1
|
Jacquinet S, Mattheus W, Quoilin S, Wyndham-Thomas C, Martin C, Van der Linden D, Mulder A, Frère J, Schirvel C. Outbreak of invasive meningococcal disease caused by a meningococcus serogroup B in a nursery school, Wallonia, Belgium, 2018. Euro Surveill 2022; 27. [PMID: 35241214 PMCID: PMC8895469 DOI: 10.2807/1560-7917.es.2022.27.9.2100224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Although most invasive meningococcal disease (IMD) cases are sporadic without identified transmission links, outbreaks can occur. We report three cases caused by meningococcus B (MenB) at a Belgian nursery school over 9 months. The first two cases of IMD occurred in spring and summer 2018 in healthy children (aged 3–5 years) attending the same classroom. Chemoprophylaxis was given to close contacts of both cases following regional guidelines. The third case, a healthy child of similar age in the same class as a sibling of one case, developed disease in late 2018. Microbiological analyses revealed MenB with identical finetype clonal complex 269 for Case 1 and 3 (unavailable for Case 2). Antimicrobial susceptibility testing revealed no antibiotic resistance. Following Case 3, after multidisciplinary discussion, chemoprophylaxis and 4CMenB (Bexsero) vaccination were offered to close contacts. In the 12-month follow-up of Case 3, no additional cases were reported by the school. IMD outbreaks are difficult to manage and generate public anxiety, particularly in the case of an ongoing cluster, despite contact tracing and management. This outbreak resulted in the addition of MenB vaccination to close contacts in Wallonian regional guidelines, highlighting the potential need and added value of vaccination in outbreak management.
Collapse
Affiliation(s)
- Stéphanie Jacquinet
- Epidemiology of infectious diseases, Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Wesley Mattheus
- National Reference Centre for Neisseria meningitidis, Sciensano, Brussels, Belgium
| | - Sophie Quoilin
- Epidemiology of infectious diseases, Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Chloé Wyndham-Thomas
- Epidemiology of infectious diseases, Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Charlotte Martin
- Infectious Diseases Department, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Dimitri Van der Linden
- Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Brussels, Belgium.,Pediatric Infectious Diseases, General Pediatrics, Pediatric Department Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - André Mulder
- Pediatric Intensive Care Unit, Centre Hospitalier Chrétien (CHC) Liège, Belgium
| | - Julie Frère
- University Department of Paediatrics, Centre Hospitalier Universitaire (CHU) Liège, Belgium
| | - Carole Schirvel
- Agence pour une vie de qualité, infection prevention and control, Wallonia, Belgium
| |
Collapse
|
2
|
Fastl C, Devleesschauwer B, van Cauteren D, Lajot A, Leroy M, Laisnez V, Schirvel C, Mahieu R, Pierard D, Michel C, Jacquinet S. The burden of legionnaires' disease in Belgium, 2013 to 2017. ACTA ACUST UNITED AC 2020; 78:92. [PMID: 33042538 PMCID: PMC7539445 DOI: 10.1186/s13690-020-00470-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 09/11/2020] [Indexed: 11/17/2022]
Abstract
Background Legionnaires’ disease (LD) is a severe bacterial infection causing pneumonia. Surveillance commonly underestimates the true incidence as not all cases are laboratory confirmed and reported to public health authorities. The aim of this study was to present indicators for the impact of LD in Belgium between 2013 and 2017 and to estimate its true burden in the Belgian population in 2017, the most recent year for which the necessary data were available. Methods Belgian hospital discharge data, data from three infectious disease surveillance systems (mandatory notification, sentinel laboratories and the national reference center), information on reimbursed diagnostic tests from the Belgian National Institute for Health and Disability Insurance and mortality data from the Belgian statistical office were used. To arrive at an estimate of the total number of symptomatic cases in Belgium, we defined a surveillance pyramid and estimated a multiplication factor to account for LD cases not captured by surveillance. The multiplication factor was then applied to the pooled number of LD cases reported by the three surveillance systems. This estimate was the basis for our hazard- and incidence-based Disability-Adjusted Life Years (DALYs) calculation. To account for uncertainty in the estimations of the DALYs and the true incidence, we used Monte Carlo simulations with 10,000 iterations. Results We found an average of 184 LD cases reported by Belgian hospitals annually (2013–2017), the majority of which were male (72%). The surveillance databases reported 215 LD cases per year on average, 11% of which were fatal within 90 days after diagnosis. The estimation of the true incidence in the community yielded 2674 (95% Uncertainty Interval [UI]: 2425–2965) cases in 2017. LD caused 3.05 DALYs per case (95%UI: 1.67–4.65) and 8147 (95%UI: 4453–12,426) total DALYs in Belgium in 2017, which corresponds to 71.96 (95%UI: 39.33–109.75) DALYs per 100,000 persons. Conclusions This analysis revealed a considerable burden of LD in Belgium that is vastly underestimated by surveillance data. Comparison with other European DALY estimates underlines the impact of the used data sources and methodological approaches on burden estimates, illustrating that national burden of disease studies remain essential.
