ABSTRACT
Más de 700.000 casos y alrededor de 6.000 muertes se produjeron en la última epidemia de cólera registrada en América Latina, ocurrida en 1991. Esta se inició en el Perú y se propagó de país en país, afectando a la mayor parte de la región, incluyendo Chile. Comparado al Perú, la epidemia en Chile tuvo consecuencias menores debido a las medidas adoptadas por el Sistema Nacional de Servicios de Salud, en conjunto con otras entidades del Estado. Dentro de estas medidas destacan el establecimiento del Consejo Nacional de Salud, la planificación estratégica de los Servicios de Salud, el fortalecimiento de los Sistemas de Vigilancia Epidemiológica y de Laboratorios Clínicos y Ambientales, la educación de la población y las estrategias de prevención. La mantención de las medidas de sanidad ambiental y la colaboración de la población son fundamentales para evitar la aparición futura de la enfermedad.
During the latest Latin American epidemic of cholera (1991), more than 70,000 cases were identified and over 6,000 deaths occurred. Cholera started in Peru and expanded to the rest of Latin American countries, including Chile. Compared to Peru, the epidemic in Chile had minor consequences due to the strategies adopted by the National System of Health Services, together with other public institutions. These strategies included the establishment of a National Committee for Cholera, strategic planning of health services, strengthening of epidemiologic surveillance systems and of clinical and environmental laboratories, education of the population, and preventive strategies, among others. Maintenance of environmental health measures and the populations collaboration are essential to avoid future emergence of this disease.
Subject(s)
Humans , Cholera/epidemiology , Cholera/prevention & control , Epidemics , Health Services Administration , Health Planning/organization & administration , Population Surveillance , Chile/epidemiology , Environment , Health Education/organization & administration , Latin America/epidemiology , Public Health , Peru/epidemiology , Risk FactorsABSTRACT
The article summarizes the scientific evidence related with protection conferred by the 23 valent polysaccharide vaccine against invasive pneumococcal disease, non bacteraemic pneumococcal pneumonia, and probable pneumococcal pneumonia in the elderly. Eider patients with and without risk factors are considered. The impact of herd immunity conferred by vaccination of children with conjugated pneumococcal vaccine in reduction of pneumonia in adults is discussed. Based on this analysis, the Advisory Committee on Immunizations of the Chilean Infectious Disease Society makes recommendations on the most efficient vaccine strategy for reduction of pneumococcal pneumonia in the elderly.
Subject(s)
Evidence-Based Medicine , Meta-Analysis as Topic , Pneumococcal Infections/prevention & control , Pneumococcal Vaccines/administration & dosage , Streptococcus pneumoniae/immunology , Adult , Advisory Committees , Chile , Humans , Middle Aged , Pneumococcal Vaccines/adverse effects , Pneumococcal Vaccines/immunology , Pneumonia, Pneumococcal/prevention & control , Societies, MedicalABSTRACT
The article summarizes the scientific evidence related with protection conferred by the 23 valent polysacchar-die vaccine against invasive pneumococcal disease, non bacteriemic pneumococcal pneumonia, and probable pneumococal pneumonia in the elderly. Eider patients with and without risk factors are considered. The impact of herd immunitty conferred by vaccination of children with conjugated pneumococcal vaccine in reduction of penumonia in adults is discussed. Based on this analysis, the Advisory Committee on Immunizations of the Chilean Infectious Disease Society makes recommendations on the most efficient vaccine strategy for reduction of pneumococcal pneumonia in the elderly.
El artículo resume los hallazgos de la evidencia científica en relación a la protección que confiere la vacuna neumocóccica polisacárida 23 valente contra la enfermedad neumocóccica invasora, las neumonías neumocóccicas no bacteriémicas y las neumonías probablemente de etiología neumocóccica en el adulto mayor, estableciendo una categorización entre adultos mayores con factores de riesgo y sin ellos. Se documenta a la vez, el impacto que ha tenido la vacuna neumocóccica conjugada en la población infantil, en reducir las neumonías en el adulto mayor. Basados en la información disponible, el Comité Consultivo de Inmunizaciones de la Sociedad Chilena de Infectología, realiza recomendaciones sobre cuál sería la mejor forma de prevenir las enfermedades neumocóccicas en el adulto mayor.
