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1.
Pediatrics ; 145(5)2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32253263

RESUMEN

BACKGROUND: Although autodialer centralized reminder and recall (C-R/R) from state immunization information systems (IISs) has been shown to raise childhood vaccination rates, its impact on human papillomavirus (HPV) vaccination rates is unclear. METHODS: In a 4-arm pragmatic randomized controlled trial across 2 states, we randomly selected practices representative of the specialty (pediatrics, family medicine, and health center) where children received care. Within each practice, patients 11 to 17.9 years old who had not completed their HPV vaccine series (NY: N = 30 616 in 123 practices; CO: N = 31 502 in 80 practices) were randomly assigned to receive 0, 1, 2, or 3 IIS C-R/R autodialer messages per vaccine dose. We assessed HPV vaccine receipt via the IIS, calculated intervention costs, and compared HPV vaccine series initiation and completion rates across study arms. RESULTS: In New York, HPV vaccine initiation rates ranged from 37.0% to 37.4%, and completion rates were between 29.1% and 30.1%, with no significant differences across study arms. In Colorado, HPV vaccine initiation rates ranged from 31.2% to 33.5% and were slightly higher for 1 reminder compared with none, but vaccine completion rates, ranging from 27.0% to 27.8%, were similar. On adjusted analyses in Colorado, vaccine initiation rates were slightly higher for 1 and 3 C-R/R messages (adjusted risk ratios 1.07 and 1.04, respectively); completion rates were slightly higher for 1 and 3 C-R/R messages (adjusted risk ratios 1.02 and 1.03, respectively). CONCLUSIONS: IIS-based C-R/R for HPV vaccination did not improve HPV vaccination rates in New York and increased vaccination rates slightly in Colorado.


Asunto(s)
Programas de Inmunización/tendencias , Inmunización/tendencias , Vacunas contra Papillomavirus/administración & dosificación , Sistemas Recordatorios/tendencias , Vacunación/tendencias , Adolescente , Niño , Colorado/epidemiología , Femenino , Humanos , Inmunización/métodos , Programas de Inmunización/métodos , Masculino , New York/epidemiología , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/prevención & control , Vacunación/métodos
2.
BMC Infect Dis ; 20(1): 197, 2020 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-32138688

RESUMEN

BACKGROUND: The incidence rate of measles in China reached a nadir in 2012 after 2 supplementary immunization activities (SIAs) were undertaken in 2009 and 2010. However, the disease began re-emerging in 2013, with a high prevalence rate observed in 2013-2014 in the southern province of Guangdong. In this study, we assessed the changes that occurred in measles epidemiology during 2009-2016, particularly between 2009 and 2011 (when the influence of the SIAs were in full effect) and between 2012 and 2016 (when this influence subsided). METHODS: Data from 22,362 patients with measles diagnosed between 2009 and 2016, and whose diagnoses were confirmed clinically and/or with laboratory testing, were extracted from the National Infectious Disease Monitoring Information System. Descriptive analyses were performed, and changes in epidemiological characteristics between 2009 and 2011 and 2012-2016 were compared. RESULTS: There was a substantial surge in 0-8-month-old patients after 2012; the incidence rate increased from 4.0 per 100,000 population in 2011 (10.3% of the total) to 280 per 100,000 population in 2013 (32.8% of the total). Patients aged 0-6 years represented 73.4% of the total increase between 2011 and 2013. Compared with 2009-2011, adults aged ≥25 years accounted for a higher proportion of patients in 2013 and after (p < 0.01), and were highest in 2016 (31% of the patient total). CONCLUSION: Despite the remarkable results achieved by SIAs in terms of providing herd immunity, the 2013 resurgence of measles revealed insufficient immunization coverage among children. Therefore routine immunization programs should be strengthened, and supplementary vaccinations targeting adults should also be contemplated.


Asunto(s)
Sarampión/epidemiología , Adolescente , Adulto , Niño , Preescolar , China/epidemiología , Femenino , Humanos , Inmunidad Colectiva , Programas de Inmunización/métodos , Programas de Inmunización/tendencias , Incidencia , Lactante , Recién Nacido , Masculino , Sarampión/inmunología , Vacuna Antisarampión/administración & dosificación , Vacuna Antisarampión/inmunología , Estudios Retrospectivos , Cobertura de Vacunación/estadística & datos numéricos , Cobertura de Vacunación/tendencias , Adulto Joven
3.
An. pediatr. (2003. Ed. impr.) ; 92(1): 52.e1-52.e10, ene. 2020. ilus, tab
Artículo en Español | IBECS | ID: ibc-186820

