Epidemiological situation of pertussis and strategies to control it. Argentina, 2002-2011

Fil: Romanin, Viviana. Programa Nacional de Control de Enfermedades Inmunoprevenibles (ProNaCEI), Ministerio de Salud de la Nación; Argentina.Fil: Agustinho, Vanina. Programa Nacional de Control de Enfermedades Inmunoprevenibles (ProNaCEI), Ministerio de Salud de la Nación; Argentina.Fil: Califano, Gloria. Programa Nacional de Control de Enfermedades Inmunoprevenibles (ProNaCEI), Ministerio de Salud de la Nación; Argentina.Fil: Sagradini, Sandra. Programa Nacional de Control de Enfermedades Inmunoprevenibles (ProNaCEI), Ministerio de Salud de la Nación; Argentina.Fil: Aquino, Analia. Programa Nacional de Control de Enfermedades Inmunoprevenibles (ProNaCEI), Ministerio de Salud de la Nación; Argentina.Fil: Juarez, María del Valle. Programa Nacional de Control de Enfermedades Inmunoprevenibles (ProNaCEI), Ministerio de Salud de la Nación; Argentina.Fil: Antman, Julián. Dirección de Epidemiología, Ministerio de Salud de la Nación; Argentina.Fil: Giovacchini, Carlos. Dirección de Epidemiología, Ministerio de Salud de la Nación; Argentina.Fil: Galas, Marcelo F. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.Fil: Lara, Claudia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.Fil: Hozbor, Daniela. . Laboratorio Nacional de Referencia Coqueluche, VacSal, Instituto de Biotecnología y Biología Molecular. Facultad de Ciencias Exactas. Universidad Nacional de La Plata; Argentina.Fil: Gentile, Ángela. Sociedad Argentina de Pediatría; Argentina.Fil: Vizzotti, Carla. Programa Nacional de Control de Enfermedades Inmunoprevenibles (ProNaCEI), Ministerio de Salud de la Nación; Argentina.Coqueluche constituye un problema de salud pública. Objetivos: Describir la morbimortalidad y coberturas de vacunación entre 2002 y 2011, el perfil de los casos de 2011 y las estrategias de control implementadas por el Ministerio de Salud (MSN)

Impact of a maternal immunization program against pertussis in a developing country

Background: Pertussis disease is a growing concern for developing countries. In Argentina, rates of illness and death peaked in 2011. More than 50% of fatalities due to pertussis occurred in infants younger than two months of age, too young for vaccination. In 2012, the government offered immunization with a vaccine containing Tdap to all pregnant women after 20 weeks of gestation with the intent of reducing morbidity and mortality in young infants. Methods: Maternal acellular pertussis vaccine impact on reducing infant disease burden was estimated based on data from the Argentinean Health Surveillance System. We divided Argentinean states in two groups experiencing high (>50) and low (⩽50) Tdap vaccine coverage and compared these two groups using a Bayesian structural time-series model. Low coverage regions were used as a control group, and the time series were compared before and after the implementation of the Tdap program. Findings: We observed a relative reduction of 51% (95% CI [−67%, −35%]; p = 0.001) in pertussis cases in high coverage states in comparison with the low coverage areas. Analysis of infants between two and six months showed a 44% (95% CI [−66%, −24%]; p = 0.001) reduction in illness. Number of deaths was highest in 2011 with 76 fatalities, for an incidence rate of 2.9 per 100,000. Comparing with 2011, rates decreased by 87% to 10 subjects, or 0.9 per 100,000 in 2013. Interpretation: We show an age-dependent protective effect of maternal Tdap immunization in a developing country for infants younger than six months.Fil: Vizzotti, Carla. Ministerio de Salud de la Nación; ArgentinaFil: Juarez, Maria V.. Ministerio de Salud de la Nación; ArgentinaFil: Bergel, Eduardo. Fundación para la Investigación en Infectología Infantil; ArgentinaFil: Romanin, Viviana. Ministerio de Salud de la Nación; ArgentinaFil: Califano, Gloria. Ministerio de Salud de la Nación; ArgentinaFil: Sagradini, Sandra. Ministerio de Salud de la Nación; ArgentinaFil: Rancaño, Carolina. Ministerio de Salud de la Nación; ArgentinaFil: Aquino, Analía. Ministerio de Salud de la Nación; ArgentinaFil: Libster, Romina Paula. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación para la Investigación en Infectología Infantil; Argentina. Vanderbilt University; Estados UnidosFil: Polack, Fernando Pedro. Fundación para la Investigación en Infectología Infantil; Argentina. Vanderbilt University; Estados UnidosFil: Manzur, Juan. Ministerio de Salud de la Nación; Argentin

Situación epidemiológica de coqueluche y estrategias para su control. Argentina, 2002-2011

