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2.
Artigo em Alemão | MEDLINE | ID: mdl-31529181

RESUMO

Trends of frequent chronic diseases and health problems, e.g. allergic diseases, have already been published based on the KiGGS Wave 2 study as part of the health monitoring of children and adolescents in Germany. The present work complements these findings with results on less frequent noncommunicable diseases and the trend of communicable, vaccine-preventable diseases.Information from parents about diagnoses and diseases of their 0­ to 17-year-old children from the representative cross-sectional survey KiGGS Wave 2 (2014-2017) are compared with those from the KiGGS baseline survey (2003-2006) and KiGGS Wave 1 (2009-2012).The current KiGGS results show almost unchanged prevalences for the noncommunicable diseases epilepsy, migraine, and heart disease. However, the data from KiGGS Wave 2 are supportive of an increased prevalence of diabetes mellitus, which nevertheless continues to be relatively rare and predominantly type 1 diabetes in children and adolescents.The decline in measles, chicken pox, and whooping cough diseases related to changes in vaccination recommendations shows that preventive measures can effectively benefit children and adolescents.However, the data on vaccine-preventable diseases indicate regionally varying immunity gaps in certain age groups, so the prevention potential of the vaccination recommendations of the Standing Vaccination Commission (STIKO) at the Robert Koch Institute does not seem to have been sufficiently exploited.


Assuntos
Saúde do Adolescente/estatística & dados numéricos , Doença Crônica/epidemiologia , Viroses/epidemiologia , Adolescente , Varicela/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Epilepsia/epidemiologia , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Cardiopatias/epidemiologia , Humanos , Lactente , Recém-Nascido , Sarampo/epidemiologia , Transtornos de Enxaqueca/epidemiologia , Convulsões Febris/epidemiologia , Coqueluche/epidemiologia
3.
Artigo em Alemão | MEDLINE | ID: mdl-31529182

RESUMO

In KiGGS Wave 2, data from 3­ to 17-year-olds were collected from a total of 3462 persons using a standardized interview on the current use of AM/NEM in the last seven days. For trends analysis, data from 14,679 study participants in the same age group from the KiGGS baseline study were used.In KiGGS Wave 2, 36.4% (95% CI 34.1-38.8) of the 3­ to 17-year-olds had used at least one AM/NEM in the last seven days. The prevalence was highest at 46.5% in 14- to 17-year-olds and significantly different between girls and boys (56.4% vs. 37.3%). Only among girls were there significant differences by migrant background with a higher prevalence of use among girls without a migrant background.Most frequently, the preparations used were for treatment of the respiratory tract (girls: 14.2%, boys: 14.9%), followed by "Varia" (girls: 8.7%, boys: 9.3%) and preparations for the treatment of the musculoskeletal system (girls: 8.9%, boys: 5.8%). There was a significant decrease in the overall prevalence of medicine use compared to the KiGGS baseline study (46.4% vs. 36.4%). This decrease was mainly due to lower prevalences of use in the ATC main groups "N Nervous System" (7.5% vs. 5.4%), "J Systemic Anti-infectives" (2.5% vs. 1.4%) and "H Systemic Hormones, excl. Sexual Hormones and Insulins" (2.0% vs. 1.1%).The results describe key points in the use of AM/NEM, including self-medication for children and adolescents in Germany. They illustrate the use behaviour and represent a valuable supplement to prescription data.


