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      Prevalence of influenza and adherence to the anti-flu vaccination among elderly Translated title: Prevalência de gripe e aderência à vacinação anti-influenza entre idosos

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          Abstract

          INTRODUCTION: The flu, a condition that can affect the elderly by increasing the risk of serious complications can be prevented through vaccination. Estimate the prevalence of signs and symptoms suggestive of influenza in a group of elderly either vaccinated or unvaccinated against influenza was the objective this study. METHODS: This is a cross-sectional study performed in a Brazilian City. A structured questionnaire was employed to identify the presence of signs and symptoms of influenza in individuals aged 60 years or over. For analysis of associations between variables the prevalence ratio (PR) and its 95% confidence interval (95% CI) were used. RESULTS: One hundred ninety-six participants were interviewed, of whom 57.7% were female. The average age was 69.7 years. About 25% of the vaccinated and 20% of the unvaccinated in 2009, and 25% of the vaccinated and 22.5% of the unvaccinated in 2010 reported having the flu. Among the vaccinated and unvaccinated in 2009 and 2010, there was no verified association between vaccination and influenza (PR=1.24; [95% CI: 0.63-2.43] and PR=1.11; [95% CI: 0.59-2.09], respectively). CONCLUSIONS: This study suggests that, among the elderly selected, the vaccination coverage for influenza is below the ideal, even with projection of the best indices for 2011 (~ 84%). The data on vaccination and disease protection needs further research; however, the results point to the need for measures to better clarify to this population about the disease, its complications and the benefits of vaccination, in addition to combatting the stigma related to low adherence.

          Translated abstract

          INTRODUÇÃO: A gripe, condição que pode afetar a saúde dos idosos aumentando o risco de complicações graves pode ser prevenida por meio de vacina. O objetivo deste estudo foi estimar a prevalência de sinais e sintomas sugestivos de gripe em um grupo de idosos vacinados e não vacinados contra influenza. MÉTODOS: Estudo transversal realizado em uma cidade brasileira. Usou-se questionário estruturado para identificar presença de sinais e sintomas de gripe em indivíduos com idade igual ou maior de 60 anos. Para análise de associação entre variáveis empregou-se a razão de prevalência e seu intervalo de confiança a 95%. RESULTADOS: Dos 196 participantes, 57,7% eram do sexo feminino e a média de idade foi 69,7 anos. Aproximadamente, 25% dos vacinados e 20% dos não vacinados em 2009 e 25% dos vacinados e 22,5% dos não vacinados em 2010, relataram sinais e sintomas de gripe. Entre os vacinados e não vacinados, em 2009 e 2010, não foi verificada associação entre vacinação e gripe (RP = 1,24; [IC 95%: 0,63-2,43] e RP = 1,11; [IC95%: 0,59-2,09]), respectivamente). CONCLUSÕES: O estudo sugere que, entre os idosos estudados, a cobertura vacinal para a gripe encontra-se abaixo do ideal, com projeção de melhores índices para 2011 (± 84%). Os dados sobre a vacinação e proteção contra a doença carece de novas pesquisas, entretanto, os resultados apontam para necessidade de medidas para esclarecer melhor a população sobre a doença, suas complicações e benefícios da vacinação, além de combater estigmas relacionados à baixa adesão.

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          Validation of self-report of influenza and pneumococcal vaccination status in elderly outpatients.

          To assess the validity of self-reported influenza and pneumococcal vaccination status. Cross-sectional surveys of outpatients aged 65 years or older. A Veterans Affairs Medical Center (VA) and a community managed care organization (MCO). Both organizations have organized influenza and pneumococcal vaccination programs. VA subjects included all elderly respondents to a mailed survey of 500 randomly selected outpatients. MCO subjects included all respondents to a telephone survey of 300 randomly selected elderly members of the MCO. The VA survey was conducted following the 1995-1996 influenza season while the MCO survey was conducted following the 1994-1995 season. Self-report from the mailed survey for VA subjects and from the telephone survey for MCO subjects was compared to medical record documentation (paper and computerized combined). The response rate was 77% (n = 369) for the VA subjects of whom 195 (53%) were aged 65 or older. The response rate for the MCO subjects was 84% (n = 237). Self-report of influenza vaccination had a sensitivity (SENS) of 1.0 and a specificity (SPEC) of .79 with a kappa of .72 (95% CI .58-.86) among VA patients. Among MCO patients, self-report of influenza vaccination had a SENS of .98 and a SPEC of .71 with kappa of .75 (95% CI .69-.89). Self-report of pneumococcal vaccination status among VA patients had a SENS of .97 and a SPEC of .53 with a kappa of .42 (95% CI .32-.52). Among MCO patients, self-report of pneumococcal vaccination had a SENS of .90 and a SPEC of .64 with a kappa of .54 (95% CI .40-.68). A secondary analysis excluding subjects living outside of the VA's catchment area improved the specificity and indices of concordance of self-report of both influenza and pneumococcal vaccination. A secondary analysis of MCO data which excluded subjects who received a pneumococcal vaccination > 2 years prior to the study also improved concordance and the negative predictive value of self-report. Self-report of influenza vaccination is a highly sensitive and moderately specific measure. Self-report of pneumococcal vaccination is also a highly sensitive but less specific measure of vaccination status. Lower rates of validity for pneumococcal vaccination may reflect both less accurate recall, particularly for more distant vaccination, and less complete documentation in medical records.
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            Acute respiratory infection and influenza‐like illness viral etiologies in Brazilian adults †

