scholarly journals Preparing to introduce the varicella vaccine into the Italian immunisation programme: varicella-related hospitalisations in Tuscany, 2004–2012

2016 ◽  
Vol 21 (24) ◽  
Author(s):  
Sara Boccalini ◽  
Paolo Bonanni ◽  
Angela Bechini
Keyword(s):  
National Level ◽  
Varicella Vaccine ◽  
Age Groups ◽  
Immunisation Programme ◽  
Significant Decline ◽  
Hospitalisation Rate ◽  
High Coverage ◽  
The Impact ◽  
Risk Ratios ◽  
Vaccination Period

A universal immunisation programme against varicella in the form of the measles-mumps-rubella-varicella (MMRV) vaccine for toddlers aged 13–15 months was introduced in Tuscany in July 2008. An assessment of the impact of this programme on varicella-related hospitalisations 4 years after its introduction could further support its adoption at a national level. The hospitalisation data were analysed in two periods: pre-vaccination (2004–2007) and vaccination period (2009–2012). The high coverage of the vaccines (84% in 2012) resulted in a significant decline in notifications, from 33,114 (2004–2007) to 13,184 cases (2009–2012), and also of hospitalisations, from 584 (pre-vaccination period) to 325 (vaccination period). The hospitalisation rate was 4.1 per 100,000 (95% confidence intervals (CI): 3.4–4.7) before the introduction of vaccination, which dropped to 2.2 per 100,000 (95% CI: 1.7–2.7) in the vaccination period (hospitalisation risk ratios: 0.54; 95% CI:  0.472–0.619). The reduction was most significant in the youngest age groups. The introduction of universal vaccination has already led to a significant decline in hospitalisations due to varicella after just 4 years of implementation. Hospitalisation rates fell noticeably among younger individuals involved in the vaccination programme. The decrease in hospitalisation rate in the older age groups suggests a possible indirect protection.

scholarly journals The Impact of an Inactivated Hepatitis A Vaccine with One Dose in Brazil: A Retrospective Time-Series

Vaccines ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 407
Author(s):  
Ana Luiza Bierrenbach ◽  
Yoonyoung Choi ◽  
Paula de Mendonça Batista ◽  
Fernando Brandão Serra ◽  
Cintia Irene Parellada ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Hepatitis A ◽  
National Level ◽  
Age Groups ◽  
High Rate ◽  
Series Analysis ◽  
Annual Reduction ◽  
The Impact ◽  
Vaccination Period

Background: In 2014, a recommended one-dose of inactivated hepatitis A vaccine was included in the Brazilian National Immunization Program targeting children 12–24 months. This decision addressed the low to intermediate endemicity status of hepatitis A across Brazil and the high rate of infection in children and adolescents between 5 and 19 years old. The aim of the study was to conduct a time-series analysis on hepatitis A incidence across age groups and to assess the hepatitis A distribution throughout Brazilian geographic regions. Methods: An interrupted time-series analysis was performed to assess hepatitis A incidence rates before (2010–2013) and after (2015–2018) hepatitis A vaccine program implementation. The time-series analysis was stratified by age groups while a secondary analysis examined geographic distribution of hepatitis A cases. Results: Overall incidence of hepatitis A decreased from 3.19/100.000 in the pre-vaccine period to 0.87/100.000 (p = 0.022) post-vaccine introduction. Incidence rate reduction was higher among children aged 1-4 years old, with an annual reduction of 67.6% in the post-vaccination period against a 7.7% annual reduction in the pre-vaccination period (p < 0.001). Between 2015 and 2018, the vaccination program prevented 14,468 hepatitis A cases. Conclusion: Our study highlighted the positive impact of a recommended one-dose inactivated hepatitis A vaccine for 1–4-years-old in controlling hepatitis A at national level.

scholarly journals Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018

2021 ◽  
Vol 6 (7) ◽  
pp. e005429
Author(s):  
Letícia Xander Russo ◽  
Timothy Powell-Jackson ◽  
Jorge Otavio Maia Barreto ◽  
Josephine Borghi ◽  
Roxanne Kovacs ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Pay For Performance ◽  
Panel Data Analysis ◽  
National Level ◽  
Age Groups ◽  
Hospitalisation Rate ◽  
Sensitivity Analyses ◽  
Access And Quality ◽  
The Impact

