habanacontaron con más del 40% de capacidades básicas en el campo de la respuesta ante eventos.Conclusiones. Las provincias evaluadas cuentan con capacidades básicas instaladas quepermitirán la implementación del RSI-2005 según el plazo previsto por la Organización Mundialde la Salud. Es necesario establecer y desarrollar planes de acción eficaces para consolidara la vigilancia como una actividad esencial de seguridad nacional e internacional en términosde salud pública.
Objective. Obtain baseline information on the status of the basic capacities ofthe health sector at the local, municipal, and provincial levels in order to facilitateidentification of priorities and guide public policies that aim to comply with therequirements and capacities established in Annex 1A of the International HealthRegulations 2005 (IHR-2005).Methods. A descriptive cross-sectional study was conducted by application ofan instrument of evaluation of basic capacities referring to legal and institutionalautonomy, the surveillance and research process, and the response to healthemergencies in 36 entities involved in international sanitary control at the local,municipal, and provincial levels in the provinces of Havana, Cienfuegos, andSantiago de Cuba.Results. The polyclinics and provincial centers of health and epidemiology in thethree provinces had more than 75% of the basic capacities required. Twelve out of36 units had implemented 50% of the legal and institutional framework. There wasvariable availability of routine surveillance and research, whereas the entities inHavana had more than 40% of the basic capacities in the area of events response.Conclusions. The provinces evaluated have integrated the basic capacities thatwill allow implementation of IHR-2005 within the period established by the WorldHealth Organization. It is necessary to develop and establish effective action plans toconsolidate surveillance as an essential activity of national and international securityin terms of public health.
Assuntos
Humanos , Implementação de Plano de Saúde , Recursos em Saúde/estatística & dados numéricos , Serviços de Saúde/estatística & dados numéricos , Saúde Pública/legislação & jurisprudência , Estudos Transversais , Cuba , Planejamento em Desastres , Fidelidade a Diretrizes , Implementação de Plano de Saúde/legislação & jurisprudência , Política de Saúde , Prioridades em Saúde , Recursos em Saúde/legislação & jurisprudência , Recursos em Saúde/organização & administração , Recursos em Saúde/provisão & distribuição , Necessidades e Demandas de Serviços de Saúde , Pesquisa sobre Serviços de Saúde , Serviços de Saúde/provisão & distribuição , Cooperação Internacional , Responsabilidade Legal , Avaliação das Necessidades , Vigilância da População , Autonomia Profissional , Medicina Estatal/organização & administração , Medicina Estatal/estatística & dados numéricos , Organização Mundial da SaúdeRESUMO
INTRODUCCIÓN: en la medida en que la meta de la erradicación de la poliomielitis llega a su concreción, la necesidad de contar con una vacuna de polio inactivada asequible y apropiada para el uso en países en vías de desarrollo se ha convertido en una meta para la Organización Mundial de la Salud. OBJETIVO: la evaluación de la reactogenicidad de la vacuna de polio inactivada. MÉTODOS: se realizó un estudio multicéntrico con diseño experimental, correspondiente a Fase I-II de un ensayo clínico controlado, aleatorio y a simple ciegas, en 471 lactantes sanos de ambos sexos nacidos entre los meses de julio y agosto de 2006 en Camagüey, cuyos padres brindaron su consentimiento por escrito y que cumplieron con los criterios de inclusión establecidos. Los niños recibieron a las 6, 10 y 14 semanas del nacimiento, tres dosis de vacuna de polio inactivada del Instituto de Sueros de Dinamarca, autorizada para su uso en esta investigación por las autoridades regulatorias nacionales. Al grupo de estudio A, se le administró por la vía intradérmica la dosis reducida de 0,1 mL de vacuna de polio inactivada en la cara anterolateral del muslo izquierdo utilizando el inyector sin aguja Biojector® 2000. El grupo control B recibió la dosis usual de 0,5 mL por la vía intramuscular profunda, administrada en el mismo sitio descrito antes con una jeringuilla prellenada. Se observaron los eventos adversos durante la primera hora, 24, 48, y 72 h subsiguientes, así como a los 7 y 30 d de administrada la vacuna. La reactogenicidad se evaluó inicialmente por el pediatra del área y luego por el médico de familia mediante la observación de los eventos adversos. RESULTADOS: 79,6 por ciento del total de niños asignados al grupo A y 75 por ciento del grupo B finalizaron el protocolo de investigación. No se detectaron eventos adversos moderados o serios. Predominaron las reacciones adversas locales menores, sobre todo induración, dolor y enrojecimiento en el sitio de la inyección. CONCLUSIÓN: el ensayo demostró la seguridad de la vacuna de polio inactivada para su uso por vía intramuscular y reconoció la seguridad del uso de la vía intradérmica y del inyector sin agujas.
