6
views
0
recommends
+1 Recommend
2 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Enfermedad neumocócica invasiva en la población infantil de la Comunidad Valenciana Translated title: Invasive pneumococcal disease in children in the community of Valencia, Spain

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objetivo: La enfermedad neumocócica es una causa frecuente de morbilidad y mortalidad entre la población infantil. La reciente autorización de la vacuna conjugada heptavalente ha incrementado el interés científico que suscita esta enfermedad. El objetivo de este estudio es conocer las características epidemiológicas y clínicas, así como la evolución de esta enfermedad invasiva en la población infantil de la Comunidad Valenciana. Método: Los datos se han obtenido de las historias clínicas de los niños menores de 15 años, con aislamiento del neumococo, atendidos en todos los hospitales públicos de la Comunidad Valenciana durante el período 1996-2000. La evolución de la incidencia se valoró mediante la comparación de tasas, los signos clínicos y su evolución (secuelas y letalidad) mediante la evaluación de la frecuencia y su distribución por edades. Resultados: Se registró un total de 127 casos, lo que representa un promedio de tasa anual de 3,89/105 habitantes en los menores de 15 años y de 20,14 en los menores de 2 años. Presentaron antecedentes de problemas de salud un 29,1% de los pacientes. Las manifestaciones clínicas predominantes fueron sepsis/bacteriemia (38%), neumonía (31%) y meningitis (24%). Al alta, presentaban secuelas 10 niños, de los que el 75% eran menores de 2 años. Fallecieron 8 niños (letalidad del 6,3%). Conclusiones: En nuestro medio, durante el período estudiado, la infección neumocócica se presenta sobre todo en los niños menores de 2 años, así como en los mayores de esta edad con antecedentes de problemas de salud. En estos últimos se ha encontrado una mayor mortalidad. Sería conveniente introducir la enfermedad neumocócica en el Sistema de Vigilancia Epidemiológica, lo que nos permitiría disponer de estimaciones más precisas de su evolución epidemiológica y valorar si la vacuna conjugada es la solución a los problemas que plantea esta bacteria en la actualidad.

          Translated abstract

          Objective: Pneumococcal disease is an important cause of morbidity and mortality in children. The recent authorization of the heptavalent conjugate vaccine has increased interest in this disease. The objective of this study was to identify the epidemiological and clinical characteristics of this disease, as well as its outcome in the pediatric population of the Autonomous Community of Valencia. Method: Data were obtained from the medical records of children aged less than 15 years who were positive for pneumococcus isolation on admission to hospital between 1996 and 2000. All the public hospitals of the Autonomous Community of Valencia were included. Changes in incidence were evaluated by comparing rates and outcomes (sequelae and lethality) through frequency and age distribution. Results: One hundred twenty-seven cases were registered, giving a mean annual rate of 3.89/105 inhabitants aged less than 15 years. The rate was 20.14 in children aged less than 2 years. A total of 29.1% of the children had previous health problems. The main clinical manifestations included sepsis/bacteremia (38%), pneumonia (31%) and meningitis (24%). At discharge sequelae were present in 10 children, 75% of whom were aged less than 2 years. Eight children died (6.3% lethality). Conclusions: In the period and region studied, pneumococcal infection was present mainly in children aged less than 2 years and in those with previous health problems. In the last few years, mortality has increased. Thus, inclusion of pneumococcal disease in the epidemiological surveillance system would be appropriate to achieve more precise estimations of its epidemiological patterns and to determine whether the conjugate vaccine represents a solution to the problems currently associated with this bacteria.

          Related collections

          Most cited references64

          • Record: found
          • Abstract: found
          • Article: not found

          Worldwide Haemophilus influenzae type b disease at the beginning of the 21st century: global analysis of the disease burden 25 years after the use of the polysaccharide vaccine and a decade after the advent of conjugates.