Introduction. Pertussis is a challenge for public health. Objectives: To describe pertussis-related morbidity and mortality and immunization coverage for the 2002-2011 period, profile of cases for 2011, and control strategies implemented by the Ministry of Health (MoH) of Argentina. Methods. Descriptive, epidemiological surveillance study. Morbidity data were obtained from the National Health Surveillance System, while mortality data were obtained from the MoH's Health Statistics and Information Department and official jurisdictional reports. Administrative immunization coverage was used based on the data provided by the MoH's jurisdictions. The Epi Info software, version 7.1.2, was used for analysis. Results. The number of reported cases of pertussis increased between 2002 and 2011, reaching its peak in 2011: an incidence of 16 × 100 000 inhabitants, and 76 deaths. Most deaths occurred in infants younger than 1 year old. Immunization coverage achieved at a national level with the third dose and the dose administered at the time of starting primary education was >90%, while the coverage achieved with the first booster dose was 80%-90%. In 2011, 2821 confirmed cases were reported (incidence of 7 × 100 000 inhabitants): 84% in infants <1 year old; 76 deaths: 97% in infants <1 year old (60.5% in infants <2 months old). Among the strategies that were deployed, a total of 906 clinical nodes and 405 laboratory nodes were consolidated; the use of the polymerase chain reaction as a diagnostic method and the differential classification of cases were implemented, and additional vaccine doses were administered. Conclusions -The number of pertussis cases increased between 2002 and 2011; the highest morbidity and mortality occurred in infants younger than 1 year old; immunization coverage reached 80%-90%. -The highest number of pertussis-related deaths was recorded in 2011. -The MoH strengthened the epidemiological surveillance and set guidelines for control measures.Facultad de Ciencias Exacta

Situación epidemiológica de coqueluche y estrategias para su control. Argentina, 2002-2011

Introduction. Pertussis is a challenge for public health. Objectives: To describe pertussis-related morbidity and mortality and immunization coverage for the 2002-2011 period, profile of cases for 2011, and control strategies implemented by the Ministry of Health (MoH) of Argentina. Methods. Descriptive, epidemiological surveillance study. Morbidity data were obtained from the National Health Surveillance System, while mortality data were obtained from the MoH's Health Statistics and Information Department and official jurisdictional reports. Administrative immunization coverage was used based on the data provided by the MoH's jurisdictions. The Epi Info software, version 7.1.2, was used for analysis. Results. The number of reported cases of pertussis increased between 2002 and 2011, reaching its peak in 2011: an incidence of 16 × 100 000 inhabitants, and 76 deaths. Most deaths occurred in infants younger than 1 year old. Immunization coverage achieved at a national level with the third dose and the dose administered at the time of starting primary education was >90%, while the coverage achieved with the first booster dose was 80%-90%. In 2011, 2821 confirmed cases were reported (incidence of 7 × 100 000 inhabitants): 84% in infants <1 year old; 76 deaths: 97% in infants <1 year old (60.5% in infants <2 months old). Among the strategies that were deployed, a total of 906 clinical nodes and 405 laboratory nodes were consolidated; the use of the polymerase chain reaction as a diagnostic method and the differential classification of cases were implemented, and additional vaccine doses were administered. Conclusions -The number of pertussis cases increased between 2002 and 2011; the highest morbidity and mortality occurred in infants younger than 1 year old; immunization coverage reached 80%-90%. -The highest number of pertussis-related deaths was recorded in 2011. -The MoH strengthened the epidemiological surveillance and set guidelines for control measures.Facultad de Ciencias Exacta

Situación epidemiológica de coqueluche y estrategias para su control. Argentina, 2002-2011

Introduction. Pertussis is a challenge for public health. Objectives: To describe pertussis-related morbidity and mortality and immunization coverage for the 2002-2011 period, profile of cases for 2011, and control strategies implemented by the Ministry of Health (MoH) of Argentina. Methods. Descriptive, epidemiological surveillance study. Morbidity data were obtained from the National Health Surveillance System, while mortality data were obtained from the MoH's Health Statistics and Information Department and official jurisdictional reports. Administrative immunization coverage was used based on the data provided by the MoH's jurisdictions. The Epi Info software, version 7.1.2, was used for analysis. Results. The number of reported cases of pertussis increased between 2002 and 2011, reaching its peak in 2011: an incidence of 16 × 100 000 inhabitants, and 76 deaths. Most deaths occurred in infants younger than 1 year old. Immunization coverage achieved at a national level with the third dose and the dose administered at the time of starting primary education was >90%, while the coverage achieved with the first booster dose was 80%-90%. In 2011, 2821 confirmed cases were reported (incidence of 7 × 100 000 inhabitants): 84% in infants <1 year old; 76 deaths: 97% in infants <1 year old (60.5% in infants <2 months old). Among the strategies that were deployed, a total of 906 clinical nodes and 405 laboratory nodes were consolidated; the use of the polymerase chain reaction as a diagnostic method and the differential classification of cases were implemented, and additional vaccine doses were administered. Conclusions -The number of pertussis cases increased between 2002 and 2011; the highest morbidity and mortality occurred in infants younger than 1 year old; immunization coverage reached 80%-90%. -The highest number of pertussis-related deaths was recorded in 2011. -The MoH strengthened the epidemiological surveillance and set guidelines for control measures.Facultad de Ciencias Exacta