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2.
BMC Infect Dis ; 18(1): 203, 2018 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-29724175

RESUMO

BACKGROUND: The objective of this study was to assess the incidence of Herpes Zoster (HZ) among patients with chronic obstructive pulmonary disease (COPD) and the impact of HZ on the underlying COPD. METHODS: A retrospective cohort of all subjects older than 49 years was followed up between 2009 and 2014 using population and health databases of Valencia Region (Spain). HZ and COPD were identified using ICD-9 codes, differentiating COPD patients with inhaled corticosteroids prescriptions (COPD-ICS). The incidence of HZ was compared among 3 groups [non-COPD, COPD and COPD-ICS populations] and use of healthcare resource due to HZ for 6 months following HZ diagnosis through different statistical generalized linear models (GLM). We also compared resources consumption due to COPD before and after HZ. RESULTS: The cohort consisted of 2,289,485 subjects, including 161,317 COPD patients of which 29,708 were COPD-ICS. HZ incidence rates were 11 (95% confidence interval [CI]: 10.7-11.4) and 13 (95% CI: 12.3-13.8) cases/1000 persons-year for COPD and COPD-ICS populations respectively. Incidence increased with age in all groups. The risk of HZ rose by 45 and 61% among COPD and COPD-ICS patients respectively compared to non-COPD (95% credible intervals [CrI]: 1.41-1.5 and 1.52-1.71 respectively). COPD patients consumed more resources due to their HZ than non-COPD. There was no statistically significant impact of the HZ on the resources consumed due to COPD during the 6 months post-HZ compared to the 6 months pre-HZ. CONCLUSIONS: The presence of COPD increases the risk, severity and impact of zoster episodes.


Assuntos
Herpes Zoster/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/virologia , Corticosteroides/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Custos de Cuidados de Saúde , Herpes Zoster/complicações , Herpes Zoster/tratamento farmacológico , Herpes Zoster/economia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/economia , Estudos Retrospectivos , Espanha/epidemiologia
3.
J Infect ; 77(2): 131-136, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29742472

RESUMO

OBJECTIVES: To estimate the incidence and burden of postherpetic neuralgia (PHN) and to investigate risk factors for PHN in the Valencia Region of Spain. METHODS: Data were extracted from population and healthcare databases from the Valencia Region (2009-2014). Herpes zoster (HZ) and PHN were defined using ICD-9 codes and drug prescriptions in people aged ≥50 years. The risk of HZ patients for developing PHN and potential risk factors (diabetes mellitus, COPD and heart failure) were investigated. A survival analysis was developed to estimate the cumulative hazard of developing HZ and PHN between ages 50-90 years. RESULTS: From a total of 2,289,485 subjects, 87,086 cases of HZ were registered, 13,658 (15.7%) of whom developed PHN. PHN risk was higher in women and increased sharply with age and comorbidities as diabetes mellitus, COPD and heart failure. The cumulative risk of developing HZ between ages 50-90 years was 31.7% (95% CI: 31.3-32.1) and 6.9 (95% CI: 6.7-7.1) for PHN. CONCLUSIONS: PHN risk was higher in women and increased with age and comorbidities. At least 32% and 7% of people will develop HZ and PHN, respectively, between ages 50-90 years. These results should be considered for vaccine policy implementation.


Assuntos
Herpes Zoster/complicações , Neuralgia Pós-Herpética/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Estudos de Coortes , Complicações do Diabetes/complicações , Feminino , Insuficiência Cardíaca/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/complicações , Fatores de Risco , Fatores Sexuais , Espanha/epidemiologia
4.
Hum Vaccin Immunother ; 14(6): 1534-1538, 2018 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-29393748

RESUMO

INTRODUCTION: Up to date the impact of rotavirus (RV) vaccines on seizures has been poorly evaluated, with some studies but not all, showing different degrees of protection. OBJECTIVES: To assess the impact of RV vaccines on convulsions-related hospitalizations among children under 5 years of age residing in the Region of Valencia, Spain. METHODS: A population-based, ecological study using the hospital discharge record (MBDS), the population-based administrative database (SIP) and the vaccine register (SIV), among Valencia Region's children <5 years old, during 2003 - 2015. Impact of vaccination on seizures-related hospitalization rates (780.3* ICD-9-MC code) was estimated by a multivariate Bayesian mixed Poisson regression model. RESULTS: Since RV vaccines licensure in 2007, its coverage rate increased up to around 42%. When the impact of vaccination against seizures was controlled for potential confounders in the multivariate analysis, there was a non-statistically significant protective effect. CONCLUSIONS: We could not find any impact of RV vaccine coverage on seizure-related hospitalizations in children <5 years.


