a 9-a Conferință Națională de Pneumologie Pediatrică
Eveniment virtual
Joi, 1 octombrie – Sâmbătă 3 octombrie, 2020

Abstract

 CAND VACCINURILE SCHIMBA CURSUL ISTORIEI

 CAND VACCINURILE SCHIMBA CURSUL ISTORIEI

Ana-Maria Davitoiu,

Universitatea de Medicina si Famacie “Carol Davila”, Facultatea de Medicina, Bucuresti

Spital Clinic de Copii “Dr. Victor Gomoiu”, Bucurestiv

Rezumat :

Vaccinarea ramane principala metoda de preventie primara a bolilor si reprezinta o metoda de succes sub raportul pret-calitate in prevenirea bolilor infectioase. Administrarea vaccinurilor a condus, de-a lungul timpului, la salvarea a milioane de vieti prin scaderea incidentei unui numar mare de boli care prezentau o amenintare majora pentru sanatate.

Timpul a dovedit ca o crestere a acoperirii vaccinale conduce invariabil la declinul bolilor infectioase. Conform OMS o acoperire vaccinala de 90% asigura controlul unei etiologii infectioase. Studiile dovedesc ca in intervalul 2010-2020 rata de acoperire vaccinala la nivel mondial nu a depasit 86%(1).

             Pneumonia ramane in continuare cea mai comuna cauza de mortalitate infantila. Conform OMS si UNICEF, in tarile cu mortalitate ridicata in randul populatiei pediatrice, pneumonia este confirmata drept “forgotten killer of children”(2).

Tarile subdezvoltate si in curs de dezvoltare  inregistreaza 99.9% din decesele prin pneumonie la copil, majoritatea vizand continental African si Asiatic, cu aproximativ 1 milion decese anual(2).

Variati agenti patogeni pot produce pneumonii la copil, unele din aceste forme avand consecinte fatale. Impotriva celor mai multi exista vaccinuri care, la o acoperire pe scara larga, sunt in masura sa limiteze aparitia bolilor.

            Accesul la aceste vaccinuri depinde de Programul National de vaccinare al fiecarei tari si nu in ultimul rand de fondurile alocate de guverne si de sistemele de sanatate publica pentru preventia primara a bolilor.

            Principalii agenti etiologici implicati in aparitia bolii pulmonare la copil sunt : Bordetella pertussis, Mycobacterium tuberculosis, Haemophillus influenzae B, Streptococcus pneumoniae, Virusul rujeolic, Virusurile gripale, Virusul respirator sincitial. Impotriva tuturor acestor patogeni exista vaccin.

OMS estimeaza ca in anul 2010 peste 50% din decesele prin pneumonie la copiii cu varsta cuprinsa intre 1-5 ani au avut drept agenti etiologici Haemophillus influenzae si  Streptococcus  pneumonia(3).

OMS si UNICEF au lansat Planul Mondial de Preventie si Control al Pneumoniei (GAPP) implementand masuri ample pentru controlul si preventia primara a pneumoniei la copil. Programul vizeaza limitarea imbolnavirilor si a deceselor prin pneumonie aparute in urma bolilor determinate de agenti patogeni impotriva carora exista vaccin(4).

Autorii isi propun o trecere in revista a principalelor tipuri de vaccinuri disponibile in masura sa controleze aparitia bolii pulmonare la copil. Lucrarea trage un semnal de alarma cu privire la rata de acoperire vaccinala si evolutia bolii pulmonare la pacientul pediatric in ultimul deceniu.

Se subliniaza schimbarea evolutiei patologiei pediatrice in raport cu noile vaccinuri existente si incluse in Programul National de vaccinare dar si importanta controlului bolilor pulmonare prin administrarea vaccinurilor optionale disponibile in Romania.

O corecta acoperire vaccinala la nivelul diverselor arii geografice, independent de nivelul de dezvoltare economica nationala, permite o rata de acoperire mondiala prin vaccinare care duce nemijlocit la limitarea si, in cele din urma, la eradicarea bolilor.

