Knowledge, attitudes, and behaviors of parents towards varicella and its vaccination.

BACKGROUND: The aims of this cross-sectional survey were to examine the knowledge, the attitudes, and the behavior regarding the varicella infection and its vaccination and to get insight into their determinants among parents of children in Italy. METHODS: From May to June 2015 in the geographic area of Naples (Italy) a random sample of 675 parents of children aged 4-7 years received a self-administered anonymous questionnaire about socio-demographic characteristics, knowledge, attitudes, and behaviors towards varicella and its vaccination. RESULTS: A total of 414 parents responded to the questionnaire, for a response rate of 61.3%. A history of varicella was reported in 163 children (39.6%). Only 26.6% parents knew that the vaccine was available and the number of doses and this knowledge was significantly higher in those who had a university degree, in those who had received information on the vaccination from a health care provider, and in those who had vaccinated their child. The perceived utility towards vaccination had a mean value of 5.7. The positive attitude towards the utility of the vaccination was higher in parents with a level of education not higher than middle school, in those who had vaccinated their child, in those who considered the varicella a dangerous disease, and in those who had received information from a health care provider. More than one-third had vaccinated their child. Immunization was more frequent in parents who had knowledge about the vaccination, who beliefs that the immunization was useful, who believed that the disease was not dangerous, and who had not a history of varicella among their children. CONCLUSIONS: Educational programs are needed among parents as support to improve knowledge about vaccination and immunization coverage.

Assessment of the effectiveness of the universal varicella vaccination program in Toscana (Italy), in the period 2010-2013.

OBJECTIVE: To assess the effectiveness of the varicella vaccination program in Toscana after one dose of vaccine, in the birth cohorts 2008-2011. DESIGN: Varicella vaccine effectiveness (VE) was calculated using the "screening method", based on vaccine coverage (VC) at 24 months and proportion of vaccinated subjects among varicella notified cases (PVC), verified through the Local Health Units' (LHUs) immunization registries. Breakthrough varicella (BV) was defined as a case of varicella occurring in a child vaccinated ≥42 days before the date of disease onset. SETTING AND PARTICIPANTS: The study was conducted in the 12 Tuscan LHUs and included all varicella cases notified in 2010-2013 in children of the birth cohorts 2008-2011. MAIN OUTCOME MEASURES: BV cases; VE after one dose of varicella vaccine; time interval between varicella vaccination and symptom onset. RESULTS: VC was 79.8%, VE reached 90.8%(95%CI 89.5%-92.0%) and the proportion of BV among notified cases was 26.6%. The median time interval between vaccination and symptom onset was 25 months. CONCLUSIONS: The very low rate of BV cases among vaccinated children confirms the high effectiveness even of a single dose of varicella vaccine and does not support a change of the current immunization schedule.

[Coenaesthesia after infection with Varicella zoster virus. The psychodynamic meaning of suffering a children's disease at adult age]. / Zönästhesie nach Varicella-zoster-Infektion. Psychodynamische Bedeutung einer Kinderkrankheit im Erwachsenenalter.

The case report is presented of a 33-year-old male who developed coenaesthesia after suffering from chickenpox. While central nervous involvement of the herpes zoster virus infection was not found, suffering a children's disease at an adult age proved an important psychodynamic factor for release of the coenaesthetic symptomatology.

Black South African children's understanding of health and illness: colds, chicken pox, broken arms and AIDS.

PURPOSE: To examine the understanding of both health and illness (colds, broken arms, chicken pox, AIDS) in the same black South African children METHOD: The sample included 60 children (30 were 5-year-olds and 30 were 9-year-olds) selected by simple random sampling from a rural primary school. They were interviewed, using a semi-structured interview schedule, about their understanding of health issues and their exposure to learning about health or sickness. RESULTS: Differences across age in children's expressed understanding of health and illnesses were found. The 9-year-olds were more likely to give objective signs of chicken pox and AIDS than the 5-year-olds. They also knew more about objective symptoms of colds, chicken pox and AIDS, and were more likely to mention non-observable signs of colds and broken arms. Although there were no differences between the two age groups regarding 'knowing' strategies for avoiding illnesses, the older children had a more accurate knowledge about preventive measures than the younger children. The understanding of AIDS followed the same developmental sequence reported for children's understanding of general physical illness. CONCLUSION: The results have implications for the creation of developmentally appropriate and effective health and AIDS education curricula for primary and elementary grades.

[Mutism in children]. / Mutismo en niños.

