Persistencia de anti-HBs en ancianos inmunizados con una vacuna ADN recombinante anti-hepatitis B: dos años de seguimiento / Anti-HBs persistent to immune aged with a DNA recombinant anti-hepatitis B vaccine: two years of follow

Se aplicó la vacuna recombinante cubana contra el virus de la hepatitis B Herberbiovac HB a un grupo de individuos mayores de 65 años, pertenecientes a un hogar de ancianos de Ciudad de la Habana, a la dosis de 20 ug, con el esquema 0,1 y 6 meses para estudiar su inmunogenicidad, la cual fue evaluada a los 2, 7, 12 meses y 2 años después de aplicada la primera dosis. A los 60 días se obtuvo un 47,1 por ciento de títulos protectores (>10 UI/L) y media geométrica (TMG) de 6,04 UI/L. Cuando se evaluó la respuesta inmune a los 7 meses se logró un 100,0 por ciento de seroprotección (>10 UI/L); 78,6 por ciento de buenos respondedores (títulos antiHBs >100 UI/L) y media geométrica de 136,93 UI/L. Al año, la seroprotección también fue del 100 por ciento, y se logró 61,5 por ciento de títulos >100 UI/L y la media geométrica de 204,61 UI/L. La persistencia de niveles de anticuerpos protectores y TMG 2 años después de aplicada la primera dosis de la vacuna fue de 71,4 por ciento y 24,73 UI/L, respectivamente. Estos resultados evidencian el alto poder inmunogénico de esta vacuna, lo que la hace recomendable para la protección de este grupo de edad contra el virus de la hepatitis B

[Evaluation of the effectiveness of a new vaccine against human leptospirosis in groups at risk]. / Evaluación de la efectividad de una nueva vacuna contra la leptospirosis humana en grupos en riesgo.

In order to evaluate the effectiveness of a new vaccine against human leptospirosis, a prospective cohort study was done with persons in the Cuban province of Holguín who were at risk of becoming ill with leptospirosis. The study included 118,018 persons from 15 to 65 years old who were considered to face either permanent or temporary risk. The vaccinated cohort consisted of 101,137 persons. They received two vaccine doses, 6 weeks apart, of 0.50 mL via deep intramuscular injection into the deltoid muscle of the nondominant arm. The unvaccinated cohort consisted of 16,881 persons. Epidemiological surveillance began 21 days after the application of the second vaccine dose and continued for 1 year. The same criteria for suspected and confirmed cases were maintained throughout the study period. At the end of the surveillance period effectiveness was calculated as being higher than 97%. It is estimated that the vaccination program prevented eight out of ten cases that would have otherwise occurred. Vaccine reactogenicity was also measured in a subsample of 1,500 persons between 15 and 65 years old. The observed symptomatology was low. Slight pain at the injection site was the most frequent symptom (25%). The results of the study indicate the usefulness of the vaccine for disease prevention among people at risk, and its use is thus recommended.

[Immunogenicity of the Heberbiovac-HB vaccine in doses of 10.5 and 2.5 micrograms in 6-9-year-old students]. / Inmunogenicidad de la vacuna Heberbiovac-HB a las dosis de 10,5 y 2,5 micrograms en niños escolares de 6 a 9 años de edad.

The Heberbiovac-HB recombinant hepatitis B vaccine was administered at dosages of 10.5 and 2.5 micrograms in 3 groups of children aged 6-9 with a vaccination schedule at 0, 1 and 6 months of age. The immunogenecity attained between dosages was compared. The seroconversion with protective titres obtained at 2 months varied from 88.9% with 10 micrograms to 79.4% with 2.5 micrograms, whereas at 7 months it was higher than 98% in the 3 groups. The geometrical mean with 10 mg was 136.63 and 2,356.8 UI/L-1; with 5 micrograms, 77.62 and 1,958.9 UI/L-1; and with 2.5 micrograms, 32.15 and 376.3 UI/UL-1, at 2 and 7 months, respectively. A high immunogenic power of the vaccine is observed at dosages of 10 and 5 micrograms with similar results. In spite of the fact that the dosage of 2.5 micrograms is immunogenic, the response is not desirable. These results state the possibility of using a lower dosage (5 micrograms) for a low risk infantile population, which favors the cost-benefit.