Collapse
Affiliation(s)
- Christina Fastl
- Student of the Master of Science Program in Public Health, University of Southern Denmark, Esbjerg, Denmark.,Epidemiology of Infectious Diseases, Department of Epidemiology and Public Health, Sciensano, Sciensano, Rue J Wytsman 14, 1050 Brussels, Belgium
| | - Brecht Devleesschauwer
- Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium.,Lifestyle and Chronic Diseases, Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Dieter van Cauteren
- Epidemiology of Infectious Diseases, Department of Epidemiology and Public Health, Sciensano, Sciensano, Rue J Wytsman 14, 1050 Brussels, Belgium
| | - Adrien Lajot
- Epidemiology of Infectious Diseases, Department of Epidemiology and Public Health, Sciensano, Sciensano, Rue J Wytsman 14, 1050 Brussels, Belgium
| | - Mathias Leroy
- Epidemiology of Infectious Diseases, Department of Epidemiology and Public Health, Sciensano, Sciensano, Rue J Wytsman 14, 1050 Brussels, Belgium
| | - Valeska Laisnez
- Agency for Care and Health, Infection Prevention and Control, Flemish Community, Brussels, Belgium
| | - Carole Schirvel
- Agence pour une vie de qualité, Infection Prevention and Control, Wallonia, Charleroi, Belgium
| | - Romain Mahieu
- Common Community Commission, Infection Prevention and Control, Brussels, Belgium
| | - Denis Pierard
- Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, National Reference Center for Legionella, Brussels, Belgium
| | - Charlotte Michel
- Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB), National Reference Center for Legionella, Brussels, Belgium
| | - Stéphanie Jacquinet
- Epidemiology of Infectious Diseases, Department of Epidemiology and Public Health, Sciensano, Sciensano, Rue J Wytsman 14, 1050 Brussels, Belgium
| |
Collapse
|
3
|
de Azambuja E, Brandão M, Wildiers H, Laenen A, Aspeslagh S, Fontaine C, Collignon J, Lybaert W, Verheezen J, Rutten A, Vuylsteke P, Goeminne JC, Demey W, Van Beckhoven D, Deblonde J, Rottey S, Geukens T, Punie K, Bafort K, Belkhir L, Bossuyt N, Colombie V, Daubresse C, Dauby N, De Munter P, Delmarcelle D, Delvallee M, Demeester R, Delefortrie Q, Dugernier T, Holemans X, Louviaux I, Machurot P, Minette P, Mokrane S, Nachtergal C, Noirhomme S, Piérard D, Rossi C, Schirvel C, Sermijn E, Staelens F, Triest F, Van Beckhoven D, Van Goethem N, Van Praet J, Vanhoenacker A, Verstraete R, Willems E, Wyndham-Thomas C. Impact of solid cancer on in-hospital mortality overall and among different subgroups of patients with COVID-19: a nationwide, population-based analysis. ESMO Open 2020; 5:e000947. [PMID: 32978251 PMCID: PMC7520811 DOI: 10.1136/esmoopen-2020-000947] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/15/2020] [Accepted: 08/18/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cancer seems to have an independent adverse prognostic effect on COVID-19-related mortality, but uncertainty exists regarding its effect across different patient subgroups. We report a population-based analysis of patients hospitalised with COVID-19 with prior or current solid cancer versus those without cancer. METHODS We analysed data of adult patients registered until 24 May 2020 in the Belgian nationwide database of Sciensano. The primary objective was in-hospital mortality within 30 days of COVID-19 diagnosis among patients with solid cancer versus patients without cancer. Severe event occurrence, a composite of intensive care unit admission, invasive ventilation and/or death, was a secondary objective. These endpoints were analysed across different patient subgroups. Multivariable logistic regression models were used to analyse the association between cancer and clinical characteristics (baseline analysis) and the effect of cancer on in-hospital mortality and on severe event occurrence, adjusting for clinical characteristics (in-hospital analysis). RESULTS A total of 13 594 patients (of whom 1187 with solid cancer (8.7%)) were evaluable for the baseline analysis and 10 486 (892 with solid cancer (8.5%)) for the in-hospital analysis. Patients with cancer were older and presented with less symptoms/signs and lung imaging alterations. The 30-day in-hospital mortality was higher in patients with solid cancer compared with patients without cancer (31.7% vs 20.0%, respectively; adjusted OR (aOR) 1.34; 95% CI 1.13 to 1.58). The aOR was 3.84 (95% CI 1.94 to 7.59) among younger patients (<60 years) and 2.27 (95% CI 1.41 to 3.64) among patients without other comorbidities. Severe event occurrence was similar in both groups (36.7% vs 28.8%; aOR 1.10; 95% CI 0.95 to 1.29). CONCLUSIONS This population-based analysis demonstrates that solid cancer is an independent adverse prognostic factor for in-hospital mortality among patients with COVID-19. This adverse effect was more pronounced among younger patients and those without other comorbidities. Patients with solid cancer should be prioritised in vaccination campaigns and in tailored containment measurements.
