Vacinação contra rubéola em mulheres em idade reprodutiva no Município de Campinas, São Paulo, Brasil / Rubella vaccination in women of childbearing age in Campinas, São Paulo State, Brazil / Vacunación contra la rubeola de mujeres en edad reproductiva en el municipio de Campinas, São Paulo, Brasil

As mulheres em idade reprodutiva são a população de maior interesse para a prevenção da síndrome da rubéola congênita. O objetivo do trabalho foi avaliar a prevalência de vacinação contra rubéola em mulheres e identificar fatores associados e motivos da não adesão. Trata-se de estudo transversal de base populacional, realizado em Campinas, São Paulo, Brasil, em 2008/2009, com amostra por conglomerados e em dois estágios. Das 778 mulheres de 10 a 49 anos, 83,8% (IC95%: 79,6-88,0) referiram vacinação em algum momento da vida. Faixa etária (30-39 anos), renda familiar per capita superior a três salários mínimos e a orientação de profissional de saúde estiveram positivamente associadas à vacinação contra a rubéola. Os principais motivos da não adesão foram a falta de orientação do profissional de saúde sobre sua importância (48,5%) e não considerá-la necessária (18,9%). A recomendação do profissional de saúde foi o fator mais fortemente associado à adesão das mulheres à vacinação. Nesse sentido, sua indicação pelas equipes de saúde pode ampliar o conhecimento sobre sua importância e seus benefícios.

Women of reproductive age are the population of greatest interest for the prevention of congenital rubella syndrome. The aim of this study was to evaluate the prevalence of rubella vaccination in women and to identify factors associated and motives for non-adherence. A cross-sectional population-based study, in Campinas, São Paulo State, Brazil, in 2008/2009, was carried out with stratified random, two-stage cluster sampling. Of the 778 women aged 10 to 49 years, 83.8% (95%CI: 79.6-88.0) reported vaccination in life. Age group (20-39 years), per capita household income greater than 3 times the minimum wage and orientation of health care professionals about the vaccine, were positively associated with rubella vaccination. The main motives for non-adherence were lack of orientation of professionals about their importance (48.5%) and not consider it necessary (18.9%). The recommendation of professionals was the factor most strongly associated with women's adherence to vaccination. In this sense, an indication of vaccination by health care teams can increase the knowledge about the importance their and benefits.

Las mujeres en edad reproductiva son la población de mayor interés para la prevención del síndrome de la rubeola congénita. El objetivo del trabajo fue evaluar la prevalencia de vacunación contra la rubeola en mujeres e identificar factores asociados y motivos de la no adhesión al programa de vacunación. Se trata de un estudio transversal de base poblacional, realizado en Campinas, São Paulo, Brasil, en 2008/2009, con una muestra por conglomerados y en dos fases. De las 778 mujeres, de 10 a 49 años, un 83,8% (IC95%: 79,6-88,0) informaron de vacunación en algún momento de la vida. La franja de edad (30-39 años), renta familiar per cápita superior a tres salarios mínimos y la orientación de un profesional de salud estuvieron positivamente asociadas a la vacunación contra la rubeola. Los principales motivos de la no adhesión fueron la falta de orientación del profesional de salud sobre su importancia (48,5%) y no considerarla necesaria (18,9%). La recomendación del profesional de salud fue el factor más fuertemente asociado a la adhesión de las mujeres a la vacunación. En este sentido, su indicación por los equipos de salud puede ampliar el conocimiento sobre su importancia y sus beneficios.

Pediatric hospital admissions from influenza A (H1N1) in Brazil: effects of the 2010 vaccination campaign

lIn 2009, the influenza A (H1N1) virus spread rapidly around the world, causing the first pandemic of the 21st Century. In 2010, there was a vaccination campaign against this new virus subtype to reduce the morbidity and mortality of the disease in some countries, including Brazil. Herein, we describe the clinical and epidemiological characteristics of patients under 19 years of age who were hospitalized with confirmed influenza A (H1N1) infection in 2009 and 2010. We retrospectively reviewed files from the pediatric patients who were admitted to a university hospital with real-time polymerase chain reaction (RT-PCR) confirmed influenza A (H1N1) infection in 2009 and 2010. There were 37 hospitalized patients with influenza A (H1N1) in 2009 and 2 in 2010. In 2009, many of the hospitalized children had an underlying chronic disease and a lower median age than those not hospitalized. Of the hospitalized patients, 78% had a chronic disease, primarily pneumopathy (48%). The main signs and symptoms of influenza were fever (97%), cough (76%), and dyspnea (59%). Complications occurred in 81% of the patients. The median length of hospitalization was five days; 27% of the patients required intensive care, and two died. In 2010, two patients were hospitalized with influenza A (H1N1): one infant with adenovirus co-infection who had received one previous H1N1 vaccine dose and presented with respiratory sequelae and a 2-month-old infant who had a hospital-acquired infection. An impressive reduction in hospital admissions was observed in 2010 when the vaccination campaign took place in Brazil.