RESUMEN

El CAV-AEP publica anualmente el calendario de vacunaciones que estima idóneo para los niños residentes en España, teniendo en cuenta la evidencia científica disponible. Se mantiene el esquema 2 + 1 (2, 4 y 11 meses) con vacunas hexavalentes (DTPa-VPI-Hib-HB) y con antineumocócica conjugada 13-valente. Se aconseja un refuerzo a los 6 años, preferentemente con DTPa (si está disponible), junto a una dosis de polio para aquellos que recibieron esquemas 2 + 1, así como vacunación con Tdpa en adolescentes y en cada embarazo, preferentemente entre las 27 y las 32 semanas. La vacuna del rotavirus debería ser sistemática para todos los lactantes. Se sigue proponiendo la incorporación en el calendario de la vacuna antimeningocócica B, con esquema 2 + 1 en lactantes. Además de la inclusión de la vacuna antimeningocócica conjugada tetravalente (MenACWY) a los 12 años con rescate hasta los 18 años, inclusive, el CAV recomienda que esta vacuna sea introducida también a los 12 meses de edad, sustituyendo a MenC. Igualmente, se recomienda en los mayores de 6 semanas de edad con factores de riesgo o que viajen a países de elevada incidencia de estos serogrupos. Se emplearán esquemas de 2 dosis para triple vírica (12 meses y 3-4 años) y varicela (15 meses y 3-4 años). La segunda dosis se podría aplicar como vacuna tetravírica. Se recomienda la vacunación sistemática universal frente al VPH, tanto a chicas como a chicos, preferentemente a los 12 años, debiendo realizar un mayor esfuerzo para mejorar las coberturas. La de 9 genotipos amplía la cobertura para ambos sexos


The CAV-AEP annually publishes the immunisation schedule considered optimal for all children resident in Spain, taking into account the available evidence. The 2 + 1 schedule is recommended (2, 4, and 11 months) with hexavalent vaccines (DTPa-VPI-Hib-HB) and with 13-valent pneumococcal conjugate. A 6-year booster is recommended, preferably with DTPa (if available), with a dose of polio for those who received 2 + 1 schemes, as well as vaccination with Tdpa in adolescents and in each pregnancy, preferably between 27 and 32 weeks. Rotavirus vaccine should be systematic for all infants. Meningococcal B vaccine, with a 2+1 schedule, should be included in routine calendar. In addition to the inclusion of the conjugated tetravalent meningococcal vaccine (MenACWY) at 12 years of age with catch up to 18 years, inclusive, the CAV recommends this vaccine to be also included at 12 months of age, replacing MenC. Likewise, it is recommended in those over 6 weeks of age with risk factors or who travel to countries with a high incidence of these serogroups. Two-dose schedules for MMR (12 months and 3-4 years) and varicella (15 months and 3-4 years) will be used. The second dose could be applied as a tetraviral vaccine. Universal systematic vaccination against HPV is recommended, both for girls and boys, preferably at 12 years, and greater effort should be made to improve coverage. The 9 genotype extends coverage for both genders


Asunto(s)
Humanos , Lactante , Preescolar , Niño , Adolescente , Programas de Inmunización/normas , Consorcios de Salud , Programas de Inmunización/métodos , Inmunización Secundaria/tendencias , Vacunas/inmunología , España
4.
Arch Dis Child ; 105(1): 18-25, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31270097

RESUMEN

OBJECTIVE: To assess whether sustained, scheduled mobile health team (MHT) services increase antenatal care (ANC), postnatal care (PNC) and childhood immunisation in conflict-affected and remote regions of Afghanistan. DESIGN: Cross-sectional, population-based study from 2013 to 2017. Proportions were compared using multivariable linear regression adjusted for clustering and socio-demographic variables. SETTING: 54 intervention and 56 control districts in eight Afghanistan provinces. PARTICIPANTS: 338 796 pregnant women and 1 693 872 children aged under 5 years. INTERVENTIONS: 'Intervention districts' that received MHT services for 3 years compared with 'control districts' in the same province without any MHT services over the same period. MAIN OUTCOME MEASURES: District-level and clinic-level ANC, PNC, childhood immunisation (pentavalent 3, measles 1), integrated management of childhood immunisation services. RESULTS: Proportion of pregnant women receiving at least one ANC visit was higher in intervention districts (83.6%, 161 750/193 482) than control districts (61.3%, 89 077/145 314) (adjusted mean difference (AMD) 14.8%;95% CI: 1.6% to 28.0%). Proportion of children under 1 year receiving their first dose of measles vaccine was higher in intervention (73.8%, 142 738/193 412) than control districts (57.3%, 83 253/145 293) (AMD 12.8;95% CI: 2.1% to 23.5%). There was no association with PNC (AMD 2.8%;95% CI: -5.1% to 10.7%). MHTs did not increase clinic-level service provision for ANC (AMD 41.32;95% CI: -52.46 to 135.11) or any other outcomes. CONCLUSIONS: Sustained, scheduled MHT services to conflict-affected and remote regions were associated with improved coverage of important maternal and child health interventions. Outreach is an essential service and not just an 'optional extra' for the most deprived mothers and children.


