[Effects of the immunization program in Vojvodina].

INTRODUCTION: With the widespread use of active immunization, significant results have been achieved in the control and prevention of numerous communicable diseases. The Expanded Programme on Immunization of the World Health Organization is intended to strengthen national programs for the reduction in the incidence and mortality rates and global elimination or eradication of communicable diseases. The aim of this paper is to analyze results of the immunization program in Vojvodina. MATERIAL DND METHODS: The results of the immunization program were analyzed on the basis of the incidence rates, since the introduction of the mandatory reporting system, till 2006. The analysis included immunization coverage against diphtheria, tetanus, pertussis, poliomyelitis and measles as well as reported cases of missed opportunities in the period from 1997 to 2006. RESULTS: Poliomyelitis has not been reported in Vojvodina since 1963, diphtheria since 1978 and measles in the period from 2001 to 2006. Sporadic cases of pertussis have been reported in unimmunized children of the youngest age, and tetanus in unimmunized elderly population. Vaccination coverage against poliomyelitis, diphtheria, tetanus and pertussis was above 96%. Vaccination coverage against measles was lower (95% vaccination, 87% revaccination). The highest proportion of missed opportunities was caused by not responding to immunization calls (46.6%). CONCLUSION: These results can be maintained by up-to-date (UTD) immunization and high vaccination coverage without territorial and population differences. Data on the total number of children without up-to-date vaccination cannot be obtained on the basis of administrative coverage follow-up. It is necessary to establish follow-up mechanisms for UTD immunization, which would reveal the number of children at risk from vaccine preventable diseases and characteristics of unimmunized population.

[Epidemiological characteristics of tetanus in Vojvodina].

INTRODUCTION: Vojvodina is an endemic area for tetanus. MATERIAL AND METHODS: Epidemiological characteristics of tetanus were analyzed based on registered cases of disease and death in the period 1960-2004, and epidemiological investigation of 50 registered cases during the last 10 years of this period. Epidemiological characteristics were analyzed chronologically, demographically and topographically. RESULTS AND DISCUSSION: During the period of observation, the incidence rate of tetanus declined steadily. Due to immunization and extremely high coverage, tetanus has been practically eliminated in the age group of younger than 29 years. Neonatal tetanus and tetanus in the age group 30-59 years has been reduced to individual cases. Today, tetanus is a problem of the elderly population. Tetanus deaths occur statistically more often among persons older than 66 years. The average case fatality rate during the period of observation was 33.1%. The vaccination history in the majority of investigated cases was unknown (52%) or they have never been vaccinated (28%) because they were mainly elderly people born before introduction of mandatory immunization. Tetanus most often occurs after minor wounds, because of which patients do not seek medical attention. In the majority of cases tetanus occurred after limb injuries. CONCLUSION: Tetanus in Vojvodina is a problem among unimmunized elderly people. It mostly occurs after minor injuries or after contamination of chronic skin lesions. Mandatory vaccination of older age groups should contribute to further reduction in the incidence rate of tetanus.