Subject(s)
Adult , Humans , Middle Aged , Evidence-Based Medicine , Meta-Analysis as Topic , Pneumococcal Infections/prevention & control , Pneumococcal Vaccines/administration & dosage , Streptococcus pneumoniae/immunology , Advisory Committees , Chile , Pneumococcal Vaccines/adverse effects , Pneumococcal Vaccines/immunology , Pneumonia, Pneumococcal/prevention & control , Societies, MedicalABSTRACT
The mode of transmission and epidemiological approach for hepatitis A and B are different. However, both are preventable with vaccines whose efficacy and long lasting protection has been demonstrated. This review describes the secular tendency of both infections in Chile, their risk factors that have contributed to their persistence in the country and the interventions that have been carried out to reduce the disease burden. Although the vaccine for hepatitis B was incorporated to the immunization program in 2005, the vaccine for hepatitis A persists in the list of interventions that must be assumed with priority by the Ministry of Health. If Chilean health authorities pretend to reach the enteric disease indicators of developed countries, they must accelerate the epidemiological transition towards the elimination of hepatitis A.
Subject(s)
Female , Humans , Male , Hepatitis A Vaccines/administration & dosage , Hepatitis A/prevention & control , Hepatitis B Vaccines/administration & dosage , Hepatitis B/prevention & control , Chile/epidemiology , Hepatitis A/epidemiology , Hepatitis A/etiology , Hepatitis B/epidemiology , Hepatitis B/etiologyABSTRACT
The article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases in the world and in Chile and the scientific information of the licensed HPV vaccines: Gardasil® and Cervarix®. Considering the available information, the Consultive Committee of Immunizations of the Chilean Society of Infectious Diseases, summarizes its conclusions and makes recommendations for vaccination against HPV in Chile.
El artículo revisa brevemente la epidemiología de las infecciones por virus papiloma humano (VPH) y las enfermedades asociadas, tanto en el mundo como en Chile y la información científica de las vacunas contra VPH licenciadas: Gardasil® y Cervarix®. Considerando la información disponible, el Comité Consultivo de Inmunizaciones de la Sociedad Chilena de Infectología, resume sus conclusiones y hace sus recomendaciones para la vacunación contra VPH en Chile.
Subject(s)
Adolescent , Adult , Female , Humans , Middle Aged , Young Adult , Advisory Committees , Alphapapillomavirus/immunology , Papillomavirus Vaccines , Papillomavirus Infections/prevention & control , Chile/epidemiology , Papillomavirus Infections/epidemiology , Papillomavirus Vaccines/adverse effects , Papillomavirus Vaccines/immunology , Societies, Medical , Young AdultABSTRACT
For the international scientific community, it is undoubted that planetary temperature is increasing, being projected an average raise of 1.0 °C-3.5 °C by the year 2100. Forecasted consequences are diverse, most of them adverse for human health, including the establishment of favorable epidemiological scenarios for the emergence and reemergence of infectious diseases. The present article summarizes the available evidence regarding the mechanisms that promote climate change, its environmental effects and its consequences on human health. In order to accomplish this objective, demonstrated changes in the dynamics of zoonotic, vectorial, food and water-borne diseases are described. The position of Chile in the international community is commented, as well as múltiple pending challenges, among which outstands the importance of incorporating professionals that work in the health sector to the national debate.
