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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
101

Characteristic differences between parents/guardians who keep immunization records and those who do not

Mangual, Rebecca Bonilla 01 January 2002 (has links)
No description available.
102

Immunization Training Modules: Identifying Student Nurse Learning

Bates, Katie 29 January 2020 (has links)
Background: Despite the importance of vaccination in disease prevention some people choose to remain unvaccinated. Nurses are influential in the choice to vaccinate. Considering the possibility of poor public understanding of vaccines and need for continued improvement in vaccination rates, it is essential for nurses to be knowledgeable and adept at addressing vaccine concerns. Vaccination education formally begins in nursing school. Objective: To identify nursing students' vaccine understanding by exploring information learned from formal online vaccine education specifically the Nursing Initiative Promoting Immunization Training Modules (NIP-IT). Design/Setting/Participants/Methods: Nursing students enrolled in a Community Health Nursing course were required to complete three online, self-study, modules entitled Vaccine Preventable Diseases, Vaccine Concerns, and Nursing Roles. The nursing students who completed these modules responded, in writing, to an open-ended prompt asking them to identify what new piece of information they learned. Responses gathered from 244 nursing students between September of 2016 and April of 2018 were categorized and grouped according to theme using a first and second cycle coding process. Responses containing more than one idea were considered separate responses and categorized accordingly totaling 273 responses. Results: Nursing student responses revealed five major themes regarding new information learned from the online modules: (1) barriers to vaccination; (2) components of vaccines; (3) the influence of nurses; (4) vaccine-preventable diseases; and (5) community immunity. Conclusion: Formal vaccine education is a critical component of a comprehensive nursing program. The nursing students in this study described information they learned when completing the NIP-IT modules, thus it was inferred the nursing students did not have a full understanding of vaccine concepts prior to viewing the modules. Formal nursing school vaccine education is essential in developing nurses capable of navigating vaccine issues and promoting health and preventing disease through vaccination advocacy.
103

Evaluation of the effectiveness of the partnership for reviving routine immunization in northern nigeria programme in jigawa state, nigeria

Adedayo, Adegbenga Ominiabohs January 2012 (has links)
Doctor Educationis / The weak routine immunization activities in Nigeria have led to an upsurge of vaccine preventable diseases such as poliomyelitis in the northern parts of the country. This made the federal government to intensify efforts to improve routine immunization activities with various intervention programmes over the years. This commitment of the federal government towards improving routine immunization as a way to promote infant and child survival led to the partnership between the UK Department for International Development (DFID) to support the launching of Partnership for Reviving Routine Immunization in Northern Nigeria (PRRINN) programme in 2006. The programme, implemented in the northern states of Jigawa, Katsina, Yobe, and Zamfara was intended to augment other federal government immunization intervention efforts in improving routine immunizations services. After five years of programme implementation, assessment of the effectiveness of PRRINN had not be undertaken using a survey based immunization coverage to establish how well the primary objectives of the programme are being met in terms of improving routine immunization. This study was designed to evaluate the performance of the PRRINN programme in improving routine immunization coverage in Jigawa State using coverage data from the National Immunization Coverage Survey (NICS) of 2010.
104

PASSIVE IMMUNIZATION OF NEONATAL CALVES WITH POST LACTEAL SECRETION.

Al-Jashamy, Suad Abd-Alameer. January 1983 (has links)
No description available.
105

Normalization and Informed Decision-making in Public Health Programs: A Case Study of HPV Vaccination in Canada

Navaneelan, Tanya 19 November 2012 (has links)
This thesis examined the evidence, policy decision-making, and implementation of HPV vaccination in Canada as a case study to explore normalization versus individualized decision making in public health programs. Mixed methods were used: a systematic review, content analyses and policy document analysis. Overall, the scientific evidence supported an effect of vaccination against HPV infection and precancerous cervical lesions, but evidence regarding cervical cancer incidence or mortality is lacking. Scientific and medical communities appeared optimistic about the vaccine, but cautious about its readiness for routine implementation. Policy decision-making was initially cautious, but shifted towards active program implementation, possibly related to the availability of federal funding. The educational materials and media coverage both sent clearly normalizing messages about HPV vaccination. The discussion suggests that HPV vaccination might be more suited to an individualized than population approach, but many factors coincided to promote its implementation, in Canada, within a traditional public health model.
106

A study of vaccination status, weights and birthplace of children aged 12 to 23 months in the Mosvold Health Ward of KwaZulu