BackgroundEvidence on the effect of pay-for-performance (P4P) schemes on provider performance is mixed in low-income and middle-income countries. Brazil introduced its first national-level P4P scheme in 2011 (PMAQ-Brazilian National Programme for Improving Primary Care Access and Quality). PMAQ is likely one of the largest P4P schemes in the world. We estimate the association between PMAQ and hospitalisations for ambulatory care sensitive conditions (ACSCs) based on a panel of 5564 municipalities.MethodsWe conducted a fixed effect panel data analysis over the period of 2009–2018, controlling for coverage of primary healthcare, hospital beds per 10 000 population, education, real gross domestic product per capita and population density. The outcome is the hospitalisation rate for ACSCs among people aged 64 years and under per 10 000 population. Our exposure variable is defined as the percentage of family health teams participating in PMAQ, which captures the roll-out of PMAQ over time. We also provided several sensitivity analyses, by using alternative measures of the exposure and outcome variables, and a placebo test using transport accident hospitalisations instead of ACSCs.ResultsThe results show a negative and statistically significant association between the rollout of PMAQ and ACSC rates for all age groups. An increase in PMAQ participating of one percentage point decreased the hospitalisation rate for ACSC by 0.0356 (SE 0.0123, p=0.004) per 10 000 population (aged 0–64 years). This corresponds to a reduction of approximately 60 829 hospitalisations in 2018. The impact is stronger for children under 5 years (−0.0940, SE 0.0375, p=0.012), representing a reduction of around 11 936 hospitalisations. Our placebo test shows that the association of PMAQ on the hospitalisation rate for transport accidents is not statistically significant, as expected.ConclusionWe find that PMAQ was associated with a modest reduction in hospitalisation for ACSCs.

scholarly journals The decomposition of life expectancy for age and cause of death in Tuscany, Italy

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N Nante ◽  
L Kundisova ◽  
F Gori ◽  
A Martini ◽  
F Battisti ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Causes Of Death ◽  
National Level ◽  
Age Groups ◽  
Resistant Bacteria ◽  
Mortality Data ◽  
Life Expectancy At Birth ◽  
Icd 10 ◽  
Reduction Of Mortality ◽  
The Impact

Abstract Introduction Changing of life expectancy at birth (LE) over time reflects variations of mortality rates of a certain population. Italy is amongst the countries with the highest LE, Tuscany ranks fifth at the national level. The aim of the present work was to evaluate the impact of various causes of death in different age groups on the change in LE in the Tuscany region (Italy) during period 1987-2015. Material and methods Mortality data relative to residents that died during the period between 1987/1989 and 2013/2015 were provided by the Tuscan Regional Mortality Registry. The causes of death taken into consideration were cardiovascular (CVS), respiratory (RESP) and infective (INF) diseases and cancer (TUM). The decomposition of LE gain was realized with software Epidat, using the Pollard’s method. Results The overall LE gain during the period between two three-years periods was 6.7 years for males, with a major gain between 65-89, and 4.5 years for females, mainly improved between 75-89, &lt;1 year for both sexes. The major gain (2.6 years) was attributable to the reduction of mortality for CVS, followed by TUM (1.76 in males and 0.83 in females) and RESP (0.4 in males; 0.1 in females). The major loss of years of LE was attributable to INF (-0.15 in females; -0.07 in males) and lung cancer in females (-0.13), for which the opposite result was observed for males (gain of 0.62 years of LE). Conclusions During the study period (1987-2015) the gain in LE was major for males. To the reduction of mortality for CVS have contributed to the tempestuous treatment of acute CVS events and secondary CVS prevention. For TUM the result is attributable to the adherence of population to oncologic screening programmes. The excess of mortality for INF that lead to the loss of LE can be attributed to the passage from ICD-9 to ICD-10 in 2003 (higher sensibility of ICD-10) and to the diffusion of multi-drug resistant bacteria, which lead to elevated mortality in these years. Key messages The gain in LE during the period the 1987-2015 was higher in males. The major contribution to gain in LE was due to a reduction of mortality for CVS diseases.

