Home PT | IMVF - Rubella is sll causing Hearing loss...IMMUNIZATION AGAINST DIPHTHERIA, TETANUS AND...
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References: Centers for Disease Control and Preven2on, 2015. Rubella Virus. Epidemiology and Preven1on of Vaccine- Preventable Diseases,13th Edi1on, April, pp.325–340. WHO, 2013. Immuniza2on Profile - Sao Tome and Principe. pp.1–12. Available at: hNp://apps.who.int/vaccines/ globalsummary/immuniza2on/countryprofileresult.cmf?C=stp [Accessed April 27, 2013]. WHO, 2016. WHO | Infographic: Six goals of the Global vaccine ac2on plan. WHO | Infographic. Available at: hNp://www.who.int/campaigns/immuniza2on-week/2016/infographic/en/#.VyKZWhgS_is.mendeley [Accessed April 28, 2016]. WHO Media centre, 2015. Media centre - Rubella. World Health Organiza1on, pp.1–3. Available at: hNp:// www.who.int/mediacentre/factsheets/fs367/en/ [Accessed October 24, 2015]. Rubella is s*ll causing Hearing loss Cris2na Caroça 1,2,5 ; Vera Vicente 3 ; Paula Campelo 1 ; Maria Chasqueira 3 ; Helena Caria 4 ; Susana Silva 5 ; Paulo Paixão 3 ; João Paço 1,2 Preven2ng hearing loss is essen2al in a community where the prevalence of hearing loss in children is high. In this situa2on it is mandatory to iden2fy the main risk factors. This challenge becomes even more significant when some of them can be avoided. Introduc-on In São Tomé and Príncipe (STP), a Sub-Saharan African country, it was found an increased prevalence of sensorineural hearing loss (SNHL). Rubella is generally a mild illness but when pregnant women become infected, par2cularly during the first trimester of pregnancy, there is a 90% chance of the fetus having congenital rubella syndrome (CRS). The baby can be born with mul2ple defects — if it survives at all. Hearing loss is one of the defects that may arise from the CRS. Rou2ne rubella vaccina2on is not available in STP and epidemiology and immune status for rubella was never studied in this popula2on. The aim of the study is to assess the immune status of the sample obtained during humanitarian missions in STP islands and also find if there is associa-on of rubella IgG with Hearing Loss (HL). Results • Obtained a sample with 147 subjects from 2 to 14 years • 68 individuals (46.3%) - case group • 79 individuals (53.7%) - control group • IgG was posi2ve in 50.3% of the 147 subjects • There is a sta2s2cal significance between Posi2ve IgG for rubella with “no oral language” (p=0.007) • Posi2ve IgG for rubella was present in 44.6% of control group and 55.4% of case group (p=0,025) • By Binary Logis2c Regression we verify that rubella is ac-ng as a risk factor and doubles the risk of HL p=0.026; OR=2.117 CI95% [1.094-4.096] Even not knowing the 2me of infec2on, we conclude that rubella infec2on exists in STP. There is a sta2s2cally significant associa2on between HL and rubella infec2on which is also ac2ng as a risk factor, almost duplica2ng the risk of hearing loss. For this reason, it is urgent to implement rubella vaccine in this country . Material & Methods • Children [2-14] Y • Observed during humanitarian Missions STP • Audiological evalua2on • Accept par2cipate in study • Collected blood drop to Dried Blood Spot (DBS) • Case Group – at least one ear with HL • Control Group – both ears normal hearing • Sta2s2cal analysis – IBM SPSS Sta2s2c version 20.0 Conflict of Interests: authors declare no conflict of interests Acknowledgments: IgG Rubella results vs Case-Control group (n=147) 0% 20% 40% 60% 80% 100% Control Group Case Group