Fatores relacionados à vacinação contra a gripe em idosos: estudo transversal, Cambé, Paraná, Brasil / Factors associated with influenza vaccination among the elderly: a cross-sectional study in Cambé, Paraná State, Brazil

Este trabalho teve como objetivo verificar a cobertura vacinal contra a gripe em idosos e a associação entre a vacinação e variáveis socioeconômicas, demográficas, de saúde e estilo de vida. Estudo de natureza epidemiológico-descritiva, transversal, realizado de abril de 2008 a setembro de 2009, com 990 idosos do Município de Cambé, Paraná, Brasil. A cobertura vacinal foi de 74,6%. A maior taxa de adesão foi entre os indivíduos com idades de 70-79 anos [razão de prevalência ajustada (RP) = 1,05] e 80 anos ou mais (RP = 1,03), hipertensos, e com renda mensal de até 3 salários mínimos (RP = 1,10) ou superior (RP = 1,17) comparados aos idosos sem renda. Idosos sedentários (RP = 0,96) aderiram menos à vacinação, e divorciados/separados (RP = 0,92) apresentaram menor adesão comparados aos casados. Os resultados sugerem a necessidade de estratégias de atenção à saúde, considerando os fatores que interferem na adesão voluntária à vacinação, contribuindo para aumentar as chances de sucesso dos programas de imunização.

The aim of this study was to assess influenza immunization coverage in the elderly and the association between vaccination and socioeconomic, demographic, health, and lifestyle variables, using a descriptive cross-sectional epidemiological approach from April 2008 to September 2009 with 990 elderly in Cambé, Paraná State, Brazil. Vaccination coverage was 74.6%. The highest vaccination rate was among individuals 70 to 79 years of age [adjusted prevalence ratio (PR) = 1.05] and 80 or older (PR = 1.03), with hypertension, and with monthly income up to 3 times the minimum wage (PR = 1.10) or higher (PR = 1.17) compared to elderly without income. Sedentary elderly (PR = 0.96) adhered less to vaccination, and divorced/separated individuals (PR = 0.92) had lower adherence compared to the married. The results suggest the need for healthcare strategies considering the factors that affect voluntary vaccination in order to help increase the odds of success for immunization programs.

Survey of rubella knowledge and acceptability of rubella vaccination among Brazilian adults prior to mass vaccination / Encuesta sobre el conocimiento de la rubéola y la aceptabilidad de la vacunación antirrubeólica en los adultos brasileños antes de una campaña de vacunación masiva

OBJECTIVE: Evaluate knowledge of rubella and acceptability of vaccination and identify sources of health information among brazilian adults to inform communication strategies for a national vaccination campaign to eliminate rubella and congenital rubella syndrome (CRS). METHODS: From 5-8 July 2008 a qualitative telephone survey was conducted among a nonprobabilistic sample of brazilian adults 18 to 65 years of age (n = 1 023) from all five geographic regions of Brazil to measure knowledge of rubella and willingness to receive the vaccine and to identify sources of health information. Frequencies of responses were stratified by respondents' sex, age, education, and income. RESULTS: Although 69.9 percent of respondents said they knew what rubella was, actual knowledge of the disease was limited, with only 29.9 percent answering affirmatively when asked if they would recognize symptoms of rubella infection. Self-reported knowledge increased with increasing age, education, and income, and was higher among women than men. A total of 94.5 percent of the respondents expressed willingness to be vaccinated for rubella elimination. The most frequently mentioned sources of health information were television and doctors. CONCLUSIONS: Despite limited knowledge of rubella, brazilian adults expressed willingness to be vaccinated for disease elimination.

OBJETIVO: Evaluar el conocimiento de la rubéola y la aceptabilidad de la vacunación antirrubeólica, y determinar las fuentes de información sanitaria en los adultos brasileños, con objeto de fundamentar las estrategias de comunicación de una campaña nacional de vacunación dirigida a eliminar la rubéola y el síndrome de rubéola congénita (SRC). MÉTODOS: Del 5 al 8 de julio del 2008 se llevó a cabo una encuesta telefónica cualitativa en una muestra no probabilística de adultos brasileños de 18 a 65 años de edad (n = 1 023) de las cinco regiones geográficas del Brasil, con objeto de evaluar el conocimiento de la rubéola y la disposición a recibir la vacuna antirrubeólica, y determinar las fuentes de información sanitaria. Las frecuencias de las respuestas se estratificaron según el sexo, la edad, el nivel educativo y los ingresos de los entrevistados RESULTADOS: Aunque 69,9 por ciento de los entrevistados dijeron que sabían lo que era la rubéola, el conocimiento real de la enfermedad era limitado, ya que solo 29,9 por ciento respondieron afirmativamente cuando se les preguntó si reconocerían los síntomas de esta infección. El grado de conocimiento notificado por los propios entrevistados aumentó con la edad, el nivel educativo y los ingresos, y fue mayor en las mujeres que en los hombres. El 94,5 por ciento de los entrevistados expresaron su disposición a vacunarse con objeto de eliminar la rubéola. Las fuentes de información sanitaria mencionadas con mayor frecuencia fueron la televisión y los médicos. CONCLUSIONES: A pesar de tener un conocimiento limitado de la rubéola, los adultos brasileños expresaron su disposición a vacunarse con objeto de eliminar la enfermedad.