Assuntos
Suplementos Nutricionais/estatística & dados numéricos , Automedicação/estatística & dados numéricos , Adolescente , Saúde do Adolescente , Criança , Saúde da Criança , Estudos Transversais , Feminino , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência
4.
Int J Infect Dis ; 83: 3-11, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30904676

RESUMO

BACKGROUND: Human Papillomavirus (HPV) vaccination of girls was introduced in Germany in 2007. However, data on the distribution of vaccine-relevant HPV types in the general population in Germany in the prevaccine era are limited. METHODS: Serum samples collected during the German National Health Interview and Examination Survey 1998 (GNHIES98), a nationally representative study including men and women aged 18-79 years, were tested for antibodies to 19 mucosal and cutaneous HPV types. Multivariable regression models were developed to identify associations between demographic and behavioral characteristics and HPV seropositivity. RESULTS: Of the 6517 serum samples tested, almost a quarter was seropositive for at least one of the nine HPV vaccine types with no clear age-pattern. HPV-6 and HPV-59 were the most common mucosal types, while HPV-1 and HPV-4 were the most common cutaneous HPV types. Factors independently associated with HPV-16 seroprevalence were seropositive to other sexually transmitted infections and lifetime number of sex partners, as well as urbanity (only among females). CONCLUSIONS: Prevalence of naturally acquired antibodies to HPV types which can be prevented by vaccination is high in both sexes and all age groups. These data can serve as baseline estimates to evaluate the population-level impact of the current vaccination strategy.


Assuntos
Anticorpos Antivirais/sangue , Membrana Mucosa/virologia , Papillomaviridae/imunologia , Vacinas contra Papillomavirus/imunologia , Pele/virologia , Vacinação , Adolescente , Adulto , Idoso , Feminino , Alemanha/epidemiologia , Humanos , Imunização , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Soroepidemiológicos , Parceiros Sexuais , Inquéritos e Questionários , Adulto Jovem
5.
Artigo em Alemão | MEDLINE | ID: mdl-30788538

RESUMO

Since the baseline study of the "German Health Interview and Examination Survey for Children and Adolescents (KiGGS)" in 2003-2006, vaccination conditions in Germany have changed and additional vaccinations have been included in the immunization schedule. The current KiGGS data can be used to assess the current vaccination status of 3­ to 17-year-olds and trends in the 1985-2013 birth cohorts.Of the 15,023 total participants in KiGGS Wave 2, 3238 aged 3-17 years participated in the KiGGS Wave 2 examinations and submitted the complete vaccination certificate or were, according to their parents, unvaccinated. In this group, vaccination coverage was high for the majority of vaccinations for both girls and boys. Vaccination coverage has increased in children and adolescents in the last 10 years. This is especially true for vaccines for which there were strong deficiencies in the KiGGS baseline study, such as the hepatitis B and second measles vaccinations in all age groups, the booster dose against pertussis (11- to 17-year olds), as well as the booster dose against tetanus in the 7­ to 10-year-olds.Sociodemographic factors are still determinants of vaccination status. Less than one child in two is vaccinated against hepatitis B (45.9%) when parents state fear of side effects or indicate vaccine skepticism as reasons against vaccinations. Despite significant increases, vaccination coverage at the end of the second year of life is still far below 95% for all vaccinations (measles: 1st dose: 88.6%; 2nd dose: 64.4%) even in the most recent birth cohorts.The results show where further efforts are needed to increase vaccination coverage by the remaining last percentage points, achieve the timely delivery of all vaccinations listed in the immunization schedule, as well as meet the defined elimination goals.


Assuntos
Vacinação em Massa/estatística & dados numéricos , Sarampo/prevenção & controle , Cobertura Vacinal/tendências , Vacinas/administração & dosagem , Adolescente , Criança , Pré-Escolar , Feminino , Alemanha , Humanos , Masculino , Vacinação
6.
Sci Rep ; 8(1): 16696, 2018 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-30420608

