993 resultados para Dengue, prevenção
Resumo:
As recomendaes da Seco de Neonatologia da Sociedade Portuguesa de Pediatria (SNN-SPP) prevem a profilaxia medicamentosa da infeco por vrus sincicial respiratrio (VSR) com palivizumab em idades gestacionais (IG)inferiores a 30 semanas. Alguns Hospitais de Apoio Perinatal Diferenciado seguem prticas mais restritas, limitando o seu uso extrema prematuridade e/ou a prematuros com doena pulmonar crnica da prematuridade. Objectivos. Estimar a relao custo-eficcia da profilaxia com palivizumab segundo as recomendaes da SNN-SPP, atravs da aplicao de um modelo terico a uma coorte real de prematuros. Metodologia. Estudo prospectivo histrico. Coorte de crianas nascidas num Hospital de Apoio Perinatal Diferenciado entre 1/10/2002 e 30/04/2005 com IG 35 semanas. Considerou- se caso o internamento no mesmo hospital por bronquiolite por VSR nas pocas 2003/04 e 2004/05. Baseando-nos nas recomendaes SNN-SPP e no Number Needed to Treat dos estudos IMpact e IRIS, estimmos a reduo prevista nas taxas de hospitalizao caso a profilaxia fosse efectuada, comparando os seus custos com a reduo de custos de hospitalizao. Resultados. Dos 356 recm-nascidos elegveis, nove foram excludos por bito e dois por administrao de palivizumab. A taxa de hospitalizao por bronquiolite por VSR nas 345 crianas includas foi 9,3%. No subgrupo com indicao para profilaxia (26 crianas) a taxa de hospitalizao foi 15,4%, com uma estimativa de custo mdio de hospitalizao de 6.542,35. No ocorreu nenhuma morte por infeco por VSR. A reduo estimvel no nmero de hospitalizaes sob profilaxia seria de 1,5 (IMpact) ou 2,4 (IRIS). O custo necessrio para prevenir um internamento seria de 26.263,11 na melhor estimativa e 57.716,26 na pior estimativa. Concluso. Com o modelo desenvolvido, no conseguimos demonstrar nesta coorte uma estimativa de relao custo-eficcia favorvel administrao de Palivizumab segundo recomendaes da SNN-SPP.
Resumo:
O leite materno tem propriedades que o tornam nico e inimitvel. Sob o ponto de vista de prevenção da infeco,o leite de uma me , na generalidade dos casos, o alimento de eleio para o seu filho. certo que h situaes infecciosas que contra indicam o aleitamento materno mas elas so, hoje em dia, bem definidas e limitadas. Por outro lado, os conhecimentos actuais sobre as vantagens do aleitamento materno so to baseados na cincia e na evidncia, que se pode considerar um falhano dos servios de sade ter uma criana no amamentada. Aceitamos que toda a me tem o direito de dizer no, mas s se esse, for um no esclarecido. O leite materno um simbitico, uma fonte natural de lactobacilos e bfidobactrias (pr-biticos) e uma fonte natural de oligossacridos (pr-biticos) que, s por si e independentemente de todas as outras substncias que o compem, constituem uma proteco contra doenas infecciosas e no infecciosas em todos os perodos da vida nomeadamente na idade adulta. O recm-nascido pr-termo beneficiar muito se for alimentado com leite materno pelas condies que envolvem o seu nascimento e primeiros tempos de vida mas, muitas vezes, esse beneficio no utilizado, tendo frequentemente como justificao precisamente esses condicionalismos.
Resumo:
The aim of this article is to identify patterns in spatial distribution of cases of dengue fever that occurred in the municipality of Cruzeiro, State of So Paulo, in 2006. This is an ecological and exploratory study using the tools of spatial analysis in the preparation of thematic maps with data from Sinan-Net. An analysis was made by area, taking as unit the IBGE census, the analysis included four months in 2006 which show the occurrence of the disease in the city. The thematic maps were constructed by TerraView 3.3.1 software, the same software provided the values of the indicators of Global Moran (I M) every month and the Kernel estimation. In the year 2006, 691 cases of dengue were georeferenced (with a rate of 864.2 cases/100,000 inhabitants); the indicators of Moran and p-values obtained were I M = 0.080 (March) p = 0.11; I M = 0.285 (April) p = 0.01; I M = 0.201 (May) p = 0.01 and I M = 0.002 (June) p = 0.57. The first cases were identified in the Northeast and Central areas of Cruzeiro and the recent cases, in the North, Northeast and Central. It was possible to identify census tracts where the epidemic began and how it occurred temporally and spatially in the city.