Collapse
Affiliation(s)
- Evandro de Azambuja
- Department of Medical Oncology, Institut Jules Bordet and L'Université Libre de Bruxelles (U.L.B), Brussels, Belgium.
| | - Mariana Brandão
- EPI Unit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Hans Wildiers
- Department of General Medical Oncology and Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Annouschka Laenen
- Interuniversity Centre for Biostatistics and Statistical Bioinformatics, KU Leuven, Leuven, Belgium
| | | | | | | | - Willem Lybaert
- Department of Medical Oncology, AZ Nikolaas, Sint-Niklaas, Belgium
| | - Jolanda Verheezen
- Department of Medical Oncology, St. Trudo Hospital, Sint-Truiden, Belgium
| | - Annemie Rutten
- Department of Medical Oncology, GZA Ziekenhuizen, Campus Sint-Augustinus, Wilrijk, Belgium
| | - Peter Vuylsteke
- Department of Medical Oncology, UCLouvain, CHU-UCL Namur, Namur, Belgium; Department of Internal Medicine, University of Botswana, Gaborone, Botswana
| | | | - Wim Demey
- Department of Medical Oncology, AZ Klina, Brasschaat, Belgium
| | | | | | - Sylvie Rottey
- Department of Medical Oncology, Gent University Hospital, Gent, Belgium
| | - Tatjana Geukens
- Laboratory for Translational Breast Cancer Research, KU Leuven, Leuven, Belgium
| | - Kevin Punie
- Department of General Medical Oncology and Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Grammens T, Schirvel C, Leenen S, Shodu N, Hutse V, Mendes da Costa E, Sabbe M. Ongoing measles outbreak in Wallonia, Belgium, December 2016 to March 2017: characteristics and challenges. ACTA ACUST UNITED AC 2017; 22:30524. [PMID: 28488998 PMCID: PMC5434888 DOI: 10.2807/1560-7917.es.2017.22.17.30524] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 04/27/2017] [Indexed: 11/20/2022]
Abstract
We describe characteristics of an ongoing measles outbreak in Wallonia, Belgium, and difficulties in control measures implementation. As at 12 March 2017, 177 measles cases were notified, of which 50% were 15 years and older, 49% female. Atypical clinical presentation and severe complications, mainly among adults, in combination with late notification, low or unknown vaccination coverage of contacts, infected healthcare workers and increased workload due to contact tracing, are the main concerns for outbreak management.
Collapse
Affiliation(s)
- Tine Grammens
- Service of Epidemiology of Infectious Diseases, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| | - Carole Schirvel
- Infectious Disease Surveillance Unit, Agence pour une Vie de Qualité (AVIQ), Walloon region, Charleroi, Belgium
| | - Sylvie Leenen
- Infectious Disease Surveillance Unit, Agence pour une Vie de Qualité (AVIQ), Walloon region, Charleroi, Belgium
| | - Nathalie Shodu
- Infectious Disease Surveillance Unit, Agence pour une Vie de Qualité (AVIQ), Walloon region, Charleroi, Belgium
| | - Veronik Hutse
- National Reference Centre for measles, mumps and rubella, Service of Viral Diseases, Scientific Institute of Public Health, Brussels, Belgium
| | - Elise Mendes da Costa
- Service of Epidemiology of Infectious Diseases, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| | - Martine Sabbe
- Service of Epidemiology of Infectious Diseases, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| |
Collapse
|
5
|
Grammens T, Maes V, Hutse V, Laisnez V, Schirvel C, Trémérie JM, Sabbe M. Different measles outbreaks in Belgium, January to June 2016 - a challenge for public health. ACTA ACUST UNITED AC 2017; 21:30313. [PMID: 27541858 PMCID: PMC4998501 DOI: 10.2807/1560-7917.es.2016.21.32.30313] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 08/11/2016] [Indexed: 11/30/2022]
Abstract
During the first half of 2016, several outbreaks of measles were reported in the three regions of Belgium. Main challenges for public health were severe complications occurring in adults, nosocomial transmission and infection in healthcare workers. Here, we describe those outbreaks and lessons learnt for public health.
Collapse
Affiliation(s)
- Tine Grammens
- Service of Epidemiology of Infectious Diseases, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| | | | | | | | | | | | | |
Collapse
|
6
|
Braeye T, Verhaegen J, Mignon A, Flipse W, Pierard D, Huygen K, Schirvel C, Hens N. Correction: Capture-Recapture Estimators in Epidemiology with Applications to Pertussis and Pneumococcal Invasive Disease Surveillance. PLoS One 2016; 11:e0165351. [PMID: 27755593 PMCID: PMC5068773 DOI: 10.1371/journal.pone.0165351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
7
|
Braeye T, Verheagen J, Mignon A, Flipse W, Pierard D, Huygen K, Schirvel C, Hens N. Capture-Recapture Estimators in Epidemiology with Applications to Pertussis and Pneumococcal Invasive Disease Surveillance. PLoS One 2016; 11:e0159832. [PMID: 27529167 PMCID: PMC4987016 DOI: 10.1371/journal.pone.0159832] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 07/08/2016] [Indexed: 11/17/2022] Open
Abstract
Introduction Surveillance networks are often not exhaustive nor completely complementary. In such situations, capture-recapture methods can be used for incidence estimation. The choice of estimator and their robustness with respect to the homogeneity and independence assumptions are however not well documented. Methods We investigated the performance of five different capture-recapture estimators in a simulation study. Eight different scenarios were used to detect and combine case-information. The scenarios increasingly violated assumptions of independence of samples and homogeneity of detection probabilities. Belgian datasets on invasive pneumococcal disease (IPD) and pertussis provided motivating examples. Results No estimator was unbiased in all scenarios. Performance of the parametric estimators depended on how much of the dependency and heterogeneity were correctly modelled. Model building was limited by parameter estimability, availability of additional information (e.g. covariates) and the possibilities inherent to the method. In the most complex scenario, methods that allowed for detection probabilities conditional on previous detections estimated the total population size within a 20–30% error-range. Parametric estimators remained stable if individual data sources lost up to 50% of their data. The investigated non-parametric methods were more susceptible to data loss and their performance was linked to the dependence between samples; overestimating in scenarios with little dependence, underestimating in others. Issues with parameter estimability made it impossible to model all suggested relations between samples for the IPD and pertussis datasets. For IPD, the estimates for the Belgian incidence for cases aged 50 years and older ranged from 44 to58/100,000 in 2010. The estimates for pertussis (all ages, Belgium, 2014) ranged from 24.2 to30.8/100,000. Conclusion We encourage the use of capture-recapture methods, but epidemiologists should preferably include datasets for which the underlying dependency structure is not too complex, a priori investigate this structure, compensate for it within the model and interpret the results with the remaining unmodelled heterogeneity in mind.
