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Moura LDL, Neto M, Souza-Santos R. [Space-time heterogeneity of measles, mumps, and rubella vaccination indicators in children from BrazilHeterogeneidad espaciotemporal de los indicadores de inmunización con la vacuna triple viral en la población infantil de Brasil]. Rev Panam Salud Publica 2024; 48:e34. [PMID: 38686134 PMCID: PMC11053372 DOI: 10.26633/rpsp.2024.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/18/2024] [Indexed: 05/02/2024] Open
Abstract
Objective To evaluate immunization coverage and dropout rates of the measles, mumps, and rubella vaccine across Brazilian regions. Methods This ecological study employing a space-time approach used data from the National Immunization Program (PNI) and the Live Births Information System (SINASC). We estimated the annual variation (2014 to 2021) in immunization coverage and dropout rate of the measles, mumps, and rubella vaccine in children aged 12 and 15 months in the 5 570 Brazilian municipalities. Statistical analysis was conducted for the municipalities contained in each Brazilian region using the space-time scan technique, considering the Poisson probabilistic model and the hypothesis that municipalities with lower immunization coverage or high dropout rates would form space-time clusters. Results From 2014 to 2021, 38.3% and 12.9% of municipalities achieved a coverage ≥ 95.0% in the first and second doses respectively; 53.6% of municipalities had a high dropout rate (20.0% to 49.9%) and 37.2% had a very high dropout rate. The Northeast region had primary clusters for low coverage of the first (2018 to 2021) and second vaccine doses (2020 to 2021) with higher relative risks (RR) compared to other primary clusters. The RR for high dropout rate was elevated in all Brazilian regions (1.57 to 26.23). Conclusions In some Brazilian regions, the dropout rate has been high since 2014, signaling a risk of measles resurgence. In turn, space-time analysis indicated lower vaccination coverage in 2020, suggesting the influence of the COVID-19 pandemic.
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Affiliation(s)
- Lívia de Lima Moura
- Escola Nacional de Saúde Pública Sergio Arouca (ENSP)Programa de Pós-Graduação em Epidemiologia em Saúde PúblicaRio de Janeiro (RJ)BrasilEscola Nacional de Saúde Pública Sergio Arouca (ENSP), Programa de Pós-Graduação em Epidemiologia em Saúde Pública, Rio de Janeiro (RJ), Brasil.
| | - Mercedes Neto
- Universidade do Estado do Rio de Janeiro (UERJ)Departamento de Enfermagem de Saúde PúblicaRio de Janeiro (RJ)BrasilUniversidade do Estado do Rio de Janeiro (UERJ), Departamento de Enfermagem de Saúde Pública, Rio de Janeiro (RJ), Brasil.
| | - Reinaldo Souza-Santos
- Escola Nacional de Saúde Pública Sergio Arouca (ENSP)Departamento de Endemias Samuel PessoaRio de Janeiro (RJ)BrasilEscola Nacional de Saúde Pública Sergio Arouca (ENSP), Departamento de Endemias Samuel Pessoa, Rio de Janeiro (RJ), Brasil.
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Souza JFA, da Silva TPR, Oliveira TM, Vimieiro AM, Teixeira AMDS, Soares AC, Ribeiro EEN, de Freitas GL, Gaspar ED, Matozinhos FP. Impact of a research-action on vaccination indicators in the state of Minas Gerais, Brazil. Rev Saude Publica 2024; 58:09. [PMID: 38477780 PMCID: PMC10926982 DOI: 10.11606/s1518-8787.2024058005484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 04/25/2024] [Accepted: 09/23/2023] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVE Analyze the impact of the state research-action project on immunization indicators (vaccination coverage - VC, homogeneity of vaccination coverage - HVC, dropout rate - DR, and risk rating) before and after the intervention in municipalities and priority Regional Health Administrations/Regional Health Superintendencies (RHA/RHS). METHODS The state research-action project was a before-after community clinical trial conducted in 212 municipalities belonging to eight RHA/RHS in the state of Minas Gerais, Brazil. The study sample comprised RHA/RHS with a decreasing trend for routine vaccination coverage in children under one year from 2015 to 2020. This study used secondary VC and DR data from 10 immunobiologicals recommended for children younger than two years from January to December 2021 (pre-intervention period, prior to the state research-action project) and from January to December 2022 (post-intervention period). The categorical variables were presented in proportions, and initially, a comparison was made between those of DR, HVC, and the risk rating for the transmission of vaccine-preventable diseases, according to the two periods (2021 and 2022), using the McNemar test. RESULTS All immunization indicators increased after conducting the research-action project. In 2021, 80.66% of the state's municipalities had a risk rating for the transmission of vaccine-preventable diseases as "high and very high." In 2022, the value reduced to 68.40%. CONCLUSIONS Risk rating for the transmission of vaccine-preventable diseases is an important mechanism to assist managers in defining priorities. The state research-action project used a method that enabled the construction and execution of unique action plans for each municipality, directing the improvement of immunization indicators in the state.