Resumo:
In this work we propose a mathematical approach to estimate the dengue force of infection, the average age of dengue first infection, the optimum age to vaccinate children against dengue in a routine fashion and the optimum age interval to introduce the dengue vaccine in a mass vaccination campaign. The model is based on previously published models for vaccination against other childhood infections, which resulted in actual vaccination programmes in Brazil. The model was applied for three areas of distinct levels of endemicity of the city of Recife in Northeastern State of Pernambuco, Brazil. Our results point to an optimal age to introduce the dengue vaccine in the routine immunization programme at two years of age and an age interval to introduce a mass vaccination between three and 14 years of age.
Resumo:
Introduo: Nos ltimos 30 anos, em vrios pases, tem sido relatado um aumento da incidncia de tosse convulsa, sobretudo em adolescentes e adultos, apesar das altas taxas de cobertura de imunizao primria. Objectivos: Rever aspectos da epidemiologia da tosse convulsa, descrever algumas estratgias de controlo, com nfase nas que incluem a utilizao de vacinas com menores quantidades do toxide diftrico e de alguns componentes pertussis (dTpa), e a avaliao da eficcia e efectividade destas vacinas. Mtodos: Seleco de artigos relevantes, atravs da base de dados PubMed e stios de acesso livre da internet, publicados entre 1991 e 2011. Resultados: As alteraes do padro epidemiolgico so atribudas, principalmente, diminuio da imunidade ao longo dos anos, aps a vacinao ou infeco natural. Os adolescentes e adultos foram identificados como importantes fontes de transmisso da doena para lactentes muito jovens que, uma vez no imunizados ou parcialmente imunizados, so mais vulnerveis s complicaes relacionadas com a doena e apresentam maior mortalidade. A vacina (dTpa), formulada para o uso em adolescentes e adultos segura e eficaz. A sua utilizao tambm reduz a transmisso da tosse convulsa para os grupos etrios com alto risco de complicaes. Concluso: A disponibilidade da dTpa oferece novas oportunidades para reduzir o impacto da tosse convulsa. A modificao das estratgias preventivas pode levar a um melhor controlo global da doena.
Resumo:
SUMMARY The natural co-infection with dengue virus can occur in highly endemic areas where different serotypes have been observed for many years. We report one case of DENV-1/DENV-4 co-infection in human serum detected by molecular tests. Phylogenetic analysis of the sequences obtained indicated the presence of genotype V and II for DENV-1 and DENV-4, respectively.
Resumo:
Renal histology results are very scarce in dengue-associated rhabdomyolysis patients developing acute kidney injury (AKI). We report a case of dengue fever-induced AKI associated to rhabdomyolysis with a renal biopsy showing acute tubular necrosis (ATN) and renal deposition of myoglobin. A 28-year-old patient who presented dengue fever (DF) complicated by severe AKI and rhabdomyolysis is described. The patient required hemodialysis for three weeks. A renal biopsy revealed ATN with positive staining for myoglobin in the renal tubuli. The patient was discharged with recovered renal function. In conclusion, this case report described a biopsy proven ATN associated to DF-induced rhabdomyolysis, in which renal deposition of myoglobin was demonstrated. We suggest that serum creatine phosphokinase should be monitored in DF patients to allow for an early diagnosis of rhabdomyolysis and the institution of renal protective measures.
Resumo:
A finding of vertical transmission of the DEN 3 virus in male specimens of Aedes aegypti, collected in the 2009 fall-winter period, in Puerto Iguaz city, Misiones, Argentina, using the RT-PCR technique in a 15-specimen pool is reported. This result is analyzed within the context of the epidemiological situation of Argentina's northeast border.
Resumo:
Dengue is currently a major public-health problem. Dengue virus (DENV) is classified into four distinct serotypes, DENV 1-4. After 28 years of absence, DENV-4 was again detected in Brazil in 2010 in Roraima State, and one year later, the virus was identified in the northern Brazilian states of Amazonas and Pará, followed by Rio de Janeiro and São Paulo. In Minas Gerais, the first confirmed case of DENV-4 occurred in the municipality of Frutal in 2011 and has now been isolated from a growing number of patients. Although DENV-2 is associated with the highest risk of severe forms of the disease and death due to the infection, DENV-4 has also been associated with severe forms of the disease and an increasing risk of hemorrhagic manifestations. Herein, the first fatal case of confirmed DENV-4 in Brazil is reported. The patient was an 11-year-old girl from the municipality of Montes Claros in northern Minas Gerais State, Brazil. She had idiopathic thrombocytopenic purpura as a comorbid condition and presented with a fulminant course of infection, leading to death due to hemorrhagic complications. Diagnosis was confirmed by detection of Dengue-specific antibodies using IgM capture enzyme-linked immunosorbent assay and semi-nested RT-PCR. Primary care physicians and other health-care providers should bear in mind that DENV-4 can also result in severe forms of the disease and lead to hemorrhagic complications and death, mainly when dengue infection is associated with coexisting conditions.
