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3.
PLoS Comput Biol ; 16(10): e1008292, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33075052

RESUMEN

The lack of effective vaccines for many endemic diseases often forces policymakers to rely on non-immunizing control measures, such as vector control, to reduce the massive burden of these diseases. Controls can have well-known counterintuitive effects on endemic infections, including the honeymoon effect, in which partially effective controls cause not only a greater initial reduction in infection than expected, but also large outbreaks during control resulting from accumulation of susceptibles. Unfortunately, many control measures cannot be maintained indefinitely, and the results of cessation are poorly understood. Here, we examine the results of stopped or failed non-immunizing control measures in endemic settings. By using a mathematical model to compare the cumulative number of cases expected with and without control, we show that deployment of control can lead to a larger total number of infections, counting from the time that control started, than without any control-the divorce effect. This result is directly related to the population-level loss of immunity resulting from non-immunizing controls and is seen in a variety of models when non-immunizing controls are used against an infection that confers immunity. Finally, we examine three control plans for minimizing the magnitude of the divorce effect in seasonal infections and show that they are incapable of eliminating the divorce effect. While we do not suggest stopping control programs that rely on non-immunizing controls, our results strongly argue that the accumulation of susceptibility should be considered before deploying such controls against endemic infections when indefinite use of the control is unlikely. We highlight that our results are particularly germane to endemic mosquito-borne infections, such as dengue virus, both for routine management involving vector control and for field trials of novel control approaches, and in the context of non-pharmaceutical interventions aimed at COVID-19.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Enfermedades Endémicas/prevención & control , Programas de Inmunización , Animales , Número Básico de Reproducción , Infecciones por Coronavirus/prevención & control , Culicidae , Vacunas contra el Dengue/uso terapéutico , Política de Salud , Humanos , Insectos Vectores , Modelos Teóricos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Salud Pública , Rubéola (Sarampión Alemán)/prevención & control , Vacuna contra la Rubéola/uso terapéutico , Estaciones del Año , Dengue Grave/prevención & control , Vacunas Virales/uso terapéutico
4.
Lancet Glob Health ; 8(11): e1399-e1407, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33069300

RESUMEN

BACKGROUND: As of 2018, the rubella vaccine had been incorporated into the national immunisation schedule of 168 countries, representing 87% of the world's population. Countries have used different strategies to reduce the burden of congenital rubella syndrome (CRS), such as vaccinating only females. Given the different strategies, and that 26 countries still had not introduced the vaccine, we analysed global rubella surveillance data to understand rubella epidemiology and the effect of vaccination. METHODS: In this ecological analysis, we evaluated surveillance data on rubella cases that had been reported to WHO from 2007 to 2018, by age, vaccination history, and onset year. Cases were classified as either being vaccine eligible or ineligible on the basis of the country's vaccination strategy and the birth year of the person. We required all cases be confirmed by laboratory testing or that they were epidemiologically linked, and we excluded cases defined only by clinical symptoms. Incidence per million people was calculated by use of World Population Prospects data. FINDINGS: Between Jan 1, 2007, and Dec 31, 2018, from data reported to WHO as of Jan 3, 2020, there were 139 486 reported rubella cases, of which 15 613 (11%) were vaccine eligible. Annual incidence ranged from 13·9 cases per million in 2007 to 1·7 cases per million in 2018. In all years, absolute and proportional global incidence were higher among vaccine ineligible cohorts than eligible cohorts. In vaccine ineligible cohorts, 87 666 (74%) of 118 308 cases were in children younger than 15 years, compared with 8423 (54%) of 15 613 cases in vaccine eligible cohorts. Vaccine ineligible women of reproductive age (WRA) had a higher incidence than vaccine eligible WRA, except in 2011-12. INTERPRETATION: Vaccination has been successful in decreasing the burden of rubella, regardless of the strategy used. WRA remain at risk, but the risk is higher in those countries that have yet to introduce the vaccine. These countries should introduce the rubella-containing vaccine as soon as possible, to eliminate rubella, and to prevent the morbidity and mortality associated with CRS. FUNDING: None.