Asunto(s)
Campaña Afgana 2001- , Servicios de Salud del Niño , Servicios de Salud Materna , Unidades Móviles de Salud , Afganistán/epidemiología , Servicios de Salud del Niño/organización & administración , Servicios de Salud del Niño/estadística & datos numéricos , Preescolar , Estudios Transversales , Femenino , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Programas de Inmunización/métodos , Programas de Inmunización/estadística & datos numéricos , Lactante , Recién Nacido , Servicios de Salud Materna/organización & administración , Servicios de Salud Materna/estadística & datos numéricos , Vacuna Antisarampión/uso terapéutico , Unidades Móviles de Salud/organización & administración , Unidades Móviles de Salud/estadística & datos numéricos , Embarazo , Cobertura de Vacunación/métodos , Cobertura de Vacunación/estadística & datos numéricos
5.
Rev Paul Pediatr ; 38: e2018120, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31778406

RESUMEN

OBJECTIVE: To evaluate the trend of hospitalization for acute bronchiolitis in infants under one year of age, in the past eight years and after the implementation of the palivizumab immunization program in Brazil. METHODS: The study is a retrospective analysis of data on infants younger than one year of age, who were hospitalized with acute bronchiolitis between 2008 and 2015 in Brazil. The Brazilian National Health System database was used. The rates of hospitalization in the pre-implementation (2008-2012) and post-implementation (2014-2015) periods of the palivizumab immunization program were evaluated. The total number of admissions in the same period was used as a comparison. RESULTS: Between January 2008 and December 2015, 263,679 hospitalizations for bronchiolitis were recorded in infants younger than one year of age, 60% represented by boys. The incidence of hospitalization for bronchiolitis increased by 49% over this period (8.5 to 12.7 per 1,000 inhabitants per year). Between 2013 and 2014, the incidence rate of hospitalization for acute bronchiolitis decreased by 8% (12.5 to 11.5 per 1,000 inhabitants per year). However, in the second year of the program, hospitalization rate increased again by 10% (12.7 per 1,000 inhabitants per years). CONCLUSIONS: Acute bronchiolitis presented increasing rates of hospitalization over the study period. Hospitalization incidence for acute bronchiolitis declined one year after the implementation of palivizumab but increased again in the second year of the program.


Asunto(s)
Antivirales/uso terapéutico , Bronquiolitis/tratamiento farmacológico , Bronquiolitis/epidemiología , Hospitalización/tendencias , Palivizumab/uso terapéutico , Enfermedad Aguda , Antivirales/administración & dosificación , Brasil/epidemiología , Bronquiolitis/inmunología , Bronquiolitis/virología , Femenino , Implementación de Plan de Salud/métodos , Humanos , Programas de Inmunización/métodos , Incidencia , Lactante , Recién Nacido , Masculino , Palivizumab/administración & dosificación , Infecciones por Virus Sincitial Respiratorio/prevención & control , Virus Sincitiales Respiratorios/inmunología , Estudios Retrospectivos , Factores de Tiempo
7.
Rev Lat Am Enfermagem ; 27: e3225, 2019.
Artículo en Inglés, Portugués, Español | MEDLINE | ID: mdl-31826166

RESUMEN

OBJECTIVE: develop and evaluate a vaccine application for mobile devices, with update integrated with the National Immunization Program Information System, for care in vaccination rooms. METHOD: methodological research based on the Pressman System Development Life Cycle theory developed in three stages: integrative literature review, computational development, and application evaluation. The product was evaluated as to satisfaction, using a validated questionnaire, and as to usability by the System Usability Scale. RESULTS: the application functionalities were based on the survey of technological Innovations on immunization, published in the scientific literature. It displays user vaccines directly from the National Immunization Program Information System, notifies about upcoming vaccines, and enables the inclusion of vaccine cards of dependents. The evaluation resulted in users' mean score of 90.5 ± 11.1 and health professionals' mean score of 84.2 ± 19.4. CONCLUSION: the application is a technological tool with potential to improve the work process in vaccination rooms and to reach the goals of vaccine coverage. It synchronizes data with the National Immunization Program Information System, thus enabling the maintenance of people's vaccination history.


