RESUMO
Patients with inflammatory bowel disease (IBD) do not receive routine preventative care at the same rate as general medical patients. This patient population is at increased risk of vaccine preventable illness such as influenza and pneumococcal pneumonia. This review will discuss health maintenance needs and preventative care issues in patients with IBD.
Assuntos
Neoplasias Colorretais/diagnóstico , Imunossupressores/efeitos adversos , Doenças Inflamatórias Intestinais/terapia , Medicina Preventiva/métodos , Vacinação/métodos , Conservadores da Densidade Óssea/uso terapêutico , Varicela/etiologia , Varicela/imunologia , Varicela/prevenção & controle , Vacina contra Varicela/uso terapêutico , Depressão/diagnóstico , Depressão/terapia , Gerenciamento Clínico , Detecção Precoce de Câncer/métodos , Hepatite Viral Humana/etiologia , Hepatite Viral Humana/imunologia , Hepatite Viral Humana/prevenção & controle , Herpes Zoster/etiologia , Herpes Zoster/imunologia , Herpes Zoster/prevenção & controle , Vacina contra Herpes Zoster/uso terapêutico , Humanos , Hospedeiro Imunocomprometido , Vacinas contra Influenza/uso terapêutico , Influenza Humana/etiologia , Influenza Humana/imunologia , Influenza Humana/prevenção & controle , Sarampo/etiologia , Sarampo/imunologia , Sarampo/prevenção & controle , Vacina contra Sarampo-Caxumba-Rubéola/uso terapêutico , Meningite Meningocócica/etiologia , Meningite Meningocócica/imunologia , Meningite Meningocócica/prevenção & controle , Vacinas Meningocócicas/uso terapêutico , Caxumba/etiologia , Caxumba/imunologia , Caxumba/prevenção & controle , Osteoporose/diagnóstico por imagem , Osteoporose/tratamento farmacológico , Infecções por Papillomavirus/etiologia , Infecções por Papillomavirus/imunologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Vacinas Pneumocócicas/uso terapêutico , Pneumonia Pneumocócica/etiologia , Pneumonia Pneumocócica/imunologia , Pneumonia Pneumocócica/prevenção & controle , Rubéola (Sarampo Alemão)/etiologia , Rubéola (Sarampo Alemão)/imunologia , Rubéola (Sarampo Alemão)/prevenção & controle , Abandono do Hábito de Fumar , Vacinas contra Hepatite Viral/uso terapêutico , Vitamina D/uso terapêutico , Deficiência de Vitamina D/diagnósticoRESUMO
BACKGROUND: Social clustering of unvaccinated children in anthroposophical schools occurs, as inferred from various measles outbreaks that can be traced to these schools. However, accurate vaccination coverage data of anthroposophical schools are not widely available. METHODS: In 2012, we performed a survey to estimate the vaccination coverage in three different grades of 11 anthroposophical schools in Gelderland, The Netherlands. We also gauged the opinion on childhood vaccination of the parents and compared these with the results of a national survey. In 2014, we were also able to obtain the registered total vaccination coverage per school from the national vaccination register to compare this with our survey data. RESULTS: The self-reported MMR vaccination coverage (2012) in the three grades of the schools in our study was 83% (range 45-100% per school). The registered total vaccination coverage (2014) was 78% (range 59-88% per school). The 95% confidence intervals of the two different vaccination coverages overlap for all schools. The parents in this study were less convinced about the beneficial effect of vaccinations and more worried about the possible side effects of vaccination compared with parents in general. CONCLUSION: Despite high overall vaccination coverage, the WHO goal to eliminate measles and rubella will not easily be achieved when social clustering of unvaccinated children in anthroposophical schools remains.
Assuntos
Medicina Antroposófica , Programas de Imunização/estatística & dados numéricos , Vacina contra Sarampo-Caxumba-Rubéola/uso terapêutico , Instituições Acadêmicas/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Países Baixos , Pais , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: This study investigates parental decisions to vaccinate their children against measles, mumps and rubella (MMR). Parent and provider survey data allow the analysis of interactions between these major players in decision making. METHODS: Three datasets are used for analysis: (a) the basic population of the school entry-level health checkup in Munich, Germany; (b) a face-to-face survey with parents of children taking the school entry-level health checkup; (c) a face-to-face survey of the physicians treating these children. Logistic, OLS and multilevel regressions were applied. RESULTS: Homophily due to similar ages of parents and physicians boosts the decision to vaccinate children against MMR. Also in relation to parent-physician interaction, the fact that a physician may be homeopathic has no effect on a parents' decision to immunize, although vaccination-skeptical parents choose physicians who are trained in homeopathy. CONCLUSIONS: Efforts to improve the number of parental decisions for vaccination should focus on the educational level of the parents as well as homophily of parents and physicians. Notably, homogeneity of parents and providers concerning age changes decisions in favor of vaccinating.