RESUMO
OBJECTIVE: The aim: Assess of the determinants of vaccine hesitancy among parents regarding their children in Kyiv, Ukraine. PATIENTS AND METHODS: Materials and methods: Direct interview with survey on parents' attitudes and behaviors regarding their children's immunization. Vaccination hesitancy was determined with the median of responses and by self-reported question. The study was conducted among parents, whose children were patients at Children's hospitals, attend schools and kindergarten in Kyiv, Ukraine. RESULTS: Results: The median of vaccine hesitancy was 14,2% of 797 parents in Kyiv. The results show that 81.5% of parents with university degree agree that vaccination of their child is important for the health of others in the community, whereas only 67% (p≤0.05) of people who graduated from high school supported this view. The only reason to vaccinate their child is so they can enter daycare or school was marked by only 4.5% of parents with university education background and 15.3% of people who graduated from high school (p≤0,05). CONCLUSION: Conclusions: Vast majority of interviewed parents think that vaccines are important for their children; meanwhile only half of the parents fully trust the current National Immunization Schedule and fully agree that question of child vaccination is their responsibility. Consulting pediatricians and GPs are associated with more parental confidence than other medical workers. Main source of negative information about vaccines is the Internet, but some part of parents who received negative information indicates health care workers as a source of this information. Majority of parents thinks that their religion is compatible with vaccines.
Assuntos
Hesitação Vacinal , Vacinas , Criança , Humanos , Vacinação , Pais , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em SaúdeRESUMO
Key Clinical Message: Partial leukocyte adhesion deficiency type 1 (LAD-1) deficiency is extremely rare condition with milder infectious manifestation and immune system imbalance leads to increased risks of autoinflammatory complications, such as pyoderma gangrenosum, that can be triggered by trauma or pregnancy. In patients with spice-site ITGB2 variants, partial expression can occur due to different ß2 integrin isophorms expression. Abstract: LAD-1, OMIM ID #116920 is a rare, autosomal recessive disorder that results from mutations in the ITGB2 gene that encodes the CD18 ß2 integrin subunit. According to the CD18 expression, LAD-1 is categorized as severe (<2%), moderate (2%-30%), or mild (>30%). Here, we describe a 22-year-old female, who presented with inflammatory skin disease and oral cavity, as well as respiratory tract infections during the first year of life. LAD-1 was diagnosed at the age of 2 years by low expression of CD18 (1%). Whole-exome sequencing identified homozygous c. 59-10C>A variant in the ITGB2 gene. Despite severe phenotype, the patient survived to adulthood without hematopoietic stem cell transplantation and became pregnant at the age of 20 years, with pregnancy complicated by a pyoderma gangrenosum-like lesion. During her life, CD18 expression increased from 1% to 9%; at 22 years of age, 5% of neutrophils and 9% of lymphocytes were CD18+. All CD18+-lymphocytes were predominantly memory/effector cytotoxic T cells. However, revertant mosaicism was not being established suggesting that CD18 expression variability may be mediated by other mechanisms such as different ß2 integrin isophorms expression.