Assuntos
Hospitalização , Infecções por Rotavirus/complicações , Vacinas contra Rotavirus/administração & dosagem , Convulsões/epidemiologia , Convulsões/prevenção & controle , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Espanha/epidemiologia
5.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 36(1): 9-15, ene. 2018. ^graf, tab
Artigo em Espanhol | IBECS | ID: ibc-170108

RESUMO

Introducción: La transmisión vertical (TV) es relevante en la epidemiología global del virus de la inmunodeficiencia humana (VIH), representando la principal vía de infección en la edad pediátrica. Los objetivos del estudio fueron determinar la tasa de TV del VIH y su tendencia epidemiológica entre la población autóctona e inmigrante en Catalunya entre 2000-2014. Métodos: Estudio observacional prospectivo de parejas madre-hijo expuestas al VIH atendidas en 12 hospitales de Catalunya en 2000-2014. Se estimó la tasa de TV del VIH aplicando un modelo bayesiano de regresión logística. Se utilizó el software estadístico R y WinBUGS. Resultados: Se analizaron 909 gestantes, 1.009 embarazos y 1.032 niños; datos de origen materno en el 79,4% de las mujeres, el 32,7% inmigrantes y de estas el 53,0% de África subsahariana. La tasa de TV del VIH fue del 1,4% (14/1.023; IC95% 0,8-2,3). El riesgo de TV del VIH fue 10 veces menor en mujeres con buen control virológico (p=0,01), al que llegaron 2 tercios de ellas. No hubo diferencias en la tasa de TV del VIH entre mujeres autóctonas e inmigrantes (p=0,6). La proporción de mujeres inmigrantes fue significativamente mayor en el período 2008-2014 (p<0,0001), en relación con el diagnóstico de la infección por VIH (p<0,0001) y la administración de antirretrovirales (p=0,02) durante el embarazo, y con la viremia indetectable próxima al parto (p<0,001). Conclusiones: Existe un aumento progresivo de gestantes inmigrantes con VIH en Catalunya. Aun siendo la mayoría diagnosticadas durante el embarazo, la tasa de TV del VIH no fue diferente a la hallada en las mujeres autóctonas (AU)


Introduction: Mother-to-child transmission (MTCT) is relevant in the global epidemiology of human-immunodeficiency virus (HIV), as it represents the main route of infection in children. The study objectives were to determine the rate of HIV-MTCT and its epidemiological trend between the Spanish-born and immigrant population in Catalonia in the period 2000-2014. Methods: A prospective observational study of mother-child pairs exposed to HIV, treated in 12 hospitals in Catalonia in the period 2000-2014. HIV-MTCT rate was estimated using a Bayesian logistic regression model. R and WinBUGS statistical software were used. Results: The analysis included 909 pregnant women, 1,009 pregnancies, and 1,032 children. Data on maternal origin was obtained in 79.4% of women, of whom 32.7% were immigrants, with 53.0% of these from sub-Saharan Africa. The overall HIV-MTCT rate was 1.4% (14/1,023; 95% CI; 0.8-2.3). The risk of MTCT-HIV was 10-fold lower in women with good virological control (P=.01), which was achieved by two-thirds of them. The proportion of immigrants was significantly higher in the period 2008-2014 (P<.0001), for the HIV-diagnosis (P<.0001), and antiretroviral administration (P=.02) during pregnancy, and for undetectable viral load next to delivery (P<.001). There were no differences in the rate of MTCT-HIV among Spanish-born and immigrant women (P=.6). Conclusions: There is a gradual increase in HIV pregnant immigrants in Catalonia. Although most immigrant women were diagnosed during pregnancy, the rate of MTCT-HIV was no different from the Spanish-born women (AU)