Collapse
Affiliation(s)
- Toon Braeye
- Department Epidemiology of infectious diseases, Epidemiology, Scientific Institute of Public Health, Brussels, Belgium
| | - Jan Verheagen
- Department of Clinical Microbiology, University Clinic Leuven, Leuven, Belgium
| | | | - Wim Flipse
- Infectious Disease Control, Flemish Agency for Care and Health, Brussels, Belgium
| | - Denis Pierard
- Institute of Medical Microbiology, University Hospital of Brussels, Brussels, Belgium
| | - Kris Huygen
- Department immunology, Communicable and Infectious Diseases, Scientific Institute of Public Health, Brussels, Belgium
| | - Carole Schirvel
- Cellule de surveillance des maladies infectieuses, Direction générale de la santé, Brussels, Belgium
| | - Niel Hens
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Hasselt, Belgium.,Centre for Health Economic Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (WHO Collaborating Centre), University of Antwerp, Wilrijk, Belgium.,Epidemiology and social medicine (ESOC), University of Antwerp, Wilrijk, Belgium
| |
Collapse
|
8
|
Jacquinet S, Denis O, Soares FV, Schirvel C. Legionnaires' disease: overview of the situation concerning notification in Wallonia (Belgium) in 2012, a retrospective descriptive study based on a capture-recapture method. ACTA ACUST UNITED AC 2015; 73:2. [PMID: 25810914 PMCID: PMC4373001 DOI: 10.1186/2049-3258-73-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 09/28/2014] [Indexed: 11/18/2022]
Abstract
Background Legionnaires’ disease is a severe form of pneumonia, and although public health medical inspectors must be notified, it is often under-reported. The objectives of this study were to determine the completeness rate of notification of Legionnaires’ disease and to estimate the incidence of this disease in Wallonia, the southern part of Belgium, in 2012. Method This retrospective, transversal descriptive study was based on a capture-recapture method using two sources. An estimation of the total number of Legionnaires’ disease cases was calculated using Chapman and Seber’s estimators for small numbers, thereby allowing us to estimate the real incidence of this disease in Wallonia as well as the completeness rate of notification. Results The total number of estimated Legionella cases for 2012 was 45 (IC 95%:41–48) and the completeness rate was 65% (IC 95%:61-70%). The estimated incidence of Legionnaires’ disease in Wallonia was 1.27/100,000 inhabitants. Conclusions The notification rate of Legionella must be improved in Wallonia. Doctors should be made aware of the importance of diagnosing and reporting Legionnaires’ disease.
Collapse
Affiliation(s)
- Stéphanie Jacquinet
- Infectious diseases surveillance, Fédération Wallonie-Bruxelles, Belgique, Direction générale de la santé, cellule de surveillance des maladies infectieuses, Boulevard Léopold II, 44, 1080 Bruxelles, Belgique
| | - Olivier Denis
- department of microbiology, hôpital Erasme, Centre National de Référence des Légionelles, 1070 Bruxelles, Belgique ; Ecole de Santé Publique, Université Libre de Bruxelles, Campus Erasme - CP598 808 route de Lennik, 1070 Bruxelles, Belgique
| | - Filomena Valente Soares
- Ecole de Santé Publique, Université Libre de Bruxelles, Campus Erasme - CP598 808 route de Lennik, 1070 Bruxelles, Belgique
| | - Carole Schirvel
- Infectious diseases surveillance, Fédération Wallonie-Bruxelles, Belgique, Direction générale de la santé, cellule de surveillance des maladies infectieuses, Boulevard Léopold II, 44, 1080 Bruxelles, Belgique
| |
Collapse
|
9
|
Mbeva JBK, Karemere H, Schirvel C, Porignon D. Rôles exercés par le Niveau intermédiaire du système sanitaire en République démocratique du Congo : représentations des acteurs. Santé Publique 2014. [DOI: 10.3917/spub.145.0685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
10
|
Mbeva JBK, Schirvel C, Godelet E, Wodon A, Porignon D, Bonami M. [Reorganization of the provincial health system in the Democratic Republic of the Congo]. Sante Publique 2014; 26:849-858. [PMID: 25629679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION In the framework of implementation of health system reform in the Democratic Republic of the Congo (DRC), and in a context of decentralization dictated by the National Constitution, this study presents the process and results obtained in terms of the provincial level of health care organization in DRC. METHODS A two-year multidisciplinary interventional research protocol was elaborated with two phases and 9 steps including organizational analysis, team building, and organizational learning. It resulted in transformational actions and improved knowledge, allowing the development of an innovative organizational model of the intermediate level of the health care system in the Democratic Republic of the Congo. RESULTS This interventional research gave rise to function plans set up by the provincial health division (PHD) in order to develop a more participative management and to compensate for the weaknesses of the current structural organization. Experts provided support to PHD for implementation of a new structure in order to institutionalize this new participative management. The new organizational structure of the PHD is based on 4 professions: i) health district support; ii) control and inspection; iii) information, communication and research and iv) resources management. PHD and experts defined these professions and described the required skills. RESULTS were integrated into the new national health plan. CONCLUSIONS Apart from the concrete results obtained, two major challenges need to be addressed: i) support the transformation of PHD from the current situation to the new model and ii) extend this new model to the other provinces, according to the same participative approach, a necessary condition to adjust the organization flow-chart to the context.
