BACKGROUND. In a Latin American trial, a monovalent G1P[8] rotavirus vaccine showed high efficacy against severe rotavirus diarrhea. Protection was lower against serotypically unrelated G2P[4] strains, which circulated infrequently. This case-control study was undertaken to assess the effectiveness of this monovalent G1P[8] rotavirus vaccine against G2P[4] strains in Brazil. METHODS. Case patients were children with severe G2P[4] rotavirus diarrhea who presented at a hospital in Recife, Brazil, from March 2006 through September 2008. Vaccination rates among case patients were compared with rates among 2 groups of control participants-children with rotavirus-negative diarrhea and children admitted for acute respiratory tract infection (ARI)-to calculate vaccine effectiveness, after controlling for the birth month and year. RESULTS. We enrolled 70 G2P[4] rotavirus-positive case patients with severe diarrhea, 484 rotavirus-negative control participants with diarrhea, and 416 control participants with ARI, aged 6 months. Among children aged 6-11 months, the effectiveness of the vaccine against G2P[4] diarrhea was 77% (95% confidence interval [CI], 42%-91%) and 77% (95% CI, 43%-90%) among the rotavirus-negative control participants with diarrhea and control participants with ARI, respectively. Vaccine effectiveness in children aged 12 months decreased to -24% (95% CI, -190% to 47%) and 15% (95% CI, -101 to 64) among the rotavirus-negative control groups with diarrhea and ARI, respectively. CONCLUSIONS. This monovalent G1P[8] rotavirus vaccine was effective against severe G2P[4] rotavirus diarrhea among children aged 6-11 months. Effectiveness declined among children aged 12 months, which suggests waning immunity.
The introduction of a G1P[8] rotavirus vaccine in Recife, Brazil, caused a decrease in rotavirus detection from 27% (March-May, 2006) to 5.0% (March-May, 2007), with all strains becoming G2, against which less protection had been predicted.
FUNDAMENTOS E OBJETIVOS: Inatividade física é importante fator de risco para as doenças crônicas. Os resultados da literatura são controvertidos em relação à prática de atividades esportivas na infância e adolescência e atividade física na vida adulta. O objetivo deste estudo foi verificar em adultos jovens a freqüência de atividade física de lazer (AFL) e determinar se a prática de esportes durante a adolescência influenciou esta atividade. MÉTODOS: Foi realizado um estudo transversal, tipo inquérito, no período de novembro de 2003 a abril de 2004, em 170 alunos do curso médico que realizaram o estágio de internato em pediatria e tocoginecologia no Instituto Materno Infantil de Pernambuco (IMIP). Foram considerados como atletas aqueles que afirmaram terem praticado algum tipo de esporte durante pelo menos dois anos consecutivos, entre a faixa etária dos 10 aos 19 anos. Atividade física desenvolvida atualmente foi aferida através da informação sobre AFL, na última semana que antecedeu a aplicação do questionário, para a prática de algum tipo de atividade física que provocasse sudorese e respiração acelerada. Foram considerados como fisicamente ativos aqueles que despenderam um mínimo de 150 minutos de atividade física por semana. RESULTADOS: Apenas 22,5% (35/155) dos internos desenvolviam AFL. Entre aqueles que foram atletas durante a adolescência, a prática de AFL na vida adulta foi maior; 26,8% (33/123), do que aqueles não atletas, 6,2% (2/32); p < 0,03 (tabela 1). Entretanto, a presença de excesso de peso ou obesidade, hipertensão arterial, tabagismo e antecedentes familiares de doença aterosclerótica precoce não diferiu entre os grupos com maior e menor AFL. CONCLUSÃO: Práticas de atividades esportivas durante a adolescência contribuem para AFL na vida adulta.
In 2006, Brazil will initiate universal immunization of its 4-million infants with a live attenuated serotype G1P[8] human rotavirus vaccine. In anticipation of the national immunization program, this study was undertaken to characterize rotavirus strains circulating among children in Recife, one of the largest cities in the northeast region of Brazil. Group A rotaviruses were detected in 102 (35%) of 290 faecal specimens collected from children under 5 years of age who presented with acute diarrhoea during a 1-year period between May 2004 and April 2005. In addition to the globally common G1P[8] serotype that accounted for 49% of strains, emerging rotavirus serotypes G8P[6] and G9P[8] represented 2% and 29% of strains, respectively. Following cell culture adaptation, RNA-RNA hybridization demonstrated that two Brazilian G8P[6] rotavirus strains shared a high level of genomic RNA homology with Malawian G8P[6] strains, and a Brazilian G9P[8] strain was related most closely to a G9P[8] strain from India. The results suggest that certain rotavirus strains have a much wider global circulation than generally appreciated. Continued global spread of such strains might challenge the efficacy of current rotavirus vaccines.
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