Asunto(s)
Aplicaciones Móviles , Informática Aplicada a la Enfermería/instrumentación , Vacunación/instrumentación , Adolescente , Adulto , Niño , Femenino , Humanos , Programas de Inmunización/métodos , Sistemas de Información/instrumentación , Tecnología de la Información , Masculino , Persona de Mediana Edad , Vacunas , Adulto Joven
8.
Am J Trop Med Hyg ; 101(4_Suppl): 68-73, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31760975

RESUMEN

In North East Nigeria, anti-immunization rumors and sentiments have negatively impacted the country's polio eradication efforts. Since 2014, the CORE Group Partners Project (CGPP) has leveraged local-level strategies to help change prevailing attitudes and behaviors by improving immunization acceptability in some of the most difficult settlements in Nigeria's states at highest risk for polio. The CGPP's communication model in Nigeria, in part, emphasizes the need to counter suspicion and address myths and misunderstandings by convening community dialogs and compound meetings, both of which serve as safe spaces for open discussion primarily aimed at addressing non-compliance. In the communities in Kaduna, Katsina, Kano, Borno, and Yobe states located in the CGPP implementation areas, there has been a consistent reduction in the number of missed children and consistent improvement in polio immunization uptake, providing evidence of the effectiveness of the CGPP communication model. The last case of wild poliovirus in Nigeria was detected in August 2016. Since Nigeria has gone more than 3 years without a case of wild poliovirus, the CGPP communication model promises to remain highly relevant in sustaining the community's awareness about immunizations that will be required to keep the population coverage of polio immunization high and, by extension, the herd immunity required to maintain zero transmission of poliovirus in Nigeria. This article describes the various strategies used to address noncompliance and provides examples of community engagement in Yobe state, which is one of the project's largest implementation areas.


Asunto(s)
Participación de la Comunidad/métodos , Programas de Inmunización/organización & administración , Aceptación de la Atención de Salud/psicología , Poliomielitis/prevención & control , Confianza , Vacunación/psicología , Participación de la Comunidad/psicología , Femenino , Humanos , Programas de Inmunización/métodos , Masculino , Nigeria , Aceptación de la Atención de Salud/estadística & datos numéricos , Vacuna Antipolio Oral/administración & dosificación , Vacunación/estadística & datos numéricos
9.
BMC Public Health ; 19(1): 1421, 2019 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-31666039

RESUMEN

BACKGROUND: Inability to track children's vaccination history coupled with parents' lack of awareness of vaccination due dates compounds the problem of low immunization coverage and timeliness in developing countries. Traditional Reminder/Recall (RR) interventions such as paper-based immunization cards or mHealth based platforms do not yield optimal results in resource-constrained settings. There is thus a need for a low-cost intervention that can simultaneously stimulate demand and track immunization history to help reduce drop-outs and improve immunization coverage and timeliness. The objective of this study is to evaluate the impact of low-cost vaccine reminder and tracker bracelets for improving routine childhood immunization coverage and timeliness in Pakistani children under 2 years of age. METHODS: The study is an individually randomized, three-arm parallel Randomized Controlled Trial with two intervention groups and one control group. Infants in the two intervention groups will be given two different types of silicone bracelets at the time of recruitment, while infants in the control group will not receive any intervention. The two types of bracelets consist of symbols and/or numbers to denote the EPI vaccination schedule and each time the child will come for vaccination, the study staff will perforate a hole in the appropriate symbol to denote vaccine administration. Therefore, by looking at the bracelet, caregivers will be able to see how many vaccines have been received. Our primary outcome measure is the increase in coverage and timeliness of Pentavalent-3/PCV-3/Polio-3 and Measles-1 vaccine in the intervention versus control groups. A total of 1446 participants will be recruited from 4 Expanded Program on Immunization (EPI) centers in Landhi Town, Karachi. Each enrolled child will be followed up till the Measles-1 vaccine is administered, or till eleven months have elapsed since enrolment. DISCUSSION: Participant recruitment commenced on July 19, 2017, and was completed on October 10, 2017. Proposed duration of the study is 18 months and expected end date is December 1, 2018. This study constitutes one of the first attempts to rigorously evaluate an innovative, low-cost vaccine reminder bracelet. TRIAL REGISTRATION: ClinicalTrials.gov NCT03310762 . Retrospectively Registered on October 16, 2017.