Assuntos
Humanos , Masculino , Feminino , Gravidez , Síndrome de Imunodeficiência Adquirida/epidemiologia , HIV/isolamento & purificação , Emigrantes e Imigrantes/estatística & dados numéricos , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Complicações na Gravidez/epidemiologia , Síndrome de Imunodeficiência Adquirida/microbiologia , Estudos Prospectivos , Estudos de Coortes , Teorema de Bayes , Complicações na Gravidez/microbiologia
6.
Hum Vaccin Immunother ; 14(4): 906-908, 2018 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-29244612

RESUMO

The objective of the study was to evaluate the role of age and sex and their combined effect in the development of post-herpetic neuralgia (PHN) in a large population-based study, in order to confirm the results published previously by Amicizia et al. Data were extracted from population and healthcare databases from the Valencia Region (2009-2014). Logistic regressions were implemented to estimate the effect of increasing age on the probability of developing PHN stratified by sex. From a cohort of 2,289,485 subjects ≥ 50 years, 87,086 cases of HZ were registered and 13,658 (15.7%) of them developed PHN. In our population, PHN cases were more common in women and rose with increasing age independently of the sex.


Assuntos
Herpes Zoster , Neuralgia Pós-Herpética , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Projetos de Pesquisa
7.
Enferm Infecc Microbiol Clin ; 36(1): 9-15, 2018 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27609632

RESUMO

INTRODUCTION: Mother-to-child transmission (MTCT) is relevant in the global epidemiology of human-immunodeficiency virus (HIV), as it represents the main route of infection in children. The study objectives were to determine the rate of HIV-MTCT and its epidemiological trend between the Spanish-born and immigrant population in Catalonia in the period 2000-2014. METHODS: A prospective observational study of mother-child pairs exposed to HIV, treated in 12 hospitals in Catalonia in the period 2000-2014. HIV-MTCT rate was estimated using a Bayesian logistic regression model. R and WinBUGS statistical software were used. RESULTS: The analysis included 909 pregnant women, 1,009 pregnancies, and 1,032 children. Data on maternal origin was obtained in 79.4% of women, of whom 32.7% were immigrants, with 53.0% of these from sub-Saharan Africa. The overall HIV-MTCT rate was 1.4% (14/1,023; 95% CI; 0.8-2.3). The risk of MTCT-HIV was 10-fold lower in women with good virological control (P=.01), which was achieved by two-thirds of them. The proportion of immigrants was significantly higher in the period 2008-2014 (P<.0001), for the HIV-diagnosis (P<.0001), and antiretroviral administration (P=.02) during pregnancy, and for undetectable viral load next to delivery (P<.001). There were no differences in the rate of MTCT-HIV among Spanish-born and immigrant women (P=.6). CONCLUSIONS: There is a gradual increase in HIV pregnant immigrants in Catalonia. Although most immigrant women were diagnosed during pregnancy, the rate of MTCT-HIV was no different from the Spanish-born women.


Assuntos
Emigrantes e Imigrantes , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Criança , Feminino , Humanos , Gravidez , Estudos Prospectivos , Espanha/epidemiologia , Fatores de Tempo
8.
Hum Vaccin Immunother ; 13(11): 2606-2611, 2017 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-28933622