Para la comunidad científica mundial, el aumento progresivo de la temperatura del clima planetario es un hecho inequívoco, proyectándose para el año 2100 un incremento de la temperatura promedio de 1,0 °C - 3,5 °C. Las consecuencias pronosticadas son muy diversas, siendo en su mayoría adversas para la salud humana, entre las cuales se incluyen el establecimiento de escenarios epidemiológicos propicios para la emergencia y reemergencia de enfermedades infecciosas. El presente artículo sintetiza la evidencia disponible en torno a los mecanismos generadores del cambio climático, sus efectos medioambientales y sus consecuencias sobre la salud humana. Para ello, se describen cambios ya objetivados en la dinámica de enfermedades zoonóticas y vectoriales y de enfermedades transmitidas por agua y alimentos. Se comenta la posición de Chile en el concierto internacional y sus múltiples desafíos pendientes, destacándose la importancia de incorporar al debate nacional a profesionales que trabajan en el sector salud.
Subject(s)
Humans , Climate , Communicable Diseases , Hot Temperature , Chile , Communicable Diseases/epidemiology , Communicable Diseases/etiology , Communicable Diseases/transmission , Global Health , Risk AssessmentABSTRACT
This article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases globally and in Chile, and the scientific ínformatíon of the licensed HPV vaccines: Gardasil® and Cervarix®. Considering the available information, the Advisory Committee on Immunizations of the Chilean Society of Infectious Diseases recommends vaccination of teenage girls, ideally before initiating sexual actívíty, Le. approximately at the age of 12 to 13 years and vaccination of women of any age if they have not started sexual activity. If women are vaccinated after initiating sexual activity, they should be informed of the lower efficacy of immunization if HPV infection has occurred. Education on responsible sexuality and sexually transmitted diseases should be maintained as a priority. Vaccination should be highly considered for inclusion in the National Immunization Program.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Advisory Committees , Immunization , Papillomaviridae , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines , Chile/epidemiology , Papillomaviridae/classification , Papillomaviridae/genetics , Papillomaviridae/immunology , Papillomavirus Infections/epidemiology , Papillomavirus Infections/virology , Papillomavirus Vaccines/adverse effects , Papillomavirus Vaccines/immunology , Societies, Medical , Young AdultABSTRACT
The article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases in the world and in Chile and the scientific information of the licensed HPV vaccines: Gardasil and Cervarix. Considering the available information, the Consultive Committee of Immunizations of the Chilean Society of Infectious Diseases, summarizes its conclusions and makes recommendations for vaccination against HPV in Chile.
Subject(s)
Advisory Committees , Alphapapillomavirus/immunology , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines , Adolescent , Adult , Chile/epidemiology , Female , Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 , Humans , Middle Aged , Papillomavirus Infections/epidemiology , Papillomavirus Vaccines/adverse effects , Papillomavirus Vaccines/immunology , Societies, Medical , Young AdultABSTRACT
For the international scientific community, it is undoubted that planetary temperature is increasing, being projected an average raise of 1.0 degrees C-3.5 degrees C by the year 2100. Forecasted consequences are diverse, most of them adverse for human health, including the establishment of favorable epidemiological scenarios for the emergence and reemergence of infectious diseases. The present article summarizes the available evidence regarding the mechanisms that promote climate change, its environmental effects and its consequences on human health. In order to accomplish this objective, demonstrated changes in the dynamics of zoonotic, vectorial, food and water-borne diseases are described. The position of Chile in the international community is commented, as well as multiple pending challenges, among which outstands the importance of incorporating professionals that work in the health sector to the national debate.
Subject(s)
Climate , Communicable Diseases , Hot Temperature , Chile , Communicable Diseases/epidemiology , Communicable Diseases/etiology , Communicable Diseases/transmission , Global Health , Humans , Risk AssessmentABSTRACT
Thimerosal is a mercury derivative included in vaccines since 1930 with the aim to prevent microbial contamination. During the last decades, the use of thimerosal has been questioned, specifically because of a potential association with neurotoxicity. After a thorough review of published studies on pediatric use of thimerosal-containing vaccines, and of position papers from international expert groups, the Consultive Committee of Immunizations of the Chilean Society of Infectious Diseases concludes that there is no solid evidence of adverse events associated with the use of thimerosal containing vaccines in infants and children. Therefore, a change in current vaccine practices refererred to thimerosal-containing vaccines is not justified in Chile.
