Vacina dTpa em gestantes na redução da coqueluche na criança
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2018-03-02
Autores
Chadi, Paula Fernandes
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Universidade Estadual Paulista (Unesp)
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Introdução: A epidemiologia é uma ciência que estuda os processos de saúde e doença na população, sejam eles individuais ou coletivos. A lista Nacional de Notificação compulsória teve sua última atualização em 17 de fevereiro de 2016 por meio da portaria nº 204, que define novas doenças, agravos e eventos de saúde nos serviços públicos e privados em todo o território nacional, sendo a comunicação destes acontecimentos obrigatória. A coqueluche, que se encontra na lista das doenças de notificação compulsória, define-se por uma doença infecciosa aguda do trato respiratório inferior sendo seu agente etiológico a bactéria Bordetella pertussis. Apesar dos esforços dispendidos pelo Programa Nacional de Imunizações, da Vigilância Epidemiológica e outros Centros de Vigilância internacionais, no mundo, ainda, estima-se que a cada ano ocorram de 20 a 50 milhões de casos de coqueluche, com aproximadamente 200 a 400 mil mortes, sendo a maior parte em lactentes que não foram vacinados ou com a vacinação incompleta. Mesmo com a disponibilidade da vacina contra difteria, tétano e pertussis incluída no calendário vacinal da criança através da pentavalente, a imunidade não é permanente, surgindo então a pergunta deste estudo: Apenas a vacinação na gestante com dTpa elimina a coqueluche em crianças até dois anos? Objetivo: Analisar em dois municípios do interior do Estado de São Paulo, se as crianças menores de dois anos, filhos de mulheres vacinas pela dTpa tiveram coqueluche. Método: Trata-se de um estudo epidemiológico, observacional descritivo antes e depois de delineamento transversal, sobre avaliação das crianças que desenvolveram a coqueluche, notificadas nos municípios de Botucatu e Marília, interior do estado de São Paulo, no período retrospectivo (2008 a 2014) e prospectivo à vacina da dTpa na gestante (2014 a 2016). Resultados: Percebe-se que há uma carência de publicação sobre a abordagem da coqueluche na criança, sua prevenção, tratamento e controle. Todas as fichas de notificação avaliadas no estudo estavam parcialmente preenchidas, comprometendo a qualidade das informações. Em relação à avaliação comparativa entre os dois municípios em estudo, percebe-se que, no período retrospectivo o número de casos confirmados de coqueluche nos dois municípios totalizou-se em 56 casos, dos quais 25% (14) em Botucatu e 75% (42) em Marília. Já no período prospectivo, após a implantação da vacina ainda houve casos confirmados nos dois municípios, perfazendo 21 casos – 71,42% (15) em Botucatu e 28,58% (6) em Marília – e mesmo havendo redução, os casos ainda persistem apresentando exposição do público vulnerável, crianças menores de um ano a coqueluche. Conclusão: A introdução da dTpa no calendário vacinal da gestante não foi suficiente para impedir a transmissão do microorganismo Bordetella pertussis às crianças com idade inferior a dois anos, conforme a proposta do Ministério da Saúde.
