scholarly journals Epidemiological and economic efficiency of mass vaccinal prevention against pneumococcal infection in children compared with selective immunization at the example of community-acquired pneumonia

2019 ◽  
Vol 36 (4) ◽  
pp. 63-73 ◽  
Author(s):  
Vadislav V. Semerikov ◽  
Elena S. Zubova ◽  
Lyudmila V. Sofronova
Keyword(s):  
High Risk ◽  
Economic Efficiency ◽  
Pneumococcal Infection ◽  
Economic Benefits ◽  
Community Acquired Pneumonia ◽  
High Risk Group ◽  
Mass Vaccination ◽  
Morbidity And Mortality ◽  
First Year ◽  
First Year Of Life

Aim. To study the epidemiological pattern of community-acquired pneumonias in children and the influence of mass vaccinal prevention on morbidity and mortality. Materials and methods. Vaccination of children against pneumococcal infection on the territory of a large industrial center of Western Urals was analyzed, influence of mass vaccination against pneumococcal infection on pneumonia morbidity and mortality in children was determined. Results. Mass vaccinal prevention of children of the first year of life against pneumococcal infection (vaccination volume 102 353.6 per 100 thousand children under 6) significantly influenced morbidity level regarding community-acquired pneumonias in the group of vaccinated children under 2 (1619.9 0.78 versus 15233.7 2.5 per 100 thousand in the group of unvaccinated, odds ratio and its confidence interval was 9.40 [95 % CI 8.4610.44]), on community-acquired streptococcal morbidity of children under 6 (r = 0.97; regression coefficient = 36.30, р 0.001; R2 = 91.0 %, significance F = 0.01 and possibility 95.0 %) and 5-fold decreased the mortality level (from 35.2 before vaccination started to 6.8 per 100 thousand) till its full absence in the third year of realization of this strategy. No analogous influence on the main manifestations of epidemiological process of community-acquired pneumonia was noted in case of selective immunization against pneumococcal infection among 25 year olds, belonging to high risk groups (vaccination volume 10 417.08 per 100 thousand children under 6). Conclusions. The strategy of mass vaccination of children of the first year of life was characterized by the greatest epidemiological and economic benefits. Economic efficiency taking into account vaccination costs in terms of 1000 of vaccinated children was 17.1 times higher and was equal to 8.3656 mln rub per 1000 inhabitants versus 0.4890 mln rub in case of selective immunization of high risk group children.

scholarly journals The Effect of Selective and Mass Immunization Against Pneumococcal Infection on the Morbidity and Mortality due to Community-Acquired Pneumonia in Children Under 5 Years of Age

2019 ◽  
Vol 16 (4) ◽  
pp. 216-228
Author(s):  
Vadislav V. Semerikov ◽  
Elena S. Zubova ◽  
Lyudmila V. Sofronova
Keyword(s):  
Pneumococcal Infection ◽  
Chronically Ill ◽  
Community Acquired Pneumonia ◽  
Mass Vaccination ◽  
Morbidity And Mortality ◽  
Morbidity Rate ◽  
Mass Immunization ◽  
Cost Efficacy ◽  
Selective Vaccination ◽  
Children Under 5

