To combat rising incidence of serogroup C meningococcal disease in the city of Salvador, Brazil, the Bahia state immunization program initiated routine childhood immunization with meningococcal C conjugate vaccine (MenC) in February 2010, followed by mass MenC vaccination of city residents 10-24 years of age from May through August 2010. We analyzed trends in incidence of reported cases of meningococcal disease and serogroup distribution among meningococcal isolates identified in hospital-based surveillance in Salvador from January 2000 to December 2011 and estimated vaccine effectiveness using the screening method. Annual incidence of serogroup C meningococcal disease increased from 0.1 cases per 100,000 population during 2000-2006 to 2.3 in 2009 and 4.1 in 2010, before falling to 2.0 per 100,000 in 2011. Estimated coverage of mass vaccination reached 80%, 67% and 41% among 10-14, 15-19 and 20-24 year olds, respectively. Incidence in 2011 was significantly lower than average rates in 2008-2009 among children <5 years, but reductions among 10-24 year olds were not significant. Among 10-24 year olds, a single dose of MenC vaccine was 100% effective (95% confidence interval, 79-100%) against serogroup C meningococcal disease. Low coverage in the population targeted for mass vaccination may have limited impact on ongoing transmission of serogroup C meningococcal disease despite high vaccine effectiveness.
El presente estudio constituye un análisis multifactorial de los factores de riesgo de bajo peso al nacer en un grupo de recién nacidos en una zona urbana del Brasil. Se incluyeron en el estudio un total de 1 023 nacidos vivos, dados a luz en cuatro maternidades de Salvador, Bahia, entre julio de 1987 y febrero de 1988. Las fuentes de información fueron las historias clínicas y las entrevistas con las madres en la maternidad. El análisis se realizó mediante regresión logística. En el modelo final los factores de riesgo incluidos fueron los siguientes: edad materna menos de 21 años o más de 35; edad gestacional menos de 38 semanas; resultado desfavorable del embarazo anterior; intervalo intergenésico previo de 12 meses o menos; tabaquismo; e hipertensión. Se presentan los valores del riesgo atribuible poblacional para los factores de riesgo incluidos en el modelo final. Esos factores deben emplearse para detectar a las gestantes con alto riesgo de dar a luz un niño de bajo peso, a las que debe brindarse mayor atención prenatal.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.