RESUMO

Hepatitis A is a vaccine-preventable disease with a global distribution. It predominantly occurs in regions with inadequate living conditions, but also affects populations in industrialised countries. Children are frequently involved in the transmission of hepatitis A virus (HAV) and thus play a central role in the epidemiology of hepatitis A. Here, we investigated HAV infections, immunisations, and associated demographic determinants in a nationwide, population-based, cross-sectional survey conducted in Germany from 2003-2006. Out of 17,640 children and adolescents, complete data sets (HAV serology, demographic information and vaccination card) were available for 12,249 (69%), all aged 3-17 years. We found protective antibody levels (>=20 IU/L) in 1,755 (14%) individuals, 1,395 (11%) were vaccinated against hepatitis A, 360 (3%) individuals were HAV seropositive without prior hepatitis A vaccination, thus indicating a previous HAV infection. Antibody prevalence (attributable to vaccination or infection) increased significantly with age. Multivariate logistic regression revealed that predominantly children and adolescents with migration background-even if they were born in Germany-are affected by HAV infections. Our results provide a rationale to emphasise existing vaccination recommendations and, moreover, to consider additional groups with a higher risk of infection for targeted vaccination, especially children with a migration background.


Assuntos
Vírus da Hepatite A/patogenicidade , Hepatite A/epidemiologia , Hepatite A/prevenção & controle , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Alemanha/epidemiologia , Vírus da Hepatite A/imunologia , Humanos , Modelos Logísticos , Masculino , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Vacinação
7.
PLoS One ; 13(7): e0200267, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30044826

RESUMO

BACKGROUND: Infection with cytomegalovirus (CMV) remains asymptomatic in most immunocompetent hosts, but is the leading cause of congenital viral infection worldwide and can be life-threatening in immunocompromised individuals. We aimed to assess CMV seroprevalence in a nationally representative sample of adults in Germany and to identify sociodemographic factors associated with CMV seropositivity. METHODS: Blood samples from 6552 participants (18-79 years) of the "German National Health Interview and Examination Survey 1998", a population-based sample of the adult population in Germany, were tested for the presence of CMV antibodies using an Ig-multiplex assay. Weighted seroprevalence was calculated and weighted binomial regression was used to identify factors associated with CMV seropositivity. RESULTS: Overall CMV seroprevalence was 56.7% (95%CI: 54.8-58.7%), with a higher seroprevalence in women (62.3%) than in men (51.0%). Seroprevalence increased with age: from 31.8% to 63.7% in men and from 44.1% to 77.6% in women when comparing the 18-29 with the 70-79 year age-group, respectively. CMV seroprevalence in women of childbearing age (18-45 years) was 51.7%. Factors significantly associated with CMV seropositivity were age, country of birth, smoking status, education, living in northern Germany and number of household members. In addition, having attended child care was associated with seropositivity in men, and number of siblings and living in East Germany in women. CONCLUSION: Our results indicate that half the women of childbearing age were susceptible for primary CMV infection during pregnancy. CMV screening during pregnancy and informing seronegative women about CMV risk reduction measures could prevent congenital CMV infections with its serious consequences.


Assuntos
Infecções por Citomegalovirus/epidemiologia , Citomegalovirus/isolamento & purificação , Adolescente , Adulto , Idoso , Anticorpos Antivirais/sangue , Feminino , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Adulto Jovem
8.
Vaccine ; 35(38): 5156-5162, 2017 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-28801155

RESUMO

BACKGROUND: The study focused on the question of whether and - if so - to what direction and extent immunisations in the 1st year may be associated with the risk of being diagnosed with atopic diseases after the 1st year of life. METHODS: Data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, 2003-2006) were analysed. For analyses of potential associations between vaccination status and risk of hay fever, atopic dermatitis or asthma, sample sizes of 15254, 14297, and 15262, respectively, were available. RESULTS: Children with a sufficient TDPHiHeP vaccination at the end of the 1st year of life had a lower risk of being diagnosed with hay fever after the 1st year of life (adjusted prevalence ratio 0.85, 95% confidence interval 0.76-0.96). Analyses for associations between TDPHiHeP vaccination and risk of atopic dermatitis or asthma, or between age at onset of vaccination or of the number of antigens vaccinated in the 1st year of life and risk of atopic disease failed to yield statistical significance. CONCLUSIONS: Our results provide no evidence that immunisations in the 1st year of life may increase the risk of atopic disease. If any association exists at all, our results may be interpreted as weakly supportive of the hypothesis that immunisations may slightly decrease the risk of atopy in later life.


