Insights into Predictors of Vaccine Hesitancy and Promoting Factors in Childhood Immunization Programs-A Cross-Sectional Survey in Cameroon.

Background: Vaccination is claimed to be a key intervention against the COVID-19 pandemic. A major challenge today is to increase vaccine acceptance as vaccine hesitancy has delayed the eradication of polio. This study aimed to identify predictors associated with vaccine acceptance in the context of the Expanded Program on Immunization among parents of children between the ages of 12 to 23 months in the Foumbot district, Cameroon. Methods: The design of this study is a cross-sectional survey. A total of 160 mothers of children between the ages of 12 to 23 months were selected using a simple random sampling technique. A pre-tested structured questionnaire was used for data collection. Incomplete vaccination status was considered "vaccine hesitancy". Data was analyzed along with 95% confidence intervals and the p-value < 0.05. The results showed 60% vaccine acceptance and 40% vaccine hesitancy. Factors such as age-appropriate vaccination, knowledge of vaccine-preventable diseases (VPD), and religion were associated with vaccine acceptance. Conclusion: Poor knowledge of VPDs is a matter of concern as it contributes to vaccine hesitancy. The study findings provide the basis to heighten health education, the public perceived threat of the VPDs, and the consequences if no measures are taken to ensure health.

Development of an Integrative Care Program in a Pediatric Oncology Unit.

PURPOSE: The aim of this article is to describe what needs to be considered in implementing care practices, in this case an integrative care program consisting of anthroposophic treatments, in an intensive care unit (ICU) of a teaching hospital. METHODS: We used a pediatric oncology department to implement an integrative care program. We conducted a qualitative study including participant observation and semi-structured interviews with parents, nurses, doctors, and therapists. Data analysis was based on a grounded theory approach and focused on the status quo of care in the ICU. RESULTS: The following factors needed to be considered: the structure of the ICU, communication and information dissemination, and time constraints. This led to the following components of the integrative care program: (1) a training plan in anthroposophic treatments for all nurses that was conducted by 2 trained anthroposophic nurses, and (2) the introduction of an integrative shift that was on top of regular care at the ICU and focused on delivery of integrative care to patients. CONCLUSION: To add new care components to an ICU, the existing context has to be considered. Time constraints and high workload are factors that need to be recognized. In this particular context, a highly flexible program was the solution.

Anthroposophic medicine in paediatric oncology in Germany: results of a population-based retrospective parental survey.

BACKGROUND: Anthroposophic medicine (AM) is frequently utilised in German-speaking countries as a complementary and alternative medicine (CAM) treatment approach. PROCEDURE: This study presents results of a retrospective parental questionnaire comparing responses of AM-users and users of other CAM in paediatric oncology in Germany. The differences between these two groups are investigated with respect to usage, associated demographic characteristics and previous experience with CAM. RESULTS: Ninety-eight patients (27%) of the 367 CAM-users were exposed to anthroposophic treatments or therapies. Treatment duration amounted to a median 619 days for AM and 225 days for other CAM treatments. Most parents with previous experience of AM also used AM for treatment of their child's cancer disease. AM-users had a higher social status. Physicians played a relevant role for users of AM both in procuring information (24% vs. 11%; P < 0.001) and in prescribing medicines and therapies (73.0% vs. 34.9%; P < 0.001) compared to users of other CAM. AM-users communicate more frequently with their physicians about the use of CAM treatments (89.8% vs. 63.9%) and recommend CAM more often than other CAM-users (95.9% vs. 87%). CONCLUSIONS: AM plays a major role in paediatric oncology in Germany. Patients using AM sustain treatment and therapies considerably longer than patients using other CAM treatments. Furthermore, most families who had used AM before their child was diagnosed with cancer also used AM for the treatment of their child's cancer. Compared to other CAM treatments, patient satisfaction with AM appears to be very high.

Complementary and alternative treatment methods in children with cancer: A population-based retrospective survey on the prevalence of use in Germany.

INTRODUCTION: Few studies have been conducted to date on the prevalence of use of complementary and alternative treatment methods (CAMs) in paediatric oncology, and those that have been conducted are often not representative. We therefore decided to study a representative sample of children with cancer in the German population. PATIENTS AND METHODS: The study took the form of a retrospective survey amongst all parents whose children were first diagnosed with a disease covered by the German Childhood Cancer Registry in 2001. The primary objectives of the survey were to establish the prevalence of use of CAM and the factors related to its use. RESULTS: Of the 1595 questionnaires sent out, 1063 (67%) could be evaluated. 35% of the responders had used CAM. The most frequently used methods were homeopathy, dietary supplements and anthroposophic medicine including mistletoe therapy. Factors which increased the probability of using CAM were the previous use of CAM, higher social status and poor prognosis of the child's disease. The most frequently named reasons for use of CAM were physical stabilisation, strengthening the immune system and improving the chance of cure. Whilst the sources of information about CAM were in most cases not doctors, 71% of users had nevertheless spoken to a doctor about using CAM. The effects of the CAM perceived by the parents were for the most part positive. 89% of the users reported that they would recommend CAM to other parents. CONCLUSIONS: CAMs are administered alongside standard therapy to 35% of children with cancer in Germany, usually by the parents. Prospective studies on the effects and side-effects of the most frequently used methods are urgently needed, and paediatric oncologists should have sufficient knowledge of CAM to enable them to advise parents professionally and competently about these treatments, too.

Molecular mechanisms of mistletoe plant extract-induced apoptosis in acute lymphoblastic leukemia in vivo and in vitro.

Viscum album (Mistletoe) is one of the most widely used alternative cancer therapies. Aqueous mistletoe extracts (MT) contain the three mistletoe lectins I, II and III as one predominant group of biologically active agents. Although MT is widely used, there is a lack of scientifically sound preclinical and clinical data. In this paper, we describe for the first time the in vivo efficacy and mechanism of action of MT in lymphoblastic leukemia. For this purpose, we first investigated both the cytotoxic effect and the mechanism of action of two standardized aqueous MTs (MT obtained from fir trees (MT-A); MT obtained from pine trees (MT-P)) in a human acute lymphoblastic leukemia (ALL) cell line (NALM-6). MT-A, MT-P and ML-I inhibited cell proliferation as determined by Casy Count analysis at very low concentrations with MT-P being the most cytotoxic extract. DNA-fragmentation assays indicated that dose-dependent induction of apoptosis was the main mechanism of cell death. Finally, we evaluated the efficacy of MT-A and MT-P in an in vivo SCID-model of pre-B ALL (NALM-6). Both MTs significantly improved survival (up to 55.4 days) at all tested concentrations in contrast to controls (34.6 days) without side effects.

Response to subcutaneous therapy with mistletoe in recurrent multisystem Langerhans cell histiocytosis.

We report a case of histologically proven multisystem (MS) Langerhans cell histiocytosis (LCH) with recurrent disease reactivations after systemic chemotherapy. Through the use of subcutaneous therapy with mistletoe (MT), an inactive disease state was achieved.