Asunto(s)
Salud Global , Vigilancia de la Población , Rubéola (Sarampión Alemán)/epidemiología , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Esquemas de Inmunización , Incidencia , Lactante , Masculino , Persona de Mediana Edad , Rubéola (Sarampión Alemán)/prevención & control , Síndrome de Rubéola Congénita/epidemiología , Síndrome de Rubéola Congénita/prevención & control , Vacuna contra la Rubéola/administración & dosificación , Vacunación/estadística & datos numéricos , Adulto Joven
5.
Mayo Clin Proc ; 95(8): 1780-1795, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32753151

RESUMEN

In addition to the vaccines due in the first year of life, the US Advisory Committee on Immunization Practices recommends that children continue to receive vaccines regularly against a variety of infectious diseases. Starting at 12 to 15 months of life, these include the two-dose measles-mumps-rubella vaccine series and the two-dose varicella vaccine series. Also in the second year of life, infants should begin the two-dose hepatitis A vaccine series and complete the Haemophilus influenzae type B vaccine series as well as the pneumococcal conjugate vaccine series. Before 19 months of life, infants should receive the third dose of the poliovirus vaccine and the fourth dose of diphtheria-tetanus-acellular pertussis (DTaP) vaccine. The final doses of poliovirus and tetanus-diphtheria-acellular pertussis vaccines are both due at 4 to 6 years of life. Before each influenza season, every child should receive the influenza vaccine. Those less than 9 years of age who previously received less than two doses need two doses a month apart. At 11 to 12 years of life, all should get two doses of the human papillomavirus vaccine, the adolescent/adult version of the tetanus-diphtheria-acellular pertussis vaccine, and begin a two-dose series of meningococcal ACWY vaccine. Each of these vaccines is due when the vaccine works to protect against both an immediate risk as well as to provide long-term protection. Each vaccine-preventable disease varies in terms of the nature of exposure, the form of the morbidity, the risk of mortality, and potential to prevent or ameliorate its harm.


Asunto(s)
Vacunas/uso terapéutico , Adolescente , Factores de Edad , Vacuna contra la Varicela/normas , Vacuna contra la Varicela/uso terapéutico , Niño , Preescolar , Vacuna contra Difteria, Tétanos y Tos Ferina/normas , Vacuna contra Difteria, Tétanos y Tos Ferina/uso terapéutico , Femenino , Vacunas contra la Hepatitis A/normas , Vacunas contra la Hepatitis A/uso terapéutico , Humanos , Lactante , Vacunas contra la Influenza/normas , Vacunas contra la Influenza/uso terapéutico , Masculino , Vacuna Antisarampión/normas , Vacuna Antisarampión/uso terapéutico , Vacunas Meningococicas/normas , Vacunas Meningococicas/uso terapéutico , Vacuna contra la Parotiditis/normas , Vacuna contra la Parotiditis/uso terapéutico , Vacunas contra Papillomavirus/normas , Vacunas contra Papillomavirus/uso terapéutico , Vacuna contra la Rubéola/normas , Vacuna contra la Rubéola/uso terapéutico , Factores Sexuales , Vacunas/normas
7.
PLoS One ; 15(8): e0237312, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32797060

RESUMEN

During the 2012-13 rubella outbreak in Japan, local governments implemented subsidy programs for catch-up vaccination to mitigate the rubella outbreak and prevent congenital rubella syndrome (CRS). In most local governments, to prevent CRS, eligible persons of the subsidy program were women who were planning to have a child and men who were partners of pregnant women. On the other hand, in Kawasaki City, unimmunized men aged 23-39 years were additionally included in the eligible persons, because they were included in an unimmunized men group resulting from the historical transition of the national routine vaccination in Japan. The number of rubella cases in the city decreased earlier than that in the whole Japan. First, in order to estimate the effect of the catch-up vaccination campaign in Kawasaki City on the epidemic outcome, we performed numerical simulations with a Susceptible-Vaccinated-Exposed-Infectious-Recovered (SVEIR) model incorporating real data. The result indicated that the catch-up vaccination campaign showed a beneficial impact on the early decay of the rubella cases. Second, we numerically compared several different implementation strategies of catch-up vaccinations under a fixed amount of total vaccinations. As a result, we found that early and intensive vaccinations are vital for significant reduction in the number of rubella cases and CRS occurrences. Our study suggests that mathematical models with epidemiological and social data can contribute to identifying the most effective vaccination strategy.