Modelling the impact of varicella vaccination on varicella and zoster

2009 ◽  
Vol 138 (4) ◽  
pp. 469-481 ◽  
Author(s):  
M. KARHUNEN ◽  
T. LEINO ◽  
H. SALO ◽  
I. DAVIDKIN ◽  
T. KILPI ◽  
...  
Keyword(s):  
Large Scale ◽  
Vaccine Coverage ◽  
Varicella Vaccine ◽  
Age Groups ◽  
Varicella Vaccination ◽  
Negative Consequences ◽  
Serological Data ◽  
Notification Data ◽  
The Impact ◽  
Case Notification

SUMMARYIt has been suggested that the incidence of herpes zoster may increase due to lack of natural boosting under large-scale vaccination with the varicella vaccine. To study the possibility and magnitude of such negative consequences of mass vaccination, we built a mathematical model of varicella and zoster epidemiology in the Finnish population. The model was based on serological data on varicella infection, case-notification data on zoster, and new knowledge about close contacts relevant to transmission of infection. According to the analysis, a childhood programme against varicella will increase the incidence of zoster by one to more than two thirds in the next 50 years. This will be due to increase in case numbers in the ⩾35 years age groups. However, high vaccine coverage and a two-dose programme will be very effective in stopping varicella transmission in the population.

A Serological Study of the Immune Status to Rubella in a Community in Singapore

1987 ◽  
Vol 1 (2) ◽  
pp. 12-15
Author(s):  
T W Wong ◽  
YC Chan ◽  
HC Tan
Keyword(s):  
Immune Status ◽  
Age Groups ◽  
Immunisation Programme ◽  
Latex Agglutination ◽  
Reproductive Age ◽  
Congenital Rubella ◽  
Agglutination Method ◽  
The Impact ◽  
Reproductive Age Group ◽  
Rubella Antibody

In 1986, a seroepidemiological study on rubella antibody was conducted in a public housing community in Singapore using the direct latex agglutination method. The overall seropositive rate was 78.1% (95% confidence limit: 73.5% to 82.7%). There was no significant association between age and immune status for both sexes. However, the seropositive rates for females aged 15 to 19 years and 20 to 24 years were significantly higher than for females in other age groups, reflecting the impact of the rubella immunisation programme launched in 1976. There is still a considerable number of susceptible females in the reproductive age group. An extension of the present programme to cover all persons above 12 months of age is recommended, as this would reduce the overall incidence of rubella, and hence congenital rubella, by conferring immunity to young children who presently act as reservoirs of infections.

scholarly journals CHANGES IN THE POPULATION STRUCTURE OF SLATINA CITY BETWEEN YEARS 1990-2000

2021 ◽  
Vol 23 (1) ◽  
pp. 47-57
Author(s):  
Florentina MANOLEA CÎRJAN ◽  
Keyword(s):  
National Level ◽  
Age Groups ◽  
Social Transformations ◽  
Active Population ◽  
The Social ◽  
Economic Transformations ◽  
Geographical Study ◽  
Economic Profile ◽  
Travel Abroad ◽  
The Impact

The article is a contribution to the geographical study of the Slatina city in order to elucidate the impact of the economic and social transformations of 1990 – 2002 interval had on the evolution of its demographic phenomena, but also on understanding its socio-economic profile. The research methodology consisted of a comparative analysis of the numerical values provided by the Olt Regional Directorate of Statistics. The measured parameters were: the numerical evolution and its causes, the structure by sexes and age groups, the structure of the active population, the ethnic structure, and according to the practiced religion. The results of the analysis show an evolution developed on the background of the existing one at national level, having as causes: a tendency of numerical decrease determined by the decrease in the birth rate, the opening of European borders, simultaneously with a decline of the national economy, rising unemployment and travel abroad for searching of a job. The article highlights two important conclusions: the economic transformations show the existing reality in the social and economic field, their impact on the socio-economic profile of the Slatina city; the same transformations have taken place at the national level, on the background of the same causes.

scholarly journals The Impact of Non-Formal Education on Human Capital: A Generational Approach

2020 ◽  
Vol 24 (2) ◽  
pp. 316-338 ◽  
Author(s):  
Marina N. Kicherova ◽  
Galina Z. Efimova
Keyword(s):  
Human Capital ◽  
Formal Education ◽  
National Level ◽  
Age Groups ◽  
Group Method ◽  
Educational Practices ◽  
Social Transformations ◽  
Update Rate ◽  
Group Interviews ◽  
The Impact

