ABSTRACT
A coqueluche, doença infectocontagiosa, atualmente vem apresentando um perfil reemergente. Fatores como diminuição da imunidade, anos após a vacinação, mudanças no genótipo da bactéria e maior susceptibilidade entre jovens e adultos são considerados como contribuintes para o aumento da taxa da incidência da doença. Assim, esse estudo teve como objetivos verificar a distribuição espacial dos casos confirmados de coqueluche entre o período de 2007 a 2015; identificar o comportamento da série histórica da taxa de incidência da coqueluche durante o período de 2001 a 2015 no Brasil e verificar a associação da vacina contra coqueluche e a ocorrência da doença no estado do Rio Grande do Norte. Dessa forma, o caminho metodológico da pesquisa foi dividido em três partes. A análise da distribuição espacial considerou como unidade de análise as 482 Regiões Imediatas de Articulação Urbana e utilizou o software Terraview para construção dos mapas temáticos. Para se verificar a tendência da série optamos por utilizar o ajuste de uma função polinomial no tempo, utilizando-se assim modelos de regressão polinomial. Em relação a associação foi estabelecido como critério de inclusão a confirmação do caso de acordo com os critérios estabelecidos pelo Ministério da Saúde, sendo excluídos aqueles cujas fichas não encontravam-se devidamente preenchidas ou que estivessem com algum tipo de dúvida que comprometesse a coleta dos dados. Os resultados demonstraram que a doença apresentou uma distribuição espacial democrática em todo território nacional, formando pequenos clusters com altas taxas de incidência nas regiões de articulação urbana presentes nas regiões sul e sudeste. Identificamos também que houve, na série histórica, uma tendência crescente da doença ao longo de 15 anos. E por fim, os resultados apontam que independentemente do estado vacinal os indivíduos estão adoecendo por coqueluche, o que não gerou evidência científica suficiente para medir a efetividade da vacina. Os achados sugerem que aspectos relacionados a vacinação precisam ser melhor investigados para que se possa garantir o controle da doença. É necessário também que ocorram melhorias nas ações de vigilância, o que pode garantir uma representação epidemiológica fidedigna da doença (AU).
Pertussis, an infectious-contagious disease, is currently presenting a reemerging profile. Factors such as decreased immunity years after vaccination, changes in the genotype of the bacteria and increased susceptibility among young and adults are considered to have contributed to increase the disease incidence rate. Therefore, this study aimed to verify the spatial distribution of confirmed pertussis cases between 2007 and 2015; to identify the patterns in the time-series of pertussis incidence rates during the period 2001 to 2015 in Brazil and to verify the association of pertussis vaccine with the occurrence of the disease in the state of Rio Grande do Norte. Thus, the methodological path of the research was divided into three parts. The analysis of the spatial distribution considered the 482 Regions Immediate Urban Articulation as unit of analysis and used the Terraview software to construct the thematic maps. In order to verify the trend in the series we chose to use the adjustment of a polynomial function in time, using polynomial regression models. Regarding the association, the confirmation of the case was established as inclusion criteria in accordance with the criteria established by the Ministry of Health, being excluded those files that were not properly filled or had any uncertainties that could compromise the data collection. The results suggests that the disease has a democratic spatial distribution throughout the country, forming small clusters with high incidence rates in the urban articulation present in the South and Southeast regions. It was also identified in the time-series an increasing tendency of the disease over a period of 15 years. Finally, the results indicate that regardless of vaccination status individuals are being infected with pertussis, which did not generate enough scientific evidence to measure the effectiveness of the vaccine. The findings suggest that aspects related to vaccination need further investigation in order to guarantee disease control. There is also a need for improvements in surveillance actions, which can ensure a reliable epidemiological representation of the disease (AU).
Subject(s)
Humans , Child, Preschool , Child , Pertussis Vaccine/pharmacology , Whooping Cough/epidemiology , Communicable Diseases/immunology , Health Personnel , Brazil/epidemiology , Pertussis Vaccine/immunology , Linear Models , Immunization , Ecological Studies , Evaluation Studies as Topic , Spatial AnalysisABSTRACT
A coqueluche é uma doença respiratória, causada pela bactéria Bordetella pertussis. Atualmente, estima-se a ocorrência anual de 50 milhões de casos e mais de 300 mil mortes anuais em todo mundo. A transmissão ocorre, principalmente, pelo contato direto de uma pessoa doente com uma pessoa suscetível, através de gotículas de secreção da orofaringe eliminada por tosse ou espirro. O estudo realizado objetivou a caracterização da coqueluche como doença re-emergente, visando a análise epidemiológica da doença no Estado do Rio de Janeiro, valorizando também a percepção da Biossegurança pelos profissionais da área da saúde. Os resultados alcançados revelaram indicadores da ressurgência da doença no Brasil. As análises foram objeto de reflexões propostas em quatro artigos científicos, que explicitaram as metodologias utilizadas, os resultados encontrados e as discussões pertinentes à pesquisa. Os artigos intitulam-se: (1) An overview of reemerging Pertussis and evidence of ressurgence in Brazil, (2); A re-emergência da coqueluche; Da rotina dos atendimentos ao imperativo da Biossegurança (3); Fórum itinerante de ciência e saúde. Programa de capacitação para as doenças negligenciadas e re-emergentes e (4) Identification of linear B epitopes of pertactin of Bordetella pertussis induced by immunization with whole and acellular vaccine.