INTRODUCTION: as the goal of poliomyelitis eradication is about to be accomplished, the need for an affordable and appropriate inactivated poliovirus vaccine (IPV) for use in developing countries has become a target for WHO. OBJECTIVE: to evaluate the reactogenicity of the inactivated poliovirus vaccine. METHOD: an experimental-type multicenter study was conducted, as part of a Phase I-II controlled clinical randomized and blinded assay, in 471 healthy infants of both sexes born in July and August 2006 in Camagüey province. The parents of the children who met the inclusion criteria gave their consent in writing. The children received three doses of the inactivated poliovirus vaccine at 6, 10 and 14 weeks after birth. This vaccine came form the Institute of Sera in Denmark and had been approved for use in this assay by the Cuban regularoty authorities, Low 0.1 ml inactivated poliovirus vaccine dose was intradermally administered to the study group A in the anterolateral side of the left thigh using the needle-free injector called Biojector ® 2000. The usual 0.5 mL dose was intramuscularly administered on the same site using a pre-filled syringe. The adverse events were observed during the first hour, 24, 48, and 72 hours after the immunization, as well as 7 and 30 days afterwards. The pediatrician in charge of the health area evaluated the reactogenicity at first and then the family physician was in charge of observing the adverse events in the remaining period. RESULTS: the 79.6 percent of children in group A and 75 percent in group B completed the research protocol. Mild local adverse reactions prevailed, mainly induration, pain and redness at the injection site. CONCLUSION: the clinical trial proved the safety of the inactivated poliovirus vaccine for intramuscular administration, and also showed the safety of the intradermal route of administration and of the needle-free injector.
Assuntos
Humanos , Lactente , Poliomielite/prevenção & controle , Vacina Antipólio de Vírus Inativado/administração & dosagem , Vacina Antipólio de Vírus Inativado/imunologia , Injeções Intradérmicas/métodos , Método Simples-CegoRESUMO
INTRODUCTION: As the goal of poliomyelitis eradication is about to be accomplished, the need for an affordable and appropriate inactivated poliovirus vaccine (IPV) for use in developing countries has become a target for WHO. OBJECTIVE: To evaluate the reactogenicity of the inactivated poliovirus vaccine. METHOD: An experimental-type multicenter study was conducted, as part of a Phase I-II controlled clinical randomized and blinded assay, in 471 healthy infants of both sexes born in July and August 2006 in Camagüey province. The parents of the children who met the inclusion criteria gave their consent in writing. The children received three doses of the inactivated poliovirus vaccine at 6, 10 and 14 weeks after birth. This vaccine came form the Institute of Sera in Denmark and had been approved for use in this assay by the Cuban regularoty authorities, Low 0.1 mL inactivated poliovirus vaccine dose was intradermally administered to the study group A in the anterolateral side of the left thigh using the needle-free injector called Biojector 2000. The usual 0.5 mL dose was intramuscularly administered on the same site using a pre-filled syringe. The adverse events were observed during the first hour, 24, 48, and 72 hours after the immunization, as well as 7 and 30 days afterwards. The pediatrician in charge of the health area evaluated the reactogenicity at first and then the family physician was in charge of observing the adverse events in the remaining period. RESULTS: The 79.6% of children in group A and 75% in group B completed the research protocol. Mild local adverse reactions prevailed, mainly induration, pain and redness at the injection site. CONCLUSION: the Clinical trial proved the safety of the inactivated poliovirus vaccine for intramuscular administration, and also showed the safety of the intradermal route of administration and of the needle-free injector.
