Institut de veille sanitaire

About: Institut de veille sanitaire is a healthcare organization based out in Saint-Maurice, France. It is known for research contribution in the topics: Population & Public health. The organization has 1055 authors who have published 1547 publications receiving 56945 citations. The organization is also known as: INVS & InVS.

Vaccinations : actualités et perspectives

Abstract: La vaccination a pour domaine traditionnel la lutte contre les infections, avec deux objectifscomplementaires: procurer un benefice individuel, en s'opposant aux effets pathogenes desagents infectieux et assurer un benefice collectif, de sante publique, en limitant la circulationet la transmission de ces agents.La vaccination peut permettre l'elimination d'une maladie infectieuse, attestee par ladisparition des cas cliniques, ou son eradication a l'echelle mondiale supposant l'arret completde la circulation de l'agent causal. Seule l'eradication confirmee d'une maladie infectieusepermet a terme d'interrompre la vaccination correspondante.L'eradication d'une maladie infectieuse par la vaccination est conditionnee par certainescaracteristiques eco-biologiques du micro-organisme concerne. Ainsi, l'existence de reservoirsnon humains et la capacite de mutation du germe rendent „eradication impossible a envisager.L'objectif d'eradication n'a ete atteint que pour la variole en 1978; il pourrait l'etreprochainement pour la poliomyelite et plus tardivement pour la rougeole, voire l'hepatite B.En revanche, la grippe est consideree comme non eradicable, en raison de la variabilite duvirus et de l'existence d'un reservoir animal.L'emergence periodique de nouveaux agents infectieux peut avoir pour cause l'adaptation d'unvirus animal a l'homme ou l'exaltation de la pathogenicite latente d'un saprophyte. Lesfacilites de circulation des populations entre les differents continents et les modifications desecosystemes creent des conditions extremement favorables a la dissemination et aux risquesd'epidemies. Des observatoires epidemiologiques sont implantes dans les differentes regionsdu globe, comme par exemple le reseau mondial de l'OMS controlant l'eradication du virus dela poliomyelite ou le reseau de surveillance de la circulation des souches grippales. Ilsdevraient permettre de cerner les dangers potentiels d'echappement de l'agent infectieux a lastrategie de controle, de mettre en place rapidement son analyse biologique et d'etudier lespossibilites de le combattre par la mise a disposition d'un vaccin.Les politiques vaccinales sont etablies dans un contexte epidemiologique donne etregulierement reevaluees en fonction de l'evolution de ce contexte et de la couverturevaccinale atteinte. Les mesures nationales sont generalement en adequation avec les strategiesvaccinales internationales, surtout lorsque l'eradication de la maladie est visee. (...)

Epidemiology of pulmonary tuberculosis in France. Can the hospital discharge database be a reliable source of information

Abstract: Objective In France, tuberculosis surveillance is based on mandatory notification (MN) of cases. However, the MN does not allow the full description of cases, and underreporting limits data interpretation. Aiming at better describing the cases of tuberculosis, the hospital record database (PMSI) was analyzed. Patients and method Incident cases of active pulmonary tuberculosis identified in 2010 in France in the PMSI were included and their characteristics were compared with those of the cases identified through the MN. Results In 2010, 5158 incident cases of pulmonary tuberculosis were identified in the PMSI. The mean duration of hospitalization was higher for cases considered contagious — at least one positive test result on pulmonary sample — (22 vs 13 days, P Conclusion PMSI data were compatible with those of the MN and the estimation of the sensitivity was close to other French studies. PMSI can be considered as an interesting tool aiming at improving our knowledge about tuberculosis (TB) cases and strengthening awareness where the sensitivity of the MN is low.

Mean age at stroke onset: an instructive tool from epidemiological studies

Abstract: Dear Sir, With the accelerating ageing of the population, the absolute annual number of patients suffering from stroke is expected to rise over the next few years. As a result, more and more elderly stroke patients will be admitted to healthcare services. Up to now, epidemiological studies have focused on incidence and prevalence rates. Although these data are essential for measuring the frequency of the disease within a population, they do not perfectly reflect the profile of patients, especially with regard to their age. This is important because for a given incidence rate, the impact in terms of healthcare organization, outcome or costs will vary according to the age of the patient. Consequently, additional information could be provided by another epidemiologic marker: the mean age at stroke onset. In Dijon, France, mean age (±standard deviation) increased from 66 ± 3 years in 1985–1989 to 71.1 ± 2.5 years in 2000–2004 (P = 0.01) in men, and from 67.8 ± 4.4 to 75.6 ± 2.8 years (P = 0.01) in women [1]. These variations were due to demographic changes characterized by a 28% increase in the number of people >70 years, leading to a 6.6% increase in the absolute number of patients suffering from strokes despite the stable incidence in this age group. Similarly, in Auckland, the mean age at stroke onset significantly increased from 71.2 ± 13.3 years in 1981–1982 to 73 ± 13.8 years in 2000– 2003 (P < 0.001) [2]. These changes were related to a greater increase in the absolute number of strokes in the very elderly than that observed in younger people, because of a greater increase in the number of individuals in the older age groups. However, overall incidence decreased because the size of the population increased more rapidly than did the number of patients with stroke. In contrast, in Oxfordshire, UK, changes in the mean age between 1981–1984 and 2002–2004 were not significant (72.3 ± 12.7 years vs. 73.6 ± 11.9 years, P = 0.18) [3]. As a result, mean age appears to be useful for epidemiological investigations in that it gives interesting additional qualitative information about the studied population. Nevertheless, several limitations must be pointed out and taken into account when interpreting the data. The mean age must be systematically expressed with its standard deviation to reflect the spread of the results. The lower the standard deviation, the lower the dispersion of the values and the more relevant the information. In addition, the mean age could theoretically give rise to an ecological fallacy with regard to the distribution of the disease within the studied population. For example, if all stroke patients were either very young or very old, the mean age would be somewhere between, but neurologists would be confronted with two very different populations. However, because the age-specific incidence increases steeply with increasing age [1–3], such a situation is quite unlikely. Finally, the notion of mean age at stroke onset seems to be a very interesting approach in that it gives meaning to the findings provided by epidemiological studies reflecting in part the reality of dayto-day practice in vascular neurology. However, findings need to be interpreted with caution.

Surveillance of communicable diseases among the Kosovar refugees in Albania, April-June 1999.

Abstract: Albania, a country with 3.5 million inhabitants, is facing an economic and social crisis. The average per capita income is less than US$1000 per year. Since 1995 unemployment has increased by 2.7%. Poverty and migration are major constraints of the societ

The use of reimbursement data for timely monitoring of vaccination coverage: the example of human papillomavirus vaccine following public concerns about vaccine safety

Abstract: Since 2011 public concerns about Human Papillomavirus (HPV) vaccination safety and efficacy arose in France. We explored the relevance of using vaccines reimbursement data to assess the impact of those public concerns on vaccination coverage. We used the Permanent Sample of Beneficiaries which was, at the time of the study, a representative sample of 1/97th health insurance beneficiaries of the main Social Security scheme, the General Health Insurance Scheme, covering approximately 77 % of the French resident population. We estimated HPV vaccination coverage among girls born between 1995 and 1999 at their 15th, 16th and 17th birthday. The coverage for complete vaccination among 16 years old girls decreased from 26.5 % in the first semester of 2011 to 18.6 % in the first semester of 2014. HPV vaccination coverage was already low in 2011 and continued to decrease thereafter. Vaccines reimbursement data allowed us to reactively monitor the impact of the controversy on vaccination coverage and design counteracting measures.