ABSTRACT
Vaccination coverage (VC) against pertussis can increase when management practices and policies at primary care centres (PCCs) are reinforced. From 2011 to 2015, we performed a case-control study to evaluate VC among pertussis patients treated at PCCs in Barcelona, Spain. We recorded pertussis in patients from 8- to 16-year-olds at 52 PCCs. Pertussis cases had laboratory diagnostic and controls were healthy outpatients visiting the same facility for reasons other than cough. DTaP/dTap VC was recorded as either proper vaccination status (five doses recorded) or improper vaccination status (<5 doses recorded). We used a logistic regression model to estimate OR and 95% CI. We included 229 cases and 576 controls. VC was higher in cases (mean 5.01, s.e.: 0.57) than in controls (4.89, s.e.: 0.73). Around 69% of the cases had received DTaP primary immunisation after 2-5 years and 31.4% of cases had the dTap booster immunisation after 7-10 years. The 87% of children 5-9 years were properly vaccinated. We found no protection from becoming ill among properly vaccinated children (OR 1.87; 95% CI 1.22-2.85). The highest VC was observed in patients with confirmed pertussis, which was likely due to a more exhaustive follow-up of the VC in these patients. Being properly vaccinated against pertussis will probably not increase VC.
Subject(s)
Diphtheria-Tetanus-acellular Pertussis Vaccines/administration & dosage , Vaccination Coverage/statistics & numerical data , Whooping Cough/prevention & control , Adolescent , Case-Control Studies , Child , Female , Humans , Male , Spain/epidemiology , Whooping Cough/epidemiologyABSTRACT
La faringoamigdalitis aguda (FAA) es una de las enfermedades más comunes en la infancia. En las guías clínicas el límite de edad para considerar realizar una prueba de detección rápida es a partir de los tres años, ya que se ha visto que por debajo de esta edad, salvo en casos seleccionados, la probabilidad de infección bacteriana es baja, y los riesgos de fiebre reumática al no tratar son inexistentes. Existe una salvedad a esta situación, que queremos recalcar, y son los pacientes menores de tres años sintomáticos, que tienen contacto próximo (familiar o guardería) afecto de faringoamigdalitis estreptocócica. Creemos importante considerar y tener en cuenta la realización de test diagnóstico y posterior tratamiento a este grupo de pacientes, no para prevenir complicaciones, si no para disminuir el riesgo de diseminación de la infección (AU)
Acute pharyngitis is one of the most common childhood diseases. Guidelines on the diagnosis of children with streptococcal pharyngitis sugges that the most recommended age to perform a rapid antigen detection is more than three years old, because among children younger than this age the possibility/likelihood of bacterial infection is very low and the risk of acute rheumatic fever is also very low. There is an exception of this situation that we want to remark: patients younger than 3 years old, symptomatic, with a close contact (sibling or kindergarten) with group A Streptococcal pharyngitis. Its important considering the performance of a rapid antigen detection test and the treatment if positive, not just to prevent complications, but also for the reduction in the transmission of the disease to family members, classmates and other close contacts of the patient (AU)