Implementing an Influenza Vaccine Effectiveness Study in a Hospital Context in Portugal: The EVA Hospital Project
Autor(a) principal: | |
---|---|
Data de Publicação: | 2021 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438 |
Resumo: | Introduction: The project ‘Integrated Monitoring of Vaccines in Europe’ aimed to measure seasonal influenza vaccine effectiveness against hospitalised adults, aged 65 years and over, with influenza. We describe the protocol implementation in Portugal.Material and Methods: We implemented a test-negative design, targeting community-dwelling patients aged 65 years old and over hospitalised with severe acute respiratory illness. Patients were reverse transverse-polymerase chain reaction tested for influenza. Cases were those positive for influenza while others were controls. Most variables were collected using hospital medical records. Selection bias was evaluated by comparison with the laboratory influenza test requests database according to demographic characteristics. Crude, season-adjusted influenza vaccine effectiveness was estimated as = 1 – odds ratio, and 95% confidence intervals were obtained by conditional logistical regression, matched with the disease onset month.Results: The recruitment rate was 37.8%. Most participants (n = 368) were female (55.8%) and aged 80 years old and over (55.8%). This was similar to values for potentially eligible severe acute respiratory illness patients (80 years old and over: 56.8%, female: 56.2%). The proportion of missing values was below 2.5% for 20 variables and above 5% (maximum 11.6%) for six variables. Influenza vaccine effectiveness estimates were 62.1% against AH1pdm09 (95% confidence intervals: -28.1 to 88.8), 14.9% against A(H3N2) (95% confidence intervals: -69.6 to 57.3), 43.6% against B/Yam (95% confidence intervals: -66.2 to 80.8).Discussion: Given the non-existence of a coded admission database in either participating hospital the selection of severe acute respiratory illness due to clinical features was the feasible one. These results are only valid for the older adult population residing in the catchment area of the two participating hospitals who were admitted to a public hospital with severe influenza or SARI symptoms.Conclusion: Despite the low participation rate, we observed comparable characteristics of participants and eligible severe acute respiratory illness patients. Data quality was high, and influenza vaccine effectiveness results were in accordance with the results of meta-analyses and European season-specific estimates. The final sample size was low, which inhibited obtaining estimates with good precision. |
id |
RCAP_e82f1daba983b0f704a5f4d30de10abd |
---|---|
oai_identifier_str |
oai:ojs.www.actamedicaportuguesa.com:article/13438 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Implementing an Influenza Vaccine Effectiveness Study in a Hospital Context in Portugal: The EVA Hospital ProjectImplementação de um Estudo de Efetividade da Vacina Contra a Gripe no Contexto Hospitalar em Portugal: Projeto EVA HospitalInfluenzaHumanInfluenza VaccinesPortugalRespiratory Tract InfectionsReverse Transcriptase Polymerase Chain ReactionGripeInfecções RespiratóriasPortugalReacção em Cadeia da Polimerase Via Transcriptase ReversaVacina contra GripeIntroduction: The project ‘Integrated Monitoring of Vaccines in Europe’ aimed to measure seasonal influenza vaccine effectiveness against hospitalised adults, aged 65 years and over, with influenza. We describe the protocol implementation in Portugal.Material and Methods: We implemented a test-negative design, targeting community-dwelling patients aged 65 years old and over hospitalised with severe acute respiratory illness. Patients were reverse transverse-polymerase chain reaction tested for influenza. Cases were those positive for influenza while others were controls. Most variables were collected using hospital medical records. Selection bias was evaluated by comparison with the laboratory influenza test requests database according to demographic characteristics. Crude, season-adjusted influenza vaccine effectiveness was estimated as = 1 – odds ratio, and 95% confidence intervals were obtained by conditional logistical regression, matched with the disease onset month.Results: The recruitment rate was 37.8%. Most participants (n = 368) were female (55.8%) and aged 80 years old and over (55.8%). This was similar to values for potentially eligible severe acute respiratory illness patients (80 years old and over: 56.8%, female: 56.2%). The proportion of missing values was below 2.5% for 20 variables and above 5% (maximum 11.6%) for six variables. Influenza vaccine effectiveness estimates were 62.1% against AH1pdm09 (95% confidence intervals: -28.1 to 88.8), 14.9% against A(H3N2) (95% confidence intervals: -69.6 to 57.3), 43.6% against B/Yam (95% confidence intervals: -66.2 to 80.8).Discussion: Given the non-existence of a coded admission database in either participating hospital the selection of severe acute respiratory illness due to clinical features was the feasible one. These results are only valid for the older adult population residing in the catchment area