Résumé :
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[BDSP. Notice produite par INIST R0xfe0pU. Diffusion soumise à autorisation]. Background. Meningococcal disease is still a serious public health problem in many countries. A vaccine produced by Cuba was the first product against B meningococcus available on a large scale. In an attempt to control the increasing incidence of this serogroup in greater Rio de Janeiro, Brazil, the vaccine was used in 1990 in children aged 6 months-9 years. About 1.6 million children were vaccinated. Methods. In order to assess the direct effectiveness of the vaccine in preventing disease, we conducted a case-control study during the first year after vaccination. Using a hospital-based census, we selected all children hospitalized with meningococcal disease and sampled the control group among children hospitalized with other types of meningitis. Vaccine effectiveness was estimated from the relationship, 1 - OR, where OR (odds ratio) was the exponential of the logistic regression coefficient for the association between meningococcal disease and previous vaccination. Results. A total of 275 cases and 279 controls were selected between September 1990 and October 1991. Estimated protection varied among different age strata and place of residence, being high among children aged 4 years, 71% (95% Cl : 34-87%), and among those who lived in the City of Rio de Janeiro, 74% (95% Cl : 42-89%). Conclusions. The results suggest that the vaccine produced by Cuba may offer protection against serogroup B meningococcal disease, but its effects may not be homogeneous.
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