Buchmann, Eckhart Johannes January 1992 (has links)
A dissertation submitted to the Faculty of Medicine, University df the Witwatersrand in fulfilment of the requirements for the degree of Master of Science in Medicine Johannesburg 1992. / The objective of the research reported in this thesis was to describe the vaccination coverage of children aged 12 to 23 months in the Mosvold Health Ward of northern Kwa-Zulu. The Expanded Programme on Immunisation cluster sample technique was used. Simultaneous measurements of the children's weights and arm circumferences were done, and their birthplaces noted. Vaccination coverage rates were generally low; 74 to 83 per cent of the children had had BCG, 47 to 56 per cent had had three doses of DPT, 48 to 57 per cent had had three doses of polio and 47 to 56 per cent had had one dose of measles vaccine. Forty-eight per cent of the children had been born at home. Fifteen per cent had weights which Were more than two standard deviations below the median weight-for-age according to NCHS curves, 11 per cent had arm circumferences of 13,5 centimetres or less. The results are compared with other findings from else Where in southern Africa. Relevant literature on vaccination coverage improvement and the measurement thereof, is reviewed. Recommendations are made for increasing coverage rates in the Mosvold Health Ward) • / MT2017
107

Perdas vacinais nas unidades básicas de saúde da região oeste do município de São Paulo / Vaccine losses at the basic health units of Sao Paulo\'s Western Area

Coleto, Viviane Azevedo 08 December 2017 (has links)
Introdução: As ações de imunização merecem destaque mundial pelo grande impacto do uso de vacinas na prevenção das doenças imunopreveníveis. A necessidade de um diagnóstico da prevalência de perdas vacinais constitui uma etapa fundamental para o gerenciamento de vacinas no município, permitindo organizar adequadamente o sistema, evitando assim desperdícios dos recursos públicos. Objetivo: Diagnosticar e caracterizar as perdas vacinais das Unidades Básicas de Saúde da Região Oeste do município de São Paulo. Método: Trata-se de um estudo descritivo, retrospectivo, quanti-qualitativo, no qual foi utilizado como abordagem metodológica o estudo de caso. A partir dos registros de movimentação de imunobiológicos e relatórios de doses aplicadas do ano de 2015, foi calculada a taxa total das perdas, prevalência das perdas técnicas, prevalência de perdas físicas e os motivos das perdas físicas, prevalência das perdas não categorizadas e a razão das doses aplicadas por doses utilizadas. Foram realizadas entrevistas com os funcionários das salas de vacina, das UBSs da Região Oeste do município de São Paulo. Resultados: A taxa total de perdas foi de 71,3 %, a prevalência de perda técnica 18,6% e a prevalência de perda física 28,4 %. Dentre os motivos das perdas físicas, obteve-se destaque para a falta de energia elétrica, representando 18,4 % das mesmas; as perdas não categorizadas totalizaram 24,2 %. Quanto à razão de doses aplicadas, por doses utilizadas, a vacina que apresentou o maior percentual de perdas foi a vacina BCG, visto que para cada dose aplicada foram perdidas 4,86 doses. Nas entrevistas realizadas com os profissionais que trabalham nas salas de vacina, observou-se que 60% deles acreditavam que a maior causa de perda vacinal em sua unidade se devia à perda técnica. Já 36,67 % referiram que a maior causa de perda se deveu às perdas físicas, causada por falta de energia elétrica. Os profissionais apontaram sugestões para minimizar as perdas vacinais; 50 % dos entrevistados relataram que a presença de vacinas unidoses amenizaria as perdas, 46,67 % dos profissionais sugeriram a existência de gerador elétrico e 16,67 % sugeriram o agendamento de vacinas com maior percentual de perda técnica. Conclusão: Os resultados demonstraram que a taxa total de perdas vacinais na Região Oeste do município de São Paulo foi de 71,3 % e na avaliação da prevalência de perdas, obteve-se uma maior prevalência de perdas físicas. Já na opinião dos profissionais entrevistados, a maior causa de perdas deveu-se às perdas técnicas. O presente trabalho propiciou a realização de uma cartilha educativa, que propõe ações que visem diminuir as perdas vacinais nas UBSs da Região Oeste do município de São Paulo. Essa cartilha será apresentada aos órgãos da Secretaria Municipal da Saúde de São Paulo, a saber: Coordenadoria de Saúde da Região Oeste (SUVIS Oeste) e Gerência de Imunização (COVISA). / Introduction: Immunization actions deserve worldwide focus due to the great impact of the use of vaccines in the foresight of immune preventable diseases. The need of prevalence of vaccine losses diagnosis constitutes a fundamental step for the vaccines management in the city, allowing the system adequate organization, therefore avoiding public resources waste. Objective: To diagnose and feature the vaccine losses at the basic health units of Sao Paulo\'s Western Area. Method: This is a descriptive, retrospective, quantitative-qualitative study, where the case study was used as a methodological approach. The total loss rate, the technical losses prevalence, the physical losses prevalence and the physical losses reasons proportion, the unclassified losses prevalence and the dose ratio applied by the doses used were calculated from the immune-biological records movement and dose reports for the year 2015. Interviews were carried out with the employees of the basic health units\' vaccine rooms of Sao Paulo\'s Western Area. Results: The total losses prevalence was of 71.3%, the technical loss prevalence was of 18.6%, the physical loss prevalence was of 28.4%. Of the reasons for physical loss, the lack of electricity represents 18.4%. Non-categorized losses totaled 24.2%. Regarding the dose ratio applied by doses used, the vaccine that presented the highest percentage was the BCG vaccine, for each applied dose there is a loss of 4.86 doses; regarding Yellow Fever vaccine, for each applied dose, 1.63 doses are lost; as for the Triple Viral vaccine, for each applied dose, 1.31 doses are lost. From the interviews with vaccine rooms employees, it was observed that 60% of them believe that vaccine loss greatest reason in their unit is due to technical loss, and 36.67% reported that the greatest cause of loss, it is due to physical loss caused by lack of electricity. The employees gave suggestions to minimize vaccine losses; 50% of the interviewees reported that the presence of unit dose vaccines would reduce losses, 46.67% of the employees suggested the need of an electric generator, and 16.67% suggested scheduling vaccines which have a higher percentage of technical loss. Conclusion: The results showed that the vaccine losses total rate in São Paulo\'s Western Area was of 71.3%, and that in the losses prevalence evaluation, a higher prevalence of physical losses was obtained, as for the opinion of employees interviewed, the greatest cause of loss is due to technical losses. Vaccine losses monitoring is important in order to find new alternatives for the production and distribution of immune-biological agents in order to reduce losses without missing the opportunity to vaccinate. The present work led to the realization of an educational booklet, which will propose actions aimed at reducing vaccine losse at the Health Basic Units of Sao Paulo\'s West Region. This booklet will be presented to Sao Paulo\'s City Health Department agencies, namely: Western Region Health Coordination (SUVIS Oeste) and Immunization Management (COVISA).
108

