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2.
BMC Health Serv Res ; 19(1): 798, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690298

RESUMO

BACKGROUND: Improved immunization rates have reduced the incidence of vaccine-preventable diseases (VPDs) in advanced nations. Japan's unique vaccination system classifies vaccines into routine vaccines ostensibly required under the Preventive Vaccination Law and recommended but optional vaccines, although all vaccines are in fact voluntary. In Japan, low immunization rates, particularly for optional vaccines, have resulted in high rates of sequelae and death. The decision as to whether a child will receive a vaccine depends on the parents, who must obtain information, make inquiries, and make the required payment, the last of which is a major barrier. This randomized, controlled trial was conducted to evaluate the effectiveness of an immunization education program designed to meet mothers' needs. METHODS: This randomized controlled trial assigned pregnant women to intervention or control groups. The intervention was individual education sessions involving the children's fathers in shared decision-making on whether or not to immunize their child. A survey was conducted before and after the intervention. Data were analyzed using the intention-to-treat principle. RESULTS: Of 225 pregnant women, 175 (78%) participated and 171 replied to the post-survey. At age 3 months, intervention infants had higher self-reported immunization rates for hepatitis B virus vaccine (76% vs. 49%; P < 0.001) and rotavirus vaccine (84% vs. 68%; P = 0.019) than control group infants. The percentage of parents intending to vaccinate their infants was higher in the intervention group (77% vs. 52%; P < 0.01). Improvements in scores for basic knowledge (mean [SD]: 5.5 [3.6] vs. 3.0 [3.8], range: 10-30; P < 0.001), advanced knowledge (mean [SD]: 5.1 [2.4] vs. 2.8 [2.5], range: 5-15; P < 0.001), and health literacy regarding immunization (mean [SD]: 0.5 [0.8] vs. 0.2 [0.6], range: 1-5; P < 0.01) were higher in the intervention group. The rate of decision making by both parents (68% vs. 52%; P < 0.05) was higher in the intervention group. CONCLUSIONS: Our findings confirmed the program's effectiveness. The intervention improved immunization rates, the percentage of parents intending to vaccinate their infants and knowledge scores. Interventions which directly and indirectly involved fathers in shared decision-making on whether to immunize their child were effective, as were individualized interventions that provided parents with access to up-to-date information. TRIAL REGISTRATION: UMIN000012575 . Registered 14 December 2013 (The study was prospectively registered).


Assuntos
Educação em Saúde , Imunização , Pais/educação , Adulto , Tomada de Decisões , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Imunização/psicologia , Imunização/estatística & dados numéricos , Lactente , Intenção , Japão , Masculino , Pais/psicologia , Período Pós-Parto , Gravidez , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários
3.
BMC Public Health ; 19(1): 1275, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533790

RESUMO

BACKGROUND: Immunization is an effective public health intervention to reduce morbidity and mortality among children and it will become more effective if the child can receive the full course of recommended immunization doses. The objective of this study was to determine the prevalence of childhood immunization defaulters and its associated factors among children below 5 years attending registered child care centers in Petaling District, Selangor. METHODS: This was a cross-sectional survey among mothers with children below 5 years from 60 registered child care centers in District of Petaling, Selangor. Data was collected by a self-administered questionnaire from a total of 1015 mothers. Simple Logistic Regression, Chi-square or Fisher's exact test were performed to determine the association between individual categorical variables and childhood immunization defaulters. Multivariate logistic regression was used to determine the predictors of childhood immunization defaulters. RESULTS: The study showed that the prevalence rate for defaulting immunization was 20.7%. After adjusting all confounders, six statistically significant predictors of childhood immunization defaulters were determined. They were non-Muslims (aOR = 1.669, 95% CI = 1.173, 2.377, p = 0.004), mothers with diploma and below educational background (aOR = 2.296, 95% CI = 1.460, 3.610, p < 0.0001), multiple children of 5 and above in a family (aOR = 2.656, 95% CI = 1.004, 7.029, p = 0.040), mothers with younger children aged 2 years and below (aOR = 1.700, 95% CI = 1.163, 2.486, p = 0.006), long travelling time of more than 30 min to the immunization health facility (aOR = 2.303, 95% CI = 1.474, 3.599, p < 0.0001) and had delayed at least one of the immunization schedule (aOR = 2.747, 95% CI = 1.918, 3.933, p < 0.0001). CONCLUSION: This study highlights the need of implementation of intervention programs should be intensified to improve the childhood immunization status, focusing on the Non-Muslim community, mothers with low educational level, mothers with multiple children and mothers with children aged 2 years and below. In light of the growing problem of immunization defaulters in Malaysian children, identifying mothers at risk of not completing their children immunization schedule and educating them is an important strategy to recurrent outbreaks of infectious disease in the country.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Programas de Imunização/estatística & dados numéricos , Imunização/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Esquemas de Imunização , Lactente , Modelos Logísticos , Malásia , Masculino , Mães/estatística & dados numéricos , Prevalência , Inquéritos e Questionários
4.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(9): 951-954, 2019 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-31474081

