997 resultados para Pertussis Vaccine -- administration
Resumo:
ABSTRACT OBJECTIVE To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. METHODS For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for publication year. Original articles on the health impact assessment of pneumococcal and rotavirus vaccination programs in Latin America and the Caribbean in English, Spanish or Portuguese were included. RESULTS We identified 207 articles. After removing duplicates and assessing eligibility, we reviewed 33 studies, 25 focusing on rotavirus and eight on pneumococcal vaccination programs. The most frequent studies were ecological, with time series analysis or comparing pre- and post-vaccination periods. The main data sources were: health information systems; population-, sentinel- or laboratory-based surveillance systems; statistics reports; and medical records from one or few health care services. Few studies used primary data. Hospitalization and death were the main outcomes assessed. CONCLUSIONS Over the last years, a significant number of health impact assessments of pneumococcal and rotavirus vaccination programs have been conducted in Latin America and the Caribbean. These studies were carried out few years after the programs were implemented, meet the basic methodological requirements and suggest positive health impact. Future assessments should consider methodological issues and challenges arisen in these first studies conducted in the region.
Resumo:
Immune response against hepatitis B vaccine (CLB 3mg) was evaluated in 59 hemodialysis patients and 20 occupational risk personnel. Seroconversion was induced in 52.5% and 70.0% respectively. Twelve months after the first dose, 37.5% of patients and 60.0% of occupational risk personnel had detectable anti-HBs level. Antibody level was expressed in sample ratio units (SRU). Considering only the responders, in the patients group 38.7% had a low anti-HBs response (2.1-9.9 SRU) 32.3% a medium response (10-99.9 SRU) and 29.0% a high response (>100 SRU) while in occupational risk personnel these values were 14.3%, 64.3% and 21.4% respectively. The authors suggest the use of HBV vaccines with more elevated HBsAg concentration or a reinforced immunization schedule to improve the anti-HBs response not only for patients but also for healthy persons.
Resumo:
Resumo: Os profissionais de sade podem estar expostos a vrios factores indutores de stress crnico nomeadamente de natureza profissional destacando-se, entre os seus possveis efeitos, a diminuio da resposta de anticorpos aps administrao de vacinas, entre as quais, a vacina contra a gripe. Uma vez que os trabalhadores da sade esto expostos a factores indutores de stress e, simultaneamente, a agentes biolgicos cujos efeitos podero ser prevenidos pela vacinao, pertinente estudar a influncia do stress na resposta imunitria vacina contra a gripe em enfermeiros. Constituram objectivos deste trabalho: (1) estudar a associao entre a presena de stress crnico em enfermeiros hospitalares e a insuficiente resposta imunitria vacina contra a gripe, avaliada um ms aps a vacinao (T1); (2) estudar a associao entre a presena de stress crnico em enfermeiros hospitalares e a reduo dos ttulos de anticorpos dirigidos s hemaglutininas seis meses aps a vacinao (T6) e (3) identificar algumas caractersticas das unidades de internamento e do trabalho dos participantes que possam estar associadas presena de stress crnico e estudar a sua possvel associao com a resposta imunitria vacina contra a gripe. Realizou-se um estudo caso-controlo incorporado num estudo de coortes e a amostra em estudo foi constituda por 136 enfermeiros saudveis (83,8% sexo feminino; mdia de idades de 33anos) de um hospital universitrio. Realizaram-se entrevistas individuais e aplicaram-se as verses portuguesas dos questionrios The General Health Questionnaire (GHQ12) e Maslach Burnout Inventory Human Services Survey (MBI-HSS) para determinao da presena de stress crnico pelo mtodo da triangulao, no incio do estudo (T0) e realizou-se a recolha de dados relativos caracterizao de elementos de trabalho nas unidades de internamento. Foi administrada a vacina contra a gripe e determinou-se os ttulos de anticorpos dirigidos s hemaglutininas de cada estirpe componentes da vacina contra a gripe utilizada em 2007, antes da vacinao, um ms e seis meses aps a vacinao. No se encontrou associao, ao nvel de significncia de 5%, entre a presena de stress e a insuficiente resposta vacina contra a gripe, avaliada pela taxa de indivduos que apresentaram um aumento, ao fim de um ms, inferior a quatro vezes os ttulos de anticorpos antes da vacinao. No entanto, encontrou-se uma maior proporo de indivduos com stress no grupo de participantes em