Situação vacinal de crianças e adolescentes acompanhados em serviço de referência de reumatologia pediátrica / Immunization status of children and adolescents followed at a reference pediatric rheumatology center

Janaina Michelle Lima Melo 19 May 2011 (has links)
Introdução: As doenças reumáticas pediátricas compreendem um grupo heterogêneo de doenças cujas causas são multifatoriais. Pacientes portadores dessas doenças apresentam maior risco de desenvolver infecções devido ao comprometimento da resposta imune causado pela doença e também pelo uso de drogas com potencial imunossupressor. Em vista deste fato, a vacinação torna-se uma ferramenta eficaz na prevenção de doenças infecciosas e suas complicações. Contudo, ainda não existe consenso sobre as indicações e contra-indicações dessas vacinas neste grupo particular. Há poucos trabalhos publicados sobre imunogenicidade e segurança de vacinas em crianças e adolescentes com doenças reumáticas e freqüentemente esses pacientes não recebem as vacinas recomendadas para sua idade. Objetivo: Avaliar a situação vacinal de crianças e adolescentes com doenças reumáticas, as possíveis causas de atraso vacinal e o impacto da orientação específica feita pelo reumatologista pediátrico visando à atualização das vacinas segundo o calendário proposto pelo Ministério da Saúde. Materiais e Métodos: Foi realizado um inquérito com os pacientes e seus responsáveis, consulta dos cartões vacinais e revisão de prontuários dos pacientes em seguimento nos ambulatórios de Reumatologia Pediátrica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP-USP) durante o período de abril de 2008 a março de 2009, que possuíssem o cartão vacinal. Para os pacientes com atraso vacinal, prescrição específica de vacina foi feita pelo reumatologista pediátrico, e um novo registro da situação vacinal foi verificado após seis meses. O projeto foi submetido e aprovado pelo Comitê de Ética em Pesquisa do HCFMRP-USP. Resultados: Duzentos e sete pacientes (58% do sexo feminino; média de idade: 10,9 anos) foram incluídos e apresentavam os seguintes diagnósticos: 86 artrite idiopática juvenil (AIJ); 30 lúpus eritematoso sistêmico (LES); 21 dermatomiosite juvenil (DMJ); 10 esclerodermia; 20 vasculites; 10 síndrome de anticorpo anti-fosfolípide (SAAF); 6 doença mista do tecido conjuntivo ou síndrome de sobreposição (DMTC); 24 outras doenças. Anteriormente à intervenção, a cobertura vacinal segundo o calendário brasileiro de vacinação infantil foi: tuberculose (BCG): 100%; sarampo, caxumba e rubéola (SCR): 98,1%; poliomielite (Sabin - VOP): 95,2%; difteria, tétano e coqueluche: 92,8%; hepatite B: 89,4%; e febre amarela: 85%. Noventa dos 207 pacientes incluídos (43,5%) tinham atraso de pelo menos uma dose de alguma vacina recomendada. O atraso da imunização ocorreu, respectivamente, em 43%, 70%, 42,9%, 60%, 45%, 66,7% e 16,7% dos pacientes com AIJ, LES, DMJ, esclerodermia, vasculite, DMTC/síndrome de sobreposição e outras doenças reumáticas. As proporções de crianças que receberam vacinas fora do calendário básico (especiais) foram: hepatite A (9,6%); influenza (24%); meningocócica (10,6%); pneumocócica (15%), e 52,8% para varicela (38/72 pacientes suscetíveis). Em 20,8% dos pacientes a vacinação foi contraindicada pela equipe médica: 88,4% contra febre amarela e 11,6% contra SCR. O atraso da vacinação causado por receio das conseqüências das vacinas ocorreu em 25%. Prescrição específica das vacinas atrasadas foi fornecida a 44/60 pacientes (73,3%) com vacinação incompleta. A atualização completa da