Asunto(s)
Vacuna contra la Rubéola/uso terapéutico , Rubéola (Sarampión Alemán)/prevención & control , Adolescente , Adulto , Niño , Preescolar , Brotes de Enfermedades , Femenino , Humanos , Programas de Inmunización , Lactante , Japón , Masculino , Persona de Mediana Edad , Rubéola (Sarampión Alemán)/epidemiología , Adulto Joven
8.
Am J Trop Med Hyg ; 103(4): 1717-1725, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32618256

RESUMEN

In Haiti, measles, rubella, and maternal and neonatal tetanus have been eliminated, but a diphtheria outbreak is ongoing as of 2019. We conducted a nationally representative, household-based, two-stage cluster survey among children aged 5-7 years in 2017 to assess progress toward maintenance of control and elimination of selected vaccine-preventable diseases (VPDs). We stratified Haiti into West region (West department, including the capital city) and non-West region (all other departments). We obtained vaccination history and dried blood spots, and measured antibody concentrations to VPDs on a multiplex bead assay. Among 1,146 children, national seropositivity was 83% (95% CI: 80-86%) for tetanus, 83% (95% CI: 81-85%) for diphtheria, 87% (95% CI: 85-89%) for measles, and 84% (95% CI: 81-87%) for rubella. None of the children had long-term immunity to tetanus or diphtheria (IgG concentration ≥ 1 international unit/mL). Seropositivity in the West region was lower than that in the non-West region. Vaccination coverage was 68% (95% CI: 61-74%) for ≥ 3 doses of tetanus- and diphtheria-containing vaccine (DTP3), 84% (95% CI: 80-87%) for one dose of measles-rubella vaccine (MR1), and 20% (95% CI: 16-24%) for MR2. The seroprevalence of measles, rubella, and diphtheria antibodies is lower than population immunity levels needed to prevent disease transmission, particularly in the West region; reintroduction of these diseases could lead to an outbreak. To maintain VPD control and elimination, Haiti should achieve DTP3 and MR2 coverage ≥ 95%, and include tetanus and diphtheria booster doses in the routine immunization schedule.


Asunto(s)
Difteria/epidemiología , Vacuna Antisarampión/administración & dosificación , Sarampión/epidemiología , Vacuna contra la Rubéola/administración & dosificación , Rubéola (Sarampión Alemán)/epidemiología , Tétanos/epidemiología , Vacunación , Niño , Preescolar , Femenino , Haití/epidemiología , Humanos , Masculino , Estudios Seroepidemiológicos , Cobertura de Vacunación
9.
J Chromatogr A ; 1625: 461343, 2020 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-32709308

RESUMEN

A simple magnetic dispersive solid-phase extraction (MDSPE) methodology based on mesoporous Fe3O4@ succinic acid nanospheres and high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) has been developed to determine kanamycin (KNM) and neomycin (NEO) contents in Measles, Mumps, and Rubella (MMR) vaccine products. The monodispersed mesoporous Fe3O4 nanospheres with self-assembled carboxyl terminated shell have been prepared via a simple solvothermal method. These as-synthesized mesoporous Fe3O4 nanospheres showed a high magnetic saturation value (Ms = 46 emu g-1) and large specific surface area (111.12 m2 g-1) which made them potential candidates as sorbents in magnetic solid-phase extraction. The adsorption experimental data fitted well with the Freundlich-Langmuir isotherm and followed a pseudo-second-order kinetic model. Moreover influential parameters on extraction efficiency were investigated and optimized. Under optimal conditions, the limits of detection for KNM and NEO were 1.0 and 0.1 ng mL-1, respectively. Recovery assessments using real samples exhibited recoveries in the range of 96.0 ± 4.3 to 101.5 ± 7.1 %, with relative standard deviations of <10.7% (for intra- day) and <14.6% (for inter- day). The proposed method was successfully applied for different spiked and un-spiked MMR vaccine samples. The presented extraction method provides a fast, selective, robust and practical platform for the detection of KNM and NEO in MMR vaccine samples.