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Affiliation(s)
- Janaina Fonseca Almeida Souza
- Universidade Federal de Minas GeraisEscolas de EnfermagemPrograma de Pós-graduação em Saúde e EnfermagemBelo HorizonteMGBrasil Universidade Federal de Minas Gerais. Escolas de Enfermagem. Programa de Pós-graduação em Saúde e Enfermagem. Belo Horizonte, MG, Brasil
- Secretaria de Estado da Saúde de Minas GeraisBelo HorizonteMGBrasil Secretaria de Estado da Saúde de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Thales Philipe Rodrigues da Silva
- Universidade Federal de Minas GeraisEscolas de EnfermagemPrograma de Pós-graduação em Saúde e EnfermagemBelo HorizonteMGBrasil Universidade Federal de Minas Gerais. Escolas de Enfermagem. Programa de Pós-graduação em Saúde e Enfermagem. Belo Horizonte, MG, Brasil
- Universidade Federal de São PauloEscola Paulista de EnfermagemDepartamento de Enfermagem na Saúde da MulherSão PauloSPBrasilUniversidade Federal de São Paulo. Escola Paulista de Enfermagem. Departamento de Enfermagem na Saúde da Mulher. São Paulo, SP, Brasil
| | - Thais Moreira Oliveira
- Santa Casa de Belo HorizonteBelo HorizonteMGBrasil Santa Casa de Belo Horizonte. Belo Horizonte, MG, Brasil
| | - Aline Mendes Vimieiro
- Secretaria de Estado da Saúde de Minas GeraisBelo HorizonteMGBrasil Secretaria de Estado da Saúde de Minas Gerais, Belo Horizonte, MG, Brasil
| | | | - Adriana Coelho Soares
- Secretaria de Estado da Saúde de Minas GeraisBelo HorizonteMGBrasil Secretaria de Estado da Saúde de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Elice Eliane Nobre Ribeiro
- Secretaria de Estado da Saúde de Minas GeraisBelo HorizonteMGBrasil Secretaria de Estado da Saúde de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Giselle Lima de Freitas
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno-Infantil e Saúde PúblicaBelo HorizonteMGBrasil Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno-Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Eduarda Dantas Gaspar
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno-Infantil e Saúde PúblicaBelo HorizonteMGBrasil Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno-Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Fernanda Penido Matozinhos
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno-Infantil e Saúde PúblicaBelo HorizonteMGBrasil Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno-Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
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Paéz V, Rodriguez-Fernandez M, Morales D, Torres C, Ardiles A, Soza S, Bustos C, Manríquez F, García C, Rocco R, Lang M. Quality of life, exercise capacity, cognition, and mental health of Chilean patients after COVID-19: an experience of a multidisciplinary rehabilitation program at a physical and rehabilitation medicine unit. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1274180. [PMID: 38107198 PMCID: PMC10722286 DOI: 10.3389/fresc.2023.1274180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/06/2023] [Indexed: 12/19/2023]
Abstract
Background Post-COVID disabilities, encompassing physical, cognitive, and psychological aspects, constitute the primary health sequelae for survivors. While the rehabilitation needs post COVID-19 are now well understood, each country possesses unique characteristics in terms of populations, healthcare systems, social dynamics, and economic profiles, necessitating context-specific recommendations. This study aims to address two main objectives: (1) analyze the impact of an 8-week multidisciplinary rehabilitation program on the quality of life, functional capacity, cognition, and mental health adaptations in adults recovering from COVID-19 in northern Chile, and (2) propose a personalized model for predicting program dropouts and responses. Methods A total of 44 subjects were enrolled, forming two groups during the study: a treatment group (n = 32) and a dropout group (n = 12). The treatment group participated in the 8-week multidisciplinary rehabilitation program. Results The results indicate that (1) After 8 weeks, the quality of life of the patients in the treatment group exhibited significant improvements reflected in all aspects of the Short Form-36 Health Survey (SF36, p < 0.005) and the total score (p < 0.001), with a concurrent decrease in dysfunctionality (p < 0.001). (2) Significant improvements were also observed in various physical performance tests, including the: 6-minute walk test, 1-min sit-to-stand, dynamometry, Tinetti balance, and Berg score (p < 0.001). Moreover, physical therapy led to a reduction in neuropathic symptoms and pain, psychological therapy reduced anxiety and depression, and language therapy enhanced memory and speech (all p < 0.05). (3) Demographic and clinical history characteristics did not predict responses to rehabilitation. (4) A regression model for predicting changes in SF-36 total score, based on physical function, physical role, general health, and mental health, was established based on the data from study (p < 0.01, adjusted R2 = 0.893). (5) Classification models for predicting dropouts achieved 68% accuracy, with key predictors of treatment adherence including diabetes, hypertension, and dyslipidemia, Tinetti balance, physical role, and vitality of SF36, and performance on the 6-minute walk test and 1-minute sit-to-stand. Conclusions This study demonstrates significant enhancements in quality of life, improved functional performance, and reductions in mental and cognitive burdens within an 8-week rehabilitation program. Additionally, it is possible to identify patients at risk of dropping out using cost-effective, outpatient, and clinically applicable tests.