vacinação foi verificada após 6 meses em 75% destas crianças. Conclusão: A freqüência de atraso vacinal em pacientes com doenças reumáticas é alta e preocupante. A prescrição específica de vacinas durante o seguimento clínico desses pacientes tem impacto positivo na cobertura vacinal e deve ser implementada com o objetivo de diminuir a morbidade associada às infecções preveníveis. / Background: Pediatric rheumatic diseases comprise a heterogeneous group of diseases with multifactorial causes. These patients present high risk of infection due to impaired immune response and use of immunosuppressive drugs and vaccination is an effective tool for preventing infectious diseases and their sequelae. However, there is still no consensus on the recommendations of vaccines in this group. There are limited data on safety and immunogenicity of vaccines in children and adolescents with rheumatic diseases and frequently these patients do not receive adequate age-recommended vaccines. Objective: To assess the immunization status and possible causes of delayed immunization in children and adolescents with rheumatic diseases, evaluating the impact of physician specific intervention for missing vaccines. Material and Methods: We performed a survey with patients/caregivers, review of charts and immunization cards of patients with rheumatic diseases who were receiving care in a Brazilian Pediatric Rheumatology Center (HCFMRP-USP) from April/08 to March/09 and had an immunization card. For patients with delayed immunization, specific vaccine prescription was made by the pediatric rheumatologist and the new immunization status was recorded after 6 months. Results: Two hundred and seven patients (58% women; mean age: 10.9 years) were enrolled: 86 with juvenile idiopathic arthritis (JIA); 30 systemic lupus erythematosus (SLE); 21 juvenile dermatomyositis (JDM); 10 scleroderma; 20 vasculitis; 10 antiphospholipid antibody syndrome (APS); 6 mixed connective tissue disease (MCTD); 24 with other diseases. Prior to intervention, vaccines of the routine Brazilian childhood immunization schedule had been received among these children as follows: tuberculosis (BCG): 100%; mumps, measles and rubella (MMR): 98.1%; poliomyelitis (Sabin): 95.2%; tetanus, pertussis and diphtheria: 92.8%; hepatitis B: 89.4%; and yellow fever: 85%. With respect to the routine schedule 90/207 (43.5%) enrolled patients missed at least one dose of any vaccine. Delayed immunization occurred, respectively, in 43%, 70%, 42.9%, 60%, 45%, 66.7%, and 16.7% of the patients with JIA, SLE, JDM, scleroderma, vasculitis, MCTD and other rheumatic diseases. The proportions of non-routinely scheduled (special) vaccines received amongst the 207 children were: hepatitis A (9.6%); influenza (24%); meningococcal (10.6%); pneumococcal (15%), and 52.8% for varicella (38/72 susceptible patients). In 20.8% of patients vaccination was contraindicated by the physician: 88.4% for yellow fever and 11.6% for MMR. Delayed immunization caused by family/patient fear or omission occurred in 25%. Specific prescription for the missing vaccines were given to 44/60 patients (73.3%) with incomplete immunization. The complete updated vaccination was verified after 6 months in 75% of these children. Conclusion: The frequency of delayed immunization in pediatric patients with rheumatic diseases is high and worrying. Specific vaccine prescription given during the follow-up is effective and should be performed with the aim of reducing complications associated with preventable infections.
109