Subject(s)
Preservatives, Pharmaceutical , Thimerosal , Vaccines/chemistry , Autistic Disorder/chemically induced , Child , Chile , Humans , Infant , Preservatives, Pharmaceutical/adverse effects , Reference Standards , Societies, Medical , Thimerosal/adverse effects , Vaccines/adverse effectsABSTRACT
El timerosal es un derivado del mercurio utilizado desde 1930 como preservante de vacunas. En las últimas décadas ha sido cuestionada su seguridad, especialmente por la posibilidad de toxicidad neurológica. La revisión de varios estudios realizados en niños que recibieron vacunas que contienen timerosal y la posición de organismos de expertos internacionales en relación al uso de este compuesto en vacunas, permite al Comité Consultivo de Inmunizaciones concluir que no existe evidencia de eventos adversos en lactantes o niños por exposición al timerosal contenido en vacunas rutinarias y, por lo tanto, no habría razón para modificar las actuales prácticas de inmunización en Chile.
Thimerosal is a mercury derivative included in vaccines since 1930 with the aim to prevent microbial contamination. During the last decades, the use of thimerosal has been questioned, specifically because of a potential association with neurotoxicity. After a thorough review of published studies on pediatric use of thimerosal-containing vaccines, and of position papers from international expert groups, the Consultive Committee of Immunizations of the Chilean Society of Infectious Diseases concludes that there is no solid evidence of adverse events associated with the use of thimerosal containing vaccines in infants and children. Therefore, a change in current vaccine practices refererred to thimerosal-containing vaccines is not justified in Chile.
Subject(s)
Child , Humans , Infant , Preservatives, Pharmaceutical , Thimerosal , Vaccines/chemistry , Autistic Disorder/chemically induced , Chile , Preservatives, Pharmaceutical/adverse effects , Reference Standards , Societies, Medical , Thimerosal/adverse effects , Vaccines/adverse effectsABSTRACT
S. pneumoniae is a significant cause of community-acquired pneumonia in the elderly, and accounts for the majority of the pneumonia deaths among the elderly. We conducted this randomized double-blind study to evaluate the immune response to a 23-valent pneumococcal polysaccharide vaccine and the persistence of antibodies two years after the vaccination in an elderly population in Santiago, Chile. A total of 118 elderly nursing home residents received either the pneumococcal or a tetanus control vaccine. Serum samples were taken at enrolment, at two months, and at two years post-vaccination. Pre-vaccination anti-pneumococcal antibody geometric mean concentrations (GMC) were similar in both study groups, with increased levels of antibodies found only against serotype 14. The pneumococcal vaccine was highly immunogenic at 2 months, and titers remained high two years after the vaccination for the 10 serotypes studied in this elderly population. The results thus support the benefits of this pneumococcal vaccine in this elderly population who are at increased risk of invasive pneumococcal disease.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pneumococcal Infections/prevention & control , Pneumococcal Vaccines/immunology , Streptococcus pneumoniae/immunology , Antibodies, Bacterial/blood , Case-Control Studies , Chile , Double-Blind Method , Enzyme-Linked Immunosorbent Assay , Homes for the Aged , Immunoglobulin G/blood , Pneumococcal Infections/immunologyABSTRACT
BACKGROUND: S pneumoniae is the main cause of community-acquired pneumonia in the elderly, group that concentrates 95% of deaths. AIM: To assess the prevalence of nasal carriage of S pneumoniae in institutionalized elderly patients. MATERIAL AND METHODS: One hundred eighteen institutionalized subjects aged over 60 years (65 males) were enrolled. Since they were also participating in a controlled protocol related to the immunogenicity of an anti-pneumococcal vaccine, our investigation was also blind and randomized. According to randomization, they received pneumococcal or tetanic vaccine. Nasal swab cultures were taken at the beginning of the trial and two months after vaccination. According to recommended methods, we