ALFREDO ELIAS GILIO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Pediatria, Faculdade de Medicina - Docente
PAINT-62, Hospital Universitário
PAINT-62, Hospital Universitário
2 resultados
Resultados de Busca
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- Chronic medical conditions associated with invasive pneumococcal diseases in inpatients in teaching hospitals in Sao Paulo city: Estimating antimicrobial susceptibility and serotype-coverage of pneumococcal vaccines(2023) KFOURI, Renato A.; BRANDILEONE, Maria-Cristina C.; SAFADI, Marco Aurelio P.; RICHTMANN, Rosana; GILIO, Alfredo E.; ROSSI, Flavia; GUIMARAES, Thais; BIERRENBACH, Ana Luiza; MORAES, Jose C.; IPD, Sao Paulo Study Grp I. P. D. Sa Paulo Study GrpBackground: Chronic conditions increase the risk of invasive pneumococcal diseases (IPD). Pneumococcal vaccination remarkably reduced IPD morbimortality in vulnerable popula-tions. In Brazil, pneumococcal vaccines are included in the National Immunization Pro-gram (PNI): PCV10 for < 2 years-old, and PPV23 for high risk-patients aged >= 2 years and institutionalized >= 60 years. PCV13 is available in private clinics and recommended in the PNI for individuals with certain underlying conditions. Methods: A retrospective study was performed using clinical data from all inpatients from five hospitals with IPD from 2016 to 2018 and the corresponding data on serotype and antimicro-bial-non-susceptibility of pneumococcus. Vaccine-serotype-coverage was estimated. Patients were classified according to presence of comorbidities: healthy, without comorbidities; at-risk, included immunocompetent persons with specific medical conditions; high-risk, with immu-nocompromising conditions and others Results: 406 IPD cases were evaluated. Among 324 cases with information on medical condi-tions, children < 5 years were mostly healthy (55.9%), while presence of comorbidity pre-vailed in adults >= 18 years old (> 82.0%). Presence of >= 1 risk condition was reported in >= 34.8% of adults. High-risk conditions were more frequent than at-risk in all age groups. Among high-risk comorbidity (n = 211), cancer (28%), HIV/AIDS (25.7%) and hematological dis-eases (24.5%) were the most frequent. Among at-risk conditions (n = 89), asthma (16.5%) and diabetes (8.1%) were the most frequent. Among 404 isolates, 42.9% belonged to five serotypes: 19A (14.1%), 3 (8.7%), 6C (7.7%), 4 and 8 (6.2% each); 19A and 6C expressed antimicrobial-non -susceptibility. The vaccine-serotype-coverage was: PCV10, 19.1%, PCV13, 43.8%; PCV15, 47.8%; PCV20, 62.9%; PCV21, 65.8%, and PPV23, 67.3%. Information on hospital outcome was available for 283 patients, of which 28.6% died. Mortality was 54.2% for those with meningitis. Conclusion: Vaccine with expanded valence of serotypes is necessary to offer broad preven-tion to IPD. The present data contribute to pneumococcal vaccination public health policies for vulnerable patients, mainly those with comorbidity and the elderly. (c) 2023 Sociedade Brasileira de Infectologia.
- A study of acceptance and hesitation factors towards tetanus, diphtheria, and acellular pertussis (Tdap) and influenza vaccines during pregnancy(2023) QUILES, Raquel; LEME, Mateus Deckers; LO, Denise Swei; GILIO, Alfredo EliasIntroduction: Vaccination of pregnant women with tetanus, diphtheria, and acellular pertussis (Tdap) and influenza vaccines is desirable to reduce neonatal and maternal morbidity and mortality. However, vaccine coverage rates and acceptance are frequently below recommended rates.Objectives: To ascertain Tdap and influenza vaccine coverage rates in our population and to study the reasons behind sub-optimal rates.Method: A survey was submitted to pregnant or in their puerperium women at the University Hospital of Sa & SIM;o Paulo University. Data were obtained during two consecutive influenza seasons (2017-2018), and vaccination was verified through vaccination chart checking. Respondents were classified according to their status as ""Received Tdap"" and ""Didn't receive Tdap"", and as ""Know"" or ""Doesn't know"" regarding their awareness of Tdap safety during pregnancy and protective effect on the newborn. Vaccine uptake and personal awareness of vaccination status were compared among these groups for Tdap and influenza vaccines.Results: In a studied sample of 207 patients (representative of the whole), coverage rates for Tdap and influenza vaccines were respectively 85.5% and 95.2%. Additionally, 84.5% received both vaccines. There was no vaccine refusal for Tdap and only 0.5% for influenza. For either Tdap or influenza vaccines, the main reason for not vaccinating was a lack of knowledge/information. Factors associated with not vaccinating Tdap during pregnancy were lower number of prenatal visits, being unemployed or freelance worker, not being aware of vaccine safety or its benefits for the baby, not being oriented by the doctor to be vaccinated, not being aware of personal vaccination status, and not having been vaccinated for influenza.Conclusion: While influenza vaccination coverage during pregnancy was ideal, Tdap rates were below recommended values. Significant factors associated with better coverage for Tdap during pregnancy included being employed and not being self-employed, (not yet reported in the Americas) and being aware of personal vaccination status.