Situação vacinal de crianças e adolescentes acompanhados em serviço de referência de reumatologia pediátrica / Immunization status of children and adolescents followed at a reference pediatric rheumatology center

Melo, Janaina Michelle Lima 19 May 2011 (has links)
Introdução: As doenças reumáticas pediátricas compreendem um grupo heterogêneo de doenças cujas causas são multifatoriais. Pacientes portadores dessas doenças apresentam maior risco de desenvolver infecções devido ao comprometimento da resposta imune causado pela doença e também pelo uso de drogas com potencial imunossupressor. Em vista deste fato, a vacinação torna-se uma ferramenta eficaz na prevenção de doenças infecciosas e suas complicações. Contudo, ainda não existe consenso sobre as indicações e contra-indicações dessas vacinas neste grupo particular. Há poucos trabalhos publicados sobre imunogenicidade e segurança de vacinas em crianças e adolescentes com doenças reumáticas e freqüentemente esses pacientes não recebem as vacinas recomendadas para sua idade. Objetivo: Avaliar a situação vacinal de crianças e adolescentes com doenças reumáticas, as possíveis causas de atraso vacinal e o impacto da orientação específica feita pelo reumatologista pediátrico visando à atualização das vacinas segundo o calendário proposto pelo Ministério da Saúde. Materiais e Métodos: Foi realizado um inquérito com os pacientes e seus responsáveis, consulta dos cartões vacinais e revisão de prontuários dos pacientes em seguimento nos ambulatórios de Reumatologia Pediátrica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP-USP) durante o período de abril de 2008 a março de 2009, que possuíssem o cartão vacinal. Para os pacientes com atraso vacinal, prescrição específica de vacina foi feita pelo reumatologista pediátrico, e um novo registro da situação vacinal foi verificado após seis meses. O projeto foi submetido e aprovado pelo Comitê de Ética em Pesquisa do HCFMRP-USP. Resultados: Duzentos e sete pacientes (58% do sexo feminino; média de idade: 10,9 anos) foram incluídos e apresentavam os seguintes diagnósticos: 86 artrite idiopática juvenil (AIJ); 30 lúpus eritematoso sistêmico (LES); 21 dermatomiosite juvenil (DMJ); 10 esclerodermia; 20 vasculites; 10 síndrome de anticorpo anti-fosfolípide (SAAF); 6 doença mista do tecido conjuntivo ou síndrome de sobreposição (DMTC); 24 outras doenças. Anteriormente à intervenção, a cobertura vacinal segundo o calendário brasileiro de vacinação infantil foi: tuberculose (BCG): 100%; sarampo, caxumba e rubéola (SCR): 98,1%; poliomielite (Sabin - VOP): 95,2%; difteria, tétano e coqueluche: 92,8%; hepatite B: 89,4%; e febre amarela: 85%. Noventa dos 207 pacientes incluídos (43,5%) tinham atraso de pelo menos uma dose de alguma vacina recomendada. O atraso da imunização ocorreu, respectivamente, em 43%, 70%, 42,9%, 60%, 45%, 66,7% e 16,7% dos pacientes com AIJ, LES, DMJ, esclerodermia, vasculite, DMTC/síndrome de sobreposição e outras doenças reumáticas. As proporções de crianças que receberam vacinas fora do calendário básico (especiais) foram: hepatite A (9,6%); influenza (24%); meningocócica (10,6%); pneumocócica (15%), e 52,8% para varicela (38/72 pacientes suscetíveis). Em 20,8% dos pacientes a vacinação foi contraindicada pela equipe médica: 88,4% contra febre amarela e 11,6% contra SCR. O atraso da vacinação causado por receio das conseqüências das vacinas ocorreu em 25%. Prescrição específica das vacinas atrasadas foi fornecida a 44/60 pacientes (73,3%) com vacinação incompleta. A atualização completa da vacinação foi verificada após 6 meses em 75% destas crianças. Conclusão: A freqüência de atraso vacinal em pacientes com