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

In 1987 the nutritional status of Zambian children under 5 years of age was studied in 3 regions around Kamoto Hospital with the objective of exploring the prevalence if malnutrition and contributing factors such as maternal education and immunization status. Jumbe was within easy reach of the hospital with a relatively high standard of living. Masumba and Kakumbi were different areas in one region with their own health center further away from the hospital. Chibembe was isolated without good roads. The nutritional status of 1-5 year old children was measured by the Mid Upper Arm Circumference (MUAC). A questionnaire with 22 questions queried mothers about education, breast feeding, meals, water supply, and sanitation. A total of 1251 children were observed, 1222 under age 5, and 29 a little older. 40% of mothers had no education and 54% had some primary education (15.2% passed grade 4, 7.3% reached grade 6, and 18.2% finished grade 7). Less than 5% attended secondary school, and only 1% of mothers finished it. In Chibembe almost 50% of mothers had no education, secondary school education was the lowest of the regions, while in Jumbe was the highest. Immunizations included Bacillus Calmette-Guerin (BCG) at birth, diphtheria-tetanus-pertussis (DTP I, II, III, and a booster), oral polio vaccine (OPV) I, II, III, and a booster, and measles. The Chibembe region has the highest number of incomplete immunizations. In the Jumbe region unknown immunization presumably contributed to a higher number of older children. The nutritional status of children was the lowest in Chibembe region with a 10.8% rate of malnutrition and the lowest rate of maternal education. In Masumba/Kakumbi malnutrition was the lowest with 5.6%, while maternal education and complete immunization were the highest. The nutritional status of the completely immunized children was better. MUAC should be routinely employed for children under 5 years of age.
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PMID:Immunisation and nutritional status of under-fives in rural Zambia. 150 11

A repeat vaccination coverage survey has been conducted in the Edendale/Vulindlela district of KwaZulu. The survey data were processed using the Coverage Survey Analysis System (COSAS) developed by the World Health Organisation (WHO) through its Expanded Programme on Immunisation (EPI). A modified random cluster sampling method was used to select 281 children between the ages of 12 and 23 months. Of the children surveyed, 83% were in possession of Road-to-Health cards (RTHCs). The best estimate of overall coverage for doses up to and including the second doses of polio and diphtheria, pertussis and tetanus (DPT) was 85% or higher, but estimates for polio 3 and measles, at 72% and 67% respectively, remain suboptimal. Stratification of coverage into urban, peri-urban and rural categories revealed that the major contribution to the fall-off in coverage, after the second dose of polio and DPT, came from children in the peri-urban category with estimates of 52% for polio 3 and 38% for measles. The fact that coverage in the peri-urban population for doses up to and including polio 2 was 78% or higher indicated that the peri-urban influence responsible for this drop-out effect occurred between the approximate ages of 5 and 8 months. This identified populations in informal peri-urban settlements as a priority group for urgent intervention and further study. The estimation of missed opportunities at visits when vaccinations are normally given, found in this survey to occur in 17% of children, was a useful feature of COSAS and provided a basis for a specific intervention.
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PMID:The use of COSAS in the analysis of vaccination coverage in urban, peri-urban and rural populations in the Edendale/Vulindlela district of KwaZulu. 150 23

A double-blind, randomized, controlled trial comparing 4 lots of acellular pertussis-diphtheria tetanus toxoids vaccine (APDT) to whole cell DTP vaccine in 397 children was conducted at 7 clinical centers. Children were immunized at 17 to 24 months of age and sera were obtained pre- and postimmunization. Sera were analyzed for antibody to pertussis antigens (pertussis toxin, filamentous hemagglutinin, with a molecular weight of 69,000 (69k) outer membrane protein and agglutinogens) and to diphtheria and tetanus toxoids. Information concerning local reactions and systemic events was collected daily for 10 days postimmunization. The acellular vaccine produced significantly fewer local reactions than whole cell DTP. Parents reported that drowsiness or fretfulness occurred significantly less often in APDT vaccine recipients compared with whole cell DTP recipients. Fever greater than or equal to 38.3 degrees C occurred in 8% of APDT vaccine recipients and in 15% of whole cell DTP vaccine recipients (P = 0.06). The only significant difference in immune response to pertussis antigens between the two vaccines was for filamentous hemagglutinin (P less than 0.01) for which significantly higher antibody concentrations were found in the APDT vaccine group. We conclude that this APDT vaccine is safe and immunogenic when administered as a booster dose to 18-month-old children.
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PMID:Safety and immunogenicity of acellular pertussis vaccine combined with diphtheria and tetanus toxoids in 17- to 24-month-old children. 152 43