Cuvinte-cheie  : vaccin, copil, pneumonie

 

Vaccination remains the main method of primary prevention against diseases as it is a cost-effective method of preventing infectious diseases. The administration of vaccines has led over time to the saving of millions of lives by reducing the incidence of a large number of diseases which were posing major threats to health.
            Time has shown that an increase in vaccine coverage undoubtedly leads to a decline in infectious diseases. According to the WHO, a vaccination coverage of 90% guarantees the control of an infectious etiology. Studies show that during 2010-2020, the global vaccination coverage rate did not exceed 86%(1).
            Pneumonia remains the most common cause of infant mortality. According to WHO and UNICEF, in countries with high mortality within the paediatric population, pneumonia is seen as the "forgotten killer of children"(2).
            The underdeveloped and developing countries together account for 99.9% of childhood pneumonia deaths, most of them coming from the African and Asian continents, with about 1 million deaths per year(2).
            Various pathogen agents can cause pneumonia in children and some of these forms have fatal consequences. Against most of these pathogens, there are vaccines which, when used on a large scale, are able to limit the occurrence of diseases.
            Access to these vaccines depends both on each country's National Vaccination Programme and, last but not least, on how the funds are allocated for primary disease prevention by the government and the public health systems.
            The main etiological agents involved in the appearance of lung disease in children are: Bordetella pertussis, Mycobacterium tuberculosis, Haemophillus influenzae B, Streptococcus pneumoniae, Measles virus, Influenzae viruses, Respiratory syncytial virus. There is a vaccine against all these pathogens.
            The WHO estimates that, in 2010, over 50% of the deaths cause pneumonia in children aged 1-5 years old had, as etiological agents, Hemophillus influenzae and Streptococcus pneumoniae(3).
            WHO and UNICEF launched the Global Action Plan for the prevention and control of Pneumonia (GAPP) implementing comprehensive measures for the primary control and prevention of childhood pneumonia worldwide(4).
            The authors aim to review the main available types of vaccines which are able to control the occurrence of lung disease in children. The paper also raises an alarm with regard to both the vaccination coverage rate and the evolution of lung disease in the paediatric patient, over the last decade.
            There is an emphasis on the change in the evolution of paediatric pathology in relation to the new vaccines available, which are included in the National Vaccination Programme, but also on the importance of controlling lung diseases by administering the optional vaccines that are available in Romania.
            Proper vaccine coverage in various geographical areas, regardless of their national economic development, allows a global vaccination coverage rate that directly leads to the decrease and, ultimately, to the eradication of diseases.

Keywords: vaccine, child, pneumonia

Refferences:

1. World Health Organization - Progress and Challenges with Achieving Universal Immunization Coverage. 2019 WHO/UNICEF Estimates of National Immunization Coverage.2020. Available online at :

https://www.who.int/immunization/monitoring_surveillance/who-immuniz.pdf?ua=1

2. Madhi SA. Levine OS et al. Vaccines to prevent pneumonia and improve child survival. Bulletin of the World Health Organization. Paediatr Respir Rev. 2017; 22: 23–30.

3. Centers for Disease Control and Prevention. Vaccine preventable deaths and the global immunization vision and strategy, 2006-2015MMWR Morb Mortal Wkly Rep 2006; 55: 511-5

4. World Health Organization. UNICEF - Global action plan for prevention and control of pneumonia (GAPP). 2008. Available online at                         https://apps.who.int/iris/bitstream/handle/10665/70101/WHO_FCH_CAH_NCH_09.04_eng.pdf;jsessionid=AAB295FFFB5F04301C22C4FF385CA3D4?sequence=1

 


14|anamariadavitoiu@yahoo.com
A 9-a Conferință Națională de Pneumologie Pediatrică
Joi, 1 octombrie – Sâmbătă 3 octombrie, 2020

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