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Query: UMLS:C0043167 (pertussis)
 19,595 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The national immunization coverage in Thailand for all types of vaccine has been steadily increasing since 1978, when the EPI was formally launched. The coverage in 1987 was 96% for BCG, 75% for DPT, 74% for OPV, and 60% for TT. Measles vaccine, which started only in late 1984, had the lowest coverage, 51%, in 1987. During the period 1982-1987, the drop-out rates between the first and third dose of DPT and OPV decreased dramatically from 69% to 13% and from 42% to 13% respectively. Sampling surveys of immunization coverage showed higher coverage for DPT and OPV than those from reporting in all regions, especially in the capital city which has a high concentration of the private health sector. Only the northeastern region had less coverage from surveys than from reporting. Following the launch of EPI, the disease incidence demonstrated a clearly downward trend for diphtheria, poliomyelitis, and measles, while in the case of pertussis and neonatal tetanus, slower of still fluctuating declines were observed. The reported age-specific incidences per 100,000 population in 1986 for children 0-4 years were as follows: 4 for diphtheria, 0.9 for poliomyelities, 180 for measles, 14 for pertussis, and 10 for tetanus.
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PMID:Thailand Expanded Program on Immunization: a ten-years review of coverage and impact on EPI target diseases. 263 10

We studied the incidence of typhoid fever, hepatitis, poliomyelitis, scarlet fever, pertussis and measles from 1954 to 1984 as reported in the yearly records of diseases subjected to compulsory notification. Autocorrelation functions and Fourier analysis were used to study incidence fluctuation. Seasonal variations related in all cases to pathogenic factors were found for all diseases. Air borne transmission was related to a peak incidence in spring and enteric transmission in summer. Person to person transmission and crowding at school are noted as factors influencing the incidence pattern of hepatitis and scarlet fever.
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PMID:[Ecologic dynamics of infectious diseases. I. Seasonal variations]. 264 29

The incidence of hepatitis, mumps, poliomyelitis, scarlet fever, pertussis and measles from 1954 to 1984 was studied from the annual records of infectious diseases. Fluctuations were evaluated by Fourier analysis. Periodic recurrency was detected for poliomyelitis, scarlet fever, pertussis and measles and was likely for mumps. The asynchronic fluctuation of the proportion of cases and susceptible individuals is considered to be the origin of this phenomenon. Observed fluctuations corresponded to those predicted by the models.
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PMID:[Ecologic dynamics of infectious diseases. II. Periodic recurrence of epidemics]. 264 30

It is estimated that 4 million children die each year of vaccine-preventable diseases and that another 4 million are permanently disabled. Although vaccination is the most cost-effective health technology, there is a gap between what we know and what we apply. We seem to be succeeding more in attaining new knowledge than in applying what we know. It takes more than a string of discoveries to provide the benefits of science to the people. Appropriate application of the vaccines presently available against diseases such as measles, poliomyelitis, neonatal tetanus, and pertussis could result in a significant reduction in mortality and morbidity among infants and children attributable to these diseases; continued development and deployment of newer vaccines against some dominant components of the diarrhea-dysentery-pneumonia complex of illnesses could result in further reduction. Improved management practices; more heat-stable, less-expensive, and safer vaccines; and vaccines that require fewer doses are critical for success in future immunization programs.
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PMID:Importance of vaccines in child survival. 266 93

The toxicity of pertussis vaccines can probably be reduced and the immunogenicity increased by recent improvements in purity and selectivity. Inactivated poliovirus vaccines show promise of inducing immunity with 2 doses administered in infancy. The Expanded Program on Immunization (EPI) uses the diphtheria-tetanus-pertussis (DTP) vaccine, poliovirus vaccine, and measles virus vaccine. The incidence of serious toxicity (particularly screaming fits, attacks of pallor, or unusual behavior) and encephalitis is very low. A superior partially purified pertussis vaccine was developed by Sato that contained both the pertussis toxin and filamentous hemagglutinin. With the toxicity of purified-component vaccines reduced, the relevant pertussis antigens can be increased to the point where 2 doses will suffice. The present live oral polioviruses vaccine (OPV) and inactivated poliovirus vaccine (IPV) are prone to thermal instability and a cold chain may be a necessary component of immunization with live poliovirus vaccine in the near future. It was shown that 4th and 5th doses of OPV given at 4-week intervals after the 3rd dose elevated the proportion of infants who developed serum antibody to types 1, 2, and 3 antigen from 69%, 90%, and 76%, respectively, up to 83%, 96%, and 82%. DTP vaccine improved to 2 doses is adequate for initial coverage then full immunization for DPT, poliomyelitis, and measles at 3 and 9 months of age. Vero cells of a heteroploid karyotype and of an indefinite lifespan were used to develop a poliovirus vaccine, as they do not produce tumors in rodents. WHO and the US Food and Drug Administration accepted them as safe as cell substrates for certain purified viral vaccines. Measles virus vaccines also have thermal instability and immunogenicity. Thermal instability was greatly reduced with the introduction of buffered glycerol-sorbitol before lyophilization. Immunogenicity in the presence of maternally derived antibody while indicating successful immunization also indicates susceptibility to measles. In a trial of aerosolized vaccine in Mexican children of different ages using the Edmonston-Zagreb (E-Z) vaccine and the Edmonston-Swartz (E-S) vaccine, successful immunization was high even in 6-month-old infants with the E-Z strain but not with the E-S strain. Both OPV and IPV will continue in general use and improvements will come from more efficient delivery schemes, particularly pulse immunization.
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PMID:Feasible improvements in vaccines in the Expanded Programme on Immunization. 266 97