Assuntos
Poliomielite/prevenção & controle , Vacina Antipólio de Vírus Inativado/administração & dosagem , Vacina Antipólio de Vírus Inativado/imunologia , Humanos , Lactente , Injeções Intradérmicas/métodos , Método Simples-CegoRESUMO
INTRODUCCION: los estudios de seguimiento de eficacia protectora en grupos de alto riesgo a la infección por el virus de la hepatitis B, inoculados con vacunas recombinantes contra la hepatitis B, son limitados, y la duración de la protección aún no está del todo definida en los vacunados contra esta enfermedad. OBJETIVOS: determinar la eficacia protectora de la vacuna Heberbiovac HB® a diferentes dosis en niños impedidos físicos y mentales, 14 años después de aplicado el esquema primario de vacunación. MÉTODOS: en 1991 se realizó un estudio de efectividad con la vacuna Heberbiovac HB® en 2 grupos de niños impedidos físicos y mentales (A= 10 µg y B= 5 µg). El estudio fue aprobado por los Comités de Ética Médica y Revisión del Instituto de Medicina Tropical "Pedro Kourí" y el Centro de Ingeniería Genética y Biotecnología de Ciudad de La Habana; se siguieron las Buenas Prácticas Clínicas vigentes en Cuba y los principios éticos de la Declaración de Helsinki. Se empleó el esquema de vacunación 0, 1 y 6 meses, fueron incluidos los niños que resultaron negativos al antígeno de superficie del virus de la hepatitis B y al anticuerpo contra el antígeno de superficie del virus de la hepatitis B. Los sujetos se estudiaron desde el punto de vista clínico y serológicamente, hasta 14 años después de aplicado el esquema de vacunación. RESULTADOS: 1 año después del comienzo de la vacunación la seroprotección fue de 100 por ciento en ambos grupos. A los 14 años de seguimiento, ningún sujeto resultó positivo al antígeno de superficie del virus de la hepatitis B ni padeció hepatitis B aguda, lo cual resultó en 100 por ciento de protección individual. CONCLUSIONES: el poder inmunogénico de la vacuna Heberbiovac HB® fue elevado y su eficacia protectora fue de 100 por ciento en los niños impedidos físicos y mentales, en el seguimiento clínico serológico realizado hasta 14 años después de la aplicación del esquema de vacunación, resultados obtenidos por primera vez en Cuba para esta vacuna.
INTRODUCTION: the protective efficacy follow-up studies in high risk groups for hepatitis B virus infection, which were inoculated with recombinant hepatitis B vaccines, are limited and the duration of protection is yet to be determined in those vaccinated people. OBJECTIVES: to determine the protective efficacy of Heberbiovac HB® vaccine at different dosage in physically and mentally-handicapped children after 14 years of the primary vaccination schedule. METHODS: in 1991, an effectiveness study of vaccine Heberbiovac HB® was conducted in 2 groups of physically and mentally-handicapped (A=10 µg y B= 5 µg). The study was approved by the Committees of Medical Ethics and Revision of "Pedro Kourí" Tropical Medicine Institute and of the Center of Genetic Engineering and Biotechnology of the City of Havana; good clinical practice were followed and the ethical principles of Helsinki Declaration were respected for. The vaccination schedule at 0, 1 and 6 months was used in which children negative to hepatitis B virus surface antigen and to hepatitis B virus surface antigen antibody were included. The subjects were studied from the clinical and serological viewpoints up to 14 years after the implementation of the aforementioned vaccine schedule. RESULTS: one year after the beginning of the vaccination, there was full seroprotection in both groups. After 14 years of follow-up, none of the subjects was positive to hepatitis B virus surface antigen, neither were they affected by acute hepatitis B, which meant 100 percent individual protection. CONCLUSIONS: the immunogenic power of Heberbiovac HB® vaccine was high and its protective efficacy was 100 percent in physically and mentally-handicapped children according to the results of the clinical and serological follow-up extending up to 14 years after the implementation of the primary vaccination schedule. These results are achieved for the first time for this kind of vaccine.
