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

Background Pertussis 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. Methods We 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. Results The 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). Conclusions Pertussis 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 coverag

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

BACKGROUND: Pertussis 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. METHODS: We 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. RESULTS: The 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). CONCLUSIONS: Pertussis 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.Sincere thanks go to CIBER Epidemiology and Public Health, CIBERESP-Spain for funding this study, because through the concession of a aid for a short stay abroad to Ruben Solano, to complete the title international of PhD in Medicine.S

Avaliação da microfiltração marginal em técnicas de restauração de tipo ii com resina composta

Introducción: se evaluó la microfiltración marginal en las restauraciones clase II realizadas por medio de la técnica incremental oblicua, de perlas de resina y del SonicFill. Métodos: se realizó un estudio cuantitativo, experimental, in vitro y transversal en una población constituida por 30 terceros molares extraídos, en la que se realizaron 60 cavidades clase ii, independientes y estandarizadas (4 mm de ancho vestíbulo-lingual/palatino, 4 mm mesio-distal y 5 mm de profundidad). Los molares fueron divididos en tres grupos: grupo 1, técnica incremental convencional y perlas de resina; grupo 2, técnica perlas de resina y el SonicFill; grupo 3, SonicFill e incremental oblicua. Las muestras se tiñeron con azul de metileno al 0,1% durante 48 horas, se seccionaron para evaluar la penetración del colorante y las superficies se examinaron en los márgenes de las restauraciones con un microscopio óptico a 10 x de magnificación. Los datos se analizaron con el programa Excel 2007 y el sistema operativo Windows 7. Resultados: los resultados estadísticos muestran que existe una diferencia significativa en los niveles de microfiltración marginal, según la técnica de restauración utilizada. Conclusión: las restauraciones realizadas por medio del SonicFill ofrecen un mayor sellado marginal que las realizadas por medio de la técnica perlas de resina e incremental oblicua.  Introdução: avaliou-se a microfiltração marginal nas res-taurações tipo ii realizadas por meio da técnica incremental oblíqua, de pérolas de resina e do SonicFill. Métodos: realizou-se um estudo quantitativo, experimental, in vitro e transversal em uma população constituída por 30 terceiros molares extraídos, na qual se realizaram 60 cavidades tipo II, independentes e padronizadas (4 mm de largura vestíbulo-lingual/palatino, 4 mm mesio-distal e 5 mm de profundidade). Os molares foram divididos em três grupos. Grupo 1: técnica incremen-tal convencional e pérolas de resina; grupo 2: técnica pérolas de resina e o SonicFill; grupo 3: SonicFill e incremental oblíqua. As amostras se tingiram com azul de metileno a 0,1% durante 48 horas; secionaram-se para avaliar a penetração do colorante e as superfícies se examinaram a nível das margens das restaurações com um microscópio óptico a 10 x de magnificação. Os dados foram analisados com o programa Excel 2007 e o sistema operativo Windows 7. Resultados: os resultados estatísticos mostram que existe uma diferença significativa nos níveis de microfil-tração marginal, segundo a técnica de restauração utilizada. Conclusão:as restaurações realizadas por meio do SonicFill oferecem um maior se-lamento marginal que as realizadas por meio da técnica pérolas de resina e incremental oblíqua.Introduction: marginal microleakage in class ii restorations made using oblique incremental, resin beads and SonicFill techniques were evaluated. Methods: A quantitative,  experimental, in vitro and cross-section study was performed on a population consisting of 30 extracted third molars, in which there were 60  standardized independent class II cavities (buccal-lingual/palatine width of 4mm, mesiodistal width of 4mm and depth of 5mm). The molars were divided into 3 groups: group 1, the conventional incremental and resin beads technique; group 2, the resin beads and SonicFill technique; group 3, the SonicFill and incremental oblique technique. The samples were stained with 0.1% blue methylene for 48 hours, sectioned to evaluate colorant penetration and the surfaces were examined at the margins  of the restorations using a 10x optical microscope. Results: The statistical results show a significant difference in microleakage levels depending upon the restoration technique used. Conclusion: Restorations made using SonicFill offer greater marginal seal than those using resin beads and incremental oblique techniques

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

Background Pertussis 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. Methods We 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. Results The 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). Conclusions Pertussis 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 coverag