Collapse
|
11
|
Mbeva JBK, Karemere H, Schirvel C, Porignon D. [Stakeholder representations of the role of the intermediate level of the DRC health system]. Sante Publique 2014; 26:685-693. [PMID: 25490228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Intermediate health care structures in the DRC were designed during the setting-up of primary health care in a perspective of health district support. This study was designed to describe stakeholder representations of the intermediate level of the DRC health system during the first 30 years of the primary health care system. METHODS This case study was based on inductive analysis of data from 27 key informant interviews.. RESULTS The intermediate level of the health system, lacking sufficient expertise and funding during the 1980s, was confined to inspection and control functions, answering to the central level of the Ministry of health and provincial authorities. Since the 1990s, faced with the pressing demand for support from health district teams, whose self-management had to deal with humanitarian emergencies, the need to integrate vertical programmes, and cope with the logistics of many different actors, the intermediate heath system developed methods and tools to support heath districts. This resulted in a subsidiary model of the intermediate level, the perceived efficacy of which varies according to the province over recent years. CONCLUSION The "subsidiary" model of the intermediary health system level seems a good alternative to the "control" model in DRC.
Collapse
|
12
|
Tshingani K, Schirvel C, Mukumbi H, Ngambwe S, Wilmet-Dramaix M. Vulnerability factors for malnutrition among people living with HIV under antiretroviral treatment in an outpatient clinic: Kinshasa, Democratic Republic of Congo. HIV & AIDS Review 2014. [DOI: 10.1016/j.hivar.2013.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
13
|
Detemmerman L, Rousseaux D, Efstratiou A, Schirvel C, Emmerechts K, Wybo I, Soetens O, Piérard D. Toxigenic Corynebacterium ulcerans in human and non-toxigenic Corynebacterium diphtheriae in cat. New Microbes New Infect 2013; 1:18-9. [PMID: 25356320 PMCID: PMC4184488 DOI: 10.1002/2052-2975.9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 07/21/2013] [Accepted: 07/24/2013] [Indexed: 11/11/2022] Open
Abstract
Corynebacterium diphtheriae and Corynebacterium ulcerans are rarely isolated from clinical samples in Belgium. A case of toxigenic C. ulcerans in a woman is described, which confirms that this pathogen is still present. During investigation of the patient's cats, only a non-toxigenic toxin-bearing C. diphtheriae strain was detected.
Collapse
Affiliation(s)
- L Detemmerman
- National Reference Centre for Corynebacterium diphtheriae, Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel 1090, Brussels, Belgium
| | - D Rousseaux
- Laboratoire de Biologie Clinique, Clinique Sainte-Elisabeth 4802, Heusy, Belgium
| | - A Efstratiou
- WHO Global Collaborating Centre for Diphtheria & Streptococcal Infections, Public Health England London, NW9 5EQ, United Kingdom
| | - C Schirvel
- Cellule d'Inspection d'Hygiène, Direction générale de la Santé, Fédération Wallonie-Bruxelles 1080, Brussels, Belgium
| | - K Emmerechts
- National Reference Centre for Corynebacterium diphtheriae, Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel 1090, Brussels, Belgium
| | - I Wybo
- National Reference Centre for Corynebacterium diphtheriae, Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel 1090, Brussels, Belgium
| | - O Soetens
- National Reference Centre for Corynebacterium diphtheriae, Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel 1090, Brussels, Belgium
| | - D Piérard
- National Reference Centre for Corynebacterium diphtheriae, Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel 1090, Brussels, Belgium
| |
Collapse
|
14
|
Mbeva JBK, Schirvel C, Karemere H, Porignon D. [Supporting the intermediate level of health care in urban health areas in Kinshasa (1995-2005), DR Congo]. Sante Publique 2012; 24 Spec No:9-22. [PMID: 22789285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
As a result of the decentralization of health systems, some countries have introduced intermediate (provincial) levels in their public health system. This paper presents the results of a case study conducted in Kinshasa on health system decentralization. The study identified a shift from a focus on regulation compliance assessment to an emphasis on health system coordination and health district support. It also highlighted the emergence of a?managerial (as opposed to a bureaucratic) approach to health district support. The performance of health districts in terms of health care coverage and health service use were also found to have improved. The results highlight the importance of intermediate levels in?the health care system and the value of a more organic and managerial rationality in supporting health districts faced with the complexity of urban environments and the integration of specialized multi-partner programs and interventions.