Asunto(s)
Dextranos/química , Kanamicina/análisis , Nanopartículas de Magnetita/química , Vacuna Antisarampión/análisis , Paperas/inmunología , Nanosferas/química , Neomicina/análisis , Vacuna contra la Rubéola/análisis , Espectrometría de Masas en Tándem/métodos , Adsorción , Cromatografía Líquida de Alta Presión , Concentración de Iones de Hidrógeno , Cinética , Límite de Detección , Magnetismo , Nanosferas/ultraestructura , Reproducibilidad de los Resultados , Extracción en Fase Sólida , Solventes/química , Espectroscopía Infrarroja por Transformada de Fourier , Ácido Succínico/química , Factores de Tiempo , Agua/química
10.
Yakugaku Zasshi ; 140(7): 901-904, 2020.
Artículo en Japonés | MEDLINE | ID: mdl-32612053

RESUMEN

Although rubella is usually a mild, febrile illness, and up to 50% of rubella infections are asymptomatic, congenital rubella syndrome (CRS) can occur in the developing fetus of a pregnant woman infected with rubella virus (RV) in early pregnancy. After a rubella outbreak from early 2012 to late 2013 in Japan, another outbreak re-emerged from mid-2018 in the Tokyo metropolitan area and other large cities. In 2018, and up to epidemiological week (EW) 25 in 2019, more than 4000 rubella cases had been reported. Three CRS cases were also reported up to EW 24. Seroepidemiological surveys among Japanese residents indicated that the susceptible pocket to RV in male adults aged 30-50 years, as determined in 2013, remained unchanged in 2018. To reduce the number of male adults sensitive to RV, in early 2019, Japan's Ministry of Health, Labour and Welfare decided to implement routine immunization of male adults aged 40-57 years between 2019 and 2021. These male adults have been determined to have low anti-RV antibodies, and were therefore designated as the target population for this routine immunization (as category A). Although one-third of male patients with rubella reported in 2018 were in their 20 s and 30 s, these younger generations were not included in the target population for routine immunization against rubella, because they had already received a routine vaccination. Rubella vaccination is also required for male adults aged 20-40 years to diminish the susceptible pocket.


Asunto(s)
Enfermedades Transmisibles Emergentes/epidemiología , Salud Pública , Rubéola (Sarampión Alemán)/epidemiología , Adulto , Factores de Edad , Enfermedades Transmisibles Emergentes/prevención & control , Brotes de Enfermedades , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad , Embarazo , Rubéola (Sarampión Alemán)/prevención & control , Vacuna contra la Rubéola , Factores Sexuales
11.
Niger Postgrad Med J ; 27(3): 156-162, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32687113

RESUMEN

Rubella is a highly contagious disease of public health importance that is endemic in Nigeria. Rubella with its devastating sequel, congenital rubella syndrome, is a neglected disease with no surveillance system in place and no national incidence figure in Nigeria. This article, therefore, seeks to do reviews of rubella transmissibility, its reproduction number and the prospects for its control in Nigeria. This is a review of literatures with triangulation of findings along the objectives and the use of available secondary data to analyse the prospects of rubella control in Nigeria. Data were analysed and presented with appropriate tables and charts. A number of factors can fuel rubella transmission causing increase in reproduction number, Ro.The high birth rate, poor rubella surveillance and non-inclusion of rubella vaccines in the routine vaccination schedule among others are some of the factors working against a good outlook for rubella control in Nigeria. The Nigerian government should control the growing population, ensure a robust surveillance for rubella and incorporate rubella-containing vaccine in the immunisation schedule for infants with regular vaccination campaigns for older children and adults.


Asunto(s)
Transmisión Vertical de Enfermedad Infecciosa/legislación & jurisprudencia , Síndrome de Rubéola Congénita , Vacuna contra la Rubéola/administración & dosificación , Rubéola (Sarampión Alemán)/prevención & control , Adulto , Niño , Humanos , Incidencia , Lactante , Nigeria/epidemiología , Rubéola (Sarampión Alemán)/epidemiología , Rubéola (Sarampión Alemán)/transmisión
13.
MMWR Morb Mortal Wkly Rep ; 69(24): 744-750, 2020 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-32555136