RESUMO

Construction and application of immunization information system is an important part of health information, which is very useful to improve the quality, efficiency and safety of vaccination. The background, system architecture, functions and applications, working conditions and characteristics of Shandong province Immunization Information System (IIS) are introduced in this article. It is expected to provide experiences for the development of immunization information system of other provinces.


Assuntos
Imunização , Sistemas de Informação , Vacinação , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Criança , China , Humanos , Imunização/estatística & dados numéricos , Sistemas de Informação/tendências
5.
Int Arch Allergy Immunol ; 180(3): 195-201, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31505505

RESUMO

BACKGROUND: Previous studies have used serum periostin levels as a biomarker of Th2-driven inflammatory responses. However, no population-based study has yet examined the association of serum periostin levels with the allergic status of children. OBJECTIVES: The aim of this study was to determine the usefulness of periostin as a biomarker for allergy in a group of 7-year-old Korean children. METHOD: This prospective cross-sectional study examined 451 children (aged 7 years to 7 years and 11 months) from the general pediatric population who attended 6 different schools between June and July 2016. A total of 249 children, all of whom completed the questionnaire and skin prick test and provided blood samples, were included in the final analysis. RESULTS: The geometric mean serum periostin level was 107.6 ng/mL (95% CI 104.5-110.7). After adjustment for confounding, serum periostin levels were significantly associated with sensitization to poly-allergens (adjusted odds ratio, aOR 1.032, 95% CI 1.006-1.059, p = 0.016) and pollen (aOR 1.020, 95% CI 1.002-1.039, p = 0.026). Serum periostin levels were also associated with eosinophil levels (adjusted ß = 0.023, SE = 0.009, p = 0.010), but were unrelated to body mass index, sex, obesity, or presence of an allergic disease. CONCLUSIONS: Our results suggest thatserum periostin level may have limited usefulness as a biomarker of allergic disease in children.


Assuntos
Biomarcadores/sangue , Moléculas de Adesão Celular/sangue , Eosinófilos/imunologia , Hipersensibilidade/diagnóstico , Imunização/estatística & dados numéricos , Alérgenos/imunologia , Criança , Estudos Transversais , Feminino , Humanos , Hipersensibilidade/epidemiologia , Coreia (Geográfico)/epidemiologia , Masculino , Grupos Populacionais , Estudos Prospectivos , Testes Cutâneos
6.
J Manag Care Spec Pharm ; 25(9): 989-994, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31456496

RESUMO

BACKGROUND: Pharmacies have a unique opportunity to address suboptimal adult vaccination rates, but few solutions have proven effective. Such strategies are challenged by the lack of access that many pharmacies have to a patient's complete immunization history; consequently, they are unable to identify which of their patients actually require vaccination. A pharmacy-based strategy that leverages such information could enhance efforts to increase rates of guideline-based vaccination. OBJECTIVE: To determine the effect on vaccination rates of an automated telephonic intervention for adults in need of either pneumococcal vaccination or herpes zoster vaccination, or both. METHODS: Over a 1-year period, patients with identified vaccine gaps at 246 pharmacies of 3 pharmacy chains were randomly assigned to receive either usual care or an automated telephonic prompt for pneumococcal and/or herpes zoster vaccines based on patient records contained in state immunization registries and pharmacy data. The primary outcome was the proportion with administration of at least one of the vaccines offered between March 2016 and January 2017 based on intention-to-treat principles. Subgroup analyses included vaccination rates by age and sex. An as-treated analysis was also performed. RESULTS: 21,971 patients were included in the study, 57% of whom were female, with a mean age of 63 years. Vaccine administration proportions were 0.0214 (236/11,009) in the intervention group, and 0.0205 (225/10,962) in the control group (OR = 1.05, 95% CI = 0.87-1.26). Results did not differ in subgroup analyses based on patient age, sex, or individual pharmacy chain. Among intervention patients, 3,666 (0.333) completed the call by listening to the entire prompt. In an as-treated analysis comparing individuals who completed calls versus control, the intervention increased the odds of vaccination by 26% (OR = 1.26, 95% CI = 1.00-1.61). CONCLUSIONS: The automated prompt did not significantly increase vaccination rates. Potential barriers included intervention technical flaws, low rates of connecting with patients, insufficient follow-up by the pharmacy, and patients placing a relatively low priority on being vaccinated. DISCLOSURES: This project was funded by Pfizer and Merck through a grant from the Pharmacy Quality Alliance. Stolpe was an employee of the Pharmacy Quality Alliance at the onset of this project and an employee of Scientific Technologies Corporation during the data collection phase of the project. Stolpe has also served on the advisory board for Merck. Choudhry has no conflicts of interest to declare.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Imunização/estatística & dados numéricos , Telefone/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Feminino , Vacina contra Herpes Zoster/imunologia , Humanos , Vacinas contra Influenza/imunologia , Masculino , Pessoa de Meia-Idade , Farmacêuticos/estatística & dados numéricos , Vacinas Pneumocócicas/imunologia , Sistema de Registros , Inquéritos e Questionários
7.
Rev Saude Publica ; 53: 59, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31340351

