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

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

The study was designed to quantify the preterm baby's response to routine childhood immunisations. A total of 69 preterm babies were put into two groups according to their gestational age: less than 32 weeks and between 32 and 35 weeks. Within each group the babies were randomly placed into one of three schedules for immunisation with diphtheria, tetanus, pertussis and oral poliomyelitis vaccines at 3, 4 and 5 months; 3, 4, 5 and 18 months; and 3, 4 and 10 months. Antibodies were measured before immunisation, one month after the third vaccine dose and at age 19 months. Of these children, 30 had further antibody estimations when they were between 4 and 5 years of age. One month after the third immunisation and at 19 months of age all infants, independent of gestational age, had adequate immunity to the four infections. Children sampled before and after their pre-school booster, with few exceptions, showed persistence of protective antibody and an enhanced response to the booster dose respectively. No correction needs to be made for prematurity when initiating routine immunisation in premature infants.
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PMID:Immunisation of the preterm baby. 803 5

A case-control study was undertaken in Basrah Maternity and Children Hospital, Iraq. We studied 148 children who were admitted to hospital with severe pneumonia according to the World Health Organization (WHO) criteria and the controls were 250 children attending the out-patient department for non-severe respiratory infections. Significant risk factors were younger age (2-6 months), low parental education, smoking at home, prematurity, weaning from breast milk at < 6 months, a negative history of diphtheria, pertussis and tetanus vaccination, anaemia and malnutrition.
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PMID:Risk factors for severe pneumonia in children in Basrah. 1144 32

Immunization may prevent an enhanced risk of infectious diseases, providing that it is completed on time. A review of the literature summarizes several studies on effectiveness, safety and duration of protection in preterm infants. Immune maturation depends on chronological age rather than gestational age. Then immunization against diphteria-tetanus-pertussis-poliomyelitis-Haemophilus influenzae b should be initiated at 2 months of age and completed prior than 6 months. The youngest preterm infants, still hospitalized at 8 weeks of age should be monitored following the first immunization as they may develop apnea episodes, probably linked with the pertussis component of the vaccine. In premature, BCG vaccination induces a delayed hypersensitivity to tuberculin less important than in full-term neonates, and should not be given right after birth in newborns less than 33 weeks of gestational age. Hepatitis B vaccination should be offered as soon as two months of age and even at birth to children born from HBs Ag carriers. Neither duration of immunity, nor safety are modified by prematurity.
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PMID:[Efficacy and tolerance of vaccinations in premature infants]. 1210 19

The spectacular decline of infant mortality in Costa Rica from 68/1000 live births in 1970 to 20/1000 in 1980 was largely due to the implementation of public health programs in the 1970s. The abrupt decline was even more notable because deaths of infants constituted the major health problem of the country during the 1960s, accounting for 40% of all registered deaths. Socioeconomic development and reduced fertility contributed to the reduction, but 3/4 of the improvement can be attributed to extension of primary health care to previously unserved rural populations and to better secondary health care, according to a study by the Costa Rican demographer Luis Rosero Bixby. The programs targeted at less privileged groups substantially reduced class and geographic differentials in infant mortality. Infant mortality began to decline at an accelerating rate in 1972, coinciding with the first national health plan and the law of universal social security in 1971, the transfer of public hospitals to the social security system and promulgation of a general health law in 1973, and application of the rural health program in 1973 and community health program in 1976. By 1980, home services reached 60% of the population and immunization programs were in place for measles and diphtheria, pertussis, and tetanus. There was a doubling of outpatient services and a tripling of hours contracted by doctors between 1970-80. Also in 1980, 78% of the Costa Rican population was fully covered by health insurance. After 1972, infant mortality declined from all causes except complications of pregnancy and congenital anomalies. The decline was most rapid for deaths due to prematurity, illnesses avoidable by vaccination, and illnesses such as septicemia and meningitis in which prompt diagnosis and treatment can be lifesaving. Although impressive gains were made in neonatal mortality, the main share of the decline between 1970-80 was in postneonatal mortality. Reductions in deaths due to diarrheal diseases and respiratory infections through sanitation measures and immunization accounted for 3/4 of infant mortality decline before 1972 and 1/2 the reduction afterwards. After 1972, the introduction of improvements in neonatology and prenatal care and improvements in family planning service deliver produced a gradual and constant decline in neonatal mortality. Rosero Bixby's application of correlation and multiple regression analysis to census and vital statistics data for Costa Rica's 79 counties indicated that 41% of the decline in infant mortality from 1972-80 could be attributed to extension of primary health care principally in rural areas, while 75% could be attributed to improvements in primary and secondary health care together. Socioeconomic progress contributed about 22% to the decline and reduced fertility about 5%. The analysis did not take into account fertility declines or socioeconomic progress achieved before the 1970s.
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PMID:[Public health programs have greatly reduced infant mortality in Costa Rica]. 1226 50

