Objective There is little information about vaccine schedule compliance in very-low-birth-weight infants in developing countries. The aim of the study was to describe the compliance with the vaccine schedule among this population in Lima, Peru. Patients and Methods We conducted a prospective cohort study in four hospitals in Lima in infants with a birth-weight of less than 1500g, followed from birth up to 12 months of age every 2 weeks. The date and age at administration of each vacccine was recorded. Results 222 infants were enrolled. The median birth-weight was 1,250g (range 550-1,499g) and the median gestational age was 30.0 weeks (range 23-37 weeks). The mean age for the first pentavalent (DPT, Hib, HepB) and oral polio vaccine administration was 4.3 ± 1.4 months in infants with a birth-weight of <1000g vs. 3.1 ± 1.0 in infants with a birth-weight 1000- 1500g (p<0.001); 4.1 ± 0.9 vs. 3.3 ± 1.1 for rotavirus (p<0.05); and 5.1 ± 2.1 vs. 4.3 ± 1.8 for the 7-valent pneumococcal conjugated vaccine. Only 35% had received the three doses of oral polio and pentavalent vaccine by seven months, although by nine months 81% had received these vaccines. Conclusions Vaccination of very-low-birth-weight infants in Peru is significantly delayed, especially in infants with a birth-weight of <1000g. Urgent educational interventions targeting physicians and nurses should be implemented in order to improve vaccination rates and timing in these high risk populations.
Abstract. We conducted a prospective cohort study in four hospitals in Lima, Peru in infants with a birth weight 1,500 g followed from birth hospital discharge up to 1 year of age to determine the incidence of respiratory syncytial virus (RSV) hospitalizations. We enrolled 222 infants from March of 2009 to March of 2010: 48 infants with a birth weight 1,000 g and 174 infants with a birth weight of 1,000-1,500 g (birth weight = 1,197 ± 224 g; gestational age = 30.1 ± 2.6 weeks). There were 936 episodes of respiratory infections; the incidence of respiratory infections during the first 1 year of life was 5.7 episodes/child-years. The incidence of RSV respiratory infections that required emergency room management was 103.9 per 1,000 child-years, and the incidence of RSV hospitalizations was 116.2 per 1,000 child-years (244.9 in infants with a birth weight 1,000 g and 88.9 in infants 1,000-1,500 g; P 0.05). The incidence of RSV respiratory infections that required emergency management or hospitalization is high among pre-mature infants in Lima.
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