Assuntos
Dermatite Atópica/imunologia , Dermatite Atópica/prevenção & controle , Vacinação , Adolescente , Criança , Pré-Escolar , Difteria/imunologia , Difteria/prevenção & controle , Feminino , Haemophilus influenzae/imunologia , Hepatite B/imunologia , Hepatite B/prevenção & controle , Humanos , Lactente , Recém-Nascido , Masculino , Poliomielite/imunologia , Poliomielite/prevenção & controle , Coqueluche/imunologia , Coqueluche/prevenção & controle
9.
BMC Infect Dis ; 17(1): 356, 2017 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-28525973

RESUMO

BACKGROUND: In 2004, universal childhood varicella vaccination was introduced in Germany. We aimed to determine the age-specific prevalence of anti-varicella zoster virus (VZV) IgG-antibodies among children in the pre-varicella vaccine era in Germany, to identify factors associated with VZV seropositivity, and to assess the suitability of a commercially available ELISA for VZV seroepidemiological studies by comparing it with an in-house fluorescent antibody to membrane antigen test (FAMA) as the gold standard. METHODS: Serum samples of 13,433 children and adolescents aged 1-17 years included in the population-based German Health Interview and Examination Survey for Children and Adolescents (KiGGS; conducted 2003-2006) were tested for anti-VZV IgG by ELISA. All samples with equivocal ELISA results and a random selection of ELISA-negative and -positive samples were tested by FAMA. Statistical analyses were conducted using a weighting factor adjusting the study population to the total population in Germany. Seroprevalences were calculated as percentages (%) with a 95% confidence interval (CI). Odds ratios (OR) were computed by multivariate logistic regression to determine the association between socio-demographic factors and VZV seropositivity. RESULTS: The VZV seropositivity rate was 80.3% (95% CI: 79.3-81.3) in varicella-unvaccinated children and adolescents. VZV seropositivity rates differed significantly between age groups up to age 6 years, but not by gender. Of 118 retested serum samples with an equivocal ELISA result, 45.8% were FAMA-positive. The proportion of samples tested as false-negative in by ELISA varied by age group: 2.6% in children aged 1-6 and 9% in children aged 7-17 years. Multivariate analyses showed that age, having older siblings, and early daycare start were associated with seropositivity in preschoolers; migration background reduced the chance of VZV seropositivity in schoolchildren (OR: 0.65; 0.43-0.99) and adolescents (OR: 0.62; 0.4-0.97). CONCLUSION: In the pre-varicella vaccine era, most children in Germany contracted varicella by age six. Schoolchildren with a migration background and children without siblings have an increased risk of being VZV seronegative and should be targeted for catch-up vaccination, if they have no history of chickenpox. ELISAs are suitable for use in population-level serosurveys on VZV, but samples with equivocal ELISA results should be retested by FAMA.


Assuntos
Anticorpos Antivirais/sangue , Herpesvirus Humano 3/imunologia , Estudos Soroepidemiológicos , Adolescente , Anticorpos Anti-Idiotípicos , Antígenos Virais , Varicela/epidemiologia , Vacina contra Varicela/imunologia , Vacina contra Varicela/uso terapêutico , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Alemanha/epidemiologia , Herpesvirus Humano 3/patogenicidade , Humanos , Lactente , Modelos Logísticos , Masculino , Vacinação/estatística & dados numéricos
10.
PLoS One ; 7(8): e42867, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22880124