doenças reumáticas é alta e preocupante. A prescrição específica de vacinas durante o seguimento clínico desses pacientes tem impacto positivo na cobertura vacinal e deve ser implementada com o objetivo de diminuir a morbidade associada às infecções preveníveis. / Background: Pediatric rheumatic diseases comprise a heterogeneous group of diseases with multifactorial causes. These patients present high risk of infection due to impaired immune response and use of immunosuppressive drugs and vaccination is an effective tool for preventing infectious diseases and their sequelae. However, there is still no consensus on the recommendations of vaccines in this group. There are limited data on safety and immunogenicity of vaccines in children and adolescents with rheumatic diseases and frequently these patients do not receive adequate age-recommended vaccines. Objective: To assess the immunization status and possible causes of delayed immunization in children and adolescents with rheumatic diseases, evaluating the impact of physician specific intervention for missing vaccines. Material and Methods: We performed a survey with patients/caregivers, review of charts and immunization cards of patients with rheumatic diseases who were receiving care in a Brazilian Pediatric Rheumatology Center (HCFMRP-USP) from April/08 to March/09 and had an immunization card. For patients with delayed immunization, specific vaccine prescription was made by the pediatric rheumatologist and the new immunization status was recorded after 6 months. Results: Two hundred and seven patients (58% women; mean age: 10.9 years) were enrolled: 86 with juvenile idiopathic arthritis (JIA); 30 systemic lupus erythematosus (SLE); 21 juvenile dermatomyositis (JDM); 10 scleroderma; 20 vasculitis; 10 antiphospholipid antibody syndrome (APS); 6 mixed connective tissue disease (MCTD); 24 with other diseases. Prior to intervention, vaccines of the routine Brazilian childhood immunization schedule had been received among these children as follows: tuberculosis (BCG): 100%; mumps, measles and rubella (MMR): 98.1%; poliomyelitis (Sabin): 95.2%; tetanus, pertussis and diphtheria: 92.8%; hepatitis B: 89.4%; and yellow fever: 85%. With respect to the routine schedule 90/207 (43.5%) enrolled patients missed at least one dose of any vaccine. Delayed immunization occurred, respectively, in 43%, 70%, 42.9%, 60%, 45%, 66.7%, and 16.7% of the patients with JIA, SLE, JDM, scleroderma, vasculitis, MCTD and other rheumatic diseases. The proportions of non-routinely scheduled (special) vaccines received amongst the 207 children were: hepatitis A (9.6%); influenza (24%); meningococcal (10.6%); pneumococcal (15%), and 52.8% for varicella (38/72 susceptible patients). In 20.8% of patients vaccination was contraindicated by the physician: 88.4% for yellow fever and 11.6% for MMR. Delayed immunization caused by family/patient fear or omission occurred in 25%. Specific prescription for the missing vaccines were given to 44/60 patients (73.3%) with incomplete immunization. The complete updated vaccination was verified after 6 months in 75% of these children. Conclusion: The frequency of delayed immunization in pediatric patients with rheumatic diseases is high and worrying. Specific vaccine prescription given during the follow-up is effective and should be performed with the aim of reducing complications associated with preventable infections.
110

Avaliação da imunidade protetora induzida com antígeno bruto e purificado de Taenia crassiceps contra cisticercose murina / Evaluation of protective immunity induced by crude and purified antigens of Taenia crassiceps against murine cysticercosis

