Content:
- Editorial
- RSV infection in the Czech Republic – analysis of hospitalizations in the years 2017–2021 – Roman Prymula, Petr Pazdiora, Ladislav Dušek
- Why is there a threat of the emergence and spread of measles in Slovakia? – Henrieta Hudečková, Romana Ulbrichtová, Martin Novák, Mária Tatarková, Eva Malobická, Ján Mikas, Adriana Mečochová, Viera Švihrová, Mária Štefkovičová
- The worldwide burden of malaria and novel preventive approaches – Eva Pernicová, Martin Krsek
- Vaccination against rotavirus infections, data about failures of vaccination in information systems – Petr Pazdiora
- Development of a Vaccine against Respiratory Syncytial Virus (RSV) – Vanda Boštíková
Editorial
Vážení čtenáři, kolegové a kolegyně,
v poslední době proběhlo a ještě bude probíhat několik kulatých stolů na téma zavádění nových vakcín, očkování v dospělosti nebo očkování proti pneumokokovým nákazám. Ukazuje se, že sice o problémech dobře víme, ale poněkud je nejsme schopni efektivně řešit. Cílem všech je nepochybně transparentní systém zavádění nových vakcín do očkovacího kalendáře, avšak praktická realizace poněkud pokulhává.
Model Národní imunizační komise (NIKO) jako orgánu řešícího priority v oblasti očkování nefunguje. Důvodem je, že tato komise by měla být zcela nezávislá a dávat odborná doporučení proti čemu, kdy a jak očkovat. Neměla by to být komise, která rozhoduje. Tuto funkci by měly plnit pojišťovny, ministerstvo a zástupci NIKO v podobě nadřízeného orgánu nad NIKO.
Stávají smíšený model dává obrovskou sílu zdravotním pojišťovnám, které snadno přehlasují odborné společnosti, z nichž každá má na rozdíl od pojišťoven pouhý jeden hlas. Navenek výstup vypadá tak, že odborná komise doporučení nevydala, ale realita je, že rozhodly ekonomické aspekty. Systém je o to komplikovanější, že díky minulým diskuzím o legitimitě povinného očkování, je toto většinově definováno zákonem, a tedy prakticky i jakýkoliv posun vyžaduje změnu zákona. Proto i kdyby nakrásně NIKO nějaké očkování doporučilo a doporučení schválil i ministr, ještě zdaleka není vyhráno, neboť rozhodují poslanci.
Musíme vážně iniciovat diskuzi, jak by měl funkční systém vypadat, aby byl v praxi realizovatelný, a jaké metody hodnocení nových vakcín by měly být použity (Health Technology Assessment, Cost-benefit analýza, apod.).
S přáním pěkného léta na obzoru
prof. MUDr. Roman Prymula, CSc., Ph.D.
RSV infection in the Czech Republic – analysis of hospitalizations in the years 2017-2021
Summary
Introduction: Respiratory syncytial virus (RSV) is a pathogen that usually causes mild cold-like symptoms. However, it can sometimes cause serious illness, especially in premature babies and infants. RSV is the most common cause of bronchiolitis and pneumonia in children under one year of age worldwide. A significant increase occurs especially during the respiratory season and in compensatory waves in the post-covid era.
Methodology: Data from the National Register of Reimbursed Health Services and the National Register of Hospitalizations were used for the analyses. The number of hospitalizations for RSV infection by age group for the years 2017 to 2021 was analyzed. Also the number of hospitalizations in children under five years with a diagnosis of acute bronchitis – J20 regardless of the causative agent and especially the diagnosis J20.5, acute bronchitis caused by RSV and J21 bronchiolitis regardless of the causative agent and specifically J21.0 bronchiolitis due to RSV, further diagnosis of pneumonia J12.1 and diagnosis of tracheitis J04 were compared.
Results and discussion: Hospitalizations show considerable variation in individual years from 213 to 1 804. The highest incidence of hospitalization in the age group under one year is documented in 2021, a total of 1 349. If we were to choose an indicator diagnosis for RSV, it is clearly bronchiolitis, when e.g. in 2019, out of 200 hospitalizations for bronchiolitis, 151 were caused by RSV, and in 2021, out of 412 hospitalizations for bronchiolitis, 330 were caused by RSV, i.e. more than 75% in both years.
Conclusion: It can be stated that even in the Czech Republic, RSV diseases dominate in the category under one year of age and subsequently in the category under five years of age, but they also occur in older age categories. It is clear from the data that RSV infection constitutes a substantial part of serious hospitalizations in the lowest age group. The data imply the need to find new preventive measures to prevent this burden.
Keywords:
RSV, bronchitis, bronchiolitis, tracheitis, pneumonia, hospitalization
Roman Prymula,1,2 Petr Pazdiora,3 Ladislav Dušek4,5
1Ústav preventivního lékařství, Lékařská fakulta v Hradci Králové, Univerzita Karlova
2Agel
3Ústav epidemiologie, Lékařská fakulta v Plzni, Univerzita Karlova
4Institut biostatistiky a analýz, Lékařská fakulta, Masarykova univerzita
5Ústav zdravotnických informací a statistiky České republiky
Why is there a threat of the emergence and spread of measles in Slovakia?
Summary
Introduction: In today’s globalized society, measles represents the most serious infectious disease. Sufficiently high immunity (over 95%) limits the chain spread and the causative agent doesn’t circulate within the region. The aim of this study was to analyse the epidemiological situation in the occurrence of measles in Slovakia in the years 1990–2021, to assess vaccination with the first and second doses of the vaccine for the monitored period of 2003–2021 according to birth years and to evaluate the average vaccination with two doses at the national, regional and district level.
