Vaccine-preventable diseases and their impact on Latin American children

Ulloa‐Gutiérrez, Rolando; Miño, G; Odio, Carla; Ávila-Agüero, María Luisa; Brea, José António Fraiz

doi:10.1586/erv.11.153

Cited by 9 publications

(8 citation statements)

References 14 publications

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“…19 In our region, the first Latin American country that introduced the varicella vaccine in its official immunization schedule was Uruguay, where outpatient visits and hospitalizations reduced by 87 % and 81 %, respectively. 18,20 In our study, more than half of outpatient visits (57.6 %) and hospitalizations (65 %) occurred in children younger than 5 years, which is similar to what was observed in the United States before the introduction of the vaccine. 21,22 In our population, infants younger than 1 year and adolescents older than 14 years were 1.7 and 3.7 times at a higher risk for hospitalization than the rest of the cases.…”

Section: Discussionsupporting

confidence: 85%

Clinical and epidemiological impact of varicella infection in children prior to the introduction of the varicella vaccine in the national immunization schedule of Argentina

Neyro¹,

Ferolla

Molise

et al. 2019

Arch Argent Pediat

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Introduction. In Argentina, an estimated 400 000 varicella cases occur annually. Given the under-recording of existing cases, the actual burden of disease is unknown. Objective. To assess the burden of varicella before the introduction of the varicella vaccine in the national immunization schedule. Materials and methods. Retrospective, analytical, observational study carried out in three hospitals of Argentina. Review of medical records from outpatient visits to the Emergency Department and from patients younger than 18 years hospitalized for varicella. Period: 1/2011-12/2013. Results. A total of 382 782 outpatients were seen; 3367 (0.88 %) corresponded to visits due to varicella; 57.6 % were ≤ 4 years old. A total of 164 (4.9 %) patients required hospitalization, with an overall hospitalization rate of 65.3/10 000 hospitalized patients/year (95 % confidence interval [CI]: 55.4-76.5); hospitalization rate in healthy children: 57.2/10 000 (95 % CI: 67.7-48.0); median age: 31.5 months. The most common causes of hospitalization were skin and/or soft tissue infections (61.1 %) and respiratory infections (10.1 %). Also, 54.3 % were treated with acyclovir and 73.1 %, with antibiotics. Bacteremia developed in 5/67 patients (7.5 %), all cases were caused by Gram-positive cocci and occurred in immunocompetent patients. Out of 19 immunocompromised patients, 36.8 % had complications (5 skin and/or soft tissue infection and 2 pneumonia cases). The median length of stay was 4 days, which is significantly more prolonged in immunocompromised patients. One patient required intensive care. No patient died. Conclusion. The burden of disease was significant, with a considerable impact in patients without an underlying disease.

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Section: Discussionsupporting

confidence: 85%

Clinical and epidemiological impact of varicella infection in children prior to the introduction of the varicella vaccine in the national immunization schedule of Argentina

Neyro¹,

Ferolla

Molise

et al. 2019

Arch Argent Pediat

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“…Apart from Europe and the USA, similarly high impact of publicly funded, mainly single-dose, routine varicella vaccination programmes in early childhood was reported in Uruguay [7] and more recently in Taiwan [37], Australia [38,39], Canada [40] and Costa Rica [41] (Table 7). In all these countries, higher levels of coverage were reached earlier, and stronger reductions found in a shorter time than in both German surveillance systems, reflecting a more reluctant attitude towards varicella vaccination by physicians and parents in Germany [24].…”

Section: Discussionmentioning

confidence: 83%

Varicella routine vaccination and the effects on varicella epidemiology – results from the Bavarian Varicella Surveillance Project (BaVariPro), 2006-2011