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Affiliation(s)
- Valeria Paéz
- Biomedical Department, Center for Research in Physiology and Medicine of Altitude, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maria Rodriguez-Fernandez
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Diego Morales
- Physical Medicine and Rehabilitation Service, Clinical Hospital of the University of Antofagasta, Antofagasta, Chile
| | - Camillo Torres
- Department of Medical Sciences, University of Antofagasta, Antofagasta, Chile
| | - Andrés Ardiles
- Physical Medicine and Rehabilitation Service, Clinical Hospital of the University of Antofagasta, Antofagasta, Chile
| | - Sergio Soza
- Physical Medicine and Rehabilitation Service, Clinical Hospital of the University of Antofagasta, Antofagasta, Chile
| | - Cynthia Bustos
- Physical Medicine and Rehabilitation Service, Clinical Hospital of the University of Antofagasta, Antofagasta, Chile
| | - Fernanda Manríquez
- Physical Medicine and Rehabilitation Service, Clinical Hospital of the University of Antofagasta, Antofagasta, Chile
| | - Cesar García
- Physical Medicine and Rehabilitation Service, Clinical Hospital of the University of Antofagasta, Antofagasta, Chile
| | - Rossana Rocco
- Physical Medicine and Rehabilitation Service, Clinical Hospital of the University of Antofagasta, Antofagasta, Chile
| | - Morin Lang
- Laboratorio de Fisiología del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
- Departamento de Ciencias de la Rehabilitación y Movimiento Humano, Facultad Ciencias de la Salud, Universidad de Antofagasta, Antofagasta, Chile
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Marinho CV, Queiroz RCDS, Araujo WRM, Tonello AS, Thomaz EBAF. Indicators of the National Immunization Program for children under one year old: time trend in Maranhão, Brazil, 2010 to 2021. CIENCIA & SAUDE COLETIVA 2023; 28:2335-2346. [PMID: 37531541 DOI: 10.1590/1413-81232023288.07312023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 04/17/2023] [Indexed: 08/04/2023] Open
Abstract
We aimed to analyze the trend of indicators of the National Immunization Program (acronym in Portuguese. PNI) in children under one-year-old and classify municipalities regarding the risk of transmission of vaccine-preventable diseases (RTVPD) in Maranhão from 2010 to 2021. This ecological time series study was based on secondary data on vaccination coverage (VC). vaccination coverage homogeneity (VCH). proportion of abandonment (PA). and RTVPD. with state coverage for vaccines in the national children's calendar. Prais-Winsten regression estimated trends (α=5%) and the indicators' annual percentage change (APC). We identified fluctuating and discrepant VC between vaccines. with a decreasing trend (p < 0.01). except those against Hepatitis B (p = 0.709) and oral human rotavirus (p = 0.143). The sharpest falls were for Yellow Fever (APC = 12.24%) and BCG (APC = 12.25%) vaccines. All VCH rates were lower than expected. with a drop from 2014 and APC between 5.75% (Pneumococcal 10; p = 0.033) and 14.02% (Poliomyelitis; p < 0.01). We observed an increasing trend in PA for Pentavalent (APC = 4.91%; p < 0.01) and Poliomyelitis (APC = 3.55%; p < 0.01). We identified an increase of 52.54% in the proportion of municipalities in Maranhão from 2015 to 2021. with extremely high (p = 0.025) and high (p = 0.028) RTVPD. The PNI indicators deteriorated. reaffirming the susceptibility to the emergence of vaccine-preventable diseases.
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Affiliation(s)
- Cleia Varão Marinho
- Programa de Pós-Graduação em Saúde da Família, Universidade Federal do Maranhão. Centro Pedagógico Paulo Freire, Campus do Bacanga, Sala de Tutoria, 1º andar, Asa Norte. 65080-805 São Luís MA Brasil.
| | | | - Waleska Regina Machado Araujo
- Superintendência de Epidemiologia e Controle de Doenças, Secretaria Estadual de Saúde do Maranhão. São Luís MA Brasil
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Castilletti C, Capobianchi MR. Polio is back? The risk of poliomyelitis recurrence globally, and the legacy of the severe acute respiratory syndrome coronavirus 2 pandemic. Clin Microbiol Infect 2022; 29:414-416. [PMID: 36503117 PMCID: PMC9731642 DOI: 10.1016/j.cmi.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/22/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Concetta Castilletti
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Maria Rosaria Capobianchi
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy.
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