Assuntos
Adolescente , Criança , Humanos , Crianças com Deficiência , Hepatite B/prevenção & controle , Pessoas com Deficiência Mental , Vacinas de DNA/administração & dosagem , Fatores de TempoRESUMO
INTRODUCTION: Chronic migraine refractory to preventive treatment is a common clinical situation in general neurology clinics. The aim is to analyse our experience with zonisamide in the preventive treatment of patients with frequent refractory migraine. PATIENTS AND METHODS: Those patients with no response or intolerance to topiramate and at least one more preventative received zonisamide. This drug was increased 25 mg per week up to 200 mg/day. The efficacy of zonisamide was evaluated in terms of 'response' (reduction in attack frequency below 50%) at the third month of treatment. RESULTS: Our series comprises a total of 172 patients, with ages ranging from 22 to 69 years. 85% were women. The final dosage of zonisamide was 50-200 mg/day, with the 100 mg/day being the most frequently administered dose. Zonisamide was efficacious (response) in 76 (44%) patients; response being excellent in 22 (13%). MIDAS score was reduced by 43.2%. Zonisamide was not tolerated by 27% of the patients, mainly due to subjective mental slowness or digestive symptoms. CONCLUSIONS: These results, obtained in a big sample of patients refractory or intolerant to topiramate and other preventatives, indicate that, at least in conditions of daily clinical practice, zonisamide, at relatively low dosages, is an option to be considered for the preventive treatment of patients with frequent migraine.
Assuntos
Anticonvulsivantes/uso terapêutico , Isoxazóis/uso terapêutico , Transtornos de Enxaqueca , Adulto , Idoso , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/prevenção & controle , Satisfação do Paciente , Resultado do Tratamento , Adulto Jovem , ZonisamidaRESUMO
INTRODUCTION: the protective efficacy follow-up studies in high risk groups for hepatitis B virus infection, which were inoculated with recombinant hepatitis B vaccines, are limited and the duration of protection is yet to be determined in those vaccinated people. OBJECTIVES: to determine the protective efficacy of Heberbiovac HB vaccine at different dosage in physically and mentally-handicapped children after 14 years of the primary vaccination schedule. METHODS: in 1991, an effectiveness study of vaccine Heberbiovac HB was conducted in 2 groups of physically and mentally-handicapped (A = 10 microg y B = 5 microg). The study was approved by the Committees of Medical Ethics and Revision of "Pedro Kouri" Tropical Medicine Institute and of the Center of Genetic Engineering and Biotechnology of the City of Havana; good clinical practice were followed and the ethical principles of Helsinki Declaration were respected for. The vaccination schedule at 0, 1 and 6 months was used in which children negative to hepatitis B virus surface antigen and to hepatitis B virus surface antigen antibody were included. The subjects were studied from the clinical and serological viewpoints up to 14 years after the implementation of the aforementioned vaccine schedule. RESULTS: one year after the beginning of the vaccination, there was full seroprotection in both groups. After 14 years of follow-up, none of the subjects was positive to hepatitis B virus surface antigen, neither were they affected by acute hepatitis B, which meant 100 % individual protection. CONCLUSIONS: the immunogenic power of Heberbiovac HB vaccine was high and its protective efficacy was 100% in physically and mentally-handicapped children according to the results of the clinical and serological follow-up extending up to 14 years after the implementation of the primary vaccination schedule. These results are achieved for the first time for this kind of vaccine.
Assuntos
Crianças com Deficiência , Hepatite B/prevenção & controle , Pessoas com Deficiência Mental , Vacinas de DNA/administração & dosagem , Adolescente , Criança , Humanos , Fatores de TempoRESUMO
Se explicó la adaptación del modelo de las enfermedades transmisibles de Coreil y otros, a la dinámica de la adquisición del VIH desde la perspectiva del individuo susceptible. Se hizo una revisión, acerca de la situación internacional y de Cuba de esta enfermedad, mediante el desarrollo de la discusión filosófica de los conceptos y las bases de un enfoque diferente de riesgo. Se demostró la aplicabilidad de este modelo y se previó su utilidad para el estudio de los determinantes que intervienen en la adquisición de la infección.
The adaptation of Coreil et al´s communicable disease model to the dynamics of contracting HIV from the sensitive individual perspective was intended to be explained in this article. A literature review on the situation of this disease in Cuba and worldwide by developing the phylosophical debate on concepts and the basis for a different risk approach was made. The applicability and usefulness of this model for the study of determinants involved in HIV infection was shown.