RESUMO

AIMS: This study was designed to assess the impact of diabetes on the risk and severity of herpes zoster (HZ), and the impact of HZ on diabetes. It focused primarily on immunocompetent patients aged ≥ 50 years who would be eligible for preventive vaccination. METHODS: Using population and healthcare databases of Valencia Region (Spain), a retrospective cohort of all subjects ≥ 50 years was followed up between 2009 and 2014. HZ and diabetes were defined using ICD-9 codes. We compared the incidence of HZ between non-diabetes and diabetes groups and healthcare resource consumption due to HZ in the 6 months following HZ diagnosis using different statistical generalized linear models (GLM). We also compared resources consumption due to diabetes treatment and haemoglobinA1c(HbA1c) levels before and after HZ. RESULTS: The cohort consisted of 2,289,485 individuals ≥ 50 years old, 397,940 of whom had diabetes. HZ incidence rate was 9.3 cases/1000 persons with diabetes-year (95% CI: 9.1-9.4). Incidence increased with age in all groups. The risk of HZ increased in the diabetes group compared to the non-diabetes group (RR 1.2, 95% credibility interval [CrI] 1.17-1.22). Patients with diabetes utilized more health care resources due to their HZ episodes than patients without diabetes. In 24% of well controlled patients with diabetes (HbA1C levels ≤ 6.5%), HbA1C increased after HZ. CONCLUSIONS: Diabetes increased by 20% the risk of HZ. HZ contributed to the deterioration of glycaemic control and higher healthcare resource consumption in people with diabetes, becoming a priority population for HZ immunization.


Assuntos
Complicações do Diabetes/virologia , Diabetes Mellitus/virologia , Herpes Zoster/epidemiologia , Vigilância da População , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Diabetes Mellitus/epidemiologia , Feminino , Herpes Zoster/virologia , Herpesvirus Humano 3/isolamento & purificação , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neuralgia Pós-Herpética/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Espanha/epidemiologia , Vacinação
9.
Vaccine ; 35(25): 3342-3346, 2017 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-28499554

RESUMO

OBJECTIVES: To assess the effectiveness of the HPV vaccines in preventing genital warts in young women. DESIGN: Population-based study using health databases. SETTING: Valencian Community (Spain). PARTICIPANTS: All girls and women aged 14-19years who were registered in the Valencian Community between January 2009 and December 2014 (n=279,787). MAIN OUTCOME MEASURES: Incident cases of genital warts were defined as the first activation of diagnosis code ICD-9-CM 078.11 (Condyloma acuminatum) in primary care and outpatient clinics during the study period. RESULTS: There were 612 cases of genital warts. The overall incidence rate was 75.8/100,000 person-years (95% CrI 69.7-81.8). There was a decrease in genital warts when female candidates to be vaccinated with quadrivalent HPV vaccine reached the age of 18 (in 2012), compared to previous years. Incidence of genital warts in unvaccinated women and those who received the bivalent vaccine was higher than in girls and women who received the quadrivalent HPV vaccine. The effectiveness of a three-dose regimen of the quadrivalent HPV vaccine was 77% (95 CrI: 66-85%), whereas that of a single dose was 61% (95 CrI: 20-87%). No effectiveness was seen with a full vaccination course with the bivalent HPV vaccine. CONCLUSIONS: Three doses of the quadrivalent HPV vaccine were effective against genital warts in our population. Moreover, with low vaccine coverage the incidence of genital warts decreased only in the vaccinated.


Assuntos
Condiloma Acuminado/prevenção & controle , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Adolescente , Condiloma Acuminado/virologia , Feminino , Humanos , Esquemas de Imunização , Incidência , Papillomaviridae/isolamento & purificação , Papillomaviridae/fisiologia , Infecções por Papillomavirus/epidemiologia , Espanha/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Vacinação , Potência de Vacina , Adulto Jovem
10.
BMC Infect Dis ; 17(1): 267, 2017 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-28399824