Background. It is required to perform estimation of epidemiological and cost efficacy (regarding morbidity rate) of mass routine vaccination against pneumococcal infection in Russian children and carried out earlier selective vaccination of children from high-risk groups on the basis of four-year experience. It is also important to estimate the rate of hospital admissions in this patient group, long-term and annual cycles, morbidity age and etiology structure, and mortality due to community-acquired pneumonia as one of the most common form of pneumococcal disease. The aim is to study the effect of selective and mass immunization against pneumococcal infection on the morbidity and mortality due to community-acquired pneumonia in children under 5 years of age. Methods. The analysis of communityacquired pneumonia morbidity (in 2003–2018) and mortality due to pneumonias (in 2003–2018) in children under the 14 years old in Perm was carried out. Serotypes of circulating pneumococcus, etiology of community-acquired pneumonias and immunization cost efficacy (direct expense on health care) were further studied. The analysis of study indexes was carried out following selective (vaccination of at-risk children in 2011–2014) and mass (vaccination of infants in 2015–2018) immunization strategies. Results. The morbidity rate of community-acquired pneumonias decreased by 4.0 times (from 267.0 to 66.7 for 1000) after performing selective vaccination (2011–2014) in at-risk children (frequently and chronically ill children). The morbidity rate of community-acquired pneumonias in non vaccinated children of the same group increased by 2.0 times (from 40.0 to 80.0 for 1000 non-vaccinated). The prophylactic efficacy index was 46.0. Whereby the antibacterial index among vaccinated frequently and chronically ill children was 0.11 on one child. This index has decreased by 2.6 times (from 0.11 to 0.04 on one child) in a year within the framework of prospective controlled randomized clinical study. The antibacterial index among non-vaccinated children of this group remained slightly the same: 0.09 and 0.12 respectively. During the selective vaccination the mortality rate among infants decreased by 2 times: long-term average index was 17.9 (2011–2014) against 35.2 (2003-2010) on 100 thousand children. Mass vaccination of infants against pneumococcal infection has reduced the incidence of community-acquired pneumonias among children under 2 years of age and has led to absence of multiple sites of pneumococcal infection in children’s organizations. It also has reduced the number of hospitalized children and achieved zero mortality due to pneumonias in infants by the third year of this immunization strategy implementation. The obtained results were achieved mainly due to circulation of 7 pneumococcal serotypes (6A, 6B, 9V, 14, 19A, 19F, 23F) in children under 5 years of age. The threshold level of vaccination against pneumococcal infection advancing morbidity and mortality due to pneumonias in children was specified. The strategy of mass vaccination of infants was cost-effective. Conclusion. The new data on epidemiological and cost efficacy of various immunization strategies against pneumococcal infection in children was obtained.

Morbidity and Mortality in the First Year of Life.

1958 ◽  
Vol 12 (1) ◽  
pp. 87
Author(s):  
J. W. B. Douglas ◽  
Fred Grundy ◽  
E. Lewis Faning
Keyword(s):  
Morbidity And Mortality ◽  
First Year ◽  
First Year Of Life

THE EFFECT OF MONTHLY GAMMA-GLOBULIN ADMINISTRATION ON MORBIDITY AND MORTALITY FROM INFECTION IN PREMATURE INFANTS DURING THE FIRST YEAR OF LIFE

PEDIATRICS ◽  
1963 ◽  
Vol 32 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Jules Amer ◽  
Esther Ott ◽  
Frank A. Ibbott ◽  
Donough O'Brien ◽  
C. Henry Kempe
Keyword(s):  
Premature Infants ◽  
Gamma Globulin ◽  
Repeated Administration ◽  
Morbidity And Mortality ◽  
Controlled Study ◽  
First Year ◽  
Double Blind ◽  
First Year Of Life

A double-blind controlled study to determine the effect on infections of repeated administration of large doses of gamma-globulin to premature infants revealed that significantly more of these infants had no infections and fewer had mild infections during the first year of life. The data also suggests that gamma-globulin afforded some amelioration of serious but nonfatal infections. Deaths from infection showed a similar trend in favor of the gamma-globulin group, but this difference on its own was not significant.

scholarly journals Dog ownership is associated with less wheezing among high-risk infants during the first year of life

2005 ◽  
Vol 115 (2) ◽  
pp. S136
Author(s):  
H.K. Kalra ◽  
P. Campo ◽  
D.I. Bernstein ◽  
L. Levin ◽  
R. Olds ◽  
...  
Keyword(s):  
High Risk ◽  
First Year ◽  
Dog Ownership ◽  
High Risk Infants ◽  
First Year Of Life

Morbidity and Mortality in the First Year of Life.

