Quality vaccines for all people: Report on the 16th annual general meeting of the Developing Countries Vaccine Manufacturers' Network, 05–07th October 2015, Bangkok,Thailand

The Developing Countries Vaccine Manufacturers Network (DCVMN) assembled high-profile leaders from global health organisations and vaccine manufactures for its 16th Annual General Meeting to work towards a common goal: providing quality vaccines for all people.Vaccines contribute to a healthy community and robust health system; the Ebola outbreak has raised awareness of the threat and damage one single infectious disease can make, and it is clear that the world was not prepared. However, more research to better understand emerging infectious agents might lead to suitable vaccines which help prevent future outbreaks.DCVMN members presented their progress in developing novel vaccines against Dengue, HPV, Chikungunya, Cholera, cell-based influenza and other vaccines, demonstrating the commitment towards eliminating and eradicating preventable diseases worldwide through global collaboration and technology transfer. The successful introduction of novel Sabin-IPV and Oral Cholera vaccine in China and Korea respectively in 2015 was highlighted.In order to achieve global immunisation, local authorities and community leaders play an important role in the decision-making in vaccine introduction and uptake, based on the ability of vaccines to protect vaccinated people and protect non-vaccinated in the community through herd immunity. Reducing the risk of vaccine shortages can also be achieved by increasing regulatory convergence at regional and international levels. Combatting preventable diseases remains challenging, and collective efforts for improving multi-centre clinical trials, creating regional vaccine security strategies, fostering developing vaccine markets and procurement, and building trust in vaccines were discussed.     

A study of groundwater contamination with organic fuels and potential public health impact in Itaguaí, Rio de Janeiro State,Brazil

Increasing attention is current focused on urban groundwater contamination with gasoline hydrocarbon compounds in Brazil. The compounds benzene, toluene, ethylbenzene, and xylenes (BTEX) contained in fuels are highly toxic and can have severe public health consequences, besides posing the risk of intake from the water table by way of contamination. After two years of a steady gasoline storage tank leak, water samples from private household wells in the district of Brisa Mar, Itaguaí, Rio de Janeiro State, were analyzed and the concentration of BTEX compounds was evaluated. Two out of ten water samples from the study area presented BTEX concentrations above the National Water Quality Standard (Brazilian Health Ministry Ruling No. 1469/2000), in which the maximum permissible benzene concentration is 5 micro g.L-1. Four others wells were also contaminated with nitrate, responsible for the induction of methemoglobinemia. Natural attenuation (intrinsic biodegradation) mechanisms through electron acceptors was also investigated in this study.     

Can court injunctions guarantee access to medicines in the public sector? The experience in the State of Rio de Janeiro, Brazil

There are increasing numbers of legal suits concerning access to medicines brought against the Rio de Janeiro State Health Department. The situation indicated the need for a study to clarify the underlying issues. A sample of 389 court suits from January 1991 to December 2001 (stratified by year) was used. A cross-sectional design was used to describe and analyze the legal suits in relation to the responsibilities defined under the Unified National Health System (SUS). Results suggest major delays in court decisions. Most suits are filed by the Public Defender's Office for users of the National Health System. The most frequent cases involve medicines for the cardiovascular and nervous systems, many of which involve continuous use. Prescribing practices are institutionalized through the inclusion of the most frequently prescribed drugs in public financing lists, which makes rational drug use difficult to achieve. Municipalities are not fulfilling their responsibility to supply medicines to users, and the State is thus encumbered with these responsibilities. However, the State does not adequately supply medicines to the municipalities. The apparent lack of awareness among both lawyers and clients generates stress between the Executive and Judiciary branches and limits the resources for collective pharmaceutical services.     

Are we really detecting violence in families of children visiting our health services? The experience of a public health service in Rio de Janeiro, Brazil

Domestic violence, particularly in childhood, is a growing public health concern. Information on morbidity is mostly underreported due to constraints in case detection. This paper analyzes the frequency of events measured actively by outpatient services as compared to spontaneous reports. Information on violence was assessed for 245 families from April to June 2001 using the Conflict Tactics Scales: Parent-Child Version (CTSPC) and the Revised Conflict Tactics Scales (CTS2). Cases referred to the Social Work Department provided the caseload for the active search period (12 months). There was a high prevalence of physical violence in the couple, with serious events occurring in 17.0% of the families. In relation to children, cases of "minor" physical aggression were reported in 46.0% of families and serious cases in 9.9%. The spontaneously identified prevalence was 3.3%. This case study demonstrates the missed opportunities for detection and calls attention to the need to review the approach to domestic violence by health services.     

Self-reported history of physician-diagnosed asthma and common mental disorders among civil servants at a public university in Rio de Janeiro, Brazil: the Pró-Saúde study

This study investigates the association between history of asthma and common mental disorders among employees at a public university in the State of Rio de Janeiro, Brazil. Phase 1 cross-sectional data from a cohort study (the Pró-Saúde Study) were collected from 4,030 employees. Asthma was ascertained by self-reported medical diagnosis, and the occurrence of common mental disorders was based on the General Health Questionnaire (GHQ-12). Generalized linear models were used to calculate prevalence rates. Asthma prevalence was 11% (444), of whom 39.7% (176) presented common mental disorders. History of asthma was associated with higher income (p = 0.01) and female gender (p = 0.01). The analysis adjusted by gender, age, and per capita income revealed an association between asthma and common mental disorders (PR = 1.37; 95%CI: 1.22-1.55). Employees with less than 10 years since their asthma diagnosis showed a higher prevalence of common mental disorders (PR = 1.88; 95%CI: 1.32-2.70). These findings suggest that multidisciplinary teams should consider emotional aspects of asthma patients, especially those recently diagnosed.