A medical officer for the Expanded Program on Immunization (EPI) of the World Health Organization (WHO) calls for staff at all health facilities to screen and, if appropriate, immunize every infant, child, and woman of reproductive age attending health facilities. Routine immunization services tend to miss many women and children who should be immunized. Three important components comprise the health team approach needed to avoid missed opportunities: awareness to screen, a well-organized referral system within each health facility, and regular availability of vaccines. In the health facility, the nonimmunized child is at risk of contracting measles, so all such children should be immunized before they leave the health facility. The WHO/EPI medical officer presents five ways to avoid missed opportunities: screen and immunize at every opportunity, administer all required vaccines, stress real and avoid false contraindications, train staff, and open new vials of vaccine when needed. Contraindications to immunization include severe adverse reactions after a dose of vaccine (collapse or shock, convulsions without fever, anaphylaxis, or encephalitis/encephalopathy), neurological disease (for vaccines containing whole cell pertussis), immune deficiency diseases or immunosuppression due to drugs (generally for live vaccines), and symptomatic HIV infections (for BCG or yellow fever vaccines). The following conditions do not preclude immunization: minor illnesses (e.g., upper respiratory infections); allergy, asthma, hay fever, or "snuffles"; prematurity, small-for-date infants; malnutrition; breast feeding; family history of convulsions; treatment with antibiotics, low-dose corticosteroids, or locally acting steroids; eczema or localized skin infection; chronic diseases of the heart, lung, kidney, or liver; stable neurological conditions (e.g., Down syndrome), and history of jaundice after birth. WHO/EPI has an exit survey for use at district-level clinics or hospitals available so program managers can learn if they are missing chances to immunize children.
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PMID:Opportunities to immunise. 1229 31

Morbidity and mortality due to vaccine-preventable diseases are high among persons with underlying medical conditions. Thus, inactivated influenza and pneumococcal polysaccharide vaccines are recommended for individuals with cardiac disease, diabetes mellitus, chronic obstructive pulmonary disease, immunosuppression, and other chronic illnesses. Inactivated influenza vaccine is recommended for pregnant women and for persons with asthma and neuromuscular disease. Palivizumab, a respiratory syncytial virus immunoglobulin preparation, is recommended for certain infants with prematurity and chronic lung disease. Health care workers are at high risk for acquiring and transmitting hepatitis B, pertussis, measles, varicella, and influenza; hence, vaccination against these diseases is recommended. A signed declination is recommended for health care workers who refuse influenza vaccination.
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PMID:Vaccines for persons at high risk, 2007. 1727 Jan 9

Pertussis remains a public health concern in many countries despite high vaccination coverage rates. Nosocomial outbreaks of pertussis continue to occur in neonatal units. Neonates and young infants admitted to neonatal intensive care units constitute a pool of susceptible high-risk patients given their prematurity, inadequate immune response and the fact that they are too young to have completed their primary vaccination series against pertussis. This article reviews nosocomial pertussis in neonates and infants, focusing on the role of healthcare workers (HCWs). Outbreaks in neonatal units are often traced to HCWs and are associated with serious morbidity or even a fatal outcome among susceptible young infants. A high index of suspicion is required for early recognition and isolation of patients admitted with suspected or proven pertussis, as well as for HCWs with a compatible clinical syndrome, regardless of vaccination status. Contact investigation is also essential in order to guide administration of post-exposure prophylaxis. Recommendations for a booster vaccination for HCWs are in place in several countries; however, the need of HCWs for lifelong immunity against pertussis cannot be fulfilled by the current vaccine.
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PMID:Nosocomial pertussis in neonatal units. 2415 50