1958 ◽  
Vol 121 (2) ◽  
pp. 251
Author(s):  
J. A. Heady ◽  
Fred Grundy ◽  
E. Lewis-Faning
Keyword(s):  
Morbidity And Mortality ◽  
First Year ◽  
First Year Of Life

Infection by the respiratory syncytial virus in infants and young children at high risk

2005 ◽  
Vol 15 (3) ◽  
pp. 256-265 ◽  
Author(s):  
Damien Bonnet ◽  
Achim A. Schmaltz ◽  
Timothy F. Feltes
Keyword(s):  
Respiratory Syncytial Virus ◽  
High Risk ◽  
Respiratory Tract ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Lower Respiratory Tract ◽  
First Year ◽  
Syncytial Virus ◽  
First Year Of Life ◽  
Infants And Young Children

The respiratory syncytial virus is the most common cause of infection of the lower respiratory tract in infants and young children, and is the leading cause of hospitalisation and death due to viral illness during the first year of life. In otherwise healthy infants, the virus usually causes only mild respiratory illness, but premature babies and infants with chronic lung disease, those with congenitally malformed hearts, or those who are immunodeficient, are at increased risk of serious illness, hospitalisation, and death. Recent infection with the virus is also associated with increased postoperative complications after corrective surgery for congenitally malformed hearts. No effective vaccine is currently available, and treatment is limited to supportive therapy. Prevention in groups deemed to be at high-risk, therefore, is essential. In addition to measures for control of infection, prophylactic immunotherapy is indicated in selected patients. Palivizumab (Synagis®) is a monoclonal antibody indicated for the prevention of serious viral disease of the lower respiratory tract in premature infants, those with chronic lung disease, and those with haemodynamically significant congenital cardiac lesions. Palivizumab is given intramuscularly, usually as a monthly injection during the so-called “season”. In a recent international, randomised, double-blind, placebo-controlled trial in 1,287 children less than or equal to 2 years old with haemodynamically significant congenital cardiac malformations, prophylaxis achieved a relative reduction of 45 per cent in the incidence of antigen-confirmed viral-related hospitalisation, and reduced the duration of hospital stay by 56 per cent. National and international guidelines, therefore, now recommend routine prophylaxis in the first year of life in children with haemodynamically significant congenital cardiac disease.

P01-303-Vegetative status in infants of high-risk for schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 305-305
Author(s):  
M.A. Kalinina ◽  
G.N. Schimonova
Keyword(s):  
High Risk ◽  
Mental State ◽  
Motor Development ◽  
Prognostic Significance ◽  
Age Groups ◽  
Control Group ◽  
First Year ◽  
Autonomic Tone ◽  
Autonomic Disorders ◽  
First Year Of Life

IntroductionThe study of clinical features and prognostic significance of autonomic disorders are among the most pressing problems of modern medicine.ObjectivesDynamically within 5 years were observed 50 children at high risk for schizophrenia and 40 children with hypoxic-ischemic encephalopathy of the general population. Aims. Evaluation of prognostic significance of autonomic disorders in infancy for mental health in older age groups.MethodsAll patients were examined by clinical methods and EEG, neurosonografia, original screening tables for early childhood.ResultsIn the first year of life in children at high risk for schizophrenia observed mental and motor development within the syndrome of PDD.In infancy the vagotonic orientation prevailed 72, 5%. By 3 years it changed to the amphotonic orientation reaching 76, 0% of children, while the 10, 0% acquired sympathotony, the rest remained vagotonic.The mental state of 37 children to 5 years qualified as schizotipical disorder (F 21.8). In 13 children it was diagnosed schizophrenia, children's type (F20.8). Frequent and sudden changes in the type of tonus correlated with the deterioration of the mental state of a different nature.In the control group at the first year of life prevailed vagotonic orientation, which gradually to age of one year changed by eutonic. During the first 3–5 months of infancy revealed some unstable circulatory, sleep disorders.ConclusionsThe instability of autonomic tone and an abundance of vegetative violations indicate the risk of mental pathology.

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