Collapse
|
15
|
Balaluka GB, Nabugobe PS, Mitangala PN, Cobohwa NB, Schirvel C, Dramaix MW, Donnen P. Community volunteers can improve breastfeeding among children under six months of age in the Democratic Republic of Congo crisis. Int Breastfeed J 2012; 7:2. [PMID: 22364405 PMCID: PMC3323360 DOI: 10.1186/1746-4358-7-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Accepted: 02/24/2012] [Indexed: 11/15/2022] Open
Abstract
Background Malnutrition is a major public health problem in developing countries and exclusive breastfeeding is an efficient strategy that can be used to prevent malnutrition and reduce child mortality. The objective of this study is to evaluate the effectiveness of community volunteers in promoting exclusive breastfeeding from birth in an area of endemic malnutrition. Methods This evaluation analyzed the impact of the community-based nutrition project in Katana health district of the Democratic Republic of Congo from 2004 to 2006. Each of the villages in this sector had a nutritional village committee made up of five members responsible for continuously working to raise awareness of the importance of exclusive breastfeeding from birth among pregnant women and community leaders in their respective villages. The program worked with community volunteers with a mean age of 37 years, most of whom were married (86%). Eighty percent of the community volunteers had completed secondary school or a higher level of education. Data related to the period of exclusive breastfeeding and to the number of visits made to the health services for 208 children. The data were compared with data from 178 infants collected from another health sector, which had never developed a community-based nutrition program. Results The duration of exclusive breastfeeding from birth (median, range) was 6 months (2 to 7) in the intervention area compared with 4 months (1 to 6) in the comparison area (p < 0.001). The proportion of infants receiving exclusive breastfeeding at six months of age was higher in the intervention area than in the comparison area: 57.7% (95% Confidence Interval, CI, 50.9 to 64.5) versus 2.7% (95%CI, 1.1 to 6.6) (p < 0.001). The intervention group had a higher mean weight at 12 months (standard deviation): 8.42 kg (1.41) compared to 7.97 kg (1.02), although this difference was not statistically significant (p = 0.055). Conclusions The promotion of breastfeeding by community volunteers in an area of endemic malnutrition in rural Democratic Republic of Congo increased the duration of exclusive breastfeeding from birth.
Collapse
Affiliation(s)
- Ghislain B Balaluka
- Centre de Recherche en Sciences Naturelles de Lwiro (CRSN), Bukavu, Democratic Republic of Congo.
| | | | | | | | | | | | | |
Collapse
|
16
|
Kabamba Mulongo L, Schirvel C, Mukalay Wa Mukalay A, Dramaix Wilmet M. Understanding couples' attitudes on prenatal HIV testing in the Democratic Republic of Congo. Rev Epidemiol Sante Publique 2011; 59:379-83. [PMID: 22075216 DOI: 10.1016/j.respe.2011.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 06/24/2011] [Accepted: 07/18/2011] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The prevalence of HIV-serodiscordant couples is increasing. In these couples, one member is infected with HIV and the other one is not, so HIV testing for both members of the couple remains one of the significant challenges in the prevention of sexual transmission of HIV within the couple. The aim of this study was to analyze couples' attitudes toward HIV testing after prenatal HIV testing offered to pregnant women and analyze the males' behavior with regard to their own HIV testing. METHODS One hundred and forty-three pregnant women and their partners were interviewed in the Lubumbashi health district in the Democratic Republic of the Congo. The usual descriptive statistics were applied. RESULTS Seventy-one percent of the couples declared that they accepted the HIV testing proposed to the woman and approximately 64% of the couples said they had discussed the HIV testing proposed in prenatal healthcare clinics. However, this dialogue seemed to have a poor impact on the HIV testing of the male partner: no male partner was tested in spite of the high proportion of men encouraged to do so. Nearly 30% and 50% of the couples disagreed on systematic condom use and the need for the husband's permission to undergo HIV testing, respectively. Twenty-nine percent of the couples did not wish to have the male sexual partner present at the prenatal consultation. CONCLUSION The majority of men considered that their wife's HIV testing gives them information about their own HIV status and this makes HIV testing difficult for both members of the couple. Better management of the couple in HIV screening and prevention programs therefore seems necessary.
Collapse
Affiliation(s)
- L Kabamba Mulongo
- École de Santé Publique, Université de Lubumbashi, Lubumbashi, Democratic Republic of the Congo.
| | | | | | | |
Collapse
|
17
|
Kahindo MJB, Schirvel C, Karemere H, Mitangala P, Wodon A, Porignon D. [Impact of mid-level management and support on the performance of a district health system in the Democratic Republic of the Congo]. Med Trop (Mars) 2011; 71:147-151. [PMID: 21695871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION The aim of this study was to assess the contribution of mid-level management and support practices to the overall performance of a district healthcare system. METHODS This case study was carried out in the North Kivu Province of the Democratic Republic of the Congo. It was based on analysis of (i) preventive and curative healthcare services and (ii) management and support practices provided from 2000 to 2008. RESULTS In response to recurring sociopolitical unrest since 1992, the mid-level health system (provincial level) in North Kivu has strengthened management and support practices. The main goals have been to optimize allocation of interventions by external emergency organizations and integration of specialized program activities, to harmonize intervention techniques implemented by external partners, to standardize supervision of sanitary districts with regard to care provider skills, and to adapt strategic options defined by the Ministry of Health to the provincial level. Using this comprehensive approach, the performance of the North Kivu Province in terms of curative and preventive care has exceeded the national average since 2001. Between 2001 and 2008, use of curative services progressed from 0.36 to 0.50 new cases/capita/year. Positive results have also been recorded for infrastructure coverage, essential medicine stock, health information system, and emergency preparedness. CONCLUSION Stronger mid-level management and support practices have improved care activities in the health district while protecting the population from unstructured interventions by emergency organizations or specialized programs. A comprehensive management approach has also improved the resilience of the district and increased its contribution to Millennium Development Goals.