The main causes of infant mortality in 71% of the cases are diarrhea, measles, acute respiratory infection, and neonatal tetanus. A UN child survival strategy includes growth monitoring, oral rehydration, breast feeding, immunization, fertility, food and female literacy (GOBI-FFF). Previous research has shown a correlation between low levels of infant mortality and high levels of female literacy. Educated women are more likely to delay marriage, and childbearing. Child mortality is much higher for those born to women under 20 years old and also much higher for those born within 1 or 2 after the previous birth. Maternal mortality is also higher for mothers under 20 and with closely spaced births of 3 or more children. The majority of adults in developing countries have knowledge of family planning but teen pregnancy is a concern. Better nutrition during pregnancy would decrease infant deaths. Growth monitoring is another way to reduce infant mortality and morbidity. The difficulties are in the reluctance to adapt programs to local traditional methods of growth monitoring and going to direct recording scales. Immunization is estimated to have prevented over 3 million deaths from measles, tetanus, whooping cough and polio in 1984 alone. In spite of progress, only 50% of children in developing countries are immunized against diphtheria, pertussis, polio, and tetanus by the age of 1 year. these activities must be integrated into primary health care and community development projects to make better contact with people needing this service. oral rehydration therapy not only reduces mortality from diarrhea but can reduce morbidity by reducing the duration of the illness and by increasing the weight gain. Breast feeding has been shown in many studies to reduce the risk of deaths of infants. The promotion of breast feeding includes the issues of maternity leave, job security, and child care at the work place.
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PMID:Targeted interventions and infant mortality. 269 Apr 13

Guillain-Barre syndrome is known as one of the autoimmune disease, but the etiology, pathophysiology relating immune reaction, as well as the treatment are not established. It still causes physical handicap although its rate is low. The causes, clinical symptoms and outcome of 132 cases of Guillain-Barre syndrome have been analyzed. The patients' ages ranged from 4 months to 15 years. The antecedent events for 56.1% of the patients were known. These were upper respiratory tract infection, unexplained fever, vomiting, diarrhea, vaccination, measles, german measles, shigellosis, mumps, hepatitis, pertussis and surgery in order of frequency. The CSF protein level reached a maximum at 12.3 +/- 9.5 days. Steroids did not influence the outcome of this disease. More studies are necessary to conquer the disease.
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PMID:Guillain-Barre syndrome in Korean children. 274 76

Infant mortality rate (IMR) and its relation to the utilization of health services was studied in twelve villages of ICDS block Rajsamand, Rajasthan from 1st April, 1985 to 31st March, 1986. The total number of births and infant deaths were 386 and 74, respectively during one year, computing 37.44 as birth rate and 191.70 as IMR. Neonatal deaths contributed 51.4%, the most common causes of which were septicemia (28.9%), birth asphyxia (23.6%), extreme prematurity (18.4%) and tetanus neonatorum (13.1%). The common causes of deaths in post-neonatal period were pneumonia (36.1%), diarrhea (25.0%), complications of measles (16.7%) and that of pertussis (8.3%). Extreme under utilization of preventive, promotive and curative MCH services was found to be one of the major factors for very high IMR prevailing in the region.
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PMID:Under utilization of MCH services--the major factor for very high IMR in rural Rajasthan. 275 49

In 1976, despite a 20-year immunization program, vaccine-preventable diseases (other than smallpox) remained important causes of morbidity and mortality in Thailand. Three major problems were identified: a lack of proper target age groups, inadequate vaccination coverage, and a defective cold chain. The National Expanded Programme on Immunization (EPI), focusing on diphtheria, pertussis, tetanus, poliomyelitis, measles, and tuberculosis, was initiated on a nationwide basis in 1977. Data indicate that the program has reduced morbidity and mortality from most vaccine-preventable diseases in Thailand. The goal of the EPI is to have every eligible child fully immunized with efficacious vaccines by 1990. Strategies have been developed and are being used by the "accelerated EPI" to achieve this goal.
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PMID:Expanded Programme on Immunization in Thailand. 276 97

In the developing world, excluding China, less than 40% of infants receive a third dose of diphtheria-tetanus-pertussis or poliovirus vaccines. More than 3 million children still die annually from measles, neonatal tetanus, and pertussis, while more than a quarter of a million children are crippled by poliomyelitis. Acceleration of existing efforts, with the use of approaches that must differ according to the requirements of individual countries, constitutes the overriding priority for the Expanded Programme on Immunization (EPI). In evaluating immunization programs, priority should be placed on monitoring immunization coverage and disease incidence. Routine reports are essential for this purpose, although they may usefully be supplemented by surveys. The problems revealed by an evaluation of immunization programs can be taken as being generic to the health services as a whole, until proven otherwise. Therefore, in remedying these problems, approaches that improve the health services as a whole should be sought.
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PMID:Global control of vaccine-preventable diseases: how progress can be evaluated. 276 5


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