The implemented actions to minimize the spread of the COVID-19 pandemic had a powerful effect on the transmission of other respiratory viruses, particularly influenza viruses. Influenza is a disease of viral aetiology that causes epidemics and occasionally pandemics during the wintertime almost every year. Generally, it is a mild and self-limiting disease, but it can represent high morbidity and even mortality when affecting the elderly population or people with latent chronic diseases. The existing circumstances of a persistent and ongoing epidemic caused by the SARS-CoV-2 virus, increase the probability of having active coincidence with the anticipated annual epidemic of influenza. Thus, the key is a logistic strategy for clinical and viral diagnosis of the SARS-CoV-2 virus that will determine the importance of understanding the role of influenza vaccines in virus-induced COVID-19 disease. This paper aims to compare the potential impact of the COVID-19 pandemic on the vaccination coverage of the population with the influenza vaccine. The official data for seasonal influenza vaccination were used, obtained from the weekly reports on the influenza situation in the Republic of North Macedonia from the Institute of Public Health as well as the data from the national system “MojTermin” for total vaccinated individuals with influenza vaccine for the season 2020/2021 and 2021/2022 including the 5th week. The analyzed data for the season 2021/2022 show an increase of applied doses by 8.3% compared to the season 2020/2021 and an increase of 11.5% compared to the season 2019/2020. Regarding the target groups in the season 2021/2022, including the 5th week, the coverage of influenza vaccination in children aged 6 months to 5 years has a significant decrease of 87.9% compared to the season 2020/2021. There is an increase in coverage in health professionals by 24.3% compared to last season, in the chronically ill the decrease of the applied doses is by 11.4% compared to last season, and in the elderly, over 65 it is noticeable an increase in coverage by 100% compared to the 2020/2021 season. Furthermore, there is a significant decrease of 95.7% in the vaccines administered to pregnant women compared to last season. The reduced coverage of influenza vaccination is partly due to the ambiguities arising from the influenza immunization campaign, which emphasized the importance of receiving a vaccine to minimize the spread of the influenza virus as an additional threat to the presence of COVID-19. Although the influenza vaccine does not protect against COVID-19, influenza vaccination has been part of the public health strategy to flatten the disease curve caused by respiratory viruses that attack the respiratory system, to protect and preserve the health of healthcare professionals providing care to patients with COVID-19. Influenza vaccination is still the most efficient preventive measure against influenza infections at our disposal and it is recommended by the most expert bodies including CDC, WHO, ECDC, and the National Committee for Immunization of the Republic of North Macedonia.
Nitisinone is a reversible inhibitor of 4-hydroxyphenylpyruvate dioxygenase and an active substance in the orphan drug used for the treatment of hereditary tyrosinemia type I, a rare genetic disease caused by mutations in the gene for the enzyme fumarylacetoacetase. The aim of our study was to develop a simple and accurate RP–HPLC method with UV detection for routine determination of nitisinone in commercially available pharmaceutical forms. The chromatographic separation was achieved on a reversed-phase column Purospher STAR® RP–8 end–capped (150 x 4.6 mm i.d., particle size 5 μm), with a mobile phase consisted of a mixture of acetonitrile and water acidified with o-phosphoric acid with pH adjusted to 3.0, 65:35 (V/V), filtered through 0.45μm nylon filter. The flow rate was kept at 1 mL/min. A diode array detector measured the UV absorbance at 272 nm. The injection volume was 10 μL. The method was validated by a determination of system suitability, specificity, linearity, range, accuracy, precision, detection limit and quantitation limit. Then, the method was applied for determination of nitisinon in commercially available capsules. The proposed RP-HPLC method allows a simple, accurate, precise and rapid determination of nitisinone in pharmaceuticals. The advantages of the method include simple sample treatment, good precision (RSD less than 2%) and high recovery (greater than 99%). The method could be recommended for routine analysis in quality control laboratories, in stability studies as well as for the evaluation of potentially counterfeit capsules containing nitisinone. Key words: Nitisinone; High performance liquid chromatography; Method validation; Hereditary tyrosinemia type I
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