Collapse
Affiliation(s)
- M J B Kahindo
- Centre Scientifique et Médical de l'Université Libre de Bruxelles, Belgique.
| | | | | | | | | | | |
Collapse
|
18
|
Kabamba Mulongo L, Schirvel C, Mukalay wa Mukalay A, Dramaix Wilmet M. [HIV-1 test acceptance within the prevention of mother-to-child HIV-1 transmission program in Democratic Republic of Congo]. Rev Epidemiol Sante Publique 2010; 58:313-21. [PMID: 20933349 DOI: 10.1016/j.respe.2010.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 04/19/2010] [Accepted: 04/30/2010] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND HIV-1 testing and counselling are essential activities that must be integrated into mother-to-child HIV transmission prevention programs (PMTCT) in order to identify women who can benefit from the treatment, immediately or later and from interventions that can prevent HIV in their infants. The aim of this study was to describe how women's attitudes influence acceptance of HIV-1 testing in the context of antenatal care. METHODS Four hundred and thirty-nine women attending antenatal care clinics offering HIV-1 testing in the health district of Lubumbashi in Democratic Republic of Congo were included in the study. Data were collected through interviewer-administered questionnaire. Women were asked to give their consent for a home visit and interview of their partners; 143 agreed to participate. Statistical analyses were carried out using Chi-square test and logistic regression. RESULTS The proportion of pregnant women who declared that they would accept HIV testing was 76.5%. Non-married women (p=0.046), women who had never carried out a former HIV test (p<0.001), who had mentioned that they would wish to share the results of the test with their partner or would wish to be accompanied at least once by their partner at the antenatal clinic (p<0.001), those whose partner agreed to participate in the study (p=0.010) and those who knew at least one mode of HIV transmission (p=0.025) were more likely to accept the HIV testing. CONCLUSION Improving counselling and a policy of HIV counselling and testing integrating a couple components could help to overcome obstacles to the integration of the women within PMTCT programs and help improve acceptance of HIV testing.
Collapse
|
19
|
Mukatay AWM, Kalenga PMK, Dramaix M, Hennart P, Schirvel C, Kabamba LM, Kabyla BI, Donnen P. [Factors associated with malnutrition in children aged under five years in Lubumbashi (DRC)]. Sante Publique 2010; 22:541-550. [PMID: 21360863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Nutritional status of children is a global indicator of children's well-being and, indirectly, of the community's well-being. The first objective of this work is to assess the nutritional status of children under five years-old living in a suburb of the city of Lubumbashi, DR Congo, at the end of the 1998-2003 armed conflict. The second objective aims to identify some predictors of malnutrition. A multivariate logistic regression was applied to the results of a cross-sectional survey of 1963 children from selected households. In addition to the anthropometric variables, living conditions were also used. We observed 33.5% stunted growth and 3.8% emaciation. After logistic regression, a low maternal educational level (less than 7 years), the absence of a drinking water tap available in the house or yard, male gender, and age of children ( > 11 months) were all significantly associated with increased risk of stunted growth. Moreover, decreased appetite, diarrhea and age of children ( < 12 months) were significant predictors of emaciation. Compared to the classification of the World Health Organization, our results indicate that the prevalence of stunting is high and the prevalence of emaciation is low. Interventions against malnutrition should consider the various predictors discussed in this study in order to reduce mortality and morbidity in children and contribute to their well-being.
Collapse
|
20
|
Mukalay AW, Kalenga PM, Dramaix M, Hennart P, Schirvel C, Kabamba LM, Kabyla BI, Donnen P. Facteurs prédictifs de la malnutrition chez les enfants âgés de moins de cinq ans à Lubumbashi (RDC). Santé Publique 2010. [DOI: 10.3917/spub.105.0541] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
21
|
Bitwe R, Schirvel C, Dramaix M, Hennart P. [Intra-hospital mortality of children in central Africa: looking at the impact of a training programme and increased supervision]. Sante Publique 2009; 21:415-426. [PMID: 20101820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The study's aim was to evaluate the impact of an in-service training course and supervision of physicians and nurses in terms of quality of care on intra-hospital mortality. The study included 2 cohorts of children. Cohort 1 included 414 children from 0 to 15-years-old who were followed in the paediatric wards of the provincial hospital of Goma (HPG) between April 1, 2003 and March 31, 2004. Cohort 2 included 996 children from 0 to 15-years-old where were treated and followed in the same service between January 1, 2005 and December 31, 2005. General and specific mortalities occurring before and after an intervention were compared, as were the ratios of the observed deaths to the predicted deaths through the application of the Goma1 model to cohort 2. Overall mortality decreased by 15,9% (before the intervention) to 4,6% (after the intervention), translating to a total reduction of 71,1%. The ratios between the observed deaths and the predicted deaths were lower than 1, globally and when stratified. The risk of death in the cohort 1 (before the intervention) is 6,8 times higher than in cohort 2 (after the intervention). This shows an improvement of child survival after the intervention.
