Impacto da vacina pneumocócica conjugada 10-valente (PCV10) na hospitalização de crianças por pneumonia em Goiânia: uso de dados primários e secundários

• Ano de defesa: 2015
• Autor(a) principal: Andrade, Sabrina Sgambatti de
• Orientador(a): Andrade, Ana Lúcia Sampaio Sgambatti de
• Banca de defesa: Andrade, Ana Lúcia Sampaio Sgambatti de, Moraes, Jose Cássio de, Berezin, Eitan Naaman, Sucasas, Paulo, Siqueira Júnior, João Bosco
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Goiás
• Programa de Pós-Graduação: Programa de Pós-graduação em Medicina Tropical e Saúde Publica (IPTSP)
• Departamento: Instituto de Patologia Tropical e Saúde Pública - IPTSP (RG)
• País: Brasil
• Palavras-chave em Português: Streptococcus pneumoniae; Vigilância de base populacional; Pneumonia; Pneumonia adquirida na comunidade; Vigilância de pneumonia; Vacina pneumocócica conjugada; Vacina pneumocócica conjugada 10-valente; Impacto de vacinas; Infância; Crianças
• Palavras-chave em Inglês: Streptococcus pneumoniae; Community-acquired pneumonia; Pneumococcal conjugate vaccine; 10-valent pneumococcal conjugate vaccine; Population-based surveillance; Pneumonia surveillance; Vaccine impact; Children
• Área do conhecimento CNPq: CLINICA MEDICA::DOENCAS INFECCIOSAS E PARASITARIAS
• Link de acesso: http://repositorio.bc.ufg.br/tede/handle/tede/4885

Background. Anticipating the introduction of the 10-valent pneumococcal conjugate vaccine (PCV10) on childhood National Immunization Program (NIP), an active population-based surveillance on pneumonia hospitalizations was conducted as a baseline, enabling a vaccination impact study. The objectives of the present research were: (i) to assess the reliability of the Hospital Information System of the Unified Health System (SIH-SUS) as a data source for assessing PCV10 impact on pneumonia; (ii) to measure the impact of vaccination with PCV10 in reducing the incidence of clinical and X-Ray confirmed pneumonia, in children residing in Goiânia municipality. Methods. In this study, we conducted an active prospective population-based surveillance on pneumonia in the post PCV10 vaccination period (2011-2013), in all 17 pediatric hospitals of Goiânia, with similar methodology used in the previous pneumonia surveillance during the pre vaccination period (2007-2009). Children aged 2-35 months of age, admitted to hospitalization with suspected diagnosis of pneumonia, were elegible for the survey. Clinical pneumonia and X-Ray confirmed pneumonia were the outcomes. The intervention was the PCV10, introduced in June 2010 in Goiania. Probabilistic linkage was performed between the SIH-SUS database (secondary data) and the active population surveillance (primary data) for the year 2012, to measure the agreement of case identification on pneumonia hospitalization rates between both data sources. To assess the impact of PCV10, annual incidence of clinical pneumonia and X-Ray confirmed pneumonia (per 100,000 population) and respective 95% confidence interval (95%CI) was estimated for the post vaccinations period and compared to the rates obtained for the pre vaccination period. The relative risk for pneumonia and respective 95%CI were calculated based on Poisson distribution. The percentage change in rates (1-relative risk) between pre and post vaccination periods was calculated. Results. Pneumonia incidence rates obtained by the SIH-SUS were statistically similar to those obtained by active population surveillance for children 2-23meses (p = 0.184). On the PCV10 impact evaluation study, the rates of hospitalization for clinical and RXT confirmed pneumonia in children under 24 months decreased 13.1% (from 5,728/100,000 to 4,976/100,000) and 25.4% (from 2,497/100,000 to 1,862/100,000), respectively, after routine immunization.