Introduction. The update rate of information and the scope of social transformations became a trend of modern life. To remain competitive, a person needs to foster his/her competencies and skills. Non-formal education is becoming the most mobile way to solve the tasks, allowing to quickly acquire relevant knowledge and experience. Research interest is focused on the impact of non-formal education on the formation and development of the human capital. The purpose of the article is to study the involvement of representatives of various generations in a non-formal education. Materials and Methods. The research draws on the methodology of the in-depth interview interpretation analysis. The data was obtained using the focus group method: a series of 27 group interviews, 9 for each age category (youth, mature and older). The focus groups included 253 people – residents of Tyumen, Tobolsk, Ishim, and settlements in the South of the Tyumen region. Results. The possibilities of non-formal education in the process of accumulation and realization of human capital were revealed. The analysis of the practices of youth, adult and older generation’s non-formal education was carried out. Based on the study of generational theories, the educational attitudes of various age groups and the needs for non-formal learningwere analyzed. Based on the analysis of the intensity of educational practices, three types of actors were identified depending on their involvement in non-formal education: the active type “eternal student”, the moderate type “situational student” and the passive type “indifferent student”, which were found in representatives of different generations. The authors identified the following things that motivate and demotivate people to receive non-formal education: operational updating of competencies, fostering of personal and professional skills for a specific professional position, reducing the qualification gap. Analysing the non-formal educational practices of youth, adults, and the older generation, the authors found that non-formal education significantly affects the dynamics of professionalization, the nature of social and labour transfers. Discussion and Conclusion. The results of the study will aid in sizing the impact of non-formal education on human capital in terms of the generational approach. The materials of the article are useful for building an educational ecosystem at the regional and national level and for practical application in the development and adjustment of strategies for working with people of different age groups.

scholarly journals Varicella vaccination as useful strategy for reducing the risk of varicella-related hospitalizations

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Marrella ◽  
A Casuccio ◽  
E Amodio ◽  
F Vitale
Keyword(s):  
Vaccination Coverage ◽  
Age Groups ◽  
Incidence Rates ◽  
Varicella Vaccination ◽  
Age Group ◽  
Annual Percent Change ◽  
High Coverage ◽  
Joint Point ◽  
Hospitalization Rates ◽  
The Impact

Abstract Introduction The present study summarizes evidences of the impact of varicella vaccination (VV) on hospitalization rates attributable to this infectious disease in Italy. Methods We have carried out a retrospective observational study that analysed hospital discharge records and VV coverage at 24 months collected from 2003 to 2018 by the Italian Health Ministry. All hospitalizations with the presence of an ICD-9 CM 059.X code in the principal diagnosis or in any of the five secondary diagnoses were considered as related to varicella. The hospitalization rate reduction was evaluated by calculating average annual percent change (AAPC) through joint-point analysis. Results Hospitalization rates showed a decreasing risk by age: children aged &lt;1 year were the most affected age group in each region (42.56/100,000 per year), whereas lower incidence rates were found in older age groups (23.76/100,000 in 1 to 5 years age group and &lt;4/100,000 in the following groups). Varicella hospitalization rates decreased significantly after the introduction of VV (3.42 vs. 2.67 per 100,000; P &lt; 0.001). During the first five years after vaccination introduction hospitalization rates showed a statistically significant decrease especially for infants aged &lt;1 year (AAPC -34.98%; p &lt; 0.001) and 1 to 5 years old (AAPC -35.22%; P &lt; 0.01). VV coverage was strongly correlated with hospitalization rates decrease over each paediatric age group (R-squared 0.38 in aged &lt;1 year, p &lt; 0.001; 0.71 in 1 to 5 years old, p &lt; 0.001; 0.93 in 6 to 14 years old, p &lt; 0.0001). Conclusions All the previously reported findings confirm that hospitalization rates are strictly related to both the number of years since vaccination introduction and the vaccination coverage. VV confirms to be an important step in public health strategies and the introduction of universal vaccination, with high vaccination coverage, should be considered as an extremely powerful tool for reducing the risk of complications. Key messages This study adds update findings to the literature and shows that varicella hospitalizations in Italy, from 2003 to 2018, have reduced their burden, that was high in years before varicella vaccination. Varicella vaccination introduction and high coverage are powerful tools for reducing the risk of varicella complications and related hospitalizations in the general population.

scholarly journals Subnational mortality estimates for India in 2019: a baseline for evaluating excess deaths due to the COVID-19 pandemic