Asunto(s)
Programas de Inmunización/métodos , Esquemas de Inmunización , Padres , Sistemas Recordatorios , Cobertura de Vacunación , Vacunación , Vacunas/administración & dosificación , Cuidadores , Preescolar , Análisis Costo-Beneficio , Países en Desarrollo , Femenino , Humanos , Lactante , Masculino , Sarampión/prevención & control , Pakistán , Poliomielitis/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto , Sistemas Recordatorios/instrumentación , Proyectos de Investigación , Estudios Retrospectivos , Población Urbana
10.
Artículo en Inglés | MEDLINE | ID: mdl-31752274

RESUMEN

In May 2018, the non-governmental organization (NGO) Doctors with Africa CUAMM began to implement an intervention to strengthen Chiulo Hospital's public health section to deliver immunization services in Mucope Comuna, Ombadja District. We aimed to evaluate the effect of this intervention. During the intervention period, actions such as staff training, improvement in the monitoring of vaccine stockpile, and the involvement of Community Health Workers were performed. The effects of the intervention on the number of vaccine doses administered were examined using negative binomial regression. Doses administered were 14,221 during the intervention period and 11,276 in the pre-intervention one. The number of administered doses was 26% higher (95% CI 9%-45%) in the intervention period than in the pre-intervention period. This was driven by vaccine doses administered during outreach sessions, where a statistically significant increase of 62% (95% CI 28%-107%) was observed. Regarding individual vaccines, statistically significant increases in the number of doses were observed for OPV2 (76%), OPV3 (100%), Penta3 (53%), PCV3 (53%), and Rota2 (43%). The NGO interventions led to improved delivery of immunization services in the study area. Greater increases were observed for vaccine doses that are more likely to be missed by children.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Programas de Inmunización/métodos , Programas de Inmunización/organización & administración , Negativa a la Vacunación/estadística & datos numéricos , Vacunación/estadística & datos numéricos , Angola , Niño , Preescolar , Humanos , Lactante , Masculino , Desarrollo Sostenible
11.
Int J Gynecol Cancer ; 29(8): 1317-1326, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31455660

RESUMEN

Cervical cancer incidence and mortality have decreased in high-income countries, but low- and middle-income countries continue to bear a significant burden from the disease. Human papillomavirus (HPV) vaccines are a promising alternative for disease control; however, their introduction is slow in settings with greater need. We conducted a review of HPV vaccine efficacy and effectiveness reported in clinical trials and population-based studies. Efficacy of HPV vaccines is close to 100% when using a three-dose schedule in HPV-negative young women (<25 years old) for protection against persistent infection and HPV vaccine-type associated pre-cancerous lesions. Furthermore, sustained protection for up to 12 years of follow-up has been demonstrated; cross-protection against non-vaccine types is particularly observed for the bivalent vaccine, and preliminary data regarding impact on invasive cancer have emerged. Given its lower efficacy, catch-up vaccination beyond 19 years of age and proposals for vaccinating adult women deserve careful evaluation in accurately designed studies and economic analyses. Despite positive results regarding immunogenicity and post-hoc analysis for cervical intra-epithelial neoplasia in clinical trials, population-based data for prime and booster two-dose schedules are not available. Evaluation of vaccine safety from surveillance systems in immunization programs that have already distributed more than 270 million doses found no association of HPV vaccination with serious side effects. The introduction of HPV vaccination in national immunization programs remains the main challenge in tackling the burden of cervical cancer (up to 2018, only 89 countries have introduced vaccination worldwide, and most of these are high-income countries). Access models and technical capacity require further development to help low- and middle-income countries to increase the pace of vaccine delivery. Alternative approaches such as one-dose schedules and vaccination at younger ages may help reduce the programmatic and economic challenges to adolescent vaccination.


Asunto(s)
Programas de Inmunización/métodos , Papillomaviridae/inmunología , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Ensayos Clínicos como Asunto , Humanos , Infecciones por Papillomavirus/epidemiología , Ensayos Clínicos Controlados Aleatorios como Asunto
12.
BMC Public Health ; 19(1): 1064, 2019 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-31391028