RESUMO

We have undertaken a seroprevalence study with more than 13,000 children, who had been included in the German KIGGS survey, a representative sample of children and adolescents 0-17 years of age. The IgG titres against measles, mumps and rubella were determined in 1 to 17 year olds While 88.8% of the children were MMR-vaccinated at least once, 76.8% of children aged 1 to 17 years showed prevalence of antibodies to MMR. The highest seronegativity was seen with respect to mumps. Gender differences were most pronounced with regard to rubella IgG titres: girls aged 14 to 17 years were best protected, although seronegativity in 6.8% of this vulnerable group still shows the need of improvement. Search for predictors of missing seroprevalence identified young age to be the most important predictor. Children living in the former West and children born outside of Germany had a higher risk of lacking protection against measles and rubella, while children with a migration background but born in Germany were less often seronegative to measles antibodies than their German contemporaries. An association of seronegativity and early vaccination was seen for measles but not for mumps and rubella. A high maternal educational level was associated with seronegativity to measles and rubella. In vaccinated children, seronegativity was highest for mumps and lowest for rubella. For mumps, high differences were observed for seronegativity after one-dose and two-dose vaccination, respectively. Seronegativity increases as time since last vaccination passes thus indicating significant waning effects for all three components of MMR.


Assuntos
Imunoglobulina G/imunologia , Sarampo/epidemiologia , Sarampo/imunologia , Caxumba/epidemiologia , Caxumba/imunologia , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/imunologia , Adolescente , Anticorpos Antivirais/imunologia , Criança , Pré-Escolar , Feminino , Alemanha/epidemiologia , Humanos , Lactente , Masculino , Vacina contra Sarampo-Caxumba-Rubéola/imunologia , Análise Multivariada , Razão de Chances , Fatores de Risco , Estudos Soroepidemiológicos , Vacinação
11.
Vaccine ; 30(13): 2349-56, 2012 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-22289512

RESUMO

In this paper we examine different time periods after vaccinations and investigate whether the risk of sudden infant death is different during the post-vaccination period than at other times. Three already published case-control studies are re-examined in this context. Several evaluation approaches are presented. The recently developed self-controled case series (SCCS) method for terminal events, which only takes the cases into account, is used in addition. There is no increased or reduced risk of sudden infant death during the period after the vaccination. The previously reported protective effect seen in case contol studies is based on the inclusion of unvaccinated cases. The results of the case-control analysis of one study is affected by two confounders. The SCCS method for terminal events, in which all time-independent confounders are eliminated, is an alternative to case-control analysis when it comes to the temporal association between exposed time periods and SIDS after vaccination.


Assuntos
Estudos de Casos e Controles , Interpretação Estatística de Dados , Morte Súbita do Lactente/etiologia , Vacinação/efeitos adversos , Vacinas/efeitos adversos , Humanos , Lactente , Risco , Vacinação/métodos , Vacinas/administração & dosagem
12.
Vaccine ; 29(45): 7949-59, 2011 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-21872633

RESUMO

BACKGROUND AND OBJECTIVE: In the European Region, measles elimination is now targeted to 2015. To measure progress towards elimination age-group specific susceptibility targets have been defined. Age-specific measles susceptibility in children and adolescents was evaluated in Germany. Taking into account a broad range of socio-demographic, health- and vaccination status related variables, populations for vaccination campaigns were identified. METHOD: We analysed data from children aged 1-17 years in the representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Measles immunoglobulin G antibodies were measured in 13,977 participants by enzyme immunoassay (ELISA). Bivariate and multivariate logistic regression analyses were used to determine parental and infant related factors associated with measles susceptibility. RESULTS: The overall prevalence of seronegativity in children tested for measles IgG aged 1-17 years was 10.0% (95% CI 9.4-10.7). The prevalence of seronegativity in the German population was below the WHO targets for measles elimination in children aged 2-9 year-olds but exceeded the target for 10-17 year-olds. Age differences in the level of seronegativity were found to be mainly due to differences in vaccination coverage. A higher level of susceptibility was observed if parents did not comply with the request to present the child's vaccination card. In vaccinated children, immigration, male gender, very young age at first vaccination and a longer time period since last vaccination were associated with a higher level of susceptibility. CONCLUSION: Further increase of the two-dose vaccination coverage is necessary in order to achieve the WHO targets. Catch up vaccination campaigns should focus on adolescents and immigrants.