Introduction: Epidemiology is an area of public health aimed at understanding health-disease processes within the population, an aspect that differentiates it from the clinic, since its objective is the study of these processes, individual or collective. The National Compulsory Notification list was last updated on February 17th, 2016 through ordinance No. 204, which defines new diseases, injuries and health events in public and private services throughout the national territory, and the communication is mandatory. Pertussis on the list of compulsorily notifiable diseases is defined as an acute infectious disease of the lower respiratory tract, its etiological agent being Bordetella pertussis. Despite the efforts made by the National Immunization Program (PNI), Epidemiological Surveillance and other International Surveillance Centers, it is still estimated that 20 to 50 million cases of pertussis occur every year, with approximately 200 to 400,000 deaths, most of them in infants who were not vaccinated or had incomplete vaccination. Even though the DTP vaccine is in the child's immunization schedule, immunity is not permanent, so the question arises in this study, only vaccination in the pregnant woman reduces the infection of the Bordetella pertussis bacterium in children up to 4 (four) years? Objective: To analyze in two municipalities of the interior of the State of São Paulo, if children under two years of age, children of dTpa vaccine women had pertussis. Method: This is a descriptive and observational epidemiological study before and after a cross-sectional study on the evaluation of children who developed the disease by the Bordetella pertussis microorganism reported in the municipalities of Botucatu and Marília, in the state of São Paulo, in the period retrospective and prospective study of the dTpa vaccine in the pregnant woman from 2008 to 2016. Results: It is noticed that there is a lack of publication about the pertussis approach in the child its prevention, treatment and control. All of the notification sheets evaluated in the study were partially completed. Regarding the comparative evaluation between the two municipalities under study, it can be seen that in the retrospective period from January 2008 to October 31th, 2014, the number of confirmed cases in the two municipalities was analyzed, in a total of 56 cases, of which 14 (25%) in Botucatu and 42 (75%) in Marília. Since the prospective period analyzed after the implementation of the vaccine from November 1th, 2014 to December 31th, 2016, there are still positive cases in the two municipalities, 21 cases, of which 15 (71.42%) were in Botucatu and six (28.58 %) in Marília, that even reducing still persist presenting risk to the vulnerable public. Conclusion: The introduction of dTpa into the pregnant woman's immunization schedule was not sufficient to prevent transmission of the Bordetella pertussis microorganism to children under two years of age, as proposed by the Ministry of Health.
Introduction: Epidemiology is an area of public health aimed at understanding health-disease processes within the population, an aspect that differentiates it from the clinic, since its objective is the study of these processes, individual or collective. The National Compulsory Notification list was last updated on February 17th, 2016 through ordinance No. 204, which defines new diseases, injuries and health events in public and private services throughout the national territory, and the communication is mandatory. Pertussis on the list of compulsorily notifiable diseases is defined as an acute infectious disease of the lower respiratory tract, its etiological agent being Bordetella pertussis. Despite the efforts made by the National Immunization Program (PNI), Epidemiological Surveillance and other International Surveillance Centers, it is still estimated that 20 to 50 million cases of pertussis occur every year, with approximately 200 to 400,000 deaths, most of them in infants who were not vaccinated or had incomplete vaccination. Even though the DTP vaccine is in the child's immunization schedule, immunity is not permanent, so the question arises in this study, only vaccination in the pregnant woman reduces the infection of the Bordetella pertussis bacterium in children up to 4 (four) years? Objective: To analyze in two municipalities of the interior of the State of São Paulo, if children under two years of age, children of dTpa vaccine women had pertussis. Method: This is a descriptive and observational epidemiological study before and after a cross-sectional study on the evaluation of children who developed the disease by the Bordetella pertussis microorganism reported in the municipalities of Botucatu and Marília, in the state of São Paulo, in the period retrospective and prospective study of the dTpa vaccine in the pregnant woman from 2008 to 2016. Results: It is noticed that there is a lack of publication about the pertussis approach in the child its prevention, treatment and control. All of the notification sheets evaluated in the study were partially completed. Regarding the comparative evaluation between the two municipalities under study, it can be seen that in the retrospective period from January 2008 to October 31th, 2014, the number of confirmed cases in the two municipalities was analyzed, in a total of 56 cases, of which 14 (25%) in Botucatu and 42 (75%) in Marília. Since the prospective period analyzed after the implementation of the vaccine from November 1th, 2014 to December 31th, 2016, there are still positive cases in the two municipalities, 21 cases, of which 15 (71.42%) were in Botucatu and six (28.58 %) in Marília, that even reducing still persist presenting risk to the vulnerable public. Conclusion: The introduction of dTpa into the pregnant woman's immunization schedule was not sufficient to prevent transmission of the Bordetella pertussis microorganism to children under two years of age, as proposed by the Ministry of Health.
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Palavras-chave
coqueluche, epidemiologia, vacinação, pertussis, epidemiology, vaccination