            Abstract Influenza‐like illness (ILI) definitions have been used worldwide for influenza surveillance. These different case definitions can vary with regard to sensitivity and predictive values for laboratory confirmed influenza. The literature has indicated the inclusion of other viruses may be the cause of these variable results. The objective of the study was to evaluate ILI national sentinel criteria and viral etiologies in adults diagnosed with acute respiratory infection (ARI) and/or ILI from 2001 to 2003 in Sao Paulo, Brazil. Clinical and laboratory evaluations were observed from 420 adults and collected on a daily basis from outpatient care units at University Hospital. The ILI definition included: fever plus at least one respiratory symptom (cough and/or sore throat) and one constitutional symptom (headache, malaise, myalgia, sweat or chills, or fatigue). DFA and RT‐PCR for influenza, parainfluenza, respiratory syncytial virus, adenovirus, enterovirus, coronavirus, rhinovirus, and metapneumovirus were performed on nasal washes and 61.8% resulted positive. The respiratory viruses detected most often were influenza and rhinovirus. ILI was reported for 240/420 patients (57.1%), with influenza and rhinovirus etiologies accounting for 30.9% and 19.6%, respectively. Rhinovirus peak activity was concurrent with the influenza season. These findings highlight the implications of other viruses in ILI etiology and suggest that during the influenza season, this clinical overlap must be considered in the diagnosis and clinical management of patients. J. Med. Virol. 80:1824–1827, 2008. © 2008 Wiley‐Liss, Inc.
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              Characterization of Viral Agents Causing Acute Respiratory Infection in a San Francisco University Medical Center Clinic during the Influenza Season

              Abstract Background. With use of polymerase chain reaction (PCR) and a centrifugation-enhanced viral culture method, we characterized the viruses causing acute respiratory infection in adults during an influenza season. Methods. During January-March 2002, nasopharyngeal wash specimens from previously healthy adults presenting with respiratory symptoms were evaluated for viral pathogens with centrifugation-enhanced viral culture and PCR. Results The diagnoses in 266 cases included unspecified upper respiratory infection (in 142 [54%] of the cases), acute bronchitis (42 [16%]), sinusitis (23 [9%]), pharyngitis (22 [8%]), and pneumonia (17 [6%]). The use of a shell vial assay and PCR identified a pathogen in 103 (39%) of the patients, including influenza A or B in 54, picornavirus in 28 (including rhinovirus in 24), respiratory syncytial virus (RSV) in 12, human metapneumovirus in 4, human coronavirus OC43 in 2, adenovirus in 2, parainfluenza virus type 1 in 1, and coinfection with influenza and parainfluenza virus type 1 in 2. Conclusion. Our findings demonstrate that, even during the influenza season, rhinovirus and RSV are prevalent and must be considered in the differential diagnosis of adult acute respiratory infection before prescribing antiviral medication. Human coronavirus and human metapneumovirus did not play a substantial role. PCR was an especially useful tool in the identification of influenza and other viral pathogens not easily detected by traditional testing methods.
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                Author and article information

                Journal
                rsbmt
                Revista da Sociedade Brasileira de Medicina Tropical
                Rev. Soc. Bras. Med. Trop.
                Sociedade Brasileira de Medicina Tropical - SBMT (Uberaba, MG, Brazil )
                0037-8682
                1678-9849
                December 2012
                : 45
                : 6
                : 670-674
                Affiliations
                [02] Ribeirão Preto SP orgnameUniversidade de São Paulo orgdiv1Faculdade de Medicina de Ribeirão Preto orgdiv2Departamento de Medicina Social
                [01] Ribeirão Preto SP orgnameUniversidade de São Paulo orgdiv1Faculdade de Medicina de Ribeirão Preto
                Article
                S0037-86822012000600003 S0037-8682(12)04500603
                290b72fd-3c64-4b51-aa3d-d8707003d5de

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 12 September 2011
                : 30 October 2012
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 27, Pages: 5
                Product

                SciELO Brazil

                Categories
                Major Articles

                Saúde do idoso,Influenza virus,Adherence,Anti-flu vaccine,Elderly health,Vírus Influenza,Aderência,Vacinação anti-gripe

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