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Biomedical subjects

Isabel N P Miceli

Publications and source records attributed to Isabel N P Miceli.

3 recordsLinked to original sources

[Pertussis: its evolution in Argentina at the end of the twentieth century].

The objective of this study was to analize data of pertussis morbidity and mortality in Argentina and vaccination coverage with combined pertussis vaccine (DwPT), which was available from 1969 until 2000 inclusive, and to investigate their interrelation. A retrospective study was performed based on National Registers. Notification and mortality annual mean variation rates and geometric mean rates, by periods, were analyzed, and correlation coefficients between each one of them and with vaccination coverage were calculated. Notification annual mean variation rates for 1969-2000 were -14.34 and for 1980-2000 -17.26; mortality annual mean variation rates for 1980-2000 was -10.41. Vaccination coverage in infants up to one year of age (3 doses) was 44.4% in 1980; less than 60% until 1982 and higher than 80% after 1990. A highly significant inverse correlation was observed, between (a) vaccine implementation, increase in its coverage, introduction of a fifth vaccine dose, and (b) notification and mortality rates. It was observed during the study, that in our country there is a relatively little knowledge about disease occurrence in adults, and an apparent absence of population-based studies performed on the efficacy of erythromycin chemo prophylaxis in epidemics outbreaks. Based on these data, strategies for a better surveillance and control of pertussis, are exposed.

Adolescent↗

[Childhood tuberculosis and its diagnosis in Argentina].

TB notification rate in infants and children 0-4 years was 24.3/100,000 in Argentina, in 2000, for a global incidence of 31.8/100,000. A 17% of all TB cases occurred in children (0-14 years), indicating a very active TB transmission. Usually TB is diagnosed when the disease is already advanced. Main criteria for the diagnosis are: a previous contact with an infectious TB patient, a positive PPD test result and clinical--radiological signs and symptoms. Bacteriology plays a limited role in diagnosis; gastric aspirate is the most often used specimen for bacteriological examination in children. Culture is performed on solid egg-media, but other more recently developed culture media systems are available in reference laboratories. Nucleic acid amplification assays are also used, but its systematic quality control is still lacking. Their results should be considered only as complementary. Strengthening of the laboratory network will contribute to increase diagnostic certainty of childhood TB, to improve reliability of cases reported, and to a better knowledge of the drug resistance profile. Early diagnosis of TB in children, by contacts investigation of infectious patients, followed by preventive chemotherapy or treatment when necessary, may revert the current epidemiological situation. TB meningitis in the 0-4 years group showed a significantly more pronounced decline than that of adults TB for the period 1980-2000, (only 10 meningitis cases were diagnosed in year 2000, 0.29/100,000), confirming the protection conferred by BCG vaccination when applied to newborns with a continuously high coverage.

Adolescent↗