Burden of influenza-associated respiratory hospitalizations in the Americas, 2010-2015.

BACKGROUND: Despite having influenza vaccination policies and programs, countries in the Americas underutilize seasonal influenza vaccine, in part because of insufficient evidence about severe influenza burden. We aimed to estimate the annual burden of influenza-associated respiratory hospitalizations in the Americas. METHODS: Thirty-five countries in the Americas with national influenza surveillance were invited to provide monthly laboratory data and hospital discharges for respiratory illness (International Classification of Diseases 10th edition J codes 0-99) during 2010-2015. In three age-strata (<5, 5-64, and ≥65 years), we estimated the influenza-associated hospitalizations rate by multiplying the monthly number of respiratory hospitalizations by the monthly proportion of influenza-positive samples and dividing by the census population. We used random effects meta-analyses to pool age-group specific rates and extrapolated to countries that did not contribute data, using pooled rates stratified by age group and country characteristics found to be associated with rates. RESULTS: Sixteen of 35 countries (46%) contributed primary data to the analyses, representing 79% of the America's population. The average pooled rate of influenza-associated respiratory hospitalization was 90/100,000 population (95% confidence interval 61-132) among children aged <5 years, 21/100,000 population (13-32) among persons aged 5-64 years, and 141/100,000 population (95-211) among persons aged ≥65 years. We estimated the average annual number of influenza-associated respiratory hospitalizations in the Americas to be 772,000 (95% credible interval 716,000-829,000). CONCLUSIONS: Influenza-associated respiratory hospitalizations impose a heavy burden on health systems in the Americas. Countries in the Americas should use this information to justify investments in seasonal influenza vaccination-especially among young children and the elderly.

Public health impact and economic benefits of quadrivalent influenza vaccine in Latin America.

Annual trivalent influenza vaccines (TIV) containing 2 A strains and one B lineage have been recommended for the prevention of influenza in most of Latin American countries. However, the circulation of 2 B lineages (Victoria and Yamagata) and difficulties in predicting the predominating lineage have led to the development of quadrivalent influenza vaccines (QIV), including both B lineages. Thus, the objective was to estimate the public health impact and influenza-related costs if QIV would have been used instead of TIV in 3 Latin American countries. We used a static model over the seasons 2010-2014 in Brazil, 2007-2014 in Colombia and 2006-2014 in Panama, focusing on population groups targeted by local vaccination recommendations: young children, adults with risk factors and the elderly. In Brazil, between 2010 and 2014, using QIV instead of TIV would have avoided US$ 6,200 per 100,000 person-years in societal costs, based on 168 influenza cases, 89 consultations, 3.2 hospitalizations and 0.38 deaths per 100,000 person-years. In Colombia and Panama, these would have ranged from US$ 1,000 to 12,700 (based on 34 cases, 13-25 consultations, 0.6-8.9 hospitalizations and 0.04-1.74 deaths) and from US$ 3,000 to 33,700 (based on 113 cases, 55-82 consultations, 0.5-27.8 hospitalizations and 0.08-6.87 deaths) per 100,000 person-years, respectively. Overall, the broader protection offered by QIV would have reduced the influenza humanistic and economic burden in the 3 countries. Despite the lack of local data leading to several extrapolations, this study is the first to give quantitative estimates of the potential benefits of QIV in Latin America.

Características relevantes del cáncer gástrico en la República de Panamá / Characteristics Ouststanding the Gastric Neoplasm in the Republic of Panama

En la República de Panamá desde 1980 los tumores malignos ocupan el primer lugar y desde 1980 hasta 1987 el tumor maligno del estómago ocupó el primer lugar como causa de muerte dentro de los tumores. En el Registro Nacional del Cáncer del Ministerio de Salud en el período de 1981 a 1985, tienen una tasa promedio de incidencia de 8.1 por 100.000 habitantes, siendo sólo superada por el tumor maligno del cuello del utero. Al clasificar los casos de tumor maligno del estómago según provincias y sexo se pudo observar que hay un predominio del sexo masculino sobre el femenino no así, para la provincia de Veraguas que en los años 1984-1985 la tasa de incidencia femenina sobrepasó a la masculina, se pudo observar también que habrá un incremento sostenido de la incidencia en la medida que se incrementaba la edad y este incremento se hace mayor a partir de los 40 años de edad; el grupo de 70 y más años es el que presenta el riesgop mayor de padecer cáncer gástrico seguido por el grupo de 60 a 69 años y el grupo de 50 a 59 años. Se llegó a la conclusión que en Bocas del Toro y Darién la tasa de incidencia es mucho mayor para el grupo de 70 y más, comparado con las otras provincias. El cáncer de tipo intestinal tuvo porcentajes de 86 (por ciento) para la provincia de Bocas del Toro y Veraguas y 100 (por ciento) para Colón y Herrera. En cuanto a la distribución del tumor maligno del estómago según tipo de sangre, el Instituto Oncológico Nacional presenta un predominio del tipo "O" seguido muy de cerca por el tipo "A". Si se observa por ocupación se pudo constatar que el 52 (por ciento) tiene la ocupación de agricultor seguido por los oficios domésticos con un 20 (por ciento)