identified S pneumoniae, the serotypes and their antimicrobial susceptibility. RESULTS: In the first nasal sample, 16% of subjects were positive for S pneumoniae. The second sample was positive in 12%. Of the 33 isolated serotypes, 9.1% demonstrated intermediate resistance to penicillin and 3.3% were resistant to chloramphenicol. CONCLUSIONS: The study demonstrated a greater percentage of colonized patients than in the general population. The isolated serotypes are the same that cause invasive diseases in this age group, according to data of the Institute of Public Health of Chile. There were no differences in the percentage of colonization between subjects vaccinated against S pneumoniae and control groups, after two months of follow up. Isolated strains had a low resistance to penicillin. High level resistance was not observed.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Carrier State/microbiology , Nasopharynx/microbiology , Pneumococcal Vaccines/therapeutic use , Streptococcus pneumoniae/drug effects , Aged , Aged, 80 and over , Community-Acquired Infections/drug therapy , Community-Acquired Infections/epidemiology , Double-Blind Method , Drug Resistance, Bacterial/drug effects , Female , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Nasopharynx/metabolism , Penicillin Resistance/drug effects , Pneumococcal Infections/drug therapy , Pneumococcal Infections/epidemiology , Seroepidemiologic Studies , Serotyping , Streptococcus pneumoniae/classificationABSTRACT
Background: S pneumoniae is the main cause of community-acquired pneumonia in the elderly, group that concentrates 95 percent of deaths. Aim: To assess the prevalence of nasal carriage of S pneumoniae in institutionalized elderly patients. Material and methods: One hundred eighteen institutionalized subjects aged over 60 years (65 males) were enrolled. Since they were also participating in a controlled protocol related to the immunogenicity of an anti-pneumococcal vaccine, our investigation was also blind and randomized. According to randomization, they received pneumococcal or tetanic vaccine. Nasal swab cultures were taken at the beginning of the trial and two months after vaccination. According to recommended methods, we identified S pneumoniae, the serotypes and their antimicrobial susceptibility. Results: In the first nasal sample, 16 percent of subjects were positive for S pneumoniae. The second sample was positive in 12 percent. Of the 33 isolated serotypes, 9.1 percent demonstrated intermediate resistance to penicillin and 3.3 percent were resistant to chloramphenicol. Conclusions: The study demonstrated a greater percentage of colonized patients than in the general population. The isolated serotypes are the same that cause invasive diseases in this age group, according to data of the Institute of Public Health of Chile. There were no differences in the percentage of colonization between subjects vaccinated against S pneumoniae and control groups, after two months of follow up. Isolated strains had a low resistance to penicillin. High level resistance was not observed.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anti-Bacterial Agents/therapeutic use , Carrier State/microbiology , Nasopharynx/microbiology , Pneumococcal Vaccines/therapeutic use , Streptococcus pneumoniae/drug effects , Community-Acquired Infections/drug therapy , Community-Acquired Infections/epidemiology , Double-Blind Method , Drug Resistance, Bacterial/drug effects , Microbial Sensitivity Tests , Nasopharynx , Penicillin Resistance/drug effects , Pneumococcal Infections/drug therapy , Pneumococcal Infections/epidemiology , Seroepidemiologic Studies , Serotyping , Streptococcus pneumoniae/classificationABSTRACT
The article briefly reviews the epidemiology of rotavirus infection and the scientific information of the rotavirus vaccines: Rotashield, withdrawn from the market due to its association with intussusception, Rotateq currently in an advanced phase of development, and Rotarix, recently licensed in Chile. Considering the available information, the Consultive Committee of Immunizations of the Chilean Society of Infectious Diseases, summarizes its conclusions and makes recommendations for infants vaccination against rotavirus in our country.