RESUMO

BACKGROUND: Rotavirus vaccines are available in Spain from 2007. They are recommended by the Spanish Pediatric Association, but not funded by the National Health System (NHS) and its coverage rate reached 40-50%. The hospitalization rate reduction of rotavirus caused gastroenteritis (RVAGE) directly attributable to vaccination remains unclear due to the large differences described in published studies, ranging from 14 to 44.5% in children <5 years of age, even with similar vaccination coverage. These results could be partly explained by variability in hospitalization policies, different study designs and the timeframe of observation. In addition, the direct economic impact of the reduction of hospitalizations has never been estimated. Therefore, there is a need to analyze the long-term impact of rotavirus vaccines on RVAGE and all cause gastroenteritis (AGE) hospitalizations and the national health system associated costs, minimizing potential confounders or biases. METHODS: A population-based, ecological study using the hospital discharge registry's Minimum Basic Data Set (MBDS) and the vaccine register (SIV) was performed, among Valencia Region's children <5 years old, during 2002 - 2015. RVAGE and AGE hospitalization risk was analyzed by vaccine coverage and adjusted by the total hospitalization rate for all causes to avoid external biases. The impact of AGE-associated health care utilization in prevaccine (2003-2006) versus postvaccine (2008-2014) years was also assessed. RESULTS: After vaccines licensure, the incidence of RVAGE-associated hospitalizations decreased markedly. A general vaccine coverage-related reduction in RVAGE or AGE-hospitalizations risk was observed in all age groups. Compared with unvaccinated children, RVAGE hospitalization risk decreased by 67% (95% CI: 55-67), 71% (95% CI: 58-81) and 68% (95% CI: 18-92) in children 0, 1 and 4 years of age, respectively, with a vaccination coverage between 40 and 42%. Overall, the hospital related costs were reduced around EUR 6 Mill per 105 children in 7 years. CONCLUSIONS: Despite the low-medium vaccine coverage, the introduction of rotavirus vaccines had a specific coverage-related response impact in the hospitalizations for RVAGE and AGE in children <5 years and their use substantially reduced hospital related costs. The model used reassures that the estimated impact is due to the vaccination and not to other external factors.


Assuntos
Gastroenterite/virologia , Hospitalização , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus/administração & dosagem , Criança , Pré-Escolar , Feminino , Gastroenterite/economia , Gastroenterite/epidemiologia , Gastroenterite/prevenção & controle , Custos Hospitalares , Hospitalização/economia , Humanos , Incidência , Lactente , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Alta do Paciente , Sistema de Registros , Rotavirus/imunologia , Infecções por Rotavirus/economia , Infecções por Rotavirus/epidemiologia , Vacinas contra Rotavirus/economia , Vacinas contra Rotavirus/imunologia , Espanha/epidemiologia
11.
Vaccine ; 34(48): 5912-5915, 2016 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-27789146

RESUMO

Immunochromatography (ICG) is highly used in clinical settings for rotavirus (RV) diagnosis. The specificity of the tests differs by brand type and is not 100%, therefore its use when the prevalence of the disease is low (i.e. in vaccinated children) may result in a proportion of false positive diagnoses. In some areas, vaccine effectiveness studies or surveillance is done using ICG. Our objective was to estimate the validity of ICG test in vaccinated children, and estimate the number of false positive results in the Valencian Region of Spain, where all RV infections are diagnosed using ICG and are not confirmed by PCR. Population based registries were used to identify all results from the RV antigen tests performed between January 2008 and June 2012 in children under 37months. Hospitalization and vaccination status of the patients were obtained by linking different databases through a unique identification number. The Positive Predictive Value of the ICG test depending on the vaccination status of the child, hospitalization and the rotavirus season was estimated by a Bayesian model of latent classes. Of the 48,833 tests with valid results, 9429 were done in vaccinated children, and of those 3963 (42%) during the rotavirus season. The prevalence of positive results in vaccinated varied from 2.9 to 21.4% of the tests depending on the hospitalization and seasonality. The estimated PPV also varied from 27.1 to 84.6% when stratified by these two parameters. Globally it is calculated that approximately 267 out of the 520 (51.3%) positives in vaccinated children were false positive tests. The large percentage of false positives, due to an excessive number of tests in vaccinated and out of the RV season, if interpreted as vaccine failures, can cause a loss of confidence in the vaccine and lower the estimates of vaccine effectiveness.