RESUMEN

BACKGROUND: Access to quality essential healthcare services and vaccines for all is key to achieving universal health coverage. Inequities driven by differences in place of residence and socio-economic status persist among different communities hindering the achievement of sustained performance on immunization indicators. Innovative community-based Reach Every Child (REC) interventions at the sub-county and county level can reduce these local inequities. This study determines the effect of an enhanced door-to-door immunization strategy on improving immunization coverage in hard-to-reach areas of Migori. METHODS: This was a cross-sectional review of District Health Information System 2 immunization data for July and August 2018 for Migori County. During the presidential immunization rapid results initiative (RRI) in July 2018, poorly performing wards/facilities were mapped using the Quantum Geographic Information Systems methodology, and unreached rural-urban populations identified. Through review of facility level Kenya Expanded Programme on Immunization data, 64 health facilities with over 100 unimmunized children each between January 2017 and June 2018 in all sub-counties were prioritized. In August 2018, intensified fixed-point immunization services were offered within the prioritized facilities. Further, a 3-day door-to-door defaulter tracing by community health volunteers and household level immunization by nurses was conducted. Immunization coverage performance for access and utilization for the two periods were compared using z-tests/t-tests. RESULTS: Cumulatively, a total of 10,744 and 14,809 children were reached with immunization in July and August respectively for the 64 facilities. There were significant increases in the immunization coverage for BCG (74.4% vs 89.9%, P = 0.0001), Penta 1(96.2% vs 102%, P = 0.0649), Penta 3 (92.3% vs 112.1%, P = 0.0001), MR1 (81.7% vs 111.5%, P < 0.0001) and the fully immunized children at 1 year (78.6% vs 103.9%, P < 0.0001). Penta 3 and MR1 drop-out rates (3.99% vs - 9.86%, P = 0.0007; 15.06% vs - 9.27%, P = 0.0001 respectively) decreased significantly. Similar significant effects were observed at the subcounty levels (P < 0.05). CONCLUSION: Hard-to-reach populations require multiple REC strategies to reach every child with immunization. Health facilities should actively analyze and use routine immunization data and invest in community health strengthening systems to identify hard-to-reach areas to be targeted with outreaches to improve immunization coverage.


Asunto(s)
Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Programas de Inmunización/métodos , Cobertura de Vacunación/estadística & datos numéricos , Estudios Transversales , Humanos , Lactante , Kenia , Evaluación de Programas y Proyectos de Salud , Vacunas/administración & dosificación
13.
Nurs Forum ; 54(4): 553-556, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31389612

RESUMEN

The State of Connecticut mandates that prekindergarten children be vaccinated against the influenza virus each year by December 31st. Annually, prekindergarten students in urban schools in Connecticut are not compliant with this statute due to many factors such as parents' lack of education. The purpose of an educational intervention project (EIP) is to provide urban prekindergarten parents/caregivers with education about the influenza virus, influenza vaccine, the community resources, and Connecticut mandates. An influenza vaccine educational intervention was provided to parents and caregivers of prekindergarten students in one urban elementary school in Connecticut. Parents were educated during an open house at the school and then 4 weeks later at a Meet and Greet with prekindergarten parents. Information regarding influenza virus, vaccine, and state regulations was provided along with Pre- and post-questionnaires to assess the level of knowledge. The goal of this EIP is increased knowledge of the influenza virus, the vaccine, community resources, and state regulations. The success of this educational intervention can be shared and implemented in other licensed prekindergarten programs to increase parents' knowledge and it would lead to increased rates of district-wide compliance and decreased student absences. Most importantly, implications point to the potential protection of the public from an illness stemming from the influenza virus.


Asunto(s)
Programas de Inmunización/normas , Vacunas contra la Influenza/uso terapéutico , Connecticut , Humanos , Programas de Inmunización/métodos , Programas de Inmunización/tendencias , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/tratamiento farmacológico , Gripe Humana/prevención & control , Evaluación de Programas y Proyectos de Salud/métodos , Vacunación/métodos , Vacunación/psicología , Vacunación/normas
14.
Indian Pediatr ; 56(6): 453-458, 2019 06 15.
Artículo en Inglés | MEDLINE | ID: mdl-31278221

RESUMEN

Typhoid fever, an infection with potentially life threatening complications, is responsible for 11 to 21 million illness episodes and 145,000 to 161,000 deaths each year globally. India is a high burden country and also faces the challenge of antimicrobial resistance, which further narrows treatment options. This review analyzes the need for typhoid vaccination in India, and appraises the evidence on efficacy, immunogenicity and cost-effectiveness of currently available typhoid vaccines. In 2018, WHO prequalified the first typhoid conjugate vaccine Vi-TT and recommended it for children aged 6-23 months, along with measles vaccine at 9 or 15 months of age through the expanded programme on immunization. With the high endemicity of typhoid in India and the proven cost-effectiveness of the conjugate vaccine, a roll-out of typhoid vaccine should be considered at the earliest.