Subject(s)
Rotavirus Infections/prevention & control , Rotavirus Vaccines/administration & dosage , Vaccines, Attenuated/administration & dosage , Advisory Committees , Age Factors , Animals , Cattle , Chile/epidemiology , Drug Approval , Gastroenteritis/virology , Humans , Infant , Intussusception/etiology , Rotavirus Infections/epidemiology , Rotavirus Vaccines/adverse effects , Rotavirus Vaccines/immunology , Societies, Medical , Vaccines, Attenuated/adverse effects , Vaccines, Attenuated/immunologyABSTRACT
En este artículo se identifican algunos indicadores socioeconómicos que tienen directo impacto en la salud de la población. Ellos son: Tasa de crecimiento de la población, Producto Geográfico Bruto, Tasa de Alfabetismo de Adultos, Línea de Pobreza, Clasificación de la población según ingreso económico, Medidas de distancia del ingreso, Razón de extremos, Coeficiente de Gini, Indice de Concentración e Indice del Desarrollo Humano. Se efectúa una definición de cada uno de ellos, se proporcionan fuentes de información para la obtención de datos necesarios para la construcción de ellos. Estos indicadores, al ser construidos a partir de las mismas fuentes, sostenidas en el tiempo, con la seguridad de la calidad del dato, permiten establecer tendencias de crecimiento o de mayor pobreza, además de poder compararse con la situación de otros países de la Región o de otras. El aporte de la Epidemiología al conocimiento de estos indicadores a partir de la mirada sociológica, económica, permite trabajar con información más integradora y más fidedigna.
Subject(s)
Humans , Economic Indexes , Epidemiologic Studies , Health Status Indicators , Research , Social IndicatorsABSTRACT
Se presenta una breve revisión de la epidemiología de la infección por rotavirus y de los antecedentes científicos de las vacunas Rotashield®, retirada del mercado luego de mostrar asociación con invaginación intestinal en EEUU, Rotateq® actualmente en fases finales de desarrollo y Rotarix®, recientemente licenciada en Chile. Considerando estos antecedentes, el Comité Consultivo de Inmunizaciones de la Sociedad Chilena de Infectología, indica sus conclusiones y recomendaciones en relación a la vacunación anti-rotavirus de lactantes en nuestro país.
Subject(s)
Humans , Infant , Rotavirus Infections/prevention & control , Intussusception/chemically induced , Immunization Programs/standards , Rotavirus Vaccines/adverse effects , Rotavirus Vaccines/immunology , Rotavirus Vaccines/standards , Chile , Diarrhea/prevention & control , Diarrhea/virology , Gastroenteritis/prevention & control , Gastroenteritis/virology , Rotavirus Infections/complications , Rotavirus Vaccines/administration & dosageABSTRACT
Esta publicación pretende informar sobre el rol que cumplen los indicadores de salud, proporcionando una definición, las condiciones mínimas que debe cumplir la información que conforma un indicador, tales como validez, confiabilidad, especificidad, sensibilidad, mensurabilidad, entre otras. Además se explica su utilidad en el conocimiento del estado de salud de las poblaciones, permiten establecer comparaciones al interior de los distritos o regiones de un país y entre países. Su permanencia en el tiempo permite comparar tendencias al interior de una comunidad o un país. Dan cuenta de la gestión, del impacto de intervenciones en el área laboral, de las inequidades, del monitoreo de la calidad de vida, entre algunos usos. En esta primera parte se detalla la utilidad de los indicadores de salud en la evaluación de los sistemas de salud, en la evaluación del ausentismo laboral por causa médica y en la evaluación de la respuesta de la comunidad al envejecimiento de la población.
Subject(s)
Humans , Delivery of Health Care , Epidemiology , Health Status IndicatorsABSTRACT
El Instituto de Salud Pública de Chile y la Sociedad Chilena de InfectologÝa han aunado sus esfuerzos para coordinar y co-dirigir una red nacional para la vigilancia de resistencia de agentes patógenos a antimicrobianos según sÝndromes clÝnicos. El objetivo de esta red es establecer un sistema nacional de vigilancia de la resistencia a antimicrobianos, estandarizado y coordinado, que proporcione información actualizada acerca de los agentes infecciosos mßs relevantes por sÝndromes clÝnicos bien definidos, por edad y por lugar de origen: hospitalaria o de la comunidad. Nos parece fundamental la participación de todos los Servicios de Salud del paÝs en esta red, para obtener datos de calidad, representativos de nuestra realidad nacional, que sean de real utilidad en el manejo de los pacientes.
