Marcelo Comerlato Scotta1, Tiago Neves Veras2, Paula Colling Klein3, Virgínia Tronco4, Fernando P Polack5, Rita Mattiello6, Paulo M C Pitrez7, Marcus H Jones8, Renato T Stein9, Leonardo A Pinto10. 1. Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil; Aliança Infant, Argentina-Brasil (Comprises partnership between institutions "a" and "c"). Electronic address: marcelo.scotta@acad.pucrs.br. 2. Jeser Amarante Faria Children's Hospital, Araranguá Street, 554, Joinville 89204-310, SC, Brazil. Electronic address: tnveras@hotmail.com. 3. Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil. Electronic address: paulack@gmail.com. 4. Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil. Electronic address: virginiatronco@yahoo.com.br. 5. Fundacion INFANT, Gavilán 94, (C1234BAA), Ciudad de Buenos Aires, Argentina; Vanderbilt University, 2201 West End Ave, Nashville 37235, TN, USA; Aliança Infant, Argentina-Brasil (Comprises partnership between institutions "a" and "c"). Electronic address: fernando.p.polack@vanderbilt.edu. 6. Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil; Aliança Infant, Argentina-Brasil (Comprises partnership between institutions "a" and "c"). Electronic address: rita.mattiello@pucrs.br. 7. Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil; Aliança Infant, Argentina-Brasil (Comprises partnership between institutions "a" and "c"). Electronic address: pmpitrez@pucrs.br. 8. Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil; Aliança Infant, Argentina-Brasil (Comprises partnership between institutions "a" and "c"). Electronic address: mhjones@pucrs.br. 9. Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil; Aliança Infant, Argentina-Brasil (Comprises partnership between institutions "a" and "c"). Electronic address: rstein@pucrs.br. 10. Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil. Electronic address: leonardo.pinto@pucrs.br.
Abstract
INTRODUCTION: Pneumococcal disease is a major public health problem worldwide. From March to September of 2010, 10-valent pneumococcal non-typeable Haemophilus influenzae protein conjugate vaccine (PHiD-CV) was introduced in the Brazilian childhood National Immunization Program (NIP) in all 27 Brazilian states. The aim of the present study is to report national time-trends in incidence of hospital admissions for childhood pneumonia in Brazil before and after two years of introduction of this new pneumococcal conjugate vaccine. METHODS: Analysis of hospitalization data of children aged 0-4 years in Brazilian public health system with an admission diagnosis of pneumonia from 2002 to 2012 was performed comparing pre (2002-2009) and post-vaccination periods (2011-2012). Hospital number of admission due to pneumonia and all non-respiratory diseases were obtained from DATASUS, the Brazilian government open-access public health database system. Incidence of pneumonia hospitalization was compared to incidence of all non-respiratory admissions. RESULTS: Admission rates for pneumonia decreased steadily from 2010 to 2012. In children aged less than four years, incidence of pneumonia hospitalizations decreased 12.65% when pre (2002-2009) and post-vaccination introduction periods (2011-2012) were compared and adjusted for seasonality and secular-trend (p<0.001). On the other hand, non-respiratory admission rates remained stable comparing both periods (p=0.39). CONCLUSION: Childhood pneumonia hospitalization rates were fluctuating prior to 2010 and decreased significantly in the two years after PHiD-CV introduction. Conversely, rate of non-respiratory admissions has shown no decrease. These data are an evidence of the effectiveness and public health impact of this new pneumococcal vaccine.
INTRODUCTION:Pneumococcal disease is a major public health problem worldwide. From March to September of 2010, 10-valent pneumococcal non-typeable Haemophilus influenzae protein conjugate vaccine (PHiD-CV) was introduced in the Brazilian childhood National Immunization Program (NIP) in all 27 Brazilian states. The aim of the present study is to report national time-trends in incidence of hospital admissions for childhood pneumonia in Brazil before and after two years of introduction of this new pneumococcal conjugate vaccine. METHODS: Analysis of hospitalization data of children aged 0-4 years in Brazilian public health system with an admission diagnosis of pneumonia from 2002 to 2012 was performed comparing pre (2002-2009) and post-vaccination periods (2011-2012). Hospital number of admission due to pneumonia and all non-respiratory diseases were obtained from DATASUS, the Brazilian government open-access public health database system. Incidence of pneumonia hospitalization was compared to incidence of all non-respiratory admissions. RESULTS: Admission rates for pneumonia decreased steadily from 2010 to 2012. In children aged less than four years, incidence of pneumonia hospitalizations decreased 12.65% when pre (2002-2009) and post-vaccination introduction periods (2011-2012) were compared and adjusted for seasonality and secular-trend (p<0.001). On the other hand, non-respiratory admission rates remained stable comparing both periods (p=0.39). CONCLUSION: Childhood pneumonia hospitalization rates were fluctuating prior to 2010 and decreased significantly in the two years after PHiD-CV introduction. Conversely, rate of non-respiratory admissions has shown no decrease. These data are an evidence of the effectiveness and public health impact of this new pneumococcal vaccine.
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