RESUMEN
La población escolar se caracteriza por presentar un perfil de salud con una baja tasa de mortalidad y una baja frecuencia de internaciones en comparación con otros grupos etarios, lo cual contribuye a que sea percibida como una población sana. Sin embargo, esta población no es inmune a la alta carga de morbilidad por enfermedades crónicas no transmisibles (ECNT) que se observa globalmente. Existen diversas iniciativas para la aplicación de políticas y programas dirigidos a la población escolar con el objetivo de reducir el impacto de los principales factores de riesgo de ECNT. Estas intervenciones tienen como principales escenarios a la escuela y a los centros de salud locales, donde se desarrollan acciones de promoción de la salud y se propicia el acceso al control anual de salud. El Programa Nacional de Salud Escolar (PROSANE) tiene como objetivo propiciar y fortalecer la implementación de políticas de cuidado de la población en edad escolar de Argentina. El artículo describe esta estrategia, su modalidad de implementación y sus resultados. La implementación del PROSANE ha permitido visibilizar a esta población, elaborar un análisis sanitario y promover su acceso al sistema de salud
Asunto(s)
Humanos , Servicios de Salud Escolar , Promoción de la SaludRESUMEN
With more vaccines becoming available worldwide, vaccine research is on the rise in developing countries. To gain a better understanding of safety reporting from vaccine clinical research in developing countries, we conducted a systematic review in Medline and Embase (1989-2011) of published randomized clinical trials (RCTs) reporting safety outcomes with ≥50% developing country participation (PROSPERO systematic review registration number: CRD42012002025). Developing country vaccine RCTs were analyzed with respect to the number of participants, age groups studied, inclusion of safety information, number of reported adverse events following immunization (AEFI), type and duration of safety follow-up, use of standardized AEFI case definitions, grading of AEFI severity, and the reporting of levels of diagnostic certainty for AEFI. The systematic search yielded a total number of 50 randomized vaccine clinical trials investigating 12 different vaccines, most commonly rotavirus and malaria vaccines. In these trials, 94,459 AEFI were reported from 446,908 participants receiving 735,920 vaccine doses. All 50 RCTs mentioned safety outcomes with 70% using definitions for at least one AEFI. The most commonly defined AEFI was fever (27), followed by local (16) and systemic reactions (14). Logistic regression analysis revealed a positive correlation between the implementation of a fever case definition and the reporting rate for fever as an AEFI (p=0.027). Overall, 16 different definitions for fever and 7 different definitions for erythema were applied. Predefined AEFI case definitions by the Brighton Collaboration were used in only two out of 50 RCTs. The search was limited to RCTs published in English or German and may be missing studies published locally. The reported systematic review suggests room for improvement with respect to the harmonization of safety reporting from developing country vaccine clinical trials and the implementation of standardized case definitions.