Whooping cough is a respiratory disease caused by the bacteria Bordetellapertussis. Today there is an estimate of fifty million cases a year and about three hundred thousand deaths worldwide. Transmission takes place mainly through direct contact of asick to a susceptible person and spreads by oropharynx fluid droplets released bycoughing or sneezing. The present study aimed at defining whooping cough as a reemergent disease, taking the epidemiologic analysis of the disease in the state of Rio de Janeiro as base and also surveying perception and compliance to biosafety proceduresamong health workers. Results obtained strongly indicated resurgence of the disease in Brazil and data has been presented in scientific paper format , into four propositions thatdiscussed methodology used, main results and thoughts pertaining to the investigation: The papers are entitled (1) An overview of re-emerging pertussis and evidence ofresurgence in Brazil, (2) Re-emergence of whooping cough : from routine clinical evaluation to the demand of biosafety, (3) Mobile fora for science and health : a capacitybuildingprogram for neglected and re-emergent diseases and (4) Identification of linear B epitopes of pertactin of Bordetella pertussis induced by immunization with whole and acellular vaccine.
Subject(s)
Whooping Cough/epidemiology , Health Personnel , Pertussis Vaccine/pharmacology , Pertussis Vaccine/historyABSTRACT
The hypoglycemic effect of Bordetella pertussis (Challenge strain No.18323) purified cell extract (protein with traces of carbohydrates, 2 mg%) administered (0.1 mg/100 g body wt. i.v.) into mice on the activities of the key regulatory enzymes, viz. glucokinase, phosphofructokinase, pyruvate kinase, glyceraldehyde phosphodehydrogenase, glucose-6-phosphate dehydrogenase (G-6-PD) and lactate dehydrogenase, of glycolytic pathway in liver has been studied at varying intervals after injection. The maximum hypoglycaemic effect was observed at the end of 12 hr, while activities of all the enzymes studied showed significant enhancement after 18 hr, thus suggesting increased glucose utilization towards the formation of pyruvate. Actinomycin D is found to inhibit stimulation of G-6-PD activity in B. pertussis treated animals, thereby indicating the role of B. pertussis in synthesis of this enzyme.
Subject(s)
Animals , Bordetella pertussis , Glucokinase/metabolism , Glucosephosphate Dehydrogenase/metabolism , Glyceraldehyde-3-Phosphate Dehydrogenases/metabolism , Glycolysis/drug effects , L-Lactate Dehydrogenase/metabolism , Liver/drug effects , Male , Mice , Pertussis Vaccine/pharmacology , Phosphofructokinase-1/metabolism , Pyruvate Kinase/metabolism , Time FactorsABSTRACT
A good correlation was observed between mouse intracerebral potency in terms of International Units and 50 per cent histamine sensitizing dose (HSD50) of various types of pertussis vaccine. The correlation was significant irrespective of the inactivating agent used for the preparation of pertussis vaccine. If the potency of the vaccine increased, the HSD50 decreased and vice versa showing a negative correlation between potency and HSD50. The relative histamine sensitizing (HS) activities of various types of pertussis vaccines in comparison to that of heat inactivated pertussis vaccine (HIPV) obtained in different experiments were very similar although the HSD50 values of same types of vaccines obtained in these experiments varied greatly. The conventional HIPV preparations having potency around 8 IU per 40 x 10(9) organisms had HSD50 values in the range of 1.0 to 2.2 x 10(8) organisms. The estimation of HSD50 of pertussis vaccine has been found to be a useful measure of the toxicity of the vaccine and also correlates well with the potency of the vaccine.
Subject(s)
Animals , Brain/immunology , Histamine Release , Mice , Pertussis Vaccine/pharmacology , Reference StandardsSubject(s)
Infant , Child, Preschool , Humans , Male , Female , Pertussis Vaccine/pharmacology , Whooping Cough/epidemiology , Pertussis Vaccine/adverse effectsABSTRACT
The injection of streptozotocin(stz) at a high dose (60 mg/kg) into young male rats produces direct beta cell destruction and leads to insulin dependent diabetes (IDD). In contrast the injection of multiple smal doses of stz (40 mg/Kg/d for 5 days) produce IDD, which resembles type l diabetes in man. The provocative effects of the pertussis vaccine (PV) and cyclosporin(CA) against the development of IDD induced by stz were studied. When PV in a dose of 3.75 X 10(10) microorganism was administered to single or multiple stz treated rats, hyperglycemia still developed and persisted during the experiment. No difference was noted in blood glucose levels, but plasma insulin levels were higher in PV treated rats. When CA (10 mg/kg) was administered daily to single or multiple stz treated rats, hyperglycemia seemed to be lower, but this was not statistically significant, however, plasma insulin levels were higher in CA treated rats. The results of this experiment suggest that PV and CA provide some protection to the beta cells of the pancreas.