RESUMEN

Rubella is the leading vaccine-preventable cause of birth defects. Rubella typically manifests as a mild febrile rash illness; however, infection during pregnancy, particularly during the first trimester, can result in miscarriage, fetal death, or a constellation of malformations known as congenital rubella syndrome (CRS), commonly including one or more visual, auditory, or cardiac defects (1). In 2012, the Regional Committee of the World Health Organization (WHO) Western Pacific Region (WPR)* committed to accelerate rubella control, and in 2017, resolved that all countries or areas (countries) in WPR should aim for rubella elimination† as soon as possible (2,3). WPR countries are capitalizing on measles elimination activities, using a combined measles and rubella vaccine, case-based surveillance for febrile rash illness, and integrated diagnostic testing for measles and rubella. This report summarizes progress toward rubella elimination and CRS prevention in WPR during 2000-2019. Coverage with a first dose of rubella-containing vaccine (RCV1) increased from 11% in 2000 to 96% in 2019. During 1970-2019, approximately 84 million persons were vaccinated through 62 supplementary immunization activities (SIAs) conducted in 27 countries. Reported rubella incidence increased from 35.5 to 71.3 cases per million population among reporting countries during 2000-2008, decreased to 2.1 in 2017, and then increased to 18.4 in 2019 as a result of outbreaks in China and Japan. Strong sustainable immunization programs, closing of existing immunity gaps, and maintenance of high-quality surveillance to respond rapidly to and contain outbreaks are needed in every WPR country to achieve rubella elimination in the region.


Asunto(s)
Erradicación de la Enfermedad , Vacuna contra la Rubéola/administración & dosificación , Rubéola (Sarampión Alemán)/epidemiología , Rubéola (Sarampión Alemán)/prevención & control , Adolescente , Adulto , Asia/epidemiología , Australasia/epidemiología , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Embarazo , Adulto Joven
14.
Pan Afr Med J ; 35(Suppl 1): 3, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32373254

RESUMEN

The African Region is committed to measles elimination by 2020 but coverage with the first dose of measles-containing vaccine was only 70% in 2017. Several obstacles to achieving high coverage with measles and rubella vaccines exist, some of which could be overcome with new vaccine delivery technologies. Microarray array patches (MAPs) are single-dose devices used for transcutaneous administration of molecules, including inactivated or attenuated vaccines, that penetrate the outer stratum corneum of the skin, delivering antigens to the epidermis or dermis. MAPs to deliver measles and rubella vaccines have the potential to be a transformative technology to achieve elimination goals in the African Region. MAPs for measles and rubella vaccination have been shown to be safe, immunogenic and thermostable in preclinical studies but results of clinical studies in humans have not yet been published. This review summarizes the current state of knowledge of measles and rubella MAPs, their potential advantages for immunization programs in the African Region, and some of the challenges that must be overcome before measles and rubella MAPs are available for widespread use.


Asunto(s)
Vacuna Antisarampión/administración & dosificación , Sarampión/prevención & control , Vacuna contra la Rubéola/administración & dosificación , Rubéola (Sarampión Alemán)/prevención & control , Parche Transdérmico , Cobertura de Vacunación/métodos , Administración Cutánea , África/epidemiología , Humanos , Programas de Inmunización/métodos , Microtecnología/instrumentación , Aceptación de la Atención de Salud/estadística & datos numéricos , Cobertura de Vacunación/estadística & datos numéricos
15.
Int J Infect Dis ; 94: 25-28, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32112963

RESUMEN

OBJECTIVES: The aim was to examine rubella seronegativity among women of childbearing age after the introduction of rubella-containing vaccine (RCV) among teenage girls and universal MMR programs in South Korea. METHODS: The serum IgG data of 72 114 women aged 20-49 years, who had undergone rubella antibody testing at the Gangnam CHA Medical Center between 2004 and 2018, were examined. A serum IgG level <10.0 IU/ml was considered negative. The study population was divided into three cohorts based on the vaccination policy: cohort 1, 1955-1976 (no national immunization program); cohort 2, 1977-1985 (national rubella only vaccination for high schoolers); cohort 3, 1986-1993 (combination strategy). We compared the rate of seronegativity and the adjusted odds ratio (OR) of seronegativity of each cohort. RESULTS: The overall proportion of seronegative women decreased significantly, from 6.1% in 2004 to 2.5% in 2018 (Kendall tau = -0.89, p < 0.001). The rate of seronegativity was highest among women who were not targeted for national immunization (born in 1955-1977, 5.2%), while it was lowest among candidates receiving routine and catch-up vaccinations (born in 1986-1993, 2.2%). When controlling for the effect of age and year of testing, the OR for seronegativity was lower for cohort 2 (adjusted OR 0.68, 95% confidence interval (CI) 0.60-0.76) and cohort 3 (OR 0.55, 95% CI 0.40-0.75) when compared to cohort 1. CONCLUSIONS: Women who were covered by either vaccination program were less susceptible to rubella infection, supporting the value of both approaches. The study findings will serve as empirical evidence for an immunization program targeted towards young women and children.


