Assessment of human health vulnerability to climate variability and change in Cuba.

In this study we assessed the potential effects of climate variability and change on population health in Cuba. We describe the climate of Cuba as well as the patterns of climate-sensitive diseases of primary concern, particularly dengue fever. Analyses of the associations between climatic anomalies and disease patterns highlight current vulnerability to climate variability. We describe current adaptations, including the application of climate predictions to prevent disease outbreaks. Finally, we present the potential economic costs associated with future impacts due to climate change. The tools used in this study can be useful in the development of appropriate and effective adaptation options to address the increased climate variability associated with climate change.

[Meningococcal disease in the City of Havana before and after vaccination]. / Comportamiento de la enfermedad meningocócica en el territorio de Ciudad de La Habana antes y después de la vacunación.

The development of risk before and after vaccination in the City of Havana province was described. Data were collected from epidemiological surveys of all cases under 5 years diagnosed with meningococcal disease during pre-vaccination period (1983-1984) and post-vaccination period (989,1990 and 1998). They were processed by using the Geographic Information System Mapinfo 4.1. During 1983 and 1984 when there was no vaccinal intervention, high incidence rates in all age groups were observed in most of the municipalities of the province. However, in 1989, the vaccination coverage was extensive and from that moment on, the incidence rates decreased and the number of meningitis-free municipalities grew. A decrease in frequency of sick children, non-vaccinated children and a very small number of children who were not vaccinated as they should have been was observed. The benefits of an homogeneous intervention at territorial level in the province were proved.

The Epidemiological Impact of Antimeningococcal B Vaccination in Cuba

The incidence of invasive meningococcal disease (IMD) before (1984-1988) and after (1989-1994), a nationwide intervention with VA-MENGOC-BC vaccination started in 1989, was compared. The prevaccination period incidence density (ID> 8.8/ 105 year-person) was higher than the postvaccination ID (ID< 6.5/ 105 year-person). The percentage proportional differences from the start to the end of each period of ID in the vaccinal period was higher (87 percent) than the prevaccinal (37 percent) with significant differences among vaccinated groups (< 25 years old). A break-point (Chow test) was confirmed by the decrease in the ID between 1989 and 1990 in children under 1 year old, 5-9, 10-14, 15-19 and 50-54 years. Comparison of ID using maps showed a decrease in IMD in all municipalities during the postvaccination period. These findings support the epidemiological impact of VA-MENGOC-BC vaccination in the reduction of IMD morbidity

Vacuna VA-MENGOC-BC: su repercusión sobre la enfermedad meningocócica en niños de 1 a 4 años / VA-MENGOC-BC vaccine: its impact on meningococcal disease in children 1-4 years old

VA-MENGOC-BC vaccine has been administered to Cuban infants since 1991 through the National Immunization Program (NIP) so it was necessary to evaluate its effects on 1-4 years-old children included in the highest risk group. To this end, a descriptive study of the morbidity and mortality from meningococal disease was carried out taking the vaccine histories of 145 cases occurred from 1991 to 1996 into account. The decreasing trend of the incidence density (ID) of meningococcal disease in all the age groups in the studied period was among the most important results, the highest decline was observed in one-year old infants with an ID of. 10.8 per 100,000 children/years at the end of the period. The percent distribution of occurrence showed a predominance of one-year old group at the beginning of the program. Implementation, and a change to 3-4 years old group at the end of the period. A high of percent of vaccinated sick children had been immunized against MD over one year ago (697.5 days as average). 35 children died during the period and the highest mortality density decline (1 per 100,000 children a year) was observed as of 1993; 2 years-old children were at highest risk of death. Seventy three percent (73.1) of those vaccinated had been immunized for over once year. The general lethality was 24.1, the lowest was 14.3 in one year old children. The changes occurred in meningococcal disease behaviour within this high risk group, which are attributed to the administration of vaccine as part of the NIP fully justifies the continuation of the application of this vaccine.

Sistema de vigilancia de eventos adversos consecutivos a la vacunación en la República de Cuba / Adverse reaction surveillance system for vaccination in the Republic of Cuba

We briefly sets forth the design of a surveillance system of adverse events as a part of the Vaccination Program in Cuba since it has had a world impact and thus, the real scope of such events can be known in the country. On the other hand, this system may be useful for Cuban vaccine-producing industries to prove innocousness of their products after these being licensed. Family physician and nurse program which covers 98 of the Cuban population will make the active-passive surveillance of all those persons who had been vaccinated in a territory possible. This surveillance system will be able to measure risks of adverse events by vaccine, age, number of doses, province and municipalities and by batch and manufacturer so that the causes leading to those events can be known. For this reason, it will contribute to improve the quality of services, protect the vaccination quality and upgrade the Cuban surveillance system.