Assuntos
Anticorpos Antivirais/sangue , Imunoglobulina G/sangue , Sarampo/epidemiologia , Sarampo/imunologia , Adolescente , Anticorpos , Criança , Pré-Escolar , Estudos Transversais , Erradicação de Doenças/métodos , Ensaio de Imunoadsorção Enzimática , Feminino , Alemanha/epidemiologia , Humanos , Lactente , Masculino , Sarampo/prevenção & controle , Modelos Estatísticos , Estudos Soroepidemiológicos
13.
Dtsch Arztebl Int ; 108(7): 99-104, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21412506

RESUMO

BACKGROUND: Whether unvaccinated children and adolescents differ from those vaccinated in terms of health is subject to some discussion. METHOD: We evaluated data on diseases that are preventable by vaccination, infectious and atopic diseases, and vaccinations received that had been collected between 2003 and 2006 in a representative sample of 17 641 subjects aged 0 to 17 years in the framework of the German Health Interview and Examination Survey for Children and Adolescents (Kinder- und Jugendgesundheitssurvey, KiGGS). RESULTS: Evaluable data on vaccinations were available for 13 453 subjects aged 1-17 years from non-immigrant families. 0.7% of them (95% confidence interval: 0.5%-0.9%) were not vaccinated. The lifetime prevalence of diseases preventable by vaccination was markedly higher in unvaccinated than in vaccinated subjects. Unvaccinated children aged 1-5 years had a median number of 3.3 (2.1-4.6) infectious diseases in the past year, compared to 4.2 (4.1-4.4) in vaccinated children. Among 11- to 17-year-olds, the corresponding figures were 1.9 (1.0-2.8) (unvaccinated) versus 2.2 (2.1-2.3) (vaccinated). The lifetime prevalence of at least one atopic disease among 1- to 5-year-olds was 12.6% (5.0%-28.3%) in unvaccinated children and 15.0% (13.6%-16.4%) in vaccinated children. In older children, atopy was more common, but its prevalence was not found to depend on vaccination status: among 6- to 10-year-olds, the prevalence figures were 30.1% (12.9%-55.8%) for unvaccinated children versus 24.4% (22.8%-26.0%) for vaccinated children, and the corresponding figures for 11- to 17-year-olds were 20.3% (10.1%-36.6%) versus 29.9% (28.4%-31.5%). CONCLUSION: The prevalence of allergic diseases and non-specific infections in children and adolescents was not found to depend on vaccination status.


Assuntos
Hipersensibilidade Imediata/epidemiologia , Hipersensibilidade Imediata/prevenção & controle , Controle de Infecções/estatística & dados numéricos , Vacinação em Massa/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Comorbidade , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Prevalência , Medição de Risco , Fatores de Risco
14.
Stat Med ; 30(6): 666-77, 2011 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-21337361

RESUMO

The self-controlled case series method (SCCS) was developed to analyze the association between a time-varying exposure and an outcome event. We consider penta- or hexavalent vaccination as the exposure and unexplained sudden unexpected death (uSUD) as the event. The special situation of multiple exposures and a terminal event requires adaptation of the standard SCCS method. This paper proposes a new adaptation, in which observation periods are truncated according to the vaccination schedule. The new method exploits known minimum spacings between successive vaccine doses. Its advantage is that it is very much simpler to apply than the method for censored, perturbed or curtailed post-event exposures recently introduced. This paper presents a comparison of these two SCCS methods by simulation studies and an application to a real data set. In the simulation studies, the age distribution and the assumed vaccination schedule were based on real data. Only small differences between the two SCCS methods were observed, although 50 per cent of cases could not be included in the analysis with the SCCS method with truncated observation periods. By means of a study including 300 uSUD, a 16-fold risk increase after the 4th dose could be detected with a power of at least 90 per cent. A general 2-fold risk increase after vaccination could be detected with a power of 80 per cent. Reanalysis of data from cases of the German case-control study on sudden infant death (GeSID) resulted in slightly higher point estimates using the SCCS methods than the odds ratio obtained by the case-control analysis.