Farias, Cristiane Rocha de 10 April 2012 (has links)
A neurocisticercose é a forma mais severa relacionada ao complexo teníase-cisticercose, causada pela Taenia solium. Diversas medidas de controle já foram propostas, ressaltando a profilaxia via hospedeiro intermediário com o desenvolvimento de vacinas contra a cisticercose suína, que podem ser previamente avaliadas em um modelo experimental intraperitoneal com cisticercos de Taenia crassiceps, em camundongos Balb/c, constituindo a cisticercose murina. No presente trabalho foram avaliados: a resposta imune humoral pela pesquisa de anticorpos IgG anti-T. crassiceps por teste ELISA e Imunoblot, relação IgG1/IgG2a e, análise dos índices de avidez; a resposta imune celular, de acordo com os resultados de proliferação celular, dosagem de citocinas e teste de hipersensibilidade tardia (HTT) e; o índice de proteção (IP) induzido por antígeno bruto (LV-total) e purificado (18/14) de T. crassiceps, com ou sem o auxílio de adjuvantes, sob protocolos de imunização ativa por via subcutânea e oral. Paralelamente à análise de imunização ativa, houve avaliação do protocolo de imunização passiva com anticorpos monoclonais (AcMo) anti-T. crassiceps. Foram analisados 19 grupos experimentais divididos em três protocolos de imunização ativa por via subcutânea. No protocolo I foram avaliados três grupos experimentais imunizados com 10&#181;g de 18/14, uma dose, e auxílio dos adjuvantes PSS/DDA, Al(OH)3 ou sem o auxílio destes. Os grupos apresentaram IP entre 24,9% e 51,8%. No protocolo II foram analisados nove grupos imunizados com 5, 10 ou 20&#181;g de 18/14 e diferentes esquemas de adjuvantes: DODAB (IP entre 90,3% e 100,0%), PSS/DDA (IP entre 63,6% e 70,1%) ou Al(OH)3 (IP entre 60,7% e 100,0%). Comparando as concentrações antigênicas, os grupos apresentaram maiores IP quando imunizados com 5 ou 10&#181;g de 18/14. No protocolo III foram analisados sete grupos imunizados com 20, 40 e/ou 60&#181;g de 18/14, com duas ou três doses, em diferentes esquemas de adjuvantes: PSS/DDA e Al(OH)3 ou sem adjuvantes, com IP entre 63,5% e 100,0%. A avaliação da resposta imune humoral dos grupos imunizados por via subcutânea demonstraram a presença de anticorpos IgG por teste ELISA em todos os grupos imunizados, sem correlação dos índices de reatividade (IR) com os IP. Por imunoblot, foram reconhecidas, pelo menos, as proteínas de 14 e 18 kDa após 15 (T15), 30 (T30) e/ou 60 (T60) dias contados a partir da 1ª dose de imunização. Os grupos imunizados por via subcutânea que apresentaram IP> 90,0% tiveram relação IgG1/IgG2a >1,0 no T30 e <1,0 no T60. Quanto à avaliação da resposta imune celular, 10 dos 12 grupos avaliados por ensaios de proliferação de células obtidas de linfonodos induzidas por 18/14 apresentaram índices de estimulação (IE) positivos, enquanto que o antígeno L-Vtotal demonstrou-se imunossupressor nestes experimentos. A análise de dois grupos imunizados de forma ativa, por via subcutânea, com IP=100%, mostrou o predomínio de citocinas com polarização Th1 (IFN-&#947;) no T60 e Th2 (IL-4) no T120. Não houve correlação dos IP com os resultados obtidos com HTT, porém, os resultados foram variáveis de acordo com o perfil antigênico e o adjuvante utilizado pela via subcutânea. Sequencialmente foram analisados seis grupos imunizados de forma ativa, por via oral, com 10, 20 ou 30&#181;g de LV-total, uma ou duas doses, com o auxílio de Al(OH)3 que apresentaram IP entre 48,3% e 100,0%, sem diferença significativa entre os grupos, exceto com o grupo imunizado com duas doses de 30&#181;g, o qual apresentou 100,0% de IP. No T15 e T30 os IR obtidos em teste ELISA para pesquisa de anticorpos IgG anti-T. crassiceps foram entre 0,9 e 2,4, enquanto que no T60 entre 2,6 e 5,1. Por Imunoblot, foram reconhecidas as proteínas de 14, 18, 30 e >40kDa no T60. A relação IgG1/IgG2a foi <1,0 no T30 e no T60, enquanto que HTT foi apresentado <40,0% no T30 e T60. Adicionalmente aos ensaios de imunização ativa, seis grupos de camundongos Balb/c imunizados de forma passiva com anticorpos monoclonais anti-T. crassiceps apresentaram IP até 93,0%. De acordo com os resultados obtidos, antígenos bruto e purificado de T. crassiceps foram considerados promissores para imunização murina, principalmente o 18/14 quando utilizado com DODAB ou hidróxido de alumínio pela via subcutânea. Os mecanismos protetores não foram totalmente elucidados, porém, demonstram polarização para resposta Th1 e proteção parcial dependente de IgG, demonstrada pelos ensaios de imunização