Collapse
|
22
|
Bisimwa G, Mambo T, Mitangala P, Schirvel C, Porignon D, Dramaix M, Donnen P. Nutritional Monitoring of Preschool-Age Children by Community Volunteers during Armed Conflict in the Democratic Republic of the Congo. Food Nutr Bull 2009; 30:120-7. [DOI: 10.1177/156482650903000203] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background The coverage of preschool preventive medical visits in developing countries is still low. Consequently, very few children benefit from continuous monitoring during the first 5 years of life. Objective To assess community volunteers' effectiveness in monitoring the growth of preschool-age children in a context of endemic malnutrition and armed conflict. Methods Community volunteers were selected by village committees and trained to monitor children's growth in their respective villages. Community volunteers monitored 5,479 children under 5 years of age in the Lwiro Health Sector of the Democratic Republic of the Congo from January 2004 to December 2005 under the supervision of the district health office. Children's weight was interpreted according to weight-for-age curves drawn on the growth sheet proposed by the World Health Organization and adopted by the Democratic Republic of the Congo. Results During the 2-year program, the volunteers weighed children under 5 years of age monthly. The median percentage of children weighed per village varied between 80% and 90% for children of 12–59 months, and 80% and 100% for children of less than 12 months even during the conflict period. The median percentage of children between 12 and 59 months of age per village ranked as highly susceptible to malnutrition by the volunteers decreased from 4.2% (range, 0% to 35.3%) in 2004 to 2.8% (range, 0.0% to 18.9%) in 2005. Conclusions The decentralization of weighing of children to the community level could be an alternative for improving growth monitoring of preschool-age children in situations of armed conflict or political instability. This option also offers an opportunity to involve the community in malnutrition care and can be an entry point for other public health activities.
Collapse
|
23
|
Bisimwa BG, Mambo MT, Mitangala NP, Schirvel C, Porignon D, Dramaix WM, Donnen P. [The effectiveness of community volunteers in counting populations and assessing their nutritional vulnerability during armed conflict: district health in D.R. Congo, Central Africa]. Sante 2009; 19:81-86. [PMID: 20031515 DOI: 10.1684/san.2009.0156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The study assessed the ability of community volunteers, working with district health officials, to conduct a local census to count the population in their villages and assess their nutritional vulnerability. The study involved organizing community volunteers in village nutrition committee and assigning them to count the village population in a Kivu rural health district (D.R.Congo) and assess their vulnerability in terms of nutrition. The study took place in March and April 2003, during armed conflict in the region. Community volunteers supervised by district health officials collected data, presented here as median proportions (with their Max and Min), by age category. The results show that community volunteers were able to conduct this census with reliable results. The population distribution by age category was similar to the national model from a survey by experts. The community volunteers estimated a median of 22.2 % (6.2-100 %) of households in each village in the eastern DR Congo were vulnerable and required foreign aid. Community volunteers can contribute accurately to the collection of demographic data to be used in health programme planning, thus allowing these data to be followed even during instability and armed conflicts.
Collapse
Affiliation(s)
- B G Bisimwa
- Département d'épidémiologie et de médecine sociale, Ecole de santé publique, Université libre de Bruxelles, route de Lennik, Bruxelles, Belgique.
| | | | | | | | | | | | | |
Collapse
|
24
|
Karemere H, Byamungu T, Kahindo JB, Wodon A, Porignon D, Schirvel C. Hôpitaux généraux de référence en Ituri – RD Congo : des normes sanitaires à la réalité. Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.06.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
25
|
Kahindo JB, Schirvel C, Mitangala P, Brédo F, Kalambay N, Mulohwe MK, Porignon D. Pertinence du niveau intermédiaire du système sanitaire dans un milieu urbain en situation critique : de la théorie à la pratique à Kinshasa. Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.06.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
26
|
van Lom HB, Schrijver RS, Reynaud G, Schirvel C. [Safety aspects of the practical application of a gI-negative subunit vaccine against Aujeszky's disease in swine]. Tijdschr Diergeneeskd 1990; 115:159-62. [PMID: 2154870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
On two farms in an area in which Aujeszky's disease is endemic, 192 pregnant sows were vaccinated with a gI-negative sub-unit vaccine against Aujeszky's disease. The rectal temperatures of the sows were recorded once daily for seven consecutive days, starting on the day of vaccination, and the vaccinated animals were observed for local and systemic reactions. The temperatures recorded did not exceed 39.8 degrees C in any case, and local or systemic reactions caused by vaccinations were not observed. One sow (0.6 per cent) aborted, but other symptoms of disease were not apparent, and there was no relationship with vaccination. In a second experiment, the carcasses of 120 pigs, vaccinated once or twice with the same vaccine, were carefully examined for local reactions. In eleven pigs (9.1 per cent) slight cicatricial reactions were visible within from 20 to 34 days after inoculation, the diameter not exceeding 1.5 cm in any of the cases. Traces of vaccination were no longer perceptible within 84 days after vaccination. The vaccine was found to be very safe for pregnant sows under field conditions.
Collapse
|