INTRODUCTION: Mutism is absence of verbal expression with conservation of language comprehension. The origin of mutism is multifactorial and may followed from cranial trauma surgery of the posterior fossa, acquired epileptic syndromes and psychogenic origin. OBJECTIVE: To refer patients who had presented mutism of diverse etiology. CLINICAL CASES: We analysed three children who had presented mutism originated by diverse causes. Case 1. A child with family and school problems, attention deficits and limited communication resources. Neurological examination and other auxiliary test (EEG) were normal. He presented no alteration in language or speech. We recommended the change of the school and a psychotherapeutic orientation. Case 2. A 4 year old female child who has suffered varicella 15 days earlier and presented limitations in her verbal expression despite maintain her linguistically capacity. She showed a indifferent behavior and her movements were without finality. Neurological examination was normal. The girl understood and followed instruction properly. However her verbal communication was absent. Total recuperation occurred in 72 hours. Case 3. A 12 years old child who had suffered a cranial traumatism with loss of consciousness ten days earlier. After this traumatism, he presented behavior changes, disorientation and blurred vision. Additionally he presented stereotypies and limitations in psychosocial connections. Despite his mutism, he conserved the structure and content of language. SPECT showed hypoperfusion in orbitotemporal region. Improvement was total 20 days after his traumatism. CONCLUSIONS: The mutism has multifactorial etiology. References were made to three cases who's mutism was related to emotional causes, post-varicella complications and posttraumatic events.

Parental attitudes toward varicella vaccination. The Puget Sound Pediatric Research Network.

OBJECTIVES: To evaluate parental health beliefs regarding the varicella vaccine and to identify potential areas for interventions designed to increase immunization against varicella. SETTING: Data were collected in the offices of pediatricians who are members of the Puget Sound Pediatric Research Network, a regional practice-based research group in the Seattle, Wash, area. METHODS: At the time of an office visit, parents were asked to complete a survey on the varicella vaccine. Respondents indicated level of agreement with 10 health belief statements regarding the immunization using a 6-point Likert scale from "completely agree" to "completely disagree"; responses were subsequently transformed to an ordinal scale from 1 to 6, with 6 corresponding to highly positive beliefs. A composite health belief score for each respondent was computed by averaging responses to all statements. Parents also were asked to indicate the level of influence of their child's pediatrician on their decision to use the varicella vaccine. RESULTS: A total of 598 surveys were completed. Generally, parents agreed that the vaccine was worthwhile even if the only benefit was preventing a rare complication. Conversely, the majority of parents disagreed that varicella vaccine was worthwhile if the only benefit was preventing lost time from work, and that the immunization was worthwhile even if immunity was not lifelong. Parents who indicated that their child's pediatrician's opinion significantly influenced their decision to use the vaccine had higher composite health belief scores than those who indicated less influence (median scores, 4.3 and 4.0, respectively; P<.001). CONCLUSIONS: In this sample, parents had more positive health beliefs about the ability of varicella vaccine to prevent rare complications than to save time lost from work. These data also suggest that pediatricians can have an important role in increasing positive health beliefs about the vaccine. These findings may help future interventions to increase the immunization rate against varicella.

The relationship of schizophrenic births to 16 infectious diseases.

BACKGROUND: Recently, several investigators have reported an association between influenza epidemics and increased birth rates of 'preschizophrenic' individuals some four to six months later. Here we examine whether maternal exposure to other infectious diseases can also predispose the foetus to later schizophrenia. METHOD: Two independent sets of dates of birth of first admission schizophrenic patients, born between 1938 and 1965 in England and Wales, were obtained from the Mental Health Enquiry in England and Wales. Data on the number of deaths per month from 16 infectious diseases between 1937 and 1965 in England and Wales were also collected. We used a Poisson regression model to examine the relationship between deaths from infectious diseases and schizophrenic births. RESULTS: In the two separate data sets, increased national deaths from bronchopneumonia preceded, by three and five months respectively, increased numbers of schizophrenic births. We did not find any other significant associations between schizophrenic births and any of the other 15 infectious diseases. CONCLUSIONS: The association between deaths from bronchopneumonia and increased schizophrenic births some months later may be a reflection of the fact that bronchopneumonia deaths increase markedly during influenza epidemics.

A measure of family disruption for use in chickenpox and other childhood illnesses.

A search of the literature showed the lack of a suitable measure for assessing the impact of minor illness on children and their families. Such illness can lead to considerable disruption within the family and particularly to the parent primarily responsible for the care of the ill child. Discussion groups were run with parents who had a child who had had chickenpox within the previous 6 months. Analysis of the transcripts from the groups produced items indicating three types of disruption; parents' distress, changes in the behaviour of the ill child and general disruption to family arrangements. Items from the transcripts were formed into a questionnaire which was then used in a study of 61 families in which a child had become ill with chickenpox within the previous 7 days. The principal carer completed the measure every evening for a fortnight. The results of the study showed considerable disruption over the first few days of the child's illness, followed by a steady reduction over the whole 2-week period.(ABSTRACT TRUNCATED AT 250 WORDS)

Childhood chickenpox: its impact on child and family.

Sixty-nine parents took part in nine discussion groups designed to explore the effect of childhood chickenpox on the behaviour of the affected child, on family routines and on the parents themselves. Although most parents thought of chickenpox as a relatively trivial illness, it was found that there was considerable disruption to family organization and plans and, often, great strain was imposed on a parent, usually the mother. Some families incurred extra financial burdens in terms of time taken from work, the purchase of over the counter preparations, childminders and special treats for the sick child. It was apparent that parents needed more information and reassurance about the nature and course of the illness.