que ocorreu uma diminuio do ttulo de anticorpos dirigidos hemaglutinina AH1 (ac AH1) em T6, quando comparado com o respectivo grupo controlo. A diferena entre grupos foi estatisticamente significativa, quando se avaliou a presena de stress pelo mtodo da triangulao usando a entrevista (p=0,006), pelo mtodo da triangulao usando o GHQ12 (p=0,045) e ainda usando a combinao dos trs critrios (p=0,001). Aps anlise multivariada, verificou-se que a associao entre a presena de XXVI stress e a reduo dos ac AH1 em T6 manteve significado estatstico (respectivamente, p= 0,010, p= 0,042 e p=0,002) e apresentou odds ratio ajustados, em funo de cada um dos mtodos de avaliao da presena de stress, de 3,643, de 2,733 e de 5,223. A quantidade de trabalho percepcionada como sobrecarga constituiu o factor indutor de stress mais vezes referido (58,8% da amostra e 61,8% dos enfermeiros de unidades de internamento), seguida dos conflitos entre profissionais. O contacto com o sofrimento e a morte de doentes foram identificados em quarto lugar pela amostra, mas em segundo pelos enfermeiros de unidades de internamento. Nesses, verificou-se uma associao positiva entre trabalhar em Servios onde o nmero de doentes falecidos foi muito elevado e a presena de stress, medido pelo mtodo da triangulao usando a entrevista (p=0,039), usando o GHQ12 (p=0,019), usando a escala de exausto emocional do MBI-HSS (p=0,012) e pela combinao dos trs mtodos (p=0,014). Verificou-se tambm uma associao positiva entre a presena de stress, identificada pelo mtodo da triangulao usando a escala de exausto emocional do MBI-HSS, e o trabalho em servios de internamento onde a percentagem de doentes idosos (p=0,025) e a taxa de letalidade (p=0,036) foram elevadas. Contudo, no se encontrou associao entre a exposio muito frequente ao sofrimento e morte de doentes e a reduo do ttulo de ac AH1 em T6. Possivelmente, a exposio a esse factor indutor de stress, apesar de estar relacionada com a presena de stress nos enfermeiros de servios de internamento, no foi suficientemente intenso para, por si s, estar associada reduo do ttulo de ac AH1 em T6. A associao encontrada entre a presena de stress crnico e a reduo do ttulo de anticorpos AH1 em T6 vem apoiar a resposta questo de investigao inicialmente colocada de que o stress poder influenciar negativamente a manuteno dos ttulos de anticorpos, mesmo em indivduos adultos no idosos. Assim, o risco de um enfermeiro com stress apresentar reduo do ttulo de anticorpos dirigidos hemaglutinina da estirpe AH1N1 A/Solomon Islands/3/2006 ao fim dos seis meses do estudo, foi 3,6, 2,7 ou 5,2 vezes superior ao de um enfermeiro sem stress, consoante o critrio de stress ter sido determinado, respectivamente, pelo mtodo da triangulao usando a entrevista, pelo mtodo da triangulao utilizando o GHQ12 ou pela combinao dos trs critrios. Summary: Health workers may be exposed to various factors causing chronic stress namely those related directly to their activity, in particular the decrease in the capacity of the response of antibodies after the administration of the vaccines, amongst others the Influenza vaccine. Since health workers are exposed to factors causing stress and at the same time biological agents, whose effects may be prevented through vaccination, it is important to study the influence of stress in the immunity response to the Influenza vaccine on nurses. The aims of this study are: (1) to examine the relation between chronic stress in hospital nurses and the insufficient immunity response to the Influenza vaccine, assessed at one month after vaccination (T1); (2) to examine the relation between chronic stress in hospital nurses and the decrease of the hemagglutinin titles of antibodies six months after vaccination (T6); (3) to identify some characteristics of internment units and the work of the participants that may be related to the presence of chronic stress and to study its possible relation with the immunity response to the Influenza vaccine. A control-case study, integrated in a coortes study, was carried out and the sample under analysis consisted of 136 healthy nurses (83,8% female; average age 33 years old) from a university hospital. Several individual interviews were conducted and the portuguese versions of General Health Questionnaire (GHQ12) and Maslach Burnout Inventory Human Services Survey (MBI-HSS) was applied in order to determine the presence of chronic stress, using the triangulation method at the beginning of the study (T0). Data concerning the particular features of the internment units was collected. The Influenza vaccine was administered and the titles of hemagglutinin antibodies of each strain composing the Influenza vaccine used in 2007, before vaccination, and a