et al. 2013

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BackgroundIn 2004, routine varicella vaccination was recommended in Germany for children 11-14 months of age with one dose, and since 2009, with a second dose at 15-23 months of age. The effects on varicella epidemiology were investigated.MethodsData on varicella vaccinations, cases and complications were collected from annual parent surveys (2006-2011), monthly paediatric practice surveillance (Oct 2006 - Sep 2011; five varicella seasons) and paediatric hospital databases (2005-2009) in the area of Munich (about 238,000 paediatric inhabitants); annual incidences of cases and hospitalisations were estimated.ResultsVaricella vaccination coverage (1st dose) in children 18-36 months of age increased in two steps (38%, 51%, 53%, 53%, 66% and 68%); second-dose coverage reached 59% in the 2011 survey. A monthly mean of 82 (62%) practices participated; they applied a total of 50,059 first-dose and 40,541 second-dose varicella vaccinations, with preferential use of combined MMR-varicella vaccine after recommendation of two doses, and reported a total of 16,054 varicella cases <17 years of age. The mean number of cases decreased by 67% in two steps, from 6.6 (95%CI 6.1-7.0) per 1,000 patient contacts in season 2006/07 to 4.2 (95%CI 3.9-4.6) in 2007/08 and 4.0 (95%CI 3.6-4.3) in 2008/09, and further to 2.3 (95%CI 2.0-2.6) in 2009/10 and 2.2 (95%CI 1.9-2.5) in 2010/11. The decrease occurred in all paediatric age groups, indicating herd protection effects. Incidence of varicella was estimated as 78/1,000 children <17 years of age in 2006/07, and 19/1,000 in 2010/11. Vaccinated cases increased from 0.3 (95%0.2-0.3) per 1,000 patient contacts in 2006/07 to 0.4 (95%CI 0.3-0.5) until 2008/09 and decreased to 0.2 (95%CI 0.2-0.3) until 2010/11. The practices treated a total of 134 complicated cases, mainly with skin complications. The paediatric hospitals recorded a total of 178 varicella patients, including 40 (22.5%) with neurological complications and one (0.6%) fatality due to varicella pneumonia. Incidence of hospitalisations decreased from 7.6 per 100,000 children <17 years of age in 2005 to 4.3 in 2009, and from 21.0 to 4.7 in children <5 years of age.ConclusionsOverall, the results show increasing acceptance and a strong impact of the varicella vaccination program, even with still suboptimal vaccination coverage.

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“…Furthermore, none of the cases in DR were laboratory-confirmed, but rather were diagnosed as pertussis by physicians on the basis of clinical symptoms. These deficiencies in the surveillance of pertussis have also been reported in other Latin-American countries [22, 23]. …”

Section: Discussionmentioning

confidence: 79%

Epidemiology of pertussis in two Ibero-American countries with different vaccination policies: lessons derived from different surveillance systems

Solano

Masa-Calles

Garib³

et al. 2016

BMC Public Health

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BackgroundPertussis is a re-emerging disease worldwide despite its high vaccination coverage. European and Latin-American countries have used different surveillance and vaccination policies against pertussis. We compared the epidemiology of this disease in two Ibero-American countries with different vaccination and surveillance policies.MethodsWe compared the epidemiology of pertussis in Spain and the Dominican Republic (DR). We present a 10-year observational study of reported pertussis based on suspected and/or probable cases of pertussis identified by the national mandatory reporting system in both countries between 2005 and 2014. Both countries have a similar case definition for pertussis surveillance, although Spain applies laboratory testing, and uses real time PCR and/or culture for case confirmation while in DR only probable and/or suspected cases are reported. We analyzed incidence, hospitalization, case-fatality rates, mortality and vaccination coverage.ResultsThe average annual incidence in children aged <1 year was 3.40/100,000 population in Spain and 12.15/100,000 in DR (p = 0.01). While the incidence in DR was generally higher than in Spain, in 2011 it was six times higher in Spain than in DR. The highest infant mortality in Spain was 0.017/100,000 in 2011, and the highest in DR was 0.08/100,000 in 2014 (p = 0.01). The proportion of hospitalized cases per year among children <1 year varied between 22.0% and 93.7% in Spain, and between 1.1% and 29.4% in DR (p = 0.0002), while mortality varied from 0 to 0.017 and 0 to 0.08 per 100,000 population in Spain and DR, respectively (p = 0.001). Vaccination coverage was 96.5% in Spain and 82.2% in DR (p = 0.001).ConclusionsPertussis is a public health problem in both countries. Surveillance, prevention and control measures should be improved, especially in DR. Current vaccination programs are not sufficient for preventing continued pertussis transmission, even in Spain which has high vaccination coverage.

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Vaccine-preventable diseases and their impact on Latin American children

Cited by 9 publications

References 14 publications

Clinical and epidemiological impact of varicella infection in children prior to the introduction of the varicella vaccine in the national immunization schedule of Argentina

Clinical and epidemiological impact of varicella infection in children prior to the introduction of the varicella vaccine in the national immunization schedule of Argentina

Varicella routine vaccination and the effects on varicella epidemiology – results from the Bavarian Varicella Surveillance Project (BaVariPro), 2006-2011

Epidemiology of pertussis in two Ibero-American countries with different vaccination policies: lessons derived from different surveillance systems

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