Asunto(s)
Accesibilidad a los Servicios de Salud , Programas de Inmunización , Fiebre Tifoidea/prevención & control , Vacunas Tifoides-Paratifoides , Niño , Preescolar , Análisis Costo-Beneficio , Costos de la Atención en Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Programas de Inmunización/métodos , Programas de Inmunización/organización & administración , Esquemas de Inmunización , India/epidemiología , Lactante , Evaluación de Necesidades , Fiebre Tifoidea/economía , Fiebre Tifoidea/epidemiología , Vacunas Tifoides-Paratifoides/administración & dosificación , Vacunas Tifoides-Paratifoides/economía , Vacunas Tifoides-Paratifoides/inmunología
15.
Braz J Infect Dis ; 23(4): 231-236, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31351815

RESUMEN

INTRODUCTION: Vaccination with tetanus-diphtheria-acellular pertussis (Tdap) has been recommended for healthcare workers (HCWs) by Brazilian Ministry of Health since November 2014. OBJECTIVE: To describe the strategies implemented to improve Tdap uptake, cumulative vaccine coverage after each intervention, variables associated to Tdap vaccination, and reasons for non-vaccination among HCWs of the main building of a quaternary hospital attached to the Sao Paulo University Medical School. METHODS: A list of HCWs eligible for pertussis vaccination was generated. From April to December 2015, the following interventions were implemented: note on intern journal reminding the importance of pertussis vaccination; email to the head nurses strengthening vaccine recommendations; lectures on pertussis and Tdap for physicians of Obstetrics and Neonatology Clinics; on-site vaccination by mobile teams at the Obstetrics, Neonatology, and Anesthesiology Clinics. Vaccine coverage was accessed at the end of each month. Multivariate Poisson regression model with a robust error variance was used to evaluate variables associated with Tdap vaccination. Reasons for non-vaccination were evaluated from January to May 2017 through phone calls for HCWs who had not received Tdap. RESULTS: The study included 456 HCWs. After the interventions, Tdap coverage raised from 2.8% to 41.2%. In the multivariate analysis, occupation (physician), working place (obstetrics or anesthesiology) and influenza vaccination in 2015 were independently associated to Tdap vaccination. The main reason for non-vaccination was unawareness of Tdap recommendations. CONCLUSIONS: Tdap uptake among HCWs was low in our hospital. Providing vaccination at convenient places/times for HCW seems to be the most efficient strategy to increase vaccine uptake.


Asunto(s)
Vacunas contra Difteria, Tétanos y Tos Ferina Acelular , Personal de Salud/estadística & datos numéricos , Hospitales Universitarios/estadística & datos numéricos , Cobertura de Vacunación/métodos , Cobertura de Vacunación/estadística & datos numéricos , Adulto , Brasil , Femenino , Humanos , Programas de Inmunización/métodos , Masculino , Análisis Multivariante , Distribución de Poisson , Vigilancia de la Población , Factores de Tiempo , Lugar de Trabajo/estadística & datos numéricos
16.
Isr J Health Policy Res ; 8(1): 63, 2019 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-31307532

RESUMEN

BACKGROUND: In July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past. This study analyzes the vaccination uptake rates resulting from the mass polio vaccination campaign on the basis of health inequality parameters of socioeconomic status (SES), principles of solidarity, and the Gini inequality index. The research explores understanding the value of the Gini inequality index within the context of SES and solidarity. METHODS: The study is based on data gathered from the Israeli Ministry of Health's administrative records from mother-and-child clinics across Israel. The research population is comprised of resident infants and children whom the Ministry of Health defined as eligible for the OPV between August and December 2013 (the "campaign period"). The analysis was carried out at the municipality level as well as the statistical area level. RESULTS: The higher the SES level of the municipality where the mother-and-child clinic is located, the lower the OPV vaccination uptake is. The greater the income inequality is in the municipality where the mother-and-child clinic is situated, the lower the vaccination uptake. CONCLUSIONS: Public health professionals promoting vaccine programs need to make specially-designed efforts both in localities with high average income and in localities with a high level of income diversity/inequality. Such practice will better utilize funds, resources, and manpower dedicated to increasing vaccination uptake across varying populations and communities.