RESUMO

OBJECTIVE: To analyze the pneumococcal meningitis incidence rates in the State of São Paulo, Brazil, by age group, municipalities and micro-regions, as well as the spatial distribution of pneumococcal meningitis incidence rates among children under 5 years old in the pre- (2005-2009) and post-vaccination (2011-2013) periods and its associations with socioeconomic variables and vaccination coverage. METHODS: The data source was the Brazilian Notifiable Diseases Information System. For the pre- and post-vaccination periods, thematic maps were built for pneumococcal meningitis incidence in under-5 children, by São Paulo state micro-regions, vaccination coverage and socioeconomic variables, using QGIS 2.6.1 software. Scan statistics performed by the SatScan 9.2 software were used to analyze spatial and spatiotemporal clusters in São Paulo municipalities and micro-regions. A Bayesian inference for latent Gaussian model with zero-inflated Poisson model through the integrated nested Laplace approximation was used in the spatial analysis to evaluate associations between pneumococcal meningitis incidence rates and socioeconomic variables of interest in São Paulo micro-regions. RESULTS: From 2005 to 2013, 3,963 pneumococcal meningitis cases were reported in São Paulo. Under-5 children were the most affected in the whole period. In the post-vaccination period, pneumococcal meningitis incidence rates decreased among this population, particularly among infants (from 4.17/100,000 in 2005 to 2.54/100,000 in 2013). Two clusters were found in pre-vaccination - one of low risk for pneumococcal meningitis, in the northwest of the state (OR = 0.45, p = 0.0003); and another of high risk in the southeast (OR = 1.62, p = 0.0000). In the post-vaccination period, only a high-risk cluster remained, in the southeast (RR = 1.97, p = 0.0570). In Bayesian analysis, wealth was the only variable positively associated to pneumococcal meningitis (RR = 1.026, 95%CI 1.002-1.052). CONCLUSIONS: Pneumococcal meningitis is probably underdiagnosed and underreported in São Paulo. Differentiated rates of pneumococcal meningitis diagnosis and reporting in each microregion, according to the São Paulo Index of Social Responsibility, might explain our results.


Assuntos
Imunização/estatística & dados numéricos , Meningite Pneumocócica/epidemiologia , Meningite Pneumocócica/prevenção & controle , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , Brasil/epidemiologia , Criança , Pré-Escolar , Mapeamento Geográfico , Humanos , Incidência , Lactente , Pessoa de Meia-Idade , Características de Residência , Adulto Jovem
8.
BMC Pregnancy Childbirth ; 19(1): 250, 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31311501

RESUMO

BACKGROUND: China has made remarkable progress in maternal and child health (MCH) over the last thirty years, but socio-economic inequalities persist. Ethnicity has become an important determinant of poor MCH outcomes, but little rigorous analytical work has been done in this area. To understand the socio-economic factors that explain ethnic variation in uptake of MCH care, we report the findings from an analysis in Sichuan province. METHODS: We linked data from the 2003, 2008 and 2013 National Health Service Surveys in Sichuan Province. The ethnic disparities in uptake of maternal care (completing 5 antenatal visits, giving birth in hospital and receiving a caesarean section) and childhood immunization (Bacillus Calmette Guerin (BCG), three doses of diphtheria (DPT) and measles immunization) were examined by geographical (Han district/county vs. ethnic minority county) and individual-based (Han women/children vs. ethnic minority women/children) comparisons. We also examined variation by distance to township and county hospitals, women's education, parity and age using weighted multilevel Poisson regressions with random intercept at district/county level. RESULTS: Ethnic inequalities in maternal care were marked, both at the geographical (district/county) and the individual level. The % of births in hospital was 90.7% among women in Han districts, compared to 83.3% among women living in Han counties (crude RR 0.93; 95% CI 0.75-1.15), 53.8% among Han women living in ethnic minority counties (crude RR 0.57; 95% CI 0.36-0.93), and 13.5% among ethnic minority women living in ethnic minority counties (crude RR 0.18; 95% CI 0.06-0.57). Adjusting the analysis for survey year, education, parity and distance to county level hospital weakened the association between geographical/individual ethnicity and uptake of maternity care, but associations remained remarkably strong. Coverage of childhood immunization was much higher than uptake of maternity care, and inequalities by ethnicity were much less pronounced. CONCLUSION: Lessons can be learned from China's successful immunization programme to further reduce inequalities in access to maternity care among ethnic minority populations in remote areas. Bringing the services closer to the women's homes and strengthening health promotion from the township to the village level may encourage more women to seek antenatal care and give birth in hospital.


