BABATUNDE OLUJIMI OLOGUNDE
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TOPIC: Discuss the impact of vaccination on the global epidemiology of bacterial infections.
Bacterial infections are infections transmitted by pathogenic bacteria. Infection occurs when an organism enters into the host and establishes a relationship which may lead to a disease condition. According to (WHO.int/topics/epidemiology/en); most bacteria are harmless or are more or less beneficial while few are pathogenic. WHO noted that pathogenic bacteria contribute to the other globally important diseases such as pneumonia whose etiologic agents could be Streptococcus pneumoniae and Pseudomonas species. Pneumonia is an inflammatory condition of the lungs which affects primarily the microscopic air sacs called alveoli. Typical symptoms include cough, chest pain, fever and difficulty in breathing. (WHO.int/topics/epidemiology/en).For the purpose of this essay I will be talking about pathogenic bacteria. These are the bacteria that cause acute infections depending on their degree of virulence.
Epidemiology, according to the British Medical Journal (BMJ) is the study of the frequency of occurrence of diseases among different groups of people. WHO defined epidemiology as the study of the spread and determinants of health related states or events such as disease condition, the application of epidemiology involves various methods investigations, surveillance and descriptive and analytical studies.
The information obtained is very useful by both the government and the health Ministry to plan and evaluate ways to prevent such diseases. Also in patient already affected, epidemiological information serves as a guide to their management. Epidemiology helps the health workers to measure the disease outcomes among the population at risk.
Vaccination: Prevention and control of bacterial infections can be achieved by vaccination. As the saying goes “prevention is better than cure”. Prevention includes vaccination as an environmental measure. Vaccination is the administration of antigenic material in order to stimulate the individual’s immune system to develop adaptive immunity to the pathogen.
According to centre for Disease Control (CDC); disease prevention is a key to public health. CDC, opined that “vaccines are responsible for control” of many infectious diseases that were once common around the world. Examples of such diseases are diphtheria, pertusis, tetanus, Haemophilus influenzae and pneumonia.
Mode of transmission ranges from mother to foetus, sperm to embryo, among families and social groups (The Marshall Protocol Knowledge Base). MPKB further stated that certain infections such as gonorrhea, influenza and common cold are transmitted through physical contact as in sexual intercourse, and droplets due to coughing and sneezing. Five papers were reviewed in this essay and critically analysed.
1. Maternal tetanus toxoid vaccination and neonatal mortality in rural North. India Singh et al (2012)
The above Journal examined the impact of antenatal vaccination in rural India where neonatal mortality ways prevalent. In this paper, Singh et al, (2012) utilized the Indian National family Health Survey (NFHS), and analysed the death rate of singleton births with maternal tetanus vaccination as well as patient attending antenatal clinics being given folic acid and iron. Tetanus is caused by Clostridium tetani, a Gram – positive bacilli.
In their observation, it was noted that part of the factors responsible for high mortality rate was lack of adequate health facility, in the larger poor society of the densely populated India.
The paper further observed that there has been improvement in health condition of the rural population partly due to advances in production of vaccines as well as storage and its distribution. As a result of this they have further recorded a higher immunological response (Singh et al, 2012). This paper concluded that in their study of the socio economic aspects of the survey, it is evident that poorer & older women rejected the vaccination.
Furthermore, religion was also an important factor that militated against the success of the exercise especially Muslims women not only in India but other party of developing country such as Nigeria, Mali, Gambia, etc. (RAM F & Singh A (2006). In their paper titled “is antenatal care effective in improving maternal health in rural ultar predesh?”
Lastly, Singh et al (2012) concluded that in spite of the effort of the government through the agency of National Rural Health Mission to avail health care to all; the poor and the marginalized were still not taken care of adequately.
2. Impact of pneumococcal conjugate vaccination on otitis media – Taylor et al (2012). In this article, the authors Taylor et all aimed to investigate the impact of pneumococcal conjugate vaccination (PCV) for the protection of patients against acute otitis media (AOM).
According to Taylor et al (2012). Acute otitis media (AOM) is among the foremost reasons for frequent hospitalization as well as prescription of antibiotics for young children. AOM is commonly reported among young children especially those within the age 1 – 3 years. The microbial pathogens implicated which account for 70 – 80% of samples collected from middle ear fluid are Streptococcus pneumoniae Haemophilus influenzae.
The figure below shows observation data base studies in OM rate for years before and after 7 – valent PCV introduction in year 2000.
Taylor at al observed that it was difficult to find appropriate controls in a well – immunized population. They however noted that OM rates have reduced by approximately 10% as a result of the introduction of 7v CRM on a long term duration.
Since Taylor et al (2012) suggested that influences other than the PC, were partly responsible for above 15% reduction, it follows that more research needs to be one to determine other factors that could be responsible for its reduction.
3. Bacterial meningitis: The impact of vaccination Makwana N & Riordan FA (2007)
In this article, the authors observed that one of the main causes of death among children under the age of 2 years is acute bacterial meningitis, due to the immaturity of their immune response to polysaccharide antigens. Makwana & Riordan (2007) noted that as a result of the introduction of Haemophillus influenzae type 6 (Hib) conjugate vaccine there was a dramatic reduction in the occurrence of all invasive Hib diseases and that of meningitis, both in the United Kingdom and United State.
However, while developed countries such as the UK and US have conveniently introduced the vaccines, most developing countries are in capacitated due to the huge cost (Makwana & Riordan, 2007)
4. Inequity Worldwide; Andre et al (2007)
In this article, Andre et al, opined that vaccines are primarily meant to prevent diseases and not necessarily for protection. However some vaccines are also for protection as well as prevention. They noted that in Finland, USA and other places across the globe, influenza vaccination was discovered to serve as protection against diseases related to the main target. They concluded that vaccination has immense benefit which extend beyond mere prevention of specific diseases in the patients.
Vaccination helps both children and adults According to Ranganathen et al. (2009), vaccination against Strept. pneumoniae have good evidence to support their use. The use of vaccine has led to decreased incidence of these infections in adults because many adults acquire infections from children Ranganathen et al. (2009), observed that streptococcal pneumonia vaccine is available for adults and has been found to decrease the risk of invasive pneumococcal disease. In the summary of the article by Andre et al (2007), they opined that a comprehensive vaccination programme is necessary for good public health and this will go a long way in minimizing inequities and poverty globally.
In order to globally combat most of not all, these pathogenic bacterial infections, the developed countries would need to come to the aid of the less developed or the developing countries through the agency of WHO.
As much as he less privileged countries are willing to be free from the global epidemic, the huge cost of the procurement of the vaccines is a major hindrance as well as religion beliefs especially the Muslim communities in Africa.
The Marshall Protocol Knowledge Base: Autoimmunity Research Foundation
Makwana, N & Riordan FA; Bacterial meningitis: The impact of vaccination (year)
Taylor S, Marchisco P, Vergison A, Harriagne J, Handsdorf WP, Hanggard M; Impact of pneumococcal conjugate vaccination on otitis media: A systematic review 2012:54 (12):1765 – 73
Sinah A, Pallikadavath S, Ogollah R, Stones W. Maternal Tetanus Toxoid Vaccination and Neonatal mortality in Rural North India. 2012; vol 7: issue 11.