RESUMO
The Lombok Hepatitis B (HB) Model Immunization Project was the first mass infant HB immunization project in Indonesia. Key aspects were the procurement of low-cost HB vaccine, integration into routine infant immunization services, and delivery of the first dose in the home within 1 week of birth. The project achieved > 90% coverage with 3 doses of vaccine. The prevalence of HB surface antigen was 1.4% in infants who received 3 doses (with the first dose within 7 days of birth) and 3.0% in those who received the first dose > 7 days after birth, compared with a baseline prevalence of 6.2% (P < .001 in each case). Most vaccine failures occurred in children born to HBe antigen-positive mothers. Antibody prevalence and titers did not correlate with protection. HB vaccine can be successfully integrated into the Expanded Programme on Immunization (EPI), strengthening the EPI and significantly reducing chronic HB infection.
Assuntos
Vacinas contra Hepatite B , Hepatite B/prevenção & controle , Programas de Imunização , Vacina BCG , Coleta de Dados , Vacina contra Difteria, Tétano e Coqueluche , Métodos Epidemiológicos , Feminino , Hepatite B/epidemiologia , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Antígenos E da Hepatite B/sangue , Humanos , Programas de Imunização/economia , Programas de Imunização/normas , Esquemas de Imunização , Indonésia/epidemiologia , Lactente , Recém-Nascido , Vacina contra Sarampo , Educação de Pacientes como Assunto , Vacina Antipólio de Vírus Inativado , Prevalência , Organização Mundial da SaúdeRESUMO
OBJECTIVE: Our objective was to examine the association between preterm delivery and bacterial vaginosis in early and late pregnancy. STUDY DESIGN: We evaluated 490 pregnant women at three hospitals in Jakarta, Indonesia, for bacterial vaginosis at 16 to 20 weeks' and 28 to 32 weeks' gestation and observed them through delivery. RESULTS: We found significant associations between preterm delivery (gestational age < 37 weeks) and bacterial vaginosis diagnosed at 16 to 20 weeks' gestation (odds ratio 2.0, 95% confidence interval 1.0 to 3.9) but not with bacterial vaginosis diagnosed at 28 to 32 weeks' gestation (odds ratio 1.5, 95% confidence interval 0.7 to 3.0). The rates of preterm delivery were almost doubled for women who had bacterial vaginosis in early pregnancy (20.5%) as compared with women who had bacterial vaginosis only in late pregnancy (10.7%). CONCLUSION: Only bacterial vaginosis diagnosed early in the second trimester of pregnancy plays a major role as a risk factor for preterm delivery.