month and six months after vaccination, were determined. There was no statistically relevant (5%) relation between stress and the insufficient immune response to the Influenza vaccine, according to the rate of individuals that showed, after a month, a level of antibodies concentration lower than four times the level prior to the vaccination. Nevertheless, there was a greater number of individuals with stress in the group of participants in which there was a decrease of the hemagglutinin titles of antibodies AH1 (ac AH1) in T6, when compared to the control group under study. The difference between groups was statistically relevant when assessing the presence of stress by triangulation method using the interview (p=0,006), by triangulation method using the GHQ12 (p=0,045) and by the combination of the three criteria (p=0,001). After multivariate analysis, it was verified that the XXVIII relation between the presence of stress and the reduction of the ac AH1 in T6 was statistically relevant (respectively, p= 0,010, p= 0,042 and p=0,002) and the odds ratio were, according to each of the methods used to assess the presence of stress, 3,643, 2,733 and 5,223. Overwork was the most emphasised stress-causing factor (58,8% of the sample and 61,8% of the nurses working in the Internment Units), followed by conflicts arousing among co-workers. Witnessing the suffering and death of patients was ranked as the fourth cause of stress, but the second by the nurses of the internment units. The former revealed a positive connection between working in the services, where there was a high rate of deaths, and the presence of stress, when assessing the presence of stress by triangulation method using the interview (p=0,039), the GHQ12 (p=0,019), the MBI-HSS emotional exhaustion scale (p=0,012) and by the combination of the three criteria (p=0,014).There was also a connection between the presence of stress, identified by the method of triangulation using the MBI-HSS emotional exhaustion scale, and working in the internment units, where the percentage of elderly people (p=0,025) and the mortality rate (p=0,036) were high. However, there was no connection between frequent exposure to suffering and death in patients and the reduction of ac AH1 titles, in T6. Although one can establish a connection between stress in nurses working in the internment units and the aforementioned stress-causing factor, the exposure to that factor was not, per se, intense enough to reduce the ac AH1 title in T6. The relation found between the presence of chronic stress and the reduction of AH1 antibodies titles in T6, corroborates the hypothesis that stress can negatively influence the title of antibodies, even in non-elderly adults. Thus, and according to the criteria used to define stress, by the triangulation method using the interview, by the triangulation method using the GHQ12 or the combination of the three criteria respectively, the risk of a nurse suffering from stress showing a reduction in the title of hemagglutinin antibodies for the strain AH1N1 A/Solomon Islands/3/2006 six-month after Influenza vaccine was 3,6, 2,7 or 5,2 times greater than on a nurse suffering from no stress at all. Rsum: Les professionnels de la sant peuvent tre exposs diffrents facteurs inducteurs de stress chronique de nature professionnelle. On remarque, parmi les effets possibles, une baisse de la rponse des anticorps aprs ladministration de vaccins, comme en particulier, le vaccin de la grippe. Lorsque les professionnels de la sant ont t exposs des facteurs inducteurs de stress, et de manire simultane, des agents biologiques dont les effets pourront tre prvenus par la vaccination, il est pertinent dtudier linfluence du stress dans la rponse immunitaire au vaccin de la grippe chez les infirmiers. Ils ont constitu des objectifs dtudes et de discussion : (1) tudier lassociation entre la prsence de stress chronique chez les infirmiers, en milieu hospitalier, et la insuffisant rponse immunitaire au vaccin de la grippe, vrifie un mois aprs la vaccination (T1); (2) tudier lassociation entre la prsence de stress chronique chez les infirmiers, en milieu hospitalier, et la rduction de la teneur des anticorps dirig la hmaglutinina six mois aprs la vaccination (T6) (3) identifier certaines caractristiques des units dinternement, et tudier les aspects du travail des participants, qui puissent tre associe la prsence de stress chronique et tudier sa possible association avec la rponse immunitaire au vaccin de la grippe. Une tude cas-contrle incorpore dans une tude de groupe a t ralise et un chantillon, pour tude, a t constitu par 136 infirmiers sains (83,8% de sexe fminin, ge moyen 33 ans) travaillant dans un hpital universitaire. Des entretiens