Assuntos
Interpretação Estatística de Dados , Modelos Estatísticos , Morte Súbita do Lactente/imunologia , Vacinação/métodos , Vacinas/administração & dosagem , Vacinas/efeitos adversos , Estudos de Casos e Controles , Simulação por Computador , Humanos , Lactente
15.
Pediatr Infect Dis J ; 30(1): 19-24, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20683220

RESUMO

BACKGROUND: Data on hepatitis B (HB) infection prevalence among children and adolescents in Germany are scarce. We estimated seroprevalence of HB infection and assessed determinants for HB infection among children and adolescents in Germany from a representative population sample. METHODS: From 2003 to 2006, the Robert Koch Institute conducted a nationwide cross-sectional Health Interview and Examination Survey for Children and Adolescents in Germany. Data on age, gender, migration background, and socioeconomic status were collected through questionnaires. A child was defined as having a 2-sided migration background if both parents, or the child and 1 parent, immigrated, and a 1-sided migration background if only 1 parent immigrated. Among children with migration background, a first-generation migrant was defined as born outside Germany; a second-generation migrant was born in Germany. Information on HB vaccination status was obtained from vaccination cards. Serologic samples from participants were tested for anti-hepatitis B core antigen (anti-HBc) and hepatitis B surface antigen. We performed weighted univariable and multivariable logistic regression analyses to assess determinants for HB infection. RESULTS: Of 13,065 participants (3-17 years), 0.5% (95% confidence interval [CI], 0.4-0.7) were anti-HBc positive, among whom 38.7% (95% CI, 20.0-57.5) were hepatitis B surface antigen positive. Two-sided migration background and being a first- or second-generation migrant were significantly associated with anti-HBc positivity (odds ratio [OR]: 8.3, 95% CI: 4.0 ­17.4; OR: 11.0, 95% CI: 3.5-35.0; OR: 3.0, 95% CI: 1.2-7.3). No further determinants were found. CONCLUSIONS: HB infection is rare among children and adolescents in Germany. First- and second-generation migrant children can be considered to be at risk for HB infection, 2-sided migration background or being a first-generation migrant carried the greatest risk. Targeted testing for HB infection and early HB vaccination should be provided to immigrants' children.


Assuntos
Emigração e Imigração/estatística & dados numéricos , Hepatite B/epidemiologia , Adolescente , Análise de Variância , Criança , Pré-Escolar , Estudos Transversais , Feminino , Alemanha/epidemiologia , Hepatite B/sangue , Hepatite B/prevenção & controle , Anticorpos Anti-Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/sangue , Vacinas contra Hepatite B/administração & dosagem , Humanos , Masculino , Programas Nacionais de Saúde , Vigilância da População , Análise de Regressão , Fatores de Risco , Estudos Soroepidemiológicos
16.
Vaccine ; 27(19): 2563-9, 2009 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-19428862

RESUMO

Data from the representative German Health Interview and Examination Survey for Children and Adolescents were used to identify unvaccinated subgroups that should be targeted by vaccination programmes in order to interrupt measles transmission. Measles vaccination coverage was low among children below the age of 3, having > or =3 siblings and in foreign-born migrants. Multivariate analyses show that vaccination coverage was strongly related to the place of birth in migrants: foreign-born children have a three-fold odds of being unvaccinated. Odds were also higher in children living in former West Germany, having > or =3 siblings, and it was especially high in children with parents reporting reservations against vaccinations.


Assuntos
Vacina contra Sarampo/imunologia , Sarampo/prevenção & controle , Vacinação/estatística & dados numéricos , Adolescente , Fatores Etários , Criança , Pré-Escolar , Emigrantes e Imigrantes , Feminino , Alemanha , Humanos , Masculino , Irmãos
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