Although injections administered during the incubation period of wild poliovirus infection have been associated with an increased risk of paralytic poliomyelitis, quantitative estimates of the risk have not been established. During a poliomyelitis outbreak investigation in Oman, vaccination records were reviewed for 70 children aged 5-24 months with poliomyelitis and from 692 matched control children. A significantly higher proportion of cases received a DTP (diphtheria and tetanus toxoids and pertussis vaccine) injection within 30 days before paralysis onset than did controls (42.9% vs. 28.3%; odds ratio, 2.4; 95% confidence interval, 1.3-4.2). The proportion of poliomyelitis cases that may have been provoked by DTP injections was 35% for children 5-11 months old. This study confirms that injections are an important cause of provocative poliomyelitis. Although the benefits of DTP vaccination should outweigh the risk of subsequent paralysis, these data stress the importance of avoiding unnecessary injections during outbreaks of wild poliovirus infection.
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PMID:Attributable risk of DTP (diphtheria and tetanus toxoids and pertussis vaccine) injection in provoking paralytic poliomyelitis during a large outbreak in Oman. 153 50

Bordetella pertussis 165-9K/129G, which produces a nontoxic form of pertussis toxin (PT), was used to prepare a whole-cell diphtheria-tetanus-pertussis (DTP) vaccine. The in vivo potency and the serological response induced by this vaccine were comparable to those of the conventional DTP vaccine which contains active PT. The toxic activities induced by PT such as leukocytosis, histamine sensitivity, and potentiation of anaphylactic reactions, which are present in the conventional DTP vaccine, were absent in the new vaccine. These results suggest that the introduction of a whole-cell vaccine containing B. pertussis 165-9K/129G would induce the same immunity as the conventional vaccine and would avoid the administration of a harmful toxin to children.
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PMID:Cellular pertussis vaccine containing a Bordetella pertussis strain that produces a nontoxic pertussis toxin molecule. 154 30

During the acellular pertussis vaccine trial in Sweden, 4 children who were randomly assigned to receive the vaccine died of suspected or confirmed bacterial infections compared to 1 expected. There were no deaths in the placebo arm. This raised concern about the role of pertussis immunization in the development of serious infections. Through linking computerized immunization records with an active surveillance system for serious bacterial infections in children, the authors studied a cohort of 64,591 children immunized through Tennessee county health clinics who had a total of 158 episodes of invasive bacterial infections after a diphtheria and tetanus toxoids and pertussis (DTP) immunization. There were 8 invasive bacterial infections that occurred within the first 7 days following DTP immunization, yielding an age-adjusted relative risk (95% confidence interval) of 1.0 (0.5 to 2.0), compared to the interval 29 or more days following immunization. There were 7 and 20 infections in the 8- through 14- and 15- through 28-day intervals following DTP immunization, giving relative risks of 0.8 (0.4 to 1.7) and 1.2 (0.7 to 1.9), respectively. These data provide reassurance that the use of DTP vaccine is not followed by a large increased risk of serious bacterial infections.
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PMID:No increased risk for invasive bacterial infection found following diphtheria-tetanus-pertussis immunization. 155 43