[Infection/immunity by hepatitis B virus in an adult population of Havana City. Cuba 1995]. / Infección/inmunidad por el virus de la hepatitis B en una población adulta de Ciudad de La Habana. Cuba 1995.

The results of a study of markers of infection/immunity by hepatitis B virus in a community of the health area in "Cristobal Labra" polyclinics, City of Habana in 1995. The studied healthy adult population was not included in any vaccination strategy with hepatitis B vaccine. Two markers were studied: Hepatitis B surface antigen and its corresponding antibody (anti-HBs). HBsAg-positivity was 1.05% and anti-HBs positivity was 13.39%. Of anti-HBs-positive cases, 13.39% had titers from 10-50 UI/L and the rest (43.68%) had titers over 50 UI/L.

[Epidemiological study on Hymenolepis nana infection in Ciego de Avila Province, Cuba]. / Estudio epidemiológico de la infección por Hymenolepis nana en la provincia de Ciego de Avila, Cuba.

An epidemiological study on H. nana infection was carried out in Ciego de Avila province, Cuba, from 1981 to 1995. In this 15 years period 3,108,422 stool samples were examined for parasites, H. nana eggs were found in 250 (0.008%). Seasonal influence of this parasitism was not detected. There were more cases in children than in adults, with males prevailing over females. The more frequent symptoms and signs were abdominal pain, diarrhea and anorexia which relationships with food habits, dwelling characteristics, children day care center and school orchards are analyzed.

[The reactogenicity and immunogenicity of the first Cuban vaccine against human leptospirosis]. / Reactogenicidad e inmunogenicidad de la primera vacuna cubana contra la leptospirosis humana.

A controlled double-blind trial was conducted with the participation of 80 adult volunteers of both sexes, who were randomly divided into groups of 40 individuals each one. The case-base study received the vaccine and the control group was administered placebo to know the safety, the behaviour of reactogenicity, and to star the immunogenicity studies of the first Cuban vaccine against human leptospirosis. The vaccine used in the case-base study was an inactivated and trivalent vaccine containing strains of Leptospira canicola, icterohaemorrhagiae and pomona, since they have the highest circulation in the country. The results obtained showed the inocuity of the vaccine as no adverse severe reactions were detected. The general symptomatology observed was low, where as febricula was the most common general symptom. It appeared during the first 3 days of observation and there were no significant differences between the 2 group. Only a mild pain at the site of the injection was reported as a local symptom, which was more frequent in the vaccinated group than in the control group (7.8 against 1.5%, respectively). The seroconversion obtained was of 29% by microagglutination, and of 34.2% by ELISA. The final results allowed to conclude that this vaccine is safe for human adults at the ages under study, and give the possibility to continue other studies in more advanced stages to complete the requirements for obtaining its license.

[Cryptosporidiosis in children with acute diarrhea from Ciego de Avila province, Cuba]. / Criptosporidiosis en niños con diarrea aguda de la provincia de Ciego de Avila, Cuba.

An epidemiological and clinical study of criptosporidiosis in children from Ciego de Avila province was carried out from 1987 to 1994. During this period 14,895 children with acute diarrhea were studied. Cryptosporidium sp. oocysts were found in the feces of 1,256 (8.4%) of them. Isolated cases prevailed over outbreaks, being the incidence rate proportional in both urban and rural areas. Seventy nine point seven per cent of infected children were less one year old, predominating the age group 6-11 months old. No influence of seasons on the occurrence of the parasitose was observed. The most frequently detected symptoms and signs were diarrhea, vomits and loss of weight. The main epidemiological factors were: 81.0% of ill children drank water directly from the aqueduct, 12.8% lived in overcrowded conditions, 11.0% had animals and 10.7% attended nursery schools.

[Immunogenicity of the Heberbiovac-HB vaccine in the physically and mentally handicapped]. / Inmunogenicidad de la vacuna Heberbiovac-HB en impedidos físicos y mentales.