Asunto(s)
Vacuna contra la Rubéola/inmunología , Rubéola (Sarampión Alemán)/epidemiología , Adulto , Anticuerpos Antivirales/sangre , Estudios de Cohortes , Susceptibilidad a Enfermedades , Femenino , Humanos , Programas de Inmunización , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Persona de Mediana Edad , Oportunidad Relativa , República de Corea/epidemiología , Rubéola (Sarampión Alemán)/inmunología , Virus de la Rubéola/inmunología , Estudios Seroepidemiológicos , Vacunas Combinadas/inmunología , Adulto Joven
16.
BMC Infect Dis ; 20(1): 219, 2020 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-32164592

RESUMEN

BACKGROUND: Control of Rubella and Congenital Rubella Syndrome using vaccination has shown great success in the America's. Uganda is due to introduce the Rubella vaccine however the magnitude of transmission is not well documented. Therefore this study was done to determine IgM sero-prevalance for Rubella in order to help monitor vaccine effectiveness post introduction of the vaccine in routine vaccination programme. METHODS: A retrospective review of suspected measles cases data for the reporting period January 2007 to December 2016 in Uganda was Done. rubella IgM testing was done on 15,296 of the cases and the data was analyzed using STATA version 13. RESULTS: In total 15,296 cases were tested and 4255 (27.8%) tested positive and among females aged 15-49 years 88 out of 322 (27%) tested positive. The age distribution range was 0-80 years, rubella IgM positivity was reported in all the 15 regions of Uganda and throughout the ten year period in every month. Age group 5-15 years had OR 2.5 p-value < 0.001 of being rubella IgM positive compared to age < 5 years and testing measles IgM negative OR 6.3 p-value < 0.001. CONCLUSION: Rubella is endemic in Uganda and although rubella IgM positivity is highest in the age 5-15 years even the younger, older and women of reprodutive age are affected. This means the risk of Congenital Rubella Syndrome is high hence the need to introduce the rubella vaccine for infants and pregnant mothers and continued surveillance to enhance its control.


Asunto(s)
Rubéola (Sarampión Alemán)/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Programas de Inmunización , Inmunoglobulina M/sangre , Lactante , Masculino , Sarampión/epidemiología , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Rubéola (Sarampión Alemán)/prevención & control , Síndrome de Rubéola Congénita/epidemiología , Síndrome de Rubéola Congénita/prevención & control , Vacuna contra la Rubéola/inmunología , Vacuna contra la Rubéola/uso terapéutico , Virus de la Rubéola/inmunología , Uganda/epidemiología , Adulto Joven
17.
BMC Infect Dis ; 20(1): 101, 2020 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-32013873