Assuntos
Imunogenicidade da Vacina , Infecções por Rotavirus/diagnóstico , Vacinas contra Rotavirus/imunologia , Teorema de Bayes , Pré-Escolar , Cromatografia de Afinidade , Erros de Diagnóstico/prevenção & controle , Reações Falso-Positivas , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Masculino , Valor Preditivo dos Testes , Sistema de Registros , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus/administração & dosagem , Espanha/epidemiologia , Vacinação , Vacinas Atenuadas/administração & dosagem , Vacinas Atenuadas/imunologia
12.
Pediatr Infect Dis J ; 35(3): 275-80, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26658376

RESUMO

BACKGROUND: There is a lack of European epidemiologic population-based studies on bronchiolitis and respiratory syncytial virus (RSV) bronchiolitis including both hospitalizations and primary care attendance. METHODS: A retrospective cohort of all children born between 2009 and 2012 was followed from birth to 2 years of age using population and health databases. We searched for global bronchiolitis (International Classification of Diseases, 9th revision, Clinical Modification codes 466.1, 466.11 and 466.19) and RSV bronchiolitis (code 466.11 and code 466.19 with positive RSV test) in the first appearance either in primary care or in hospitalization databases. A preterm subcohort (International Classification of Diseases, 9th revision, Clinical Modification codes 765) was also analyzed. RESULTS: The cohort consisted of 198,223 children of whom 41,479 were diagnosed of bronchiolitis (incidence rate 16.4/100 children <2 years per year). Of those, 5390 were hospitalized with the majority of hospitalizations occurring at <6 months of age (incidence rate of 5.2/100 children <6 months per year) and 3106 of the hospitalizations were RSV positive (incidence rate 3.2/100 children <6 months per year). RSV hospitalizations were 26% longer than non-RSV. In preterm infants, hospitalization incidence was more than double, and the mean length of hospitalization was 29% longer. CONCLUSIONS: Most (87%) bronchiolitis cases are managed in primary care offices. Approximately 2 out of every 10 children <2 are diagnosed of bronchiolitis, 3 out of every 100 are hospitalized and 1.6 out of every 100 are hospitalized with RSV bronchiolitis in our cohort. Infants between 2 and 10 weeks constitute a risk group for severe bronchiolitis.


Assuntos
Bronquiolite/epidemiologia , Vigilância da População , Bronquiolite/diagnóstico , Bronquiolite/etiologia , Bronquiolite/mortalidade , Estudos de Coortes , Feminino , Hospitalização , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Fatores Socioeconômicos , Espanha/epidemiologia
13.
BMC Infect Dis ; 15: 92, 2015 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-25872565

RESUMO

BACKGROUND: Although rotavirus vaccines have been licensed in Spain for over 8 years, they are not funded by its public health systems. The analysis of their effectiveness in the Valencia Region could better inform decisions about potential inclusion in the official immunization schedule. Our aim was to assess the effectiveness of Rotarix® (RV1) and RotaTeq® (RV5) against rotavirus hospitalizations. METHODS: We conducted a retrospective cohort study using the region's health care databases, among resident children aged <3 years covered by the National Health System, during January 2007-June 2012. We compared two cohorts of vaccinated children: the first included children who received at least one dose of a rotavirus vaccine, and the second included children who were not vaccinated with rotavirus vaccines but received at least one dose of a pneumococcal vaccine, another licensed but non-funded vaccine. The main outcome was rotavirus hospitalization, either laboratory-confirmed (confirmed) or codified as rotavirus (probable). Rotavirus vaccine effectiveness (RVE) by vaccine brand was assessed using Cox proportional hazards models. RESULTS: The study included 78,281 rotavirus and 96,643 pneumococcal vaccinees. Adjusted RVE against probable or confirmed rotavirus hospitalizations was 86% (95% CI: 78-91%) and 88% (95% CI: 81-92%) for a complete series of RV1 and RV5 respectively. CONCLUSIONS: Both rotavirus vaccines were over 85% effective against rotavirus hospitalization among young children. The high effectiveness shown argues in favor of their inclusion in the official schedule. Additional information on rotavirus vaccine safety, duration of protection, and benefit-risk will also be needed to inform such deliberations.


Assuntos
Hospitalização/estatística & dados numéricos , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus/uso terapêutico , Estudos de Casos e Controles , Pré-Escolar , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Esquemas de Imunização , Lactente , Masculino , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/uso terapêutico , Estudos Retrospectivos , Medição de Risco , Vacinas contra Rotavirus/economia , Espanha , Resultado do Tratamento , Vacinas Atenuadas/economia , Vacinas Atenuadas/uso terapêutico
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