Cumprimento do esquema vacinal em crianças internadas por pneumonia e fatores associados

Abstract

OBJECTIVE:To verify the adequacy and factors associated with compliance with the immunization schedule (BCG, DTP-Hib, MMR, PCV-10) in children hospitalized with pneumonia at a pediatric referral hospital in Northeast Brazil.METHODS:This is a cross-sectional, descriptive study with an analytical component, with a sample of 452 children hospitalized with pneumonia at the Instituto de Medicina Integral Prof. Fernando Figueira, between 2010 and 2013. The inclusion criterion was children aged from one month to less than five years of age with proof in the immunization record. The exclusion criterion was the presence of hospital-acquired pneumonia or concomitant disease. We have evaluated the adequacy of the immunization schedule for the BCG, tetravalent, MMR, and 10-valent pneumococcal conjugate (PCV-10) vaccines. We used the chi-square test and Fisher's exact test followed by multivariate Poisson regression, estimating the crude and adjusted prevalence ratios and respective 95% confidence intervals. The variables with p < 0.20 in the univariate analysis were included in the multivariate analysis.RESULTS:There was good adequacy in the immunization schedule, except for PCV-10, which presented a percentage lower than 85%. We have observed an association between adequate compliance with the immunization schedule and education level of the mother (89.9% complete high school), sex of the child (87.2% female), age of the child (94.2% younger than six months), and breastfeeding (84.3% breastfed).CONCLUSIONS:Given the high rate of education level of the mother and the high percentage of breastfeeding, we can understand that there is a better understanding of the health of the child by the mothers studied in this study, showing the effectiveness of public policies for infant feeding. However, children did not have good adequacy of the immunization schedule of PCV-10, one of the main vaccines against pneumonia, which can be one of the main factors in the causes of hospitalization, with no influence on the classification of the severity of the disease. In this way, we emphasize that the causes of pneumonia morbidity are not associated with a single factor.

Vaccine uptake and associated factors in an irregular urban settlement in northeastern Brazil: a cross-sectional study

“…The finding of an association between complete vaccination schedule and maternal education level corroborates another reports [ 3 , 5 , 7 , 9 , 23 ]. The association between poor maternal schooling and incomplete vaccination can be explained by the fact that education level influences knowledge on the different types of vaccine, why they are necessary, their availability, recommendations, benefits and risks [ 9 ].…”

“…This finding is in agreement with the results of a prospective cohort study conducted in the Brazilian state of Maranhão in which incomplete vaccination increased as a function of the child’s age [ 11 ]. A study conducted with hospitalized children in Recife reported similar findings [ 23 ]. This could be attributed to the fact that most of the vaccines included in the vaccination schedule are given in the first year of life, especially up to 6 months, on dates that match with the child’s routine check-up visit.…”

Declínio Da Cobertura Vacinal De BCG No Brasil Entre 2017 E 2021

“…Os desafios apresentados ao PNI após sua introdução são diversos e, dentre eles está a manutenção das coberturas vacinais em índices desejados (FONSECA;BUENAFUENTe, 2021). A cobertura vacinal, trata-se de um indicador de saúde que consiste em um cálculo realizado através da razão do quantitativo de vacinas que foram distribuídas pelos serviços de saúde, e o número de crianças que receberam o esquema vacinal completo de determinada vacina, relacionado ao total de crianças existentes dentro da faixa etária que se deseja analisar (SILVA et al, 2018).…”

Social inequality and pneumonia hospitalization in children under five years of age in Maranhão, Brazil

“…Brazil stands out as being one of the 15 countries with the highest incidence of this disease in children under five years of age. 11 Data from the country's national health information system, DATASUS, show that this age group accounted for one-third of all hospital admissions for pneumonia (1,277,196 cases) between 2012 and 2017. The Northeast Region was home to the second largest proportion of cases in the country, with 27.6% of all cases, 15.5% of which occurred in the State of Maranhão, occupying second place in the region and eighth place overall among Brazil's states.…”

“…14,15 These precarious material living conditions adversely affect the health of vulnerable and disadvantaged groups such as children. 13 Studies in other Brazilian states 1,10,11,16,17 have described the characteristics of hospitalizations for pneumonia in children and their relation with socioeconomic and contextual indicators. However, this type of study has yet to be conducted in the State of Maranhão, meaning that there is a lack of knowledge about the dynamics of the occurrence of pneumonia and its spatial distribution.…”