individuels ont t raliss et les versions portugaises des questionnaires de General Health Questionnaire (GHQ12) et Maslach Burnout Inventory- Human Service Survey (MBI-HSS) ont t utiliss pour dterminer la prsence de stress chronique grce la mthode de triangulation, au dbut de ltude (T0) et un relev de donnes relatives la caractrisation dlments de travail dans les units dinternement a t fait. Le vaccin de la grippe a t administr et les teneurs en anticorps dirigs aux hmaglutininas de chaque composant du vaccin de la grippe pour 2007 ont t dtermins, avant la vaccination et un mois et six mois aprs. On na pas trouv dassociation, un niveau significatif de au moins 5%, entre la prsence de stress et la insuffisant rponse au vaccin de la grippe, value par le taux dindividus qui ont prsent une augmentation, la fin du mois, infrieur quatre fois la teneur des anticorps par rapport avant la vaccination. Cependant , on a trouv une plus grande proportion dindividus victimes de stress dans le groupe des participants o il y a eu une baisse de la teneur des anticorps dirig la hmaglutinina AH1 (ac AH1) en T6, aprs comparaison avec le respectif groupe de contrle. La diffrence entre les groupes a t statistiquement significative lorsquon a vrifi la prsence de stress grce la mthode de triangulation, en utilisant lentretien (p=0,006), par la mthode de triangulation en utilisant le GHQ12 (p=0,045) et en utilisant aussi la combinaison des trois critres (p=0,001). Aprs une analyse XXX multivarie, on a vrifi que lassociation entre la prsence de stress et la rduction des ac AH1 en T6 a conserv un signifi statistique (respectivement, p=0,010, p=0,042 et p=0,002) et a prsent des odds ratio ajusts, en fonction de chacune des mthodes de vrification de la prsence de stress de 3,643, de 2,733 et de 5,223. La quantit de travail perue comme une surcharge constitue le facteur inducteur de stress le plus souvent cit (58,8% de lchantillon et 61,8% des infirmiers des units dinternement), suivi par les conflits entre professionnels. Le contact avec la souffrance et la mort des patients a t plac en quatrime position par lchantillon, mais en deuxime position par les infirmiers des units dinternement. Dans ces cas, on a vrifi une association vidente entre le fait de travailler dans des services o le nombre de patients dcds a t trs lev et la prsence de stress, identifie par la mthode de triangulation, en utilisant lentretien (p=0,039), le GHQ12 (p=0,019), lchelle de fatigue motionnelle du MBI-HSS (p=0,012) et en utilisant aussi la combinaison des trois critres (p=0,014). On a aussi vrifi une association positive entre la prsence de stress, identifie par la mthode de triangulation, en utilisant lchelle de fatigue motionnelle du MBI-HSS et le travail dans des services dinternement o le pourcentage de malade gs (p=0,025) et le taux de mortalit ont t levs (p=0,036). Malgr tout, on na pas trouv dassociation entre lexposition trs frquente la souffrance et la mort des patients et la rduction de la teneur de ac AH1 en T6. Probablement lexposition ce facteur inducteur de stress, bien quelle soit lie la prsence de stress chez les infirmiers des services dinternement, na pas t suffisamment intense pour, en elle-mme, tre associe la rduction de la teneur ac AH1 enT6. Lassociation trouve entre la prsence de stress chronique et la rduction de la teneur des anticorps AH1 en T6 vient renforcer lhypothse que le stress pourra influencer ngativement la manutention des teneurs en anticorps mme chez les individus adultes jeunes. Donc le risque quun infirmier stress prsente une rduction de la teneur en anticorps dirigs la hmaglutinina de le composant AH1N1-A/Solomon Island/3/2006 la fin des six mois dtudes a t 3,6, 2,7 ou 5,2 fois suprieure celui dun infirmier sans stress, aprs avoir dtermin le critre de stress, respectivement par la mthode de triangulation utilisant lentretien, par la mthode de triangulation utilisant le GHQ12 ou par la combinaison des trois critres.
Resumo:
Schedule for vaccination against HBV infection has usually been based on three separate injections of 20 meg of the vaccine by intramuscular route. One of the main shortcomings to its use in large scale programs has been its high cost. Ninety out of 300 health workers were submitted to three injections of 2 meg of plasma-derived vaccine (PDV) by intradermal (ID) route on days 0, 30, and 180. Anti-HBs was detected in 74 (82.2%) after the second dose and in 80 (88.9%) after the third dose, a non-significant difference. However, levels above 10 times the cut-off were observed in 29 (32.2%) and 77 (85.5%), respectively (p < 0.001). The results showed that a low-dose schedule is effective when used in health workers and should be tried with other risk groups.