Assuntos
Humanos , Síndrome da Imunodeficiência Adquirida , Doenças Transmissíveis , RiscoRESUMO
The adaptation of Coreil et al's communicable disease model to the dynamics of contracting HIV from the sensitive individual perspective was intended to be explained in this article. A literature review on the situation of this disease in Cuba and worldwide by developing the phylosophical debate on concepts and the basis for a different risk approach was made. The applicability and usefulness of this model for the study of determinants involved in HIV infection was shown.
Assuntos
Infecções por HIV/transmissão , Fármacos Anti-HIV/uso terapêutico , Atitude Frente a Saúde , Cuba/epidemiologia , Cultura , Surtos de Doenças , Feminino , Saúde Global , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , Humanos , Masculino , Modelos Teóricos , Assunção de Riscos , Comportamento Sexual , Fatores Socioeconômicos , Abuso de Substâncias por Via IntravenosaRESUMO
Se estudiaron muestras de heces y sueros obtenidos en niños menores de 3 años de edad para incrementar el conocimiento de las circulaciones de los virus vacunales durante las campañas masivas. El uso de vacuna oral antipoliomielítica (VOP) con esquemas de campañas masivas, permite la circulación del virus vacunal 2 meses después de concluidas estas. El empleo de esquemas de vacunación continua permite la circulación del virus vacunal a períodos de tiempo mayor e incluso, en poblaciones con baja cobertura de inmunidad, pueden surgir brotes epidémicos de los virus derivados de la vacuna. El total de poliovirus vacunal aislados en los niños de 2 años (11 casos, 11,0 por ciento) y las reactivaciones de anticuerpos neutralizantes (51 casos, 51,0 por ciento), demuestran una contradicción entre la verificación de las infecciones por aislamientos de los virus y los resultados de reactivación. Los bajos porcentajes de aislamientos de virus vacunal y los porcentajes significativamente altos de seroconversiones o reactivaciones a poliovirus, permiten inferir la ocurrencia de circulación silenciosa. La circulación silenciosa autolimitada a los 2 meses de concluida la campaña es debida, entre otras causas, a la respuesta inmune, homóloga o no, inducida por la infección primaria con la primera dosis de la VOP y por las infecciones secundarias. La autolimitación de la circulación de los poliovirus en campañas masivas es una excelente prevención de los riesgos que representan los virus derivados de la vacuna surgidos en vacunaciones con esquemas continuos
Assuntos
Cuba , Vacinação em Massa , Poliomielite , Poliovirus , Vacina Antipólio OralRESUMO
Samples of feces and sera obtained from 3-year-old children were studied to increase the knowledge about the circulations of virus vaccines during the massive campaigns. The use of the oral polio vaccine with schemes of massive campaigns allows the circulation of the virus vaccine 2 months after their completion. The use of continual vaccination schemes makes possible the circulation of the virus vaccine for longer periods of time. Even in populations with a low immunity coverage, epidemic outbreaks of the vaccine-derived virus may appear. The total of poliovirus vaccine isolated in 2-year-old children (11 cases, 11.0 %) and the boosts of neutralizing antibodies (51 cases, 51.0 %), show a contradiction between the verification of the infections caused by isolations of the viruses and the results of boosts. The low percentage of isolations of virus vaccine and the highly significant percentages of of seroconversions or boosts to polio virus, allow to infer the occurrence of silent circulation. The silent circulation self limited to 2 months after concluding the campaign is due, among other causes, to the homologous or not induced response by the primary infection with the first dose of oral polio vaccine and by the secondary infections. The self limitation of the circulation of the polio viruses in massive campaigns constitutes an excellent prevention of the risks represented by the vaccine-derived viruses appearing in vaccinations with continual schemes.
