Prevalence of naso-pharyngeal Pneumococcal colonization in children between 1 to 5 years old in pre-school educative centers. 2014-2015

Foundation: Streptococcus pneumoniae is part of the normal bacterial flora of the nasal and pharingeal mucosa. Naso-pharyngeal colonization precedes the pneumococcal disease and affected individuals are a reservoir at the community level.Objective: to determine the prevalence of global naso-pharyngeal colonization and by serotypes of Streptococcus pneumoniae in children of pre-school age before anti pneumoccocal vaccination.Methods: a cross descriptive study in the Cienfuegos Municipality, within the period of June 2014 and April 2015. in children aged between 1 and 5 years attending preschool educative centers (N=1 129). Samples of naso-pharyngeal exudates were taken following the set guidelines. The prevalence of colonization was estimated and the most frequent serotypes were identified.Results: the global prevalence of naso-pharyngeal colonization was 32,32 %. The most frequent vaccine serotypes were 19F (6,02 %) and 6B (3,99 %); of those related with the vaccine, 6A predominated (5,49 %) and of the not related to the vaccine the most frequently observed was 14B.Conclusion: naso-pharyngeal colonization in preschool children not vaccinated against pneumoccocus presented a high prevalence at the expense of the serotypes included in the conjugated anti-peumococcal vaccines.</p

Cost-effectiveness of introducing a domestic pneumococcal conjugate vaccine (PCV7-TT) into the Cuban national immunization programme.

OBJECTIVES: To evaluate the cost-effectiveness of introducing a domestic pneumococcal conjugate vaccine (PCV7-TT) into the Cuban National Immunization Program (NIP). METHODS: We compared PCV7-TT given at two, four and six months of age to a scenario without PCV7-TT, over a ten-year period (2020-2029). We calculated the cost (Cuban pesos - CUP) per Disability Adjusted Life Year (DALY) averted from a Government perspective. We compared results from a static cohort model and a parsimonious prediction model informed by the serotype distribution among pneumococcal carriers and cases. We ran probabilistic and deterministic uncertainty analyses. RESULTS: PCV7-TT could prevent 6897 (95% uncertainty interval, 4344-8750) hospitalizations and 189 (115-253) deaths in children <5 years of age, over the period 2020-2029. This could cost around 25 million (20-31) discounted CUP but would be offset by treatment cost savings of around 23 million (14-31). A parsimonious model predicted less favourable impact and cost-effectiveness but the cost per DALY averted was still less than 0.4 times the current GDP per capita. CONCLUSIONS: PCV7-TT is likely to be cost-effective in Cuba. The impact of the vaccine would need to be carefully monitored following its introduction into the NIP

Corrigendum to "Cost-effectiveness of introducing a domestic pneumococcal conjugate vaccine (PCV7-TT) into the Cuban national immunization programme" [Int. J. Infect. Dis. 97 (2020) 182-189].

The authors regret that the Methods section has error in the formula. Corrections follow. In the Modelling approach section… For a given week (w) of age, the number of disease events Dw was calculated as: [Figure presented] where: P × S × Aw is the number of disease events in week w of age; Vw is the effect of vaccination in week w of age; P is the number of person-years lived between birth and age 5.0 years in the birth cohort evaluated; S is the streptococcus pneumoniae (pneumococcal) disease event rate per 100,000 per year among children younger than 5 years before the introduction of vaccination; and Aw is the proportion of pneumococcal disease events in children younger than 5 years in week w of age. In the Pneumococcal disease burden inputs section… For each birth cohort, estimates of person-years lived between birth and age 5.0 years (P) were based on United Nations demographic projections (https://population.un.org/wpp/). We estimated disease event rates (S) separately for pneumococcal acute otitis media (AOM), non-severe pneumococcal pneumonia, severe pneumococcal pneumonia, pneumococcal meningitis and other non-pneumonia/non-meningitis pneumococcal disease (NPNM) (Table 1). The authors would like to apologise for any inconvenience caused

Comparación del efecto postantibiótico del G- 1 y la Gentarnicina frente a cepas de Staphylococcus aureus y Escherichia coli

Se comparó el efecto postantibiótico (EPA) del G-1 y la gentamicina frente a Escherichia coli y Staphylococcus aureus. El EPA fue inducido por exposición a una concentración de 4 x CIM del G-1 y la gentamicina, excepto para Escherichia col¿ donde se utilizó 1 x CIM de gentamicina. El G-1 produjo un EPA prolongado (> 2 h) en el rango de 08 a 3,6 h para la mayoría de las cepas ensayadas. En las cepas gram positivas estudiadas la gentamicina mostró un EPA ligeramente superior al G-1, mientras que en las cepas gram negativas fue menor. Se comparó conjuntamente el EPA del G-1 a dos y cuatro veces el valor de la CIM en las cepas de referencia. No hubo una correlación estadística entre la concentración y el EPA para el G-l.The postantibiotic effect (PAE) of G-1 and gentamicin against Escherichia coli and Staphylococcus aureus was compared. The PAE was induced by exposure to G-1 and gentamicin at 4 x MIC, éxcept for Escherichia coli where 1 x MIC for gentamicin was used. Prolonged PAE (>2 h) ranging from 0.8 to 3.6 h was produced by G-1 for most strains assayed. PAE of gentamicin was slightly superior to G-1 for grampositive strains, while it was inferior for gramnegative strains. At the same time PAE of G-1 at two and four times MIC values was compared against reference strains. There was no statistic correlation between concentration and PAE for G-1 .Colegio de Farmacéuticos de la Provincia de Buenos Aire