All Sample Control Group Case Group All Sample Posi:ve 33 41 74 Nega:ve 46 27 73 p= 0.025 IMMUNIZATION AGAINST DIPHTHERIA, TETANUS AND PERTUSSIS Target 900/0 Immunization coverage with 3 doses of diphtheria, tetanus and pertussis vaccines Gap: 65 countries 18.7 million children unvaccinated POLIO ERADICATION Target A world free of polio Gap: 2 countries Remain polio endemic USE OF NEW OR UNDERUTILIZED VACCINES Target 90 At least 90 low- and middle- income countries introduce one or more new or underutilized vaccine On TRACK 86 low- and middle-income countries added at least one new or underutilized vaccine MATERNAL AND NEONATAL TETANUS ELIMINATION Target Eliminate maternal and neonatal tetanus in 59 priority countries Gap: 21 countries 21 countries have not yet eliminated maternal and neonatal tetanus RUBELLA ELIMINATION Target Eliminate rubella from at least two WHO regions in 2015 Gap: 1/2 Half of all children do not receive the rubella vaccine MEASLES MORTALITY REDUCTION Target At least 4 WHO Regions to eliminate measles in 2015 Gap: 150/0 150/0of all children not being immunized with one dose. Only one Region has eliminated measles IMMUNIZATION FOR ALL THROUGHOUT LIFE WORLD IMMUNIZATION WEEK 2016 www.who.int/campaigns/immunization-week/2016/en CLOSE IMMUNIZI GAP SIX GOALS OF THE GLOBAL VACCINE ACTION PLAN Following the WHO slogan 1 Hospital CUF Infante Santo, Lisboa, Portugal 2 NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal 3 CEDOC, NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal 4 BioIsi – Biosystems & Integra2ve Sciences Ins2tute, Faculdade de Ciências de Lisboa, Portugal 5 ToxOmics, NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal
Transcript of Home PT | IMVF - Rubella is sll causing Hearing loss...IMMUNIZATION AGAINST DIPHTHERIA, TETANUS AND...
References:CentersforDiseaseControlandPreven2on,2015.RubellaVirus.EpidemiologyandPreven1onofVaccine-PreventableDiseases,13thEdi1on,April,pp.325–340.WHO,2013.Immuniza2onProfile-SaoTomeandPrincipe.pp.1–12.Availableat:hNp://apps.who.int/vaccines/globalsummary/immuniza2on/countryprofileresult.cmf?C=stp[AccessedApril27,2013].WHO,2016.WHO|Infographic:SixgoalsoftheGlobalvaccineac2onplan.WHO|Infographic.Availableat:hNp://www.who.int/campaigns/immuniza2on-week/2016/infographic/en/#.VyKZWhgS_is.mendeley[AccessedApril28,2016].WHOMediacentre,2015.Mediacentre-Rubella.WorldHealthOrganiza1on,pp.1–3.Availableat:hNp://www.who.int/mediacentre/factsheets/fs367/en/[AccessedOctober24,2015].
Rubellaiss*llcausingHearinglossCris2naCaroça1,2,5;VeraVicente3;PaulaCampelo1;MariaChasqueira3;
HelenaCaria4;SusanaSilva5;PauloPaixão3;JoãoPaço1,2
Preven2nghearinglossisessen2alinacommunitywheretheprevalenceofhearinglossinchildrenishigh.Inthissitua2onitismandatorytoiden2fythemainriskfactors.
Thischallengebecomesevenmoresignificantwhensomeofthemcanbeavoided.
Introduc-onInSãoToméandPríncipe(STP),aSub-SaharanAfricancountry,itwasfoundanincreasedprevalenceofsensorineuralhearingloss(SNHL).Rubellaisgenerallyamildillnessbutwhenpregnantwomenbecomeinfected,par2cularlyduringthefirsttrimesterofpregnancy,thereisa90%chanceofthefetushavingcongenitalrubellasyndrome(CRS).Thebabycanbebornwithmul2pledefects—ifitsurvivesatall.HearinglossisoneofthedefectsthatmayarisefromtheCRS.Rou2nerubellavaccina2onisnotavailableinSTPandepidemiologyandimmunestatusforrubellawasneverstudiedinthispopula2on.TheaimofthestudyistoassesstheimmunestatusofthesampleobtainedduringhumanitarianmissionsinSTPislandsandalsofindifthereisassocia-onofrubellaIgGwithHearingLoss(HL).