Assuntos
Anticorpos Antivirais/sangue , Poliomielite/prevenção & controle , Poliomielite/transmissão , Vacina Antipólio Oral , Poliovirus/isolamento & purificação , Eliminação de Partículas Virais , Fatores Etários , Sangue/virologia , Pré-Escolar , Interpretação Estatística de Dados , Fezes/virologia , Humanos , Imunização Secundária , Lactente , Poliomielite/virologia , Poliovirus/imunologia , Poliovirus/fisiologia , Vacina Antipólio Oral/administração & dosagem , Vacina Antipólio Oral/efeitos adversos , Vacina Antipólio Oral/imunologia , Fatores de TempoRESUMO
Se hizo este estudio como parte del Programa de Vigilancia que desde hace 10 años se realiza para el control perinatal de la hepatitis B en hijos de madres positivas. El control de la hepatitis B se debe fundamentalmente a la existencia de las vacunas contra esta entidad, en Cuba se cuenta con una vacuna segura y efectiva para su prevención. El riesgo de la infección perinatal, entre niños de madres positivas al antígeno de superficie de hepatitis B (AgsHB) es elevado. Muchas de estas infecciones pueden ser prevenidas si las embarazadas positivas al AgsHB son detectadas precozmente y sus hijos son vacunados al nacer. Desde septiembre de 2000 hasta diciembre de 2002, se investigaron 121 muestras de sueros de madres positivas y sus respectivos hijos a los 7 meses de edad, procedentes de todo el país, recibidas en el Laboratorio Nacional de Referencia de Hepatitis viral del Instituto de Medicina Tropical ôPedro Kouríö. A todas las muestras se les realizó la prueba para detectar AgsHB y a los niños negativos al AgsHB se les investigó anticuerpos anti-HBs. En las madres se encontró 100 por ciento de positividad al AgsHB, en los niños se obtuvo 5,7 por ciento de positividad a este antígeno. En los niños negativos la seroprotección alcanzada en este grupo fue de 94,7 por ciento con un Título Promedio Geométrico (TPG) de anti-HBs de 233,3 UI/L, predominaron los hijos normorrespondedores con 52,6 por ciento y el índice de eficacia de la vacuna utilizada osciló entre 95,9 y 99,3 por ciento
Assuntos
Humanos , Masculino , Feminino , Hepatite B , Antígenos de Superfície da Hepatite B , Complicações Infecciosas na Gravidez , Cuidado Pré-NatalRESUMO
This study was made as part of the Surveillance Program that has been implemented for 10 years for the perinatal control of hepatitis B in children of positive mothers. The control of hepatitis B is possible thanks to the existance of the vaccines against this entity. In Cuba, there is a safe and effective vaccine for its prevention. The perinatal infection risk among children of mothers positive to hepatitis B surface antigen (HbsAg) is high. Many of these infections may be prevented if mothers positive to HbsAg are early detected and their children are vaccinated at birth. 121 serum samples from positive mothers and their respective 7-month-old children from all over the country that were received at the National Viral Hepatitis Reference Laboratory of "Pedro Kouri" Tropical Medicine Institute were studied from September to December, 2000. All the samples underwent the test to detect HbsAg and anti-HBs antibodies were investigated in children negative to HbsAg. 100% of positivity to HBsAg was found among mothers. 5.7% of positivity to this antigen was obtained in children. In negative children the seroprotection attained in this group was 94.7% with an anti-HBs Geometric Mean Titer (GMT) of 233.3 UI/L. The normoresponsive children predominated with 52.6%. The Efficacy Index of the vaccine used ranged from 95.9% to 99.3%.
Assuntos
Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/imunologia , Hepatite B/prevenção & controle , Hepatite B/transmissão , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Vacinas de DNA/imunologia , Humanos , Lactente , MãesRESUMO
Se expone el Plan Temático que el Instituto de Medicina Tropical ôPedro Kouríö se propone para los próximos años y los grandes retos a enfrentar, así como la experiencia que ya acumulan sus profesionales como aval de éxito para estas intervenciones. El trabajo fundamenta la necesidad muy importante de continuar el perfeccionamiento de nuestro sistema de atención primaria de salud (APS). Se reconoce a nuestra APS como un modelo único en el mundo, y al mismo tiempo novedoso y complejo. Se plantea que la aplicación del enfoque epidemiológico a la APS puede ayudar mucho a mejorar la ejecución de los actores sociales que en ella intervienen, y por ende, mejorar el rendimiento del modelo en beneficio de la salud de la comunidad
Assuntos
Epidemiologia , Medicina de Família e Comunidade , Pesquisa sobre Serviços de Saúde , Médicos de Família , Atenção Primária à SaúdeRESUMO
Se estudió la reactogenicidad de la vacuna recombinante cubana contra el virus de la hepatitis B, derivada de células de levadura (Heberbiovac-HB), al aplicar dosis de 5 y 10 mg y emplear el esquema de inmunización 0, una segunda dosis al mes y la tercera a los 6 meses a 2 grupos de niños física y mentalmente discapacitados de 5 a 14 años de edad. Los síntomas observados en el total de la población estudiada fueron de 5,1 %, mientras que en los grupos vacunados con 10 y 5 mg, la sintomatología fue de 4,8 y 5,4 % respectivamente; sin que se encontraran diferencias significativas en los síntomas postvacunales entre los grupos de estudio. El signo predominante fue la febrícula con el 84,9 % de las observaciones positivas encontradas. En nuestro estudio se constató la baja reactogenicidad de la vacuna Heberbiovac-HB, lo que la hizo segura y recomendable para la protección contra el virus de la hepatitis B en los grupos de niños impedidos físicos y mentales estudiados.
