[High vaccination rates among children of Amsterdam]. / Hoge vaccinatiegraad van Amsterdamse kinderen.

OBJECTIVE: To examine if in Amsterdam there are social or cultural groups of children with a relatively low vaccination coverage for diphtheria, pertussis, tetanus and poliomyelitis (DPTP) and mumps, measles and rubella (MMR). DESIGN: Descriptive cross-sectional study. METHOD: In the Department of Child Health Care of the Municipal Health Service of Amsterdam all 83,217 children aged 2-12 years living in Amsterdam on the 1st of January 2000 were analysed for vaccination and sociodemographic data collected routinely by the Department of Child Health Care. The sociodemographic data concerned sex, year of birth, country of birth of the mother and child, name of the school and postal code of the home address. Schools were grouped by (religious) affiliation on the basis of the Amsterdam school guide 1999/2000. Based on postal codes children were classified by the neighbourhoods in which they were living. Neighbourhoods were grouped by socio-economic status based on data from the Central Bureau for Statistics. RESULTS: The overall vaccination rates of DPTP and MMR were 92.4% and 93.5% respectively. No important variation in vaccination coverage was identified between more and less affluent neighbourhoods. The uptake rate among foreign children was sometimes slightly higher and sometimes slightly lower compared with native children. Especially foreign children born abroad (Surinam, Antilles, Morocco, Turkey) were not fully vaccinated: 70.9% were fully immunized for DPTP, 79.5% for MMR. Children who visited anthroposophical schools were considerably less frequently fully immunized compared with children visiting other schools: for DPTP and MMR 81.0 and 59.9% respectively versus 94.4 en 95.3% for children attending general municipal schools. CONCLUSION: The vaccination coverage was high in children in Amsterdam. Further improvement of the vaccination uptake might be achieved by a more outreaching attitude to children born abroad, and by more intensely informing sceptical parents about the benefits and (supposed) dangers of vaccinations.

[Causes of death in Amsterdam children who died abroad, 1982-1993; potential for prevention]. / Doodsoorzaken van in het buitenland overleden Amsterdamse kinderen, 1982-1993; mogelijkheden voor preventie.

OBJECTIVE: To determine the causes of death among Amsterdam children dying abroad. DESIGN: Retrospective study. SETTING: Department of Youth Health Care in Amsterdam, the Netherlands. METHOD: Analysis was based on the data bank of the Department of Youth Health Care, which contains the items sex, age and ethnic origin of decreased children as well as time, place and cause of death. RESULTS: A total of 791 Amsterdam children (1 week-14 years old) died during the period 1982-1993. Of these children 98 (12.4%) died outside the Netherlands; of two the place of death was unknown. A relatively large proportion of decreased Turkish and Moroccan children died while abroad, 24.7% and 34.2% respectively. The distribution of causes of death among children dying in the Netherlands differed from children dying abroad. The most important causes abroad were accidents (especially car accidents), infections (especially gastrointestinal infections) and congenital disorders. Children who died of accidents were mainly between 1 and 9 years old. Fatal infections were primarily seen in children 0 years old and of Moroccan origin, and in the period 1982-1985. Children who died of congenital abnormalities were mostly of Moroccan origin. CONCLUSION: Mortality among Turkish and Moroccan Amsterdam children often occurred outside the Netherlands. Mortality in children visiting foreign countries was mainly the result of preventable causes such as accidents and infections.