Results• Obtainedasamplewith147subjectsfrom2to14years• 68individuals(46.3%)-casegroup• 79individuals(53.7%)-controlgroup• IgGwasposi2vein50.3%ofthe147subjects• Thereisasta2s2calsignificancebetweenPosi2veIgGforrubellawith“noorallanguage”(p=0.007)• Posi2veIgGforrubellawaspresentin44.6%ofcontrolgroupand55.4%ofcasegroup(p=0,025)• ByBinaryLogis2cRegressionweverifythatrubellaisac-ngasariskfactoranddoublestheriskofHL
p=0.026;OR=2.117CI95%[1.094-4.096]
Evennotknowingthe2meofinfec2on,weconcludethatrubellainfec2onexistsinSTP.Thereisasta2s2callysignificantassocia2onbetweenHLandrubellainfec2onwhichisalso
ac2ngasariskfactor,almostduplica2ngtheriskofhearingloss.Forthisreason,itisurgenttoimplementrubellavaccineinthiscountry.
Material&Methods
• Children[2-14]Y• ObservedduringhumanitarianMissionsSTP• Audiologicalevalua2on• Acceptpar2cipateinstudy• CollectedblooddroptoDriedBloodSpot(DBS)• CaseGroup–atleastoneearwithHL• ControlGroup–bothearsnormalhearing• Sta2s2calanalysis–IBMSPSSSta2s2cversion20.0
ConflictofInterests:authorsdeclarenoconflictofinterests
Acknowledgments:
IgGRubellaresultsvsCase-Controlgroup(n=147)
0% 20% 40% 60% 80% 100%
ControlGroup
CaseGroup
AllSample
ControlGroup CaseGroup AllSamplePosi:ve 33 41 74Nega:ve 46 27 73
p=0.025
IMMUNIZATION AGAINST DIPHTHERIA, TETANUS AND PERTUSSIS
Target
900⁄0Immunization coverage with 3 doses of diphtheria, tetanus and pertussis vaccines
Gap: 65 countries 18.7 million children unvaccinated
POLIO ERADICATION
Target A world free of polio
Gap: 2 countriesRemain polio endemic
USE OF NEW OR UNDERUTILIZED VACCINES
Target
90At least 90 low- and middle-income countries introduce one or more new or underutilized vaccine
On TRACK86 low- and middle-income countries added at least one new or underutilized vaccine
MATERNAL AND NEONATAL TETANUS ELIMINATION
Target Eliminate maternal and neonatal tetanus in 59 priority countries
Gap: 21 countries21 countries have not yet eliminated maternal and neonatal tetanus
RUBELLA ELIMINATION
Target Eliminate rubella from at least two WHO regions in 2015
Gap: 1/2Half of all children do not receive the rubella vaccine
MEASLES MORTALITY REDUCTION
Target At least 4 WHO Regions to eliminate measles in 2015
Gap: 150⁄0150⁄0 of all children not being immunized with one dose. Only one Region has eliminated measles
IMMUNIZATION FOR ALLTHROUGHOUT LIFE WORLD IMMUNIZATION WEEK 2016
www.who.int/campaigns/immunization-week/2016/en
CLOSETHE IMMUNIZATION
GAP
SIX GOALS OF THE GLOBAL VACCINE ACTION PLAN
FollowingtheWHOslogan
1HospitalCUFInfanteSanto,Lisboa,Portugal2NOVAMedicalSchool|FaculdadedeCiênciasMédicas,UniversidadeNovadeLisboa,Portugal
3CEDOC,NOVAMedicalSchool|FaculdadedeCiênciasMédicas,UniversidadeNovadeLisboa,Portugal4BioIsi–Biosystems&Integra2veSciencesIns2tute,FaculdadedeCiênciasdeLisboa,Portugal
5ToxOmics,NOVAMedicalSchool|FaculdadedeCiênciasMédicas,UniversidadeNovadeLisboa,Portugal