The reactogenecity of the Cuban recombinant yeast-derived hepatitis B vaccine (Heberbiovac-HB) was studied on administering doses of 5 and 10 mg and using the immunization scheme 0 in 2 groups of physical and mentally disabled children aged 5-14. The second dose was given at a month and the third one at 6 months. The symptoms observed in the whole population under study were 5,1 %, whereas in the groups vaccinated with 5 and 10 mg, the symptomatology was 4,8 and 5,4 %, respectively. No significant differences were observed in the postvaccinal symptoms between the studied groups. The predominant sign was low-grade fever with 84,9 % of the positive observations found. In our study, it was confirmed the low reactogenecity of the Heberbiovac-HB vaccine, which makes it safe and recommendable for the protection against the hepatitis B virus in the groups of physical and mentally disabled children that were studied.
RESUMO
Se realizó un ensayo clínico controlado, a doble ciegas, con la participación de 80 voluntarios adultos, de los 2 sexos, sanos en apariencia, que fueron distribuidos de forma aleatoriamente en 2 grupos de 40 cada uno, se constituyó un grupo de estudio (que recibió la vacuna) y un grupo control (que recibió un placebo) para conocer la seguridad, el comportamiento de la reactogenicidad y comenzar los estudios de inmunogenicidad de la primera vacuna cubana contra la leptospirosis humana. La vacuna utilizada en el grupo de estudio fue una vacuna inactivada y trivalente en cuya composición se encuentran cepas de Leptospira canicola, icterohaemorrhagiae y pomona, por ser las de mayor circulación en el país. Los resultados obtenidos demostraron la inocuidad de la vacuna, al no presentarse reacciones adversas graves. La sintomatología general observada fue baja, la febrícula fue el síntoma general encontrado en mayor proporción. Aparece durante los primeros 3 d de observación, sin encontrarse diferencias significativas entre el grupo vacunado y el placebo. Como síntoma local sólo fue referido el dolor ligero en el sitio de la inyección, en el grupo vacunado se presentó con mayor frecuencia que en el grupo control (7,8 contra 1,5 %, respectivamente). La seroconversión obtenida fue de 29 % mediante la microaglutinación, y 34,2 % por la técnica de ELISA. Los resultados obtenidos permiten concluir que ésta es segura para adultos humanos en las edades comprendidas en el estudio y permiten continuar otros estudios es fases más avanzadas para completar los requerimientos para su licenciamiento.
A controlled double blind trial was conducted with the participation of 80 adult volunteers of both sexes, who were randomly divided into groups of 40 individuals each one. The case-base study received the vaccine and the control group was administered placebo to know the safety, the behaviour of reactogenecity, and to star the immunogenecity studies of the first Cuban vaccine against human leptospirosis. The vaccine used in the case-base study was an inactivated and trivalent vaccine containing strains of Leptospira canicola, incterohaemorrhagiae and pomona, since they have the highest circulation in the country. The results obtained showed the inocuity of the vaccine as no adverse severe reactions were detected. The general symptomatology observed was low, where as febricula was the most common general symptom. It appeared during the first 3 days of observation and there were no significant differences between the 2 group. Only a mild pain at the site of the injection was reported as a local symptom, which was more frequent in the vaccinated group than in the control group (7,8 against 1,5 %, respectively). The seroconversion obtained was of 29 % by microagglutination, and of 34,2 % by ELISA. The final results allowed to conclude that this vaccine is safe for human adults at the ages under study, and give the possibility to continue other studies in more advanced stages to complete the requierements for obtaining its license.
