Variations in estimates of Guatemalan infant mortality, vaccination coverage, and ORS use reported by different resources

All available estimates of rates of infant mortality, vaccination coverage (for BCG, DPT 3, polio 3, measles, and tetanus toxoid), and ORS use in Guatemala in the 1980s were identified and investigated. A large number of sources and estimates were found. Large discrepancies were also found between the estimates for a given indicator, even when the estimates were reported for the same year by the same source. For instance, reports for 1985 yielded 10 different infant mortality estimates ranging from 56.0 to 79.8 deaths per 1 000 live births; vaccination coverage estimates ranging from 30 percent to 60.5 percent for BCG, 3.5 percent to 34.2 percent for DPT 3,3.5 percent for polio 3,11 percent to 58.2 percent for measles, and 1 percent to 8.2 percent for tetanus toxoid; and estimated use rates of oral rehydration solution ranging from 3.5 percent to 7.2 percent. In this same vein, three Guatemalan Ministry of Health estimates of infant deaths per 1 000 live births in 1984 ranged from 52.4 to 79.8; four UNICEF estimates for 1985 ranged from 65 to 79.8; and three USAID estimates for 1987 ranged from 58 to 72. The many reasons found for this diversity point to significant problems influencing the reliability of current data

Calendarios de vacunación antisarampionosa en dos dosis / Two-dose measles vaccination schedules

Como el sarampión sigue cobrando la vida de un elevado número de niños, sobre todo en los países en desarrollo, actualmente se debaten las estrategias óptimas para el control de dicha enfermedad. Como parte de ese debate, se examina la posibilidad de seguir planes de inmunización antisarampionosa en dos dosis para poder ejercer un mejor control. Hasta la fecha, la OMS no los ha recomendado. Varios países industrializados ya han adoptado un calendario de vacunación en dos dosis y a menudo administran la vacuna antisarampionosa en la misma inyección que las vacunas contra la parotiditis y la rubéola. Sin embargo, los conocimientos actuales sobre esos calendarios en los países en desarrollo no permiten formular todavía recomendaciones generales. Las investigaciones futuras deben incluir ensayos aleatorios controlados de esquemas de inmunización temprana en dos dosis para investigar varios aspectos técnicos y epidemiológicos, como el efecto de la reducción de la inmunidad y la duración de los anticuerpos. La inocuidad a largo plazo ha de determinarse con estudios suficientemente amplios. Se insta a los programas con calendarios de vacunación en dos dosis a evaluar sus efectos en la incidencia de la enfermedad, el costo, el uso de vacunas y la cobertura. Hasta que concluya una evaluación más detallada, en todos los programas de inmunización de las diversas regiones deberá darse máxima prioridad a la cobertura amplia y oportuna con una dosis de la vacuna antisarampionosa

Impact of measles vaccination on childhood mortality in rural Bangladesh

This study examines the impact of measles vaccination on childhood mortality, based on longitudinal data from the Matlab maternal and child health/family planning programme in rural Bangladesh. It analyses the mortality experience of 8135 vaccinated and 8135 randomly matched nonvaccinated children aged 9-60 months, who were observed from March 1982 to October 1985. The results indicate that measles vaccination had a pronounced impact on both short- and long-term survival--the mortality rates from vaccinated children were as much as 46 percent less than those for nonvaccinated children. Immunization of children aged up to 3 years with measles vaccine appears to improve significantly their subsequent chances of survival. The findings underscore the need to give greater priority to measles vaccination within primary health care programmes in settings such as rural Bangladesh

Measles immunization research: a review

Most global estimates indicate that more than 1 million children a year die from acute measles. The actual number of deaths may, however, be considerably higher than this. In addition, the impact of delayed mortality as a result of measles infection is only now being realized. Many months after they contract measles, children continue to experience higher levels of mortality and morbidity than those who do not. Immunization of children against measles therefore prevents mortality and morbidity not only during the acute phase but also during subsequent months. The impact of measles immunization programmes may therefore have generally been underestimated. The effects of measles infection on children during the early months of life are more damaging than those experienced by older children. Children should therefore be immunized against measles as early in life as possible, given the limitations of existing vaccines (Au)

Measles immunization research: A review

Most global estimates indicate that more than 1 million children a year die from acute measles. The actual number of deaths may, however, be considerably higher than this. In addition, the impact of delayed mortality as a result of measles infection is only now being realized. Many months after they contract meases, children continue to experience higher levels of mortality and morbidity than those who do not

Immunization of children against measles therefore prevents mortality and morbidity not only during the acute phase but also during subsequent months. The impact of measles immunization programmes may therefore have generally been underestimated

The effects of measles infection on children during the early months of life are more damaging than those experienced by older children. Children should therefore be immunized against measles as early in life as possible, given the limitations of existing vaccines(AU)

Measles vaccination

Prevention of measles poses different problems in developed and developing countries. In developed countries the risk of late complications following the use of live vaccine should be further evaluated; additional attempst might also be made to create new types of inactivated vaccine. In developing countries the introduction of live measles vaccine should be given high priority. The main problems in developing areas appear to be ones relating to vaccine stability, distribution, and cost (Au)

Evaluación de la vacuna combinada attenuvax-viruela en Chile / Evaluation of combined attenuvax-smallpox vaccine in Chile

Reactions to combined attenuvax-smallpox vaccine were studied, and were compared with those produced by each type of vaccine separately, in children from one to five years of age, controlled by maternal-child care centers under the National Health Service in Santiago, Chile. Combined freeze-dried and preblended attenuvax-smallpox vaccine and freeze-dried "Dryvax" smallpox vaccine were used. The combined vaccine was jet-injected, while the measles vaccine was administered in the form of subcutaneous injections, and the smallpox vaccine by the multipuncture technique

The new preblended and combined attenuvax-smallpox vaccine administered by jet injection produces general clinical reactions similar to or milder than those caused by each vaccine when administered separately

"Takes" were recorded in 96.9 per cent of children inoculated with the combined vaccine, which is an excellent result

To judge from the rise in titers in serological tests counts for both viruses in the cases inoculated, there was no evidence of interference between antigens. The conversion rate for each virus closely resembled that obtained when each vaccine was administered separately, and the geometric mean of the hemoagglutination inhibition titers was also very similar for the combined vaccine and for each vaccine administered separately

Revaccination against smallpox in children inoculated two months earlier with the ... (AU)