The recombinant DNA Heberbiovac-HB vaccine against hepatitis B was applied to 2 groups of children at 2 homes for the physically and mental disabled at doses of 10 and 5 micrograms with the scheme 0, 1 and 6 months to study its immunogenicity, which was evaluated at 2, 7 and 12 months after the first dose was administered. On the 60th day it was obtained 80.9% of seroprotection in children who received 10 micrograms, whereas in the group that was vaccinated with 5 micrograms 65.0% of seroprotection was attained and there were no significant differences between the groups. 100% of seroprotection (> or = 10 UI/L) was obtained in the 2 vaccinated groups when the immune response was measured 1 month after the third dose was applied. A year later, seroprotection was 100% for the 2 groups of children. The geometrical mean of the antibody titres (TMG) reached levels above 10 UI/L, which is the minimum protector, in the 2 study groups 30 days after the second dose. A month after the third dose, the TMG attained values of 527.7 UI/L in the group of 10 micrograms and of 324.7 UI/L in that of 5 micrograms. No remarkable differences were found between the groups (p < 0.05). Finally, 365 days later, the TMG descended to 139.7 UI/L and 57.3 UI/L in the same groups, respectively. It was demonstrated the high immunogenic power of this vaccine, which makes it recommendable for protecting the physical and mentally disabled children from hepatitis B virus.

[Adverse reactions and immune response to Heberbiovac-HB vaccine administered to infants simultaneously with DPT and VA-MENGOC-BC]. / Reacciones adversas y respuesta inmune de la vacuna Heberbiovac-HB aplicada a lactantes, simultáneamente con la DPT y la VA-MENGOC-BC.

The Cuban recombinant yeast-derived hepatitis B vaccine (Heberbiovac-HB) was administered to 2 groups of infants aged 3 months. A dosage of 10 micrograms was used through a scheme of 0, 1 and 6 and 0, 1, 2 and 12, coinciding with the DPT and anti-meningococcal vaccines, according to the immunization schedule. Reactogenicity and immunogenicity were studied in both groups. The reactions observed were mild and similar to other studies, where fever , erythema and induration were the most common signs. These 2 groups had high percentages of children with titres of antibodies anti HBs above 100 UI/L-1. It is demonstrated the acceptable reactogenicity of the vaccine and the non-immunological interference of other vaccines.

[The immunogenicity of the Heberbiovac-HB vaccine in the elderly]. / Inmunogenicidad de la vacuna Heberbiovac-HB en ancianos.

The Cuban recombinant vaccine against the hepatitis B virus was applied to a group of individuals over 65 from a geriatric home in Havana City. Dose of 20 ìg were administered within a scheme from 0.1 to 6 months in order to study its immunogenicity, which was evaluated at 2, 7, and 12 months after the first dose. 47.1% of protective titres and geometrical mean of 6.04 UI/L were obtained after 60 days. 100% of seroconversion (UI/L) and seroprotection (10 UI/L) and geometric mean of 136.93 UI/L were obtained when the immune response was evaluated on the 7th month. Finally, after a year, seroconversion and seroprotection were also of 100%, and the geometric mean was of 204.61 UI/L. It was proved the high immunogenic power of this vaccine, which makes it recommendable to protect this age group from the hepatitis B virus.

[The immunogenicity of the Heberbiovac-HB vaccine in children]. / Inmunogenicidad de la vacuna Heberbiovac-HB en niños.

The Cuban recombinant vaccine against hepatitis B virus was applied with doses of 10 ìg to children under 15 in a scheme from 0, 1 to 6 months. The immunogenicity was evaluated at 2, 7, and 12 months and showed 100% of seroconversion with protective titres. 65.9, 100, and 83.5% of the vaccinated attained titres higher that 100 UI/L at 60, 210, and 360 days. The geometrical mean was of 213.6, 8208.2, and 568.0 UI/L, respectively. All the groups obtained 100% of seroconversion; however, there were significant differences (p < 0.05) in favor of the preschool and school children compared with those over 10 as regards the response level (titres higher than 100 UI/L) and the geometrical mean of antibody titres in the 3 samples. It was demonstrated the high immunogenic power of the vaccine at these ages, which makes it recommendable for their protection against the hepatitis B virus (HBV).