passiva. / Neurocysticercosis is the most severe form of infection related to the complex taeniasis-cysticercosis, caused by Taenia solium. Several control measures have been proposed, emphasizing the prophylaxis via intermediate host through the development of vaccines against porcine cysticercosis, which may be previously evaluated in an intraperitoneal experimental model using cysticercus of Taenia crassiceps, in Balb/c mice, constituting the murine cysticercosis. In this study were evaluated: the humoral immune response by search of anti-T. crassiceps IgG antibody by ELISA and Immunoblot assays, IgG1/IgG2a ratio and, analysis of avidity indices; the cellular immune response by proliferation assay, cytokine maeasurements and delayed hypersensitivity assay (DHA) and; protection index (PI) induced by crude antigen (total-VF) and purified (18/14) of T. crassiceps, with or without adjuvants, through active immunization protocols by subcutaneous and oral administration. In parallel to the active immunization was performed the evaluation of passive immunization protocol with anti-T. crassiceps monoclonal antibodies (AcMo). Were analyzed 19 experimental groups, divided into three active immunization protocols by subcutaneous via. In I Protocol were evaluated three experimental groups which were immunized with 10&#181;g of 18/14 antigen, one dose, with or without PSS/DDA, Al(OH)3 adjuvants. These groups showed PI between 24,9% and 51,8%. In II Protocol were evaluated nine experimental groups which were immunized with 5, 10 or 20&#181;g of 18/14 antigen, using different schemes of adjuvants: DODAB (PI between 90,3% and 100,0%), PSS/DDA (PI between 63,6% and 70,1%) or Al(OH)3 (PI between 60,7% and 100,0%). Comparing the concentrations antigenic, groups had higher IP when immunized with 5 or 10&#181;g of 18/14 antigen. In III Protocol were evaluated seven groups immunized with 20, 40 and/or 60&#181;g of 18/14 antigen, with two or three doses, using also different schemes of adjuvants: PSS/DDA and Al(OH)3 adjuvants or without them, showing PI between 63,5% and 100,0%. The evaluation of humoral immune response of all subcutaneous immunizated groups demonstrated the presence of IgG antibodies by ELISA in all immunized groups, without correlation between reactivity indices (RI) and PI. By immunoblot, were recognized at least the 14 and 18 kDa proteins after 15 (T15), 30 (T30) and/or 60 (T60) days from the first dose immunization. The groups immunized subcutaneously that showed PI > 90,0% had IgG1/IgG2a ratio >1,0 in T30 and <1,0 at T60. About the cellular immune response evaluation, 10 among 12 groups evaluated by proliferation assays using lymphonodes stimulated with 18/14 antigen showed indices of stimulation (IS) positive, while the VF-total antigen was shown immunosuppressive in these experiments. The analysis of two groups actively immunized subcutaneously with PI equal to 100%, showed predominance of cytokines tending to Th1 (IFN-&#947;) in T60 time and Th2 (IL-4) in T120 time. There was no correlation between PI indices and the results obtained from the DHA, however, the results varied according to the antigenic profile and the adjuvant subcutaneously used. Sequentially were analyzed six groups actively immunized by oral via, with 10, 20 or 30&#181;g of LV-total, one or two doses, supported by Al(OH)3 adjuvant which showed PI between 48,3% and 100,0%, with no significant difference between the groups, except the group immunized with two doses of 30&#181;g, which had PI of 100,0%. In T15 and T30 times the reactivity indices obtained by ELISA test for the detection of IgG anti-T. crassiceps antibodies were between 0,9 and 2,4, while in T60 time they were between 2,6 and 5,1. By Immunoblot, were recognized the 14, 18, 30 and > 40kDa proteins in T60 time. The IgG1/IgG2a ratio was <1,0 in T30 and T60 time, while DHA was presented <40,0% in T30 and T60. In addition to the active immunization assays, groups of six Balb/c mice were passively immunized with anti-T. crassiceps monoclonal antibodies and they showed PI up to 93,0%. According to the obtained results, crude and purified antigens of T. crassiceps were considered promising for murine immunization, especially when 18/14 antigen was used together with DODAB or aluminum hydroxide subcutaneously. The protective mechanisms have not been fully elucidated, however, showed trend towards Th1 response and dependent partial protection of IgG, as demonstrated by passive immunization assays.

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