1 - Infectious Diseases Unit, Área da Mulher, Criança e Adolescente, Hospital Dona Estefânia, Centro Hospitalar Universitário Lisboa Central
- 38th Annual Meeting of the European Society for Paediatric Infectious Diseases
- Poster
Background: Providing health-care to children undergoing immunosuppressive therapy is challenging and increasingly common. The CRIPTO initiative (Portuguese acronym for appointment for pre-immunosuppressive therapy screening for infectious diseases) was created to try to prevent infectious complications of immunosuppressive therapy, and tackle the current suboptimal immunisation rates in this population. The aim of the present study is to characterise the population followed in CRIPTO.
Methods: We retrospectively analysed data from patients undergoing CRIPTO appointments, scheduled between February 2016 and December 2019 (47 months). The parameters included demographics, clinical information, immunisation status, infectious disease screening and the recommended vaccination schedule. Descriptive statistics were computed for all parameters.
Results: 110 patients, with an average age of 11.5 years (SD 5.2) and an average of 2.8 visits/patient (SD 1.6). Only 39.1% were assessed before starting immunosuppressants; the remaining were under corticotherapy (71.6%), immunomodulators (56.7%), calcineurin inhibitors (17.9%), biological agents (13.4%). The main causes of referral were inflammatory bowel disease (24.5%) and atopic dermatitis (9.1%), with 3 newborns enrolled for in-uterus immunosuppressant exposure. The screening identified tuberculosis (n=9) and Strongyloides infection (n=3), with no cases of HIV or hepatitis B/C. The immunisation schedule was incomplete in 19%; 481 vaccines were recommended.
Conclusions: Infectious diseases screening and vaccination of this population should be considered a priority, ideally performed before the beginning of treatment and following a consistent protocol. The cost of non-subsidised vaccination in this population is (expected to be) elevated.
Palavras Chave: immunization, immunosuppressive therapy, infection screening