Assuntos
Adulto , Feminino , Humanos , Masculino , Vacinas Bacterianas/efeitos adversos , Vacinas Bacterianas/imunologia , Leptospira interrogans serovar canicola/imunologia , Leptospira interrogans/imunologia , Leptospirose/prevenção & controle , Doença de Weil/prevenção & controle , Anticorpos Antibacterianos/sangue , Estudos de Casos e Controles , Cuba , Método Duplo-Cego , Fatores de TempoRESUMO
An epidemiological study on H. nana infection was carried out in Ciego de Avila province, Cuba, fron 1981 to 1995. In this 15 years period 3,108,422 stool samples were examined for parasites, H. nana eggs were found in 250 (0,008 percent). Seasonal influence of this parasitism was not detected. There were more cases in children than in adults, with males prevaling over females. The more frequent symptoms and signs were abdominal pain, diarrhea and anorexia which relationships with food habits, dwelling characteristics, children day care center and school orchards are analyzed
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Adolescente , Adulto , Himenolepíase/epidemiologia , Hymenolepis/isolamento & purificação , Enteropatias Parasitárias/epidemiologia , Distribuição por Idade , Cuba/epidemiologia , Fezes/parasitologia , Himenolepíase/etiologia , Himenolepíase/fisiopatologia , Hymenolepis/patogenicidade , Incidência , Contagem de Ovos de Parasitas , Distribuição por Sexo , Sinais e SintomasRESUMO
Se aplicó la vacuna ADN recombinante Heberbiovac-HB contra la hepatitis B a 2 grupos de niños recluidos en 2 hogares de impedidos físicos y mentales, a las dosis de 10 y 5 µg con el esquema 0,1 y 6 meses para estudiar su inmunogenicidad, la que fue evaluada a los 2, 7 y 12 meses después de aplicada la primera dosis. A los 60 d se obtuvo 80,9 por ciento de seroprotección en los niños que recibieron 10 µg, mientras que en el grupo que fue vacnado con 5 µg se logró 65,0 por ciento de seroprotección y no se encontraron diferencias significativas entre los grupos. Cuando se midió la respuesta inmune 1 mes después de aplicada la tercera dosis se obtuvo 100,0 por ciento de seroprotección (ò 10 UI/L) en los 2 grupos de vacunados. Al año, la seroprotección fue del 100,0 por ciento para los 2 grupos de niños. La media geométrica de los títulos de anticuerpos (TMG) alcanzó, 30 d después de la segunda dosis en los 2 grupos de estudio, niveles por encima de 10 UI/L, que es el mínimo protector. Un mes después de la tercera dosis, los TMG alcanzaron valores de 527,7 UI/L en el grupo de 10 µg y 324,7 UI/L en el de 5 µg y no se encontraron diferencias significativas entre los grupos (p < 0,05). Finalmente, a los 365 d, los TMG se situaron en 139,7 UI/L en los grupos de 10 y 5 µg, respectivamente. Se demostró el alto poder inmunogénico de esta vacuna, lo que la hace recomendable para la protección contra el virus de la hepatitis B en niños impedidos físicos y mentales
Assuntos
Humanos , Criança , Adolescente , DNA Recombinante/imunologia , Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B/imunologia , Deficiência Intelectual , Pessoas com Deficiência MentalRESUMO
Se aplicó la vacuna recombinante cubana (Heberbiovac-HB) derivada de células de levaduras, contra el virus de la hepatitis B, a la dosis de 10µg, a 2 grupos de niños de edades de 3 meses y esquema de 0, 1 y 6, y 0, 1, 2 y 12 en coincidencia con las vacunas DPT y antimeningocócica, según se establece en el programa de inmunizaciones. Se estudió la reactogenicidad e inmunogenicidad en ambos grupos, las reacciones observadas fueron ligeras y similares a otros estudios, donde la febrícula eritema e induración fueron los signos más frecuentes. Ambos grupos mostraron altos porcentajes de niños con títulos de anticuerpos anti-HBs superiores a 100 UI/L-1. Se demuestra la aceptable reactogenicidad de la vacuna y la no interferencia inmunológica por las otras vacunas aplicadas