Anna Bednarek

In Search of Factors Negatively Affecting Vaccine Immunity to Pertussis in Preschool Children before the Administration of the First Booster

Introduction: The top priority for active immunoprophylaxis of pertussis is the immunisation of infants as they can sometimes develop severe multiple-organ complications. Objectives: The aim of the work is the identification of factors negatively affecting vaccine immunity to pertussis in preschool children prior to the administration of the first booster. Patients and Methods: The research was conducted on 352 children from 4.5 to 5.9 years of age who were hospitalised in the University Children’s Hospital in Lublin (Poland) from 1 January 2012 to 31 December 2015. The children taking part in the study had been administered all the mandatory vaccines from their birth to the age of 2 or 2.5 years old according to the Polish Immunisation Program 2008–2009. The immunoenzymatic method ELISA (enzyme-linked immunosorbent assay) was applied to assess vaccine immunity to tetanus, diphtheria, pertussis, Haemophilus influenzae type b (Hib), poliomyelitis (IPV), mumps, rubella and measles. The level of vaccine antibodies to hepatitis type B was determined chemilumiscently. Results: The protective antibody titre was not found in 41 (11.65%) children before the administration of the booster. To verify the collective impact of parameters analysed on antibody titre to pertussis, the Generalized Linear Model (GLZ) was used. Gender, type of vaccine, asthma, Hib and mumps antibody titres have been shown to be predictors of vaccine immunity to pertussis. Conclusions: Immunomodulation considered on the example of titre of IgG antibody to pertussis can serve as a useful model of the assessment of development of acquired immunity after mandatory vaccinations.

Demographic and medical factors affecting short-term changes in subjective evaluation of asthma control in adolescents

Introduction Asthma control is an important measure of disease stabilization, which is linked to the treatment and lifestyle recommendations. Aim To assess the impact of selected factors on asthma control in adolescents, as assessed using the Asthma Control Test (ACT™). Material and methods The prospective study included 100 asthma patients aged between 12 and 19. Asthma was assessed in three consecutive follow-up visits spaced 3 months apart, using the standardized ACT™ questionnaire. Results Asthma was fully controlled (ACT score = 25 points) in more than half of the patients in all follow-up visits (53.0%, 54.0%, and 56.0%, respectively). More than one third of the participants scored between 20 and 24 points (37.0% vs. 39.0% vs. 40.0%). A minority of patients had uncontrolled asthma (scores below 20), and the group consistently diminished in subsequent visits (10% vs. 7% vs. 4%). Uncontrolled asthma was found significantly more often in female patients (33.33%; p < 0.001) and those living in rural areas (20.59%; p < 0.01). Treatment with a combination of inhaled corticosteroids (ICS) and LABAs was associated with worse asthma control (14.81%; p < 0.05). Better asthma control was found in patients with a family history of allergies (73.85% vs. 75.38% vs. 78.46%; p < 0.001) and in those with concurrent allergies (66.67% vs. 68.00% vs. 70.67%; p < 0.001). Conclusions Asthma control in adolescents differs by sex and residence. Concurrent allergies and family history of allergies improve asthma self-control in adolescents.

Asthma Control Test (ACT) or Asthma Control Questionnaire (ACQ)? - validity and responsiveness in children

Introduction: The monitoring of a child with asthma consists of a very important analysis of disease control, which determine further action. For the few years now there were simple standardized asthma control tests available in daily practice. However, there are no studies verifying their usefulness in various age groups. Aim of the study: The aim of the study was to compare the compatibility and usability of ACQ and ACT testing in children of different age groups. Material and methods: Between 2014-2015 we conducted a prospective randomized trial which lasted 9 months and included a group of 100 children aged 6-17 years with persistent IgE-mediated asthma. The degree of asthma control was estimated when turned on, after 3 and after 9 months, using age-appropriate ACQ and ACT questionnaires and also based on a clinical assessment by a physician. Results: In the group of children ≥ 11 years of there was strong correlation in the diagnosis of uncontrolled asthma using both tests (p Conclusions: On the basis of this study we can conclude that in children ≥ 11 years of age, both tests ACT and ACQ have equal use, in children younger reliable information about the degree of asthma control can provide ACQ.