Comparación del efecto postantibiótico del G- 1 y la Gentarnicina frente a cepas de Staphylococcus aureus y Escherichia coli

Se comparó el efecto postantibiótico (EPA) del G-1 y la gentamicina frente a Escherichia coli y Staphylococcus aureus. El EPA fue inducido por exposición a una concentración de 4 x CIM del G-1 y la gentamicina, excepto para Escherichia col¿ donde se utilizó 1 x CIM de gentamicina. El G-1 produjo un EPA prolongado (> 2 h) en el rango de 08 a 3,6 h para la mayoría de las cepas ensayadas. En las cepas gram positivas estudiadas la gentamicina mostró un EPA ligeramente superior al G-1, mientras que en las cepas gram negativas fue menor. Se comparó conjuntamente el EPA del G-1 a dos y cuatro veces el valor de la CIM en las cepas de referencia. No hubo una correlación estadística entre la concentración y el EPA para el G-l.The postantibiotic effect (PAE) of G-1 and gentamicin against Escherichia coli and Staphylococcus aureus was compared. The PAE was induced by exposure to G-1 and gentamicin at 4 x MIC, éxcept for Escherichia coli where 1 x MIC for gentamicin was used. Prolonged PAE (>2 h) ranging from 0.8 to 3.6 h was produced by G-1 for most strains assayed. PAE of gentamicin was slightly superior to G-1 for grampositive strains, while it was inferior for gramnegative strains. At the same time PAE of G-1 at two and four times MIC values was compared against reference strains. There was no statistic correlation between concentration and PAE for G-1 .Colegio de Farmacéuticos de la Provincia de Buenos Aire

Síndrome coqueluchoide y tos ferina Pertussis-like syndrome and whooping cough

El síndrome coqueluchoide, cuadro parecido a la tos ferina, es uno de los síndromes respiratorios bajos más comunes en la práctica pediátrica sobre todo en los últimos años. La tos ferina sigue siendo la enfermedad inmunoprevenible más antigua de la infancia que aún causa brotes importantes, principalmente en niños, pero también en adolescentes y adultos. El objetivo de esta revisión es proporcionar información a todos los médicos generales y pediatras de atención primaria y secundaria de salud sobre este problema epidemiológico y de su actual reemergencia. El control de esta enfermedad es un problema de salud tanto en países desarrollados como en vías de desarrollo. Uno de los mayores obstáculos que ha contribuido a una tardía intervención epidemiológica y tratamiento de la tos ferina en varios países del mundo, ha sido la baja sospecha clínica de esta enfermedad en los médicos y trabajadores de la salud, y el desconocimiento de la familia, en la mayoría de las veces. En el momento actual existe una reemergencia mundial de la tos ferina, situación que es necesario conocer y aceptar para un oportuno diagnóstico y tratamiento.<br>Pertussis-like syndrome, a clinical picture similar to whooping cough, is one of the most common lower respiratory syndromes in the pediatric practice in recent years. Whooping cough continues to be one of the oldest preventable diseases in infants, which still causes significant outbreaks mainly in children, but also in adolescents and adults. The objective of this review was to provide general physicians and pediatricians at the primary and the secondary health care levels with information about this present re-emerging epidemiological problem. The management of this disease is difficult for both the developed and the developing countries. One of the major obstacles that lead to delayed epidemiological intervention and treatment of whooping cough in several countries has been the poor clinical suspicion of the presence of the disease on the part of health workers and physicians, and the lack of knowledge within the family setting. It is required to know and to accept the re-emergence of whooping cough at present, in order to make a timely diagnosis and to apply a line of treatment

Naturally acquired immunity to Haemophilus influenzae type B in healthy Cuban children

We have evaluated the prevalence of antibody to immunogenicity of Haemophilus influenzae type b (Hib) in a group of 4 to 5 years old healthy children, who were too old to be included in the first vaccinated cohort when Hib vaccination begun in Cuba in 1999. Serum capsular polysaccharide specific IgG antibody concentrations were measured in 974 healthy children, between February and May 2002. The prevalence of Hib nasopharyngeal carriage was also estimated. The majority of children (99.7%) had more than 1 µg/ml of antibody. The preliminary report of the nasopharyngeal cultures was positive for H. influenzae in 16 children, but in only one was confirmed as Hib after serotyping (0.1% Hib nasopharyngeal carrier). These results provide evidence that in Cuba the natural active immunity to Hib can be acquired at an early age

SHORT COMMUNICATION - Naturally Acquired Immunity to Haemophilus influenzae Type B in Healthy Cuban Children

We have evaluated the prevalence of antibody to immunogenicity of Haemophilus influenzae type b (Hib) in a group of 4 to 5 years old healthy children, who were too old to be included in the first vaccinated cohort when Hib vaccination begun in Cuba in 1999. Serum capsular polysaccharide specific IgG antibody concentrations were measured in 974 healthy children, between February and May 2002. The prevalence of Hib nasopharyngeal carriage was also estimated. The majority of children (99.7%) had more than 1 µg/ml of antibody. The preliminary report of the nasopharyngeal cultures was positive for H. influenzae in 16 children, but in only one was confirmed as Hib after serotyping (0.1% Hib nasopharyngeal carrier). These results provide evidence that in Cuba the natural active immunity to Hib can be acquired at an early age