[The reactogenicity of Heberbiovac-HB vaccine at different doses]. / Reactogenicidad de la vacuna Heberbiovac-HB a diferentes dosis.

Reactogenicity was measured after applying the Heberbiovac-HB recombinant vaccine against hepatitis B virus to three groups of children aged 6-9 years. The vaccine was derived from yeast cells, administered at doses of 10, 5, and 2.5 g, with a schedule of 0, 1 and 6 months. The overall observed symptomatology was low (12.2%) in the three groups with 10.7%, 13.5%, and 12.3% for 10, 5, and 2.5 g, respectively. The predominant symptoms and signs were febricula (7.0%), local pain (3.1%), and erythema (1.2%). No significant differences were found when making a comparison between groups and sexes. An acceptable reactogenicity of the immunogen was confirmed, thus its use is recommended for the protection against hepatitis B virus.

[Effectiveness of VA-MENGOC-BC in children from 0 to 5 years of age in Cuba. First year of observation]. / Efectividad de VA-MENGOC-BC de 0 a 5 años en Cuba. Primer año de observación.

The effectiveness or post-license efficacy of the BC antimeningococcal vaccine (VA-MENGOC-BC) was assessed 1 year after the end of the immunization campaign in children aged 0 to 5 years. Occurrence of the disease before and after intervention is described and effectiveness is estimated following the recommendations described by Orenstein et al. We used 2 case definitions to compare results in groups formed following different criteria, according to the employed diagnostic tests. Two formulas are used to assess efficacy: one, estimating the rates among vaccinated and non-vaccinated; and the other one, estimating the ratio of cases per vaccinated population. The increase of the relative annual decrease of the incidence occurring since 1985--a decrease of 10% or less--which in 1990 reached 34.6% should be stressed; the ratio of new cases prevented by the intervention was higher than 75%. Effectiveness or post-license efficacy was close to 90%, independently from the case definition variant or formula employed.

[The infectious etiology of acute diarrheal diseases in the Republic of Cuba, 1991]. / Etiología infecciosa de las enfermedades diarreicas agudas en la República de Cuba, 1991.

This study was carried out in 1991 to learn the behavior of enteropathogenic agents causing acute diarrheal diseases in Cuba. 30 children, admitted in hospitals or seen in outpatient services for acute diarrheal diseases, were selected in each province taking into account that they had not received antibiotic or chemotherapy treatments in the previous 72 hours. Feces samples were taken from all patients for virological, bacteriological, and parasitological studies, and results were sent to the Pedro Kourí Institute of Tropical Medicine. Data were processed in DBASE III. Higher positivity indices were attained in the winter months. The causative agents most frequently found were: rotavirus (8.2%); Entamoeba histolytica (6.1%); and Salmonella (4.2%). Escherichia coli, Campylobacter, Shigella and rotavirus showed higher indices in winter. Shigella flexneri and Shigella sonnei predominated. Salmonella serogroups D, B, and C, and enteropathogenic Escherichia coli 0119 and 026 subsets were the most frequently found.

Intoxicaciones fatales en la ciudad de Medellin durante 1981. / Fatal poisonings in the city of Medellin during 1981

Este es un estudio descriptivo de las intoxicaciones fatales en Medellin durante 1981, hubo 99 casos de intoxicaciones fatales entre 2.663 necropsias realizadas.La mayor incidencia ocurrio en personas con edades entre 15 y 44 anos, presentandose el mas alto numero en mujeres. En cuanto el estado civil, fue mayor en solteros. El sitio mas frecuente fue en la propia residencia. Los toxicos mas empleados fueron los fosforados organicos. Se destaca que el mayor numero de intoxicaciones fatales ocurre en mujeres dedicadas a oficios domesticos y estudiantes. Los meses del ano con mayor numero de casos fueron mayo, julio y diciembre y por dias de la semana el domingo. En las intoxicaciones fatales pediatricas, la causa mas frecuente fue la accidental, y en adultos de origen suicida