of the two participating hospitals who were admitted to a public hospital with severe influenza or SARI symptoms.Conclusion: Despite the low participation rate, we observed comparable characteristics of participants and eligible severe acute respiratory illness patients. Data quality was high, and influenza vaccine effectiveness results were in accordance with the results of meta-analyses and European season-specific estimates. The final sample size was low, which inhibited obtaining estimates with good precision.Introdução: O projeto “Integrated Monitoring of Vaccines in Europe” pretende medir a efetividade da vacina antigripal nas hospitalizações por gripe nos adultos com mais de 65 anos. Este estudo pretende descrever a implementação do protocolo em Portugal.Material e Métodos: Implementou-se um estudo com desenho caso-controlo teste negativo. A população-alvo foram indivíduos com idade superior a 65 anos, hospitalizados com doença respiratória aguda grave. Os doentes foram testados para gripe por reverse transverse-polimerase chain reaction. Foram considerados casos aqueles com resultado positivo; os restantes foram controlos. Os dados foram obtidos através de registo clinicos. O potencial viés de seleção foi avaliado por comparação de características demográficas e enfermarias com dados das requisições laboratoriais. A efetividade da vacina, foi estimada em 1 – odds ratio por regressão logística condicional, emparelhada para o mês de início da doença.Resultados: A taxa de recrutamento foi de 37,8%. A maioria dos participantes (n = 368) era do sexo feminino (55,8%) e tinha idade superior a 80 anos (55,8%). Padrão similar foi verificado nos doentes elegíveis (idade superior a 80 anos: 56,8%; feminino: 56,2%). Os valores omissos foram inferiores a 2,5% em 20 variáveis e acima de 5% (máximo 11,6%) em seis variáveis. As estimativas da efetividade foram 62,1% contra AH1pdm09 (intervalo de confiança IC 95%: -28,1, 88,8); 14,9% contra A (H3) (intervalo de confiança 95%: -69,6; 57,3) e 43,6% contra B/yamagata (intervalo de confiança 95%: -66,2; 80,8).Discussão: Dada a inexistência de uma codificação em base de dados de admissão em qualquer um dos hospitais participantes, a abordagem de identificação e casos clínicos de doença respiratória aguda grave foi a exequível. Estes resultados são válidos para a população idosa residente na área de abrangência dos dois hospitais participantes que foram internados em um hospital público com gripe grave ou sintomas de doença respiratória aguda grave.Conclusão: Apesar da baixa taxa de participação, observámos características comparáveis entre os participantes e os doentes elegíveis. A qualidade dos dados foi elevada, e os resultados da efetividade concordantes com resultados de meta-análises e estimativas europeias. A reduzida dimensão da amostra impediu a obtenção de estimativas mais precisas.Ordem dos Médicos2021-01-04info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438oai:ojs.www.actamedicaportuguesa.com:article/13438Acta Médica Portuguesa; Vol. 34 No. 1 (2021): January; 20-27Acta Médica Portuguesa; Vol. 34 N.º 1 (2021): Janeiro; 20-271646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/6191https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/6192https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/12196https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/12251https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/12277https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/12837https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/12838https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/12839Direitos de Autor (c) 2020 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessMachado, AusendaGomez, VerónicaPanarra, AntónioPoças, JoseCorte-Real, RitaPeres, Maria JoãoNunes, BaltazarEVA Hospital Group, Em Representação do2022-12-20T11:06:53Zoai:ojs.www.actamedicaportuguesa.com:article/13438Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:21.130519Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Implementing an Influenza Vaccine Effectiveness Study in a Hospital Context in Portugal: The EVA Hospital Project Implementação de um Estudo de Efetividade da Vacina Contra a Gripe no Contexto Hospitalar em Portugal: Projeto EVA Hospital |
title |
Implementing an Influenza Vaccine Effectiveness Study in a Hospital Context in Portugal: The EVA Hospital Project |
spellingShingle |
Implementing an Influenza Vaccine Effectiveness Study in a Hospital Context in Portugal: The EVA Hospital Project Machado, Ausenda Influenza Human Influenza Vaccines Portugal Respiratory Tract Infections Reverse Transcriptase Polymerase Chain Reaction Gripe Infecções Respiratórias Portugal Reacção em Cadeia da Polimerase Via Transcriptase Reversa Vacina contra Gripe |
title_short |
Implementing an Influenza Vaccine Effectiveness Study in a Hospital Context in Portugal: The EVA Hospital Project |
title_full |
Implementing an Influenza Vaccine Effectiveness Study in a Hospital Context in Portugal: The EVA Hospital Project |
title_fullStr |
Implementing an Influenza Vaccine Effectiveness Study in a Hospital Context in Portugal: The EVA Hospital Project |