Family physicians can play a key role in reversing the resurgence of vaccine-preventable illnesses by making sure that patients are fully immunized. Childhood immunization schedules have recently changed. A second dose of measles, mumps and rubella (MMR) vaccine should be given at age four to six years. It has been recommended that hepatitis B vaccine be administered routinely to all infants in the United States. Both hepatitis B vaccine and hepatitis B immunoglobulin should be given to offspring of hepatitis B carriers. Haemophilus b conjugate vaccine (HbCV) should be administered to all infants, beginning at two months of age. Vaccines can be safely administered to patients with mild illnesses, allergic rhinitis, low-grade fever or penicillin allergy, as well as to those taking antibiotics. If indicated, several vaccines, such as diphtheria, tetanus and pertussis, oral poliovirus, HbCV and MMR, can be given simultaneously.
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PMID:Childhood immunizations: a practical approach for clinicians. 155 51

Factors associated with noncompliance with have a 2nd vaccination against diphtheria, tetanus, and pertussis in a treatment center in Dhaka were evaluated in order to determine which children were most at risk for not completing their immunization. This cohort study of infants was conducted at the Dhaka treatment center of the International Center for Diarrheal Disease Research, Bangladesh and included 136 unimmunized children ages 6 weeks-23 months who lived within reach of the treatment center. 1st doses of the vaccination were given and followed up 6 weeks later to ascertain compliance with having the 2nd dose. At the 6-week followup, 16 of the children could not be traced and 7 had died. All children received their 1st dose of the vaccine. In each case, health education workers had informed the mother about the value of immunization, and she was provided clear instructions concerning the return of the child after 4 weeks had passed for the 2nd dose. Rate of noncompliance with advice to return the child for 2nd vaccination was the main outcome measure. 46 of 113 children (41%) received the 2nd vaccine dose. Factors most closely associated with maternal failure to comply with 2nd dose were lack of education and low income. Children whose mothers know most about immunization at 1st interview were more likely to have their 2nd dose. Preventive health care services such as immunization are appropriately offered in treatment centers but compliance among children varies with socioeconomic status and maternal education. Further research should be aimed at ways to make health education more effective among uneducated parents.
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PMID:Compliance with diphtheria, tetanus, and pertussis immunisation in Bangladesh: factors identifying high risk groups. 155 89

From 1980 through 1989, 27,826 cases of pertussis were reported to the Centers for Disease Control, for an average annual crude incidence of 1.2 cases/100,000 population. The incidence of reported disease increased in all age groups during this period, but the increase was disproportionately large among adolescents and adults. Infants between 1 and 2 months of age were at highest risk for pertussis (average annual incidence, 62.8/100,000). Infants less than 2 months of age had the highest reported rates of pertussis-associated hospitalization (82%), pneumonia (25%), seizures (4%), encephalopathy (1%), and death (1%). Rates of complication were generally higher among unvaccinated children than among those who had received three or more doses of diphtheria-tetanus-pertussis vaccine; 64% of children 3 months to 4 years of age who had reported cases of pertussis had not been immunized appropriately for their age. Whereas control of pertussis in the United States may be further improved through increased levels of diphtheria-tetanus-pertussis vaccination among eligible infants and children, the use of acellular vaccines in adolescents and adults may also be needed to reduce the burden of pertussis in very young infants.
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PMID:Epidemiological features of pertussis in the United States, 1980-1989. 156 63

The stability of pertussis component (glutaraldehyde or heat inactivated pertussis vaccine) of the adsorbed diphtheria-pertussis-tetanus (DPT) vaccine preserved in thiomersal or benzethonium chloride was studied at 4-8 degrees C and 35 degrees C for 30 days. The potency of pertussis component of adsorbed DPT vaccine preserved with benzethonium chloride was lower than that preserved with thiomersal. After the initial loss of potency of pertussis component in the benzethonium chloride during blending, the stability of potency of pertussis component at 4-8 degrees C and 35 degrees C for 30 days was similar for vaccines preserved with either benzethonium chloride or thiomersal. The stability of both types of pertussis components inactivated with glutaraldehyde or heat was also similar at both the temperatures for 30 days.
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PMID:Comparative stabilities of glutaraldehyde & heat inactivated pertussis vaccine components of adsorbed DPT vaccine with different preservatives. 157 22


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