ABSTRACT
In 2009 the World Health Organization recommended the use of group A rotavirus (RVA) vaccines in all national immunization programs (NIPs) in order to control severe RVA gastroenteritis disease. In Brazil, Rotarix™ was introduced in the NIP in March 2006, and a significant reduction in mortality rates among children ≤ 5 years old was observed, especially in the Northern and Northeastern Brazil. In the current study the 11 gene segments of six Brazilian G1P[6] RVA strains, isolated in 2009 and 2010 from vaccinated children, were analyzed in order to investigate if the genetic composition of these strains might help to elucidate why they were able to cause acute gastroenteritis in vaccinated children. All six Brazilian RVA strains revealed a complete Wa-like genotype constellation: G1-P[6]-I1-R1-C1-M1-A1-N1-T1-E1-H1. Phylogenetic analysis showed that all six strains were nearly identical and showed a close genetic relationship with contemporary typical human Wa-like RVA strains. These results suggests that the fact that these strains were able to cause acute gastroenteritis in vaccinated children is likely not due to the genetic background of the strains, but rather to other factors such as host relating factors, co-infecting pathogens or vaccine efficacy. P[6] RVA strains are detected rather occasionally in humans in most regions of the world, except for South Asia and Sub-Saharan Africa. However, recently two studies conducted in Brazil showed the circulation of G12P[6] and G2P[6]. This is the first report on the detection and complete genome analyses of G1P[6] RVA strains in Brazil. Surveillance studies will be crucial to further investigate the prevalence of this genotype in the Brazilian population, and the efficacy of current licensed vaccines, which do not contain the P[6] genotype.
Subject(s)
Rotavirus Infections/virology , Rotavirus Vaccines , Rotavirus/classification , Rotavirus/genetics , Brazil/epidemiology , Child, Preschool , Feces/virology , Genome, Viral/genetics , Genotype , Humans , Infant , Phylogeny , Rotavirus/isolation & purification , Rotavirus Infections/epidemiology , Rotavirus Infections/prevention & control , Vaccines, AttenuatedABSTRACT
Com o objetivo de examinar aspectos qualitativos da atençäo médica em quatro Centros de Saúde do Instituto de Saúde do Estado da Bahia - ISEB, situados em Salvador, em 1980, foi realizado um estudo baseado em anotaçöes contidas nas Fichas Clínicas de pacientes que tiveram a sua primeira consulta nas referidas Unidades de Saúde entre 1 de janeiro e 31 de dezembro de 1980. Foi observado que existiu uma predominância de atendimentos nos serviços do tipo curativo e os autores chamam a atençäo para a pouca modificaçäo na qualidade dos atendimentos quando comparados aos do ano de 1976