title_full_unstemmed |
Implementing an Influenza Vaccine Effectiveness Study in a Hospital Context in Portugal: The EVA Hospital Project |
title_sort |
Implementing an Influenza Vaccine Effectiveness Study in a Hospital Context in Portugal: The EVA Hospital Project |
author |
Machado, Ausenda |
author_facet |
Machado, Ausenda Gomez, Verónica Panarra, António Poças, Jose Corte-Real, Rita Peres, Maria João Nunes, Baltazar EVA Hospital Group, Em Representação do |
author_role |
author |
author2 |
Gomez, Verónica Panarra, António Poças, Jose Corte-Real, Rita Peres, Maria João Nunes, Baltazar EVA Hospital Group, Em Representação do |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Machado, Ausenda Gomez, Verónica Panarra, António Poças, Jose Corte-Real, Rita Peres, Maria João Nunes, Baltazar EVA Hospital Group, Em Representação do |
dc.subject.por.fl_str_mv |
Influenza Human Influenza Vaccines Portugal Respiratory Tract Infections Reverse Transcriptase Polymerase Chain Reaction Gripe Infecções Respiratórias Portugal Reacção em Cadeia da Polimerase Via Transcriptase Reversa Vacina contra Gripe |
topic |
Influenza Human Influenza Vaccines Portugal Respiratory Tract Infections Reverse Transcriptase Polymerase Chain Reaction Gripe Infecções Respiratórias Portugal Reacção em Cadeia da Polimerase Via Transcriptase Reversa Vacina contra Gripe |
description |
Introduction: The project ‘Integrated Monitoring of Vaccines in Europe’ aimed to measure seasonal influenza vaccine effectiveness against hospitalised adults, aged 65 years and over, with influenza. We describe the protocol implementation in Portugal.Material and Methods: We implemented a test-negative design, targeting community-dwelling patients aged 65 years old and over hospitalised with severe acute respiratory illness. Patients were reverse transverse-polymerase chain reaction tested for influenza. Cases were those positive for influenza while others were controls. Most variables were collected using hospital medical records. Selection bias was evaluated by comparison with the laboratory influenza test requests database according to demographic characteristics. Crude, season-adjusted influenza vaccine effectiveness was estimated as = 1 – odds ratio, and 95% confidence intervals were obtained by conditional logistical regression, matched with the disease onset month.Results: The recruitment rate was 37.8%. Most participants (n = 368) were female (55.8%) and aged 80 years old and over (55.8%). This was similar to values for potentially eligible severe acute respiratory illness patients (80 years old and over: 56.8%, female: 56.2%). The proportion of missing values was below 2.5% for 20 variables and above 5% (maximum 11.6%) for six variables. Influenza vaccine effectiveness estimates were 62.1% against AH1pdm09 (95% confidence intervals: -28.1 to 88.8), 14.9% against A(H3N2) (95% confidence intervals: -69.6 to 57.3), 43.6% against B/Yam (95% confidence intervals: -66.2 to 80.8).Discussion: Given the non-existence of a coded admission database in either participating hospital the selection of severe acute respiratory illness due to clinical features was the feasible one. These results are only valid for the older adult population residing in the catchment area of the two participating hospitals who were admitted to a public hospital with severe influenza or SARI symptoms.Conclusion: Despite the low participation rate, we observed comparable characteristics of participants and eligible severe acute respiratory illness patients. Data quality was high, and influenza vaccine effectiveness results were in accordance with the results of meta-analyses and European season-specific estimates. The final sample size was low, which inhibited obtaining estimates with good precision. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-01-04 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438 oai:ojs.www.actamedicaportuguesa.com:article/13438 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/13438 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/6191 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/6192 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/12196 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/12251 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/12277 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/12837 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/12838 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13438/12839 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2020 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Direitos de Autor (c) 2020 Acta Médica Portuguesa |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf application/vnd.openxmlformats-officedocument.wordprocessingml.document application/pdf application/pdf application/vnd.openxmlformats-officedocument.wordprocessingml.document application/vnd.openxmlformats-officedocument.wordprocessingml.document application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 34 No. 1 (2021): January; 20-27 Acta Médica Portuguesa; Vol. 34 N.º 1 (2021): Janeiro; 20-27 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799130651878752256 |