          Vaccination against Haemophilus influenzae type b (Hib) diseases began a quarter of a century ago with a polysaccharide vaccine; this vaccine was followed by four different conjugates 10 years later. In this review, the burden of global Hib disease is quantified following this 25-year period of vaccine availability to determine the potential impact of conjugate vaccines. This task was accomplished by analysis of data available in 10 languages in 75 geographical regions of over 50 countries. All severe Hib diseases, not only meningitis, were characterized, and special attention was paid to the most vulnerable age group, i.e., children aged 0 to 4 years. Prior to vaccination, the weighted worldwide incidence of meningitis in patients younger than 5 years was 57/100,000, and for all Hib diseases except nonbacteremic pneumonia, it was 71/100,000, indicating 357,000 and 445,000 cases per year, respectively. At least 108,500 of these children died. For all age groups combined, there were 486,000 cases of Hib disease, excluding pneumonia, with 114,200 deaths and probably an equal number of sequelae per annum. If the figures for nonbacteremic pneumonia are included, a conservative estimate is that over 2.2 million cases of infection and 520,000 deaths from Hib disease occurred worldwide, but the true numbers might have been greater. Despite these large numbers and availability of safe and efficacious vaccines, only 38,000 cases annually are prevented-a meager 8% or less than a 2% reduction in cases, depending on whether nonbacteremic pneumonia is included in the calculations. Although vaccination has had great success in some affluent countries, the current level of activity has had a very small impact globally. The use of conjugates, preferably with a reduced number of doses and in combination with other vaccines or perhaps in fractional doses, should be extended to less privileged countries, where most Hib disease occurs.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Preventing pneumococcal disease among infants and young children. Recommendations of the Advisory Committee on Immunization Practices (ACIP).

            (2000)
            In February 2000, a 7-valent pneumococcal polysaccharide-protein conjugate vaccine (Prevnar, marketed by Wyeth Lederle Vaccines) was licensed for use among infants and young children. CDC's Advisory Committee on Immunization Practices (ACIP) recommends that the vaccine be used for all children aged 2-23 months and for children aged 24-59 months who are at increased risk for pneumococcal disease (e.g., children with sickle cell disease, human immunodeficiency virus infection, and other immunocompromising or chronic medical conditions). ACIP also recommends that the vaccine be considered for all other children aged 24-59 months, with priority given to a) children aged 24-35 months, b) children who are of Alaska Native, American Indian, and African-American descent, and c) children who attend group day care centers. This report includes ACIP's recommended vaccination schedule for infants at ages 2, 4, 6, and 12-15 months. This report also includes a pneumococcal vaccination schedule for infants and young children who are beginning their vaccination series at an older age and for those who missed doses. In addition, this report updates earlier recommendations for use of 23-valent pneumococcal polysaccharide vaccine among children aged > or =2 years. Among children aged 24-59 months for whom polysaccharide vaccine is already recommended, ACIP recommends vaccination with the new conjugate vaccine followed, > or =2 months later, by 23-valent polysaccharide vaccine. Conjugate vaccine has not been studied sufficiently among older children or adults to make recommendations for its use among persons aged > or =5 years. Persons aged > or =5 years who are at increased risk for serious pneumococcal disease should continue to receive 23-valent polysaccharide vaccine in accordance with previous ACIP recommendations.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children

                Bookmark

                Author and article information

                Journal
                gs
                Gaceta Sanitaria
                Gac Sanit
                Ediciones Doyma, S.L. (Barcelona, Barcelona, Spain )
                0213-9111
                December 2003
                : 17
                : 6
                : 458-465
                Affiliations
                [03] Valencia orgnameAyuntamiento de Valencia orgdiv1Concejalía de Sanidad y Consumo España
                [01] Valencia orgnameConselleria de Sanitat de la Comunidad Valenciana orgdiv1Dirección General para la Salud Pública orgdiv2Servicio de Salud Infantil y de la Mujer
                [02] Valencia orgnameHospital Clínico Universitario de Valencia orgdiv1Servicio de Pediatría
                Article
                S0213-91112003000600006 S0213-9111(03)01700600006
                10.1016/S0213-9111(03)71792-0
                5dd89fe6-ad65-4e93-bcd6-878fac2ad35b

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 22 November 2002
                : 01 September 2003
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 36, Pages: 8
                Product

                SciELO Public Health

                Categories
                Originales

                Enfermedad invasiva,Streptococcus pneumoniae,Invasive disease,Mortalidad,Incidencia,Infant,Infancia,Incidence,Mortality

                Comments

                Comment on this article