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BACKGROUND AND AIM OF THE WORK Thanks to the highly effective vaccine, tetanus became sporadic in high-income countries with well-established primary childhood immunization programs, but it is common in low-income countries. The migrants, leaving countries with poor immunization programs or where vaccinations have been interrupted, may represent a new risk group for tetanus in host countries. A seroprevalence study was conducted to estimate the immunological status against tetanus in young migrants without vaccination documentation. METHODS After a careful assessment by vaccination services of the Local Health Authority, all migrants recently arrived in Italy were included in the serosurvey. Titers of anti-tetanus toxoid were measured using a commercial ELISA kit. Subjects were stratified by age and by WHO region. Antibody titers 1.00 IU/ml high protection. RESULTS From January 2004 to December 2019, 2,326 blood samples were collected. Mean age was 13.9 years with no differences between WHO regions. The percentage of the subjects without protective antibodies was 22.3%, with an intermediate level was 45.2%, with high titer was 32.5%. Among migrant coming from African and Eastern Mediterranean WHO regions, the highest percentages of seronegative titers and, at the same time, the low percentages of high protective levels were found. Titers decreased with age. CONCLUSIONS The significant proportion of seronegative migrants and the decrease of protective titers increasing age, confirm the importance of the evaluation of the immunological status to employ the appropriate vaccination strategy.In Italy, over the last decade, the spread of vaccine hesitancy has caused a steep decrease in vaccination coverage rates, both at the national and regional level. In this study, we pool and critically analyze childhood immunization coverage rates (2011-2018) in Lombardy, Italy's most populated region, and compare them to national trends. Overall, childhood vaccination coverage in Lombardy is slightly higher the Italian national average. In 2017, the law on mandatory vaccinations came into force, acting as a powerful tool for coverage increase.BACKGROUND AND AIM OF THE WORK The global burden of disease attributable to seasonal influenza virus in children is difficult to quantify. Children with chronic medical conditions and healthy children may experience severe or fatal complications. Aim of the study was to estimate the influenza vaccine effectiveness (VE) in a cohort of outpatient children. METHODS From 2010 to 2018, a Pediatrician of Parma from the InfluNet network of Emilia-Romagna Region, performed nasal/throat swabs on every child with Influenza-like illness at least 14 days from the vaccination with trivalent vaccine. selleck products VE estimates against influenza season, virus type and subtype and age group were evaluated using a test-negative design. RESULTS 2,480 swabs were performed. The 57.6% of the analyzed swabs were positive for influenza viruses. Type A (57%) and type B viruses (43%) co-circulated. The 37.1% of type A viruses belonged to subtype A(H3N2), 19.4% to subtype A(H1N1)pdm09. The subtype A(H3N2) was prevalent among children up to 23 months (42.4%) while the type B in the 2-4 (40.7%) and 5-16 year old age groups (49.4%). Overall, 19.9% of the children were vaccinated. The highest prevalence of vaccinated subjects was found in children aged 5-16 (30.5%). The VE against subtype A(H1N1)pdm09 was 63% (95%CI 42.6-76.0), against type B 27.5% (95%CI 7.9-42.9) and against subtype A(H3N2) -14.3%  (95%CI - 46.0-10.7). CONCLUSIONS Our findings represent a useful contribution to the ongoing debate about the appropriateness of including influenza vaccination for healthy children, 6 months and older, in the updating National Vaccine Prevention Plan (PNPV).INTRODUCTION To investigate actual knowledge of official recommendations towards seasonal influenza (SID), and Tetanus-diphtheria acellular-pertussis (Tdap) vaccines in obstetrics/gynecologists (OBGYN). METHODS PubMed and EMBASE databases were searched. A meta-analysis was performed to calculate odds ratio (OR) and 95% confidence interval (CI) among case controls, cross-sectional studies, either questionnaire or laboratory exams based.  Results. A total of 6 studies met inclusion criteria, including 1323 OBGYN from 5 different countries. Overall, around 99% of sampled professionals were aware that official recommendations towards SID in pregnancy do exist, compared to 92% for Tdap, with significant heterogeneity (I2 > 95%, p less then 0.001). Concerns about vaccine safety was reported by 10% of respondents for Tdap, and by 6.0% for SID, but again available studies were substantially heterogenous (I2 = 86.7% and 86.0%, p less then 0.001). Eventually, 93% of respondents actively recommended SID in pregnancy, compared to 88% for Tdap (I2 98.8% and I2 95.9%, respectively p less then 0.001). The evidence of significant publication bias was initially subjectively identified from the funnel plot, and then objectively confirmed through the regression test for all analyses. CONCLUSIONS These results suggest an appropriated understanding of official recommendation among sampled OBGYN, with high shares of professionals actively promoting vaccination practices among their patients. Despite the high heterogeneity and the significant publication bias we identified, our results also hint towards extensive knowledge gaps of OBGYN, and particularly regarding unmotivated concerns about vaccine safety. As a consequence, appropriate information and formation campaigns should be appropriately tailored.BACKGROUND AND AIM The low measles vaccination coverage contributes to the re-emerging of measles in Italy. This study aimed to estimate the measles burden, expressed in Disability Adjusted Life Years (DALYs), in Umbria, for the period 2013-2018. METHODS Data on measles cases in Umbria were obtained from the MoRoNet. While data related to the resident population, were obtained from the website of the National Institute of Statistics. The estimated DALYs was calculated using the Burden of Communicable Diseases in Europe toolkit. The results are expressed in DALYs per year, per case and per 100,000 subjects, for acute illness and for sequelae. RESULTS The estimated incidence in mean for the entire period was 52.50 cases per year. Resulting in an average loss of 3.10 DALYs per year. CONCLUSIONS The data obtained from this analysis provide important information on the impact of measles in the Umbria region, and offer useful data to the Health Authorities that can be used to reduce measles incidence in the region.

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