2021 ◽  
Vol 6 (11) ◽  
pp. e007399
Author(s):  
Chalapati Rao ◽  
Amrit Jose John ◽  
Ajit Kumar Yadav ◽  
Mansha Siraj
Keyword(s):  
Excess Mortality ◽  
National Level ◽  
Age Groups ◽  
Uttar Pradesh ◽  
The Elderly ◽  
Registration System ◽  
Infant Deaths ◽  
Civil Registration ◽  
The Impact ◽  
Mortality Estimates

BackgroundEstimates of excess mortality are required to assess and compare the impact of the COVID-19 pandemic across populations. For India, reliable baseline prepandemic mortality patterns at national and subnational level are necessary for such assessments. However, available data from the Civil Registration System (CRS) is affected by incompleteness of death recording that varies by sex, age and location.MethodsUnder-reporting of CRS 2019 deaths was assessed for three age groups (< 5 years, 15–59 years and ≥60 years) at subnational level, through comparison with age-specific death rates from alternate sources. Age-specific corrections for under-reporting were applied to derive adjusted death counts by sex for each location. These were used to compute life expectancy (LE) at birth by sex in 2019, which were compared with subnational LEs from the Global Burden of Disease (GBD) 2019 Study.ResultsA total of 9.92 million deaths (95% UI 9.70 to 10.02) were estimated across India in 2019, about 2.28 million more than CRS reports. Adjustments to under-five and elderly mortality accounted for 30% and 56% of additional deaths, respectively. Adjustments in Bihar, Jharkhand, Madhya Pradesh, Maharashtra, Rajasthan and Uttar Pradesh accounted for 75% of all additional deaths. Adjusted LEs were below corresponding GBD estimates by ≥2 years for males at national level and in 20 states, and by ≥1 year for females in 12 states.ConclusionsThese results represent the first-ever subnational mortality estimates for India derived from CRS reported deaths, and serve as a baseline for assessing excess mortality from the COVID-19 pandemic. Adjusted life expectancies indicate higher mortality patterns in India than previously perceived. Under-reporting of infant deaths and those among women and the elderly is evident in many locations. Further CRS strengthening is required to improve the empirical basis for local mortality measurement across the country.

scholarly journals Declines in Pneumonia Mortality Following the Introduction of Pneumococcal Conjugate Vaccines in Latin American and Caribbean Countries

2020 ◽  
Author(s):  
Lucia H de Oliveira ◽  
Kayoko Shioda ◽  
Maria Tereza Valenzuela ◽  
Cara B Janusz ◽  
Analía Rearte ◽  
...  
Keyword(s):  
Latin American ◽  
National Level ◽  
Temporal Trends ◽  
Age Groups ◽  
Population Level ◽  
Mortality Data ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
The Impact ◽  
Latin American And Caribbean

Abstract Background Pneumococcal conjugate vaccines (PCVs) are recommended for use in pediatric immunization programs worldwide. Few data are available on their effect against mortality. We present a multicountry evaluation of the population-level impact of PCVs against death due to pneumonia in children &lt; 5 years of age. Methods We obtained national-level mortality data between 2000 and 2016 from 10 Latin American and Caribbean countries, using the standardized protocol. Time series models were used to evaluate the decline in all-cause pneumonia deaths during the postvaccination period while controlling for unrelated temporal trends using control causes of death. Results The estimated declines in pneumonia mortality following the introduction of PCVs ranged from 11% to 35% among children aged 2–59 months in 5 countries: Colombia (24% [95% credible interval {CrI}, 3%–35%]), Ecuador (25% [95% CrI, 4%–41%]), Mexico (11% [95% CrI, 3%–18%]), Nicaragua (19% [95% CrI, 0–34%]), and Peru (35% [95% CrI, 20%–47%]). In Argentina, Brazil, and the Dominican Republic, the declines were not detected in the aggregated age group but were detected in certain age strata. In Guyana and Honduras, the estimates had large uncertainty, and no declines were detected. Across the 10 countries, most of which have low to moderate incidence of pneumonia mortality, PCVs have prevented nearly 4500 all-cause pneumonia deaths in children 2–59 months since introduction. Conclusions Although the data quality was variable between countries, and the patterns varied across countries and age groups, the balance of evidence suggests that mortality due to all-cause pneumonia in children declined after PCV introduction. The impact could be greater in populations with a higher prevaccine burden of pneumonia.

Sign in / Sign up

Export Citation Format

Share Document