Asunto(s)
Programas de Inmunización/métodos , Clase Social , Cobertura de Vacunación/normas , Brotes de Enfermedades/prevención & control , Disparidades en el Estado de Salud , Humanos , Programas de Inmunización/normas , Programas de Inmunización/estadística & datos numéricos , Israel , Factores Socioeconómicos , Cobertura de Vacunación/estadística & datos numéricos
17.
Sante Publique ; Vol. 31(1): 177-186, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31210512

RESUMEN

OBJECTIVE: The objective of this study is to analyze the effect of a technical support aiming to improve vaccine program performance in the 10 health districts (HDs) of Côte d'Ivoire, in which the largest numbers of children not vaccinated against measles were registered. METHOD: These HDs benefited between June 2016 and May 2017, from four quarterly supportive supervisions along with technical support in health logistics and data management and quality. We had followed the evolution of the key indicators in each targeted HD and compared them to the other HDs. RESULTS: The measles containing vaccine coverage (MCVC) had increased and exceeded 80% in 8 out of 10 the targeted HDs. The increase of this MCVC was higher in the targeted HDs (12 points versus 3 points). The number of children not vaccinated against measles had been reduced by 66% and in 8 out of 10 HDs. The global drop-out rate decreased by 13 points in the targeted HDs, whereas it increased by 1 point in the other HDs.The timeliness increased and was more than 80% in 9 of the 10 targeted HDs. The increase of this timeliness was better in the targeted HDs (35 points versus 25 points). The overall quality index was higher in the targeted HDs (90% versus 82%) and the score per component for targeted HDs was better. CONCLUSION: This technical support has have an positive effect on the vaccine performance of targeted HDs. The current challenge is to scale up this type of intervention to all districts in the country.


Asunto(s)
Programas de Inmunización/organización & administración , Vacunación Masiva/organización & administración , Vacuna Antisarampión/administración & dosificación , Sarampión/prevención & control , Niño , Costa de Marfil/epidemiología , Humanos , Programas de Inmunización/métodos , Vacunación Masiva/métodos , Vacunación Masiva/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud
19.
Indian J Public Health ; 63(2): 139-142, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31219063

RESUMEN

Temperature excursion and exposure to sub-zero temperatures may reduce the potency of the freeze-sensitive vaccines. This study assessed temperature during vaccine transfers at various levels under the Universal Immunization Program. This cross-sectional study undertaken in 21 districts of three states of India - Bihar (n = 8), Kerala (n = 8), and Gujarat (n = 5). We documented temperature inside the cold boxes and vaccine carriers using LogTag-Trix8 data loggers. In total, 110 vaccine transportation episodes were observed; 55 inter-facility transfers and 55 outreach sessions. Sizable proportions of inter-facility (9% to 35%) and outreach vaccine transfers (18%) were exposed to sub-zero temperature. The proportions of exposure to temperature to >8°C were in the range of 0.8%-11.3% for inter-facility transfers and 2.3% for outreach sessions. The vaccines were exposed to freezing temperatures for significant durations during transportation across the cold chain. Rigorous monitoring of temperature integrity is essential to ensure the delivery of potent vaccines and to avoid vaccine failure.


Asunto(s)
Programas de Inmunización , Potencia de la Vacuna , Vacunas , Estudios Transversales , Almacenaje de Medicamentos , Humanos , Programas de Inmunización/métodos , Programas de Inmunización/organización & administración , India , Refrigeración , Temperatura , Transportes
20.
PLoS One ; 14(5): e0217415, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31150445

RESUMEN

INTRODUCTION AND METHODS: Hepatitis B is a vaccine preventable disease and is notifiable in South Africa. Hepatitis B vaccination was incorporated into the Expanded Programme on Immunisation in South Africa in 1995. We used a convenience sample from community-based febrile rash surveillance in 2013 to estimate hepatitis B sero-prevalence. Of samples serologically negative for acute measles infection, 450 samples spanning nine provinces of South Africa were tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs) and hepatitis B core antibody (anti-HBc). RESULTS: Two children (2/450; 0.4%) tested positive for HBsAg. Three hundred and three children (67.3%) had evidence of vaccine induced immunity. Vaccine induced immunity was present in 80.2% of 1-5 year olds, but only 60.3% of 10-14 year olds. Natural immunity, indicating exposure to circulating hepatitis B, was present in 13/450 (2.9%) children. CONCLUSION: Chronic hepatitis B in South African has decreased in prevalence from highly endemic levels prior to vaccine introduction to approximately 0.4% in this sample, demonstrating impact of a successful vaccination programme 18 years after introduction. Decreased vaccine-induced immunity with increasing age may reflect waning antibody titres over time.


Asunto(s)
Exantema/virología , Vacunas contra Hepatitis B/inmunología , Hepatitis B/epidemiología , Hepatitis B/inmunología , Adolescente , Niño , Preescolar , Femenino , Anticuerpos contra la Hepatitis B/inmunología , Antígenos del Núcleo de la Hepatitis B/inmunología , Antígenos de Superficie de la Hepatitis B/inmunología , Humanos , Programas de Inmunización/métodos , Lactante , Recién Nacido , Masculino , Sarampión/virología , Prevalencia , Sudáfrica/epidemiología , Vacunación/métodos
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