RESUMEN

BACKGROUND: Rubella is highly under reported in Zambia as in most sub-Saharan countries despite being a disease of major public health concern especially among women of childbearing age. In September 2016, Zambia introduced a combined measles-rubella vaccine in children 0-14 years. In this study, we estimated the proportion positive for acute rubella among suspected but negative measles cases between 2005 and 2016 and determined its correlates for monitoring rubella epidemiology post-rubella vaccine introduction. METHODS: In a retrospective study, 4497 measles IgM negative serum samples from 5686 clinically suspected measles cases were examined for rubella IgM antibodies using the Siemens, Enzygnost® ELISA kit at the national measles laboratory. Data on demographics, year and month of onset were extracted from the surveillance data. Multivariate logistic regression analysis using backward variable selection was conducted to determine independent predictors for acute rubella. The magnitude of association was estimated using adjusted odds ratio with a 95% confidence interval. RESULTS: Overall, a proportion of 29.2% (1313/4497) affecting mostly those between 5 and 24 years was determined. Only age, province, month and year were independently associated with acute rubella. The regional proportions varied from 21.8-37.3% peaking in the month of October. Persons in the age group 10-14 years (Adjusted Odds Ratio [AOR] = 2.43; 95% CI [2.01-2.95]) were more likely while those aged < 1 year less likely (AOR = 0.31; 95% CI [021-0.48]) to have acute rubella compared to those aged 25 years or older. Persons in 2010 were less likely (AOR = 0.12; CI [0.05, 0.28]) to have acute rubella compared to those in 2016. While acute rubella was more likely to occur between July and November compared to December, it was less likely to occur between February and May. CONCLUSIONS: Rubella virus was circulating in Zambia between 2005 and 2016 affecting mostly persons in the age group 5-24 years peaking in the hot dry season month of October. Although vaccination against rubella has been launched, these baseline data are important to provide a reference point when determining the impact of the vaccination program implemented.


Asunto(s)
Rubéola (Sarampión Alemán)/epidemiología , Enfermedad Aguda/epidemiología , Adolescente , Anticuerpos Antivirales/sangre , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática , Monitoreo Epidemiológico , Femenino , Humanos , Programas de Inmunización , Lactante , Recién Nacido , Masculino , Sarampión/epidemiología , Sarampión/prevención & control , Vacuna Antisarampión , Oportunidad Relativa , Estudios Retrospectivos , Rubéola (Sarampión Alemán)/prevención & control , Vacuna contra la Rubéola/uso terapéutico , Virus de la Rubéola/inmunología , Virus de la Rubéola/patogenicidad , Estaciones del Año , Adulto Joven , Zambia/epidemiología
19.
Pan Afr Med J ; 37: 171, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33447326

RESUMEN

Introduction: measles is the leading vaccine preventable childhood disease designated for elimination by WHO. More than 20 million people are affected by measles each year, particularly in Africa and Asia. With annual outbreaks reported from Ethiopia´s Oromia region. We analyzed measles containing vaccine coverage (MCV), measles cases and measles deaths over a 10-year period (2007-2016). Methods: we reviewed Oromia measles surveillance data and first-dose measles containing vaccine (MCV1) administrative coverage. Descriptive statistics and multivariable logistic regression were performed to assess variables associated with measles death. Additional spatial mapping was performed to visually display key areas of measles case distribution in Oromia. Results: a total of 26,908 measles suspect cases were identified, of which 18,223 (68%) were confirmed. A median age of 6 years (IQ range 0.5-71 years) and 288 deaths were observed. Among the total cases, 29% were unvaccinated and 46% had unknown vaccination status. The highest IR was seen in Guji zone (IR=190/100,000 population) among 1-4 years, with a majority from rural areas. Risk factors associated with death include age <5 years (AOR=1.82, CI: 1.42-2.33), unvaccinated status (AOR=1.44, CI: 1.06-1.95) and inpatient treatment (AOR=2.12, CI: 1.58-2.85). Of 8,732 measles IgM negative/indeterminate specimens, 10.5% tested positive for rubella specific IgM. Conclusion: outbreaks of measles are an ongoing public health concern in the Oromia region. Children aged 1-15 years remain at high risk for contracting measles in the region. We recommend strengthening routine immunization to reach all children, especially in rural areas and that the measles-rubella (MR) vaccine be considered.


Asunto(s)
Brotes de Enfermedades/estadística & datos numéricos , Vacuna Antisarampión/administración & dosificación , Sarampión/epidemiología , Vacunación/estadística & datos numéricos , Adolescente , Adulto , Anciano , Niño , Preescolar , Estudios Transversales , Etiopía/epidemiología , Femenino , Humanos , Lactante , Masculino , Sarampión/mortalidad , Persona de Mediana Edad , Salud Pública , Estudios Retrospectivos , Factores de Riesgo , Vacuna contra la Rubéola/administración & dosificación , Población Rural , Cobertura de Vacunación/estadística & datos numéricos , Adulto Joven
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