Resumo:
The Montenegro skin test is widely used as a diagnostic method for American cutaneous leishmaniasis (ACL) but little is known about the histological changes that occur in the skin after administration of the antigen. This report is based on histological studies of biopsied material obtained, from inoculation sites, 48 hours after individuals had been given intradermal injections with a standardized Montenegro antigen. The material examined was obtained from four distinctly different test groups: naturally infected patients with parasitologically proved ACL and with positive Montenegro's reaction; individuals without previous history of ACL and not previously tested with Montenegro antigen; participants in anti-ACL vaccine trials who developed positive reactions to Montenegro antigen after vaccination; other participants in vaccine trials who had negative Montenegro responses after vaccination or had served as controls in the trials. The histological pictures of each group are described and discussed. Histologically, the reactions of vaccinated individuals were indistinguishable from those with naturally acquired infections.
Resumo:
The authors developed a comparative study of the various methods of assessment of immune response to Hepatitis B vaccine. Eighty-six health care professionals underwent a vaccination programme with three doses of plasma-derived vaccine against Hepatitis B (H-B-Vax, Merck, Sharp & Dohme) given intra-muscularly. Assessment of immune response was carried out three months after the end of the programme, by radioimmunoassay (RIA) and enzymeimmunoassay (EIA). The results showed that the semi-quantitative assessment of Anti-HBs antibodies by RIA or EIA was perfectly comparable to the reference method (quantitative determination of antibodies by RIA). In view of these findings, the authors suggest a standardization of assessment of immune response to the vaccine, thus permitting correct planning of booster doses and easier comparison between different studies
Resumo:
A previous seroepidemiological study in the rural zone of Vargem Alta (ES) SouthEast of Brazil, showed a prevalence of up to 9% of hepatitis B surface antigen (HBsAg) in some areas. One hundred susceptible children aging 1 to 5 years old were selected and immunized with a recombinant DNA hepatitis B vaccine (Smith-Kline 20 mcg) using the 0-1-6 months vaccination schedule. Blood samples were collected at the time of the first vaccine dose (month 0) in order to confirm susceptible individuals and 1,3,6 and 8 months after the first dose , to evaluate the antibody response. Our results showed that two and five months after the second dose, 79% and 88% of children seroconverted respectively, reaching 97% after the third dose. The levels of anti-HBs were calculated in milli International Units/ml (mIU/ml) and demonstrated the markedly increase of protective levels of antibodies after the third dose. These data showed a good immunogenicity of the DNA recombinant hepatitis B vaccine when administered in children of endemic areas.
Resumo:
It was reevaluated a reduced schedule for anti-rabies post-exposure immunization with newborn mice nervous tissue vaccine (Fuenzalida 8c Palacios) in a group of 30 non exposed volunteers. The vaccine was administered by intramuscular injections on days zero, 2, 4, 16 and 27, in the deltoid area. Antibody levels were determinated by a simplified serum neutralization microtest on days zero, 16 and 37. On days 16 and 37 the antibody levels of the whole group was >0.5 IU/ml and >1.0 IU/ml, respectively. The cell mediated immunity was precociously detected (on day 4) by the delayed type hipersensitivity skin test. Our results show that this reduced schedule elicited an early and effective humoral and cellular immune response. However it is necessary other studies with larger groups of vaccinees in order to obtain definitive conclusion.
Resumo:
Apresentao realizada na Conferncia "Changing Public Sevice in a Changing World" realizada em Budapeste a 24 de Abril de 2009
Resumo:
Apresentao realizada no INA por ocasio da visita de uma delegao da Repblica da Srvia a Portugal.
Resumo:
Apresentao realizada a uma delegao da Administrao pblica da Bulgria, que visitou o INA em 2 de Dezembro de 2008.
Resumo:
Comunicao apresentada na 32 conferncia anual do European Group of Public Administration (EGPA), em Toulouse.
Resumo:
Apresentao realizada no OH&S Forum 2011 - International Forum on Occupational Health and Safety: Policies, profiles and services, na Finlndia de, 20 a 22 Junho de 2011.
Resumo:
Poster apresentado na 8. Conferncia da European Academy of Occupational Health Psychology, em Valencia, 12-14 de novembro de 2008.
