Computerised vaccination register for the Murcia region, Spain, 1991 to 2011.

We describe the Murcia regional vaccination register in Spain, which was set up in 1991, detailing its main features, advantages and limitations. We also report on some recent special actions carried out that led to an improvement in vaccination coverage against measles, rubella and mumps (MMR): by using the vaccination register, we were able to identify and vaccinate persons aged under 20 years in a measles outbreak in 2010 in the town of Jumilla who were not adequately vaccinated for their age with MMR vaccine. From spring 2012, use of our register will enable us to identify susceptible individuals in our region under 40 years of age who have received fewer than two doses of MMR vaccine and call them for the appropriate vaccination. We also set out our experience in the use of barcodes to identify individuals and collect vaccine data: our data show that the barcodes help to improve data quality and completeness. Finally, we identify certain challenges in search of greater standardisation for systems and encoding that is necessary to enable an easy exchange of data between different registers.

[Immunization: leaps into the future. The vaccinology at the beginning of the 21th century (II)]. / Inmunización: saltos al futuro. La vacunología en los albores del siglo XXI (II).

The second part of the article is a review of the perspectives on orphan vaccines, therapeutic immunization and strategies to improve the compliance to the vaccination programmes.

Analysis of factors influencing vaccine uptake: perspective from Spain.

Although each of the 17 Autonomous Regions in Spain has their own vaccination policies, factors influencing vaccine uptake do not differ considerably among them. Knowledge of vaccine preventable diseases, awareness that the diseases prevented by vaccinations are serious or very serious, awareness that vaccinations are not generally associated with serious adverse events, cost-free status and satisfaction with our computerised immunization registry, are the elements which influence vaccine uptake in our country.

Seroconversion and duration of immunity after vaccination against group C meningococcal infection in young children.

An increase in the incidence of group C meningococcal disease was observed in the Murcia Region (Spain) during 1996-1997. In September 1997, a massive vaccination campaign was implemented among the population aged 18 months to 19 years. The aim of this study was to assess the seroconversion rate of children aged 18-59 months and the persistence of immune response 1 year after vaccination. A total of 296 children were included. Blood samples were obtained before vaccination and 1 month and 1 year after vaccination. Three point seven percent of the children had bactericidal antibody titres of >/=1:8 before vaccination. One month after vaccination seroconversion was 63.7%, with a growing trend related to age at vaccination (p<0.0001). The increase in antibody titres was shown to be quantitatively greater above the age of 36 months (p<0.0001). One year after vaccination only 4.3% of the children who initially seroconverted still had bactericidal activity. Seroconversion in children under 5 increases with age but antibodies decline rapidly in the year following vaccination.

[The introduction of the child health document in the Murcia area]. / Implantación del documento de salud infantil en la región de Murcia.

OBJECTIVE: To find the level of implantation and use of the Child Health Booklet (CHB) in the Murcia region and the prevalence of breast-feeding. DESIGN: A retrospective descriptive study. SETTING: Central services of the Health Board. Community level. PATIENTS AND OTHER PARTICIPANTS: A sample consisting of the mothers of 14-week old babies with a birth-date between 16/11 and 15/12/92 (n = 197). INTERVENTIONS: A telephone survey was carried out. A telegram was sent to those who did not answer or had no telephone. MEASUREMENTS AND MAIN RESULTS: 147 mothers answered (74.6 +/- 6.1%); 137 with a telephone (88.5 +/- 5%) and ten without (22 +/- 12.7%) (p < 0.001). 134 of these (91.2 +/- 4.6%) stated that they had received the CHB: 126 when leaving hospital. One had lost it after three months. We found no differences for different Maternity hospitals. Of the 134 mothers with the CHB, 90 (67.2%) used public health services, 27 (20.1%) private ones and 17 (12.7%) both. 87.4% of the mothers took their CHB to their consultations, where health professionals asked to see it on 68.2% of the occasions. Parameters with compliance over 90% were: personal data, the type of birth along with incidents at the birth, and somatometry at the birth. Neonatal status and psychomotor development showed under 10% compliance, though in hospital there was better compliance. 85 +/- 5.8% began breast-feeding, with 31.3% +/- 7.5% carrying on up to three months. We found no association between public or private care and commitment to breast-feeding. CONCLUSIONS: A high level of distribution of the CHB and an acceptable compliance level. It is important to promote the CHB as a recording instrument and to involve the family.

[Tuberculous infection in schoolchildren in the 1st year of basic general education in the Murcia region (1985-1992)]. / Infección tuberculosa en escolares de 1st de EGB de la región de Murcia (1985-1992).

OBJECTIVE: To find the evolution of the prevalence of tubercular infection. DESIGN: Study of the tendency of the findings from crossover surveys carried out during the last 7 years. SETTING: First-year EGB students from public and private schools in the Autonomous Community of Murcia. INTERVENTION: Performing the Mantoux intradermoreaction test with 2 UT of PPDRT23/TWEEN80 for the first 5 years and 5 UT of PPDCT68/TWEEN80 the last 2, with any induration over 5 mm. being considered positive. A clinical study of school students found positive and of their family contacts. RESULTS: Coverage was established at about 80% (71,520 tests studied), with prevalence diminishing from 0.97% to 0.44%, this establishing a downward tendency (p < 0.001). 6.5% of the tuberculin-test positive students (21) and 2.8% of the family contacts (34) were diagnosed with tuberculosis. CONCLUSIONS: At the moment we lack data to suggest an increase in endemic tuberculosis among the school population. The results mentioned justify tuberculosis surveys of school students, although low prevalence suggests that the age at which it is performed should be raised.

[Evaluation of results of school health examination in the Murcia region. 1986/87]. / Evaluación de resultados del examen de salud escolar en la región de Murcia. Curso 1986/1987.

In the present study, we have carried out an evaluation of school examinations in 47,943 children in the past course. We have compared our results with those from similar previous studies in other parts of Spain. Our findings were comparable in visual acuity and scoliosis, and not so much about cryptorchidism and phimosis. We think that examinations are necessary, but it is needed to increase the quality and the effectiveness, to get closer to the knowledge of usefulness and to the correct evaluation of school health programs.

[Effects of tobacco on child health. The child as a passive smoker]. / Efectos del tabaco sobre la salud infantil. El niño como fumador pasivo.

The smoking habit within the family produces various harmful effects on child health when the child is considered as a passive smoker. In this paper we have reviewed the most recent studies which analyze the influence of parental smoking on the incidence of respiratory diseases, alteration in the pulmonary function and presence of other symptoms, during the first years of life. A number of recommendations have been extracted to prevent these problems during childhood.