Material and methods: We drew the number of reported diseases from the database of reported diseases from the EPIS SR database (Epidemiologický informačný systém prenosných ochorení Slovenskej republiky) and vaccination coverage data from regular annual administrative checks of vaccination with the first and second dose of measles-containing vaccine.
Results: Already at the end of the twentieth century, measles was eliminated in Slovakia, and we maintained the status of eliminated measles from 1999 to 2018. Currently, within the WHO European Region, we are among the countries with a renewed endemic spread. In Slovakia, over the last 10 years, vaccination with the first dose of measles-containing vaccine in the controlled birth years 2010 to 2019 has decreased in Slovakia at district, regional, and national level. The average vaccination rate with the first dose in Slovakia was 96.4% (min. 95.4% – max. 98.4%. The average vaccination rate with the second dose was over 97% in both controlled periods (years 1990–1999 and 2000–2009).
Conclusion: Vaccination is one of the most successful public health achievements, saving billions of lives. Success depends not only on strong national immunization programs, an effective vaccine and high-quality monitoring of vaccination coverage, but also on a high level of political support.
Keywords:
measles, vaccination, measles vaccination coverage, measles elimination, measles prevention
Henrieta Hudečková,1 Romana Ulbrichtová,1 Martin Novák,1 Mária Tatarková,1 Eva Malobická,1
Ján Mikas,2 Adriana Mečochová,2 Viera Švihrová,1 Mária Štefkovičová,3
1Ústav verejného zdravotníctva, Jesseniova lekárska fakulta Martin, Univerzita Komenského Bratislava, Slovenská republika
2Úrad verejného zdravotníctva Slovenskej republiky, Bratislava
3Fakulta zdravotníctva, Trenčianska univerzita Alexandra Dubčeka v Trenčíne, Slovenská republika
The worldwide burden of malaria and novel preventive approaches
Summary
Malaria is a life-threatening tropical disease caused by 5 species of parasites of the Plasmodium genus. This infection is transmitted to humans via the bites of infected Anopheles mosquito females.
According to WHO, there were an estimated 241 million cases of malaria and approximately 627 000 deaths in 2020 which meant an increase compared to the previous 20-year period with a decreasing tendency. This is assumed to be a result of health service disruptions due to the COVID-19 pandemic.
The African Region accounts for most of the global malaria burden with 95% of world cases and 96% of the deaths. Children under 5 years of age are considered the most vulnerable group as they make up almost 80% of all deaths in Africa.
Over the years, both preventive and repressive programs have been introduced by several organizations in order to reduce the worldwide impact of malaria. Recently, the development of effective vaccines against this disease has been prioritized.
Keywords:
malaria, Plasmodium, preventive programs, resistance, vaccine
Eva Pernicová,1,2 Martin Krsek2
1Centra očkování a cestovní medicíny Avenier, Brno
2Ústav veřejného zdraví, Lékařská fakulta, Masarykova univerzita, Brno
Vaccination against rotavirus infections, data about failures of vaccination in information systems
Summary
Introduction: Information System of Infectious Diseases (ISIN) is created mainly to record acute diseases. Vaccination data is among the captured data. Based on legal obligations, The State Institute for Drug Control (SUKL) also obtains data on vaccination failure.
Objective: To verify the suitability of the information system ISIN and SUKL for partial evaluation of vaccination impact.
Results: In years 2018–2021 a total of 15,013 cases of rotavirus gastroenteritis were reported. In 213 patients, a history of vaccination against these infections was given, 160 patients had completed vaccination. There was a significantly higher risk of hospitalization in unvaccinated patients than in vaccinated children of the same age (x2 = 18,01; p = 0,00002). Three infants who died of this infection were also unvaccinated. The risk of hospitalization was for unvaccinated children aged one year was 9.6–27.3 times higher than for vaccinated children in individual years. In the reported years, SUKL received 21 vaccination failure reports.
Discussion and conclusions: While the Infectious Disease Information System cannot substitute long-term prospective monitoring of vaccinated individuals in evaluating vaccination efficacy, it can provide interesting information that can contribute to monitoring vaccination efficacy. To obtain more accurate vaccination data from both systems, it is desirable to improve the quality of reporting. The long-term exceptionality of vaccination failure against rotavirus infections is another argument for the promotion and spread of this vaccination.
Keywords:
rotavirus infection, failure of vaccination, hospitalisation
Petr Pazdiora
Ústav epidemiologie Lékařské fakulty v Plzni, Univerzita Karlova
Development of a Vaccine against Respiratory Syncytial Virus (RSV)
Summary
Respiratory syncytial virus (RSV) is responsible for respiratory tract infections. It is a highly cosmopolitan virus. It infects the majority of the child population before the age of two. RSV infection is highly contagious. The virus is spread by tiny droplets in the air (sneezing, coughing). Direct routes of transmission (e.g. kissing) as well as through contaminated objects have also been described. The problem of the high prevalence and very rapid spread of RSV in the population during the third year of the ongoing SARS-CoV-2 pandemic has made efforts to develop a vaccine against this highly contagious respiratory virus all the more stimulating.
Keywords:
respiratory syncytial virus, SARS-CoV-2, epidemic, children, vaccination, vaccines
Vanda Boštíková
Katedra epidemiologie, Fakulta vojenského zdravotnictví, Univerzita obrany, Hradec Králové