Assuntos
Disparidades em Assistência à Saúde/etnologia , Imunização/estatística & dados numéricos , Serviços de Saúde Materna , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Pré-Escolar , China/epidemiologia , Grupos Étnicos , Feminino , Pesquisas sobre Serviços de Saúde , Acesso aos Serviços de Saúde , Humanos , Imunização/métodos , Lactente , Serviços de Saúde Materna/organização & administração , Serviços de Saúde Materna/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Gravidez , Fatores Socioeconômicos
9.
BMC Health Serv Res ; 19(1): 371, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185983

RESUMO

BACKGROUND: The aim of this study was to assess the accuracy and quality of immunization data on the pentavalent (diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type B (Hib)) and MMR vaccines as the administrative data of the expanded program on immunization (EPI) in Iran. METHODS: We conducted a Data Quality Self-assessment (DQS) survey from October to December 2017. Standardized DQS tools were used to assess the accuracy of reported immunizations data and quality of the immunization monitoring system at the provincial level of the healthcare system including health houses, health posts, rural and urban health centers and district health centers. Multistage cluster random sampling with proportional to size (PPS) weights was used to select target provinces and related health units. Accuracy ratio, quality index (QI), completeness and relevant quality indices of first dose of MMR (MMR1) and third dose of pentavalent vaccines were reported. Corresponding period of the survey was limited to reported administrative immunization data during the first 6 months of 2016. RESULTS: In relation to accuracy ratio, there was some evidence of under reporting of pentavalent (3rd dose) and MMR1 vaccines in health house units which were 100.94 and 101.1%, respectively. Completeness of reporting for both vaccines at different provincial levels was near 100%. However, the corresponding value for pentavalent (3rd dose) and MMR1 vaccines at the level of urban health centers was 96.67 and 94.17% respectively. Among the five components of a monitoring system data usage and core output had the lowest QI scores in either rural or urban as well as district healthcare centers. CONCLUSIONS: Findings from our DQS survey reveals that administrative reporting of the immunization data was adequate at provincial and district levels of the healthcare centers. Although, addressing the existing concerns regarding timelines of the reporting by health authorities and staffs of EPI is warranted.


Assuntos
Vacina contra Difteria, Tétano e Coqueluche , Vacinas Anti-Haemophilus , Vacinas contra Hepatite B , Programas de Imunização/estatística & dados numéricos , Programas Nacionais de Saúde/estatística & dados numéricos , Confiabilidade dos Dados , Vacina contra Difteria, Tétano e Coqueluche/uso terapêutico , Vacinas Anti-Haemophilus/uso terapêutico , Inquéritos Epidemiológicos , Vacinas contra Hepatite B/uso terapêutico , Humanos , Imunização/estatística & dados numéricos , Lactente , Irã (Geográfico) , Autoavaliação , Vacinas Combinadas
10.
JMIR Mhealth Uhealth ; 7(6): e13256, 2019 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-31199340

RESUMO

BACKGROUND: Disparities in cervical cancer incidence and mortality signify the need for intervention efforts targeting Korean American immigrant women. OBJECTIVE: The purpose of this study was to demonstrate how a culturally targeted and tailored mobile text messaging intervention, mobile screening (mScreening), was developed to promote the uptake of Papanicolaou tests and human papillomavirus vaccine among young Korean American immigrant women. METHODS: Guided by the Fogg behavior model, the mScreening intervention was developed through a series of focus groups. Braun and Clarke's thematic analysis was used to identify core themes. RESULTS: Overall, 4 themes were identified: (1) tailored message content (ie, basic knowledge about cervical cancer), (2) an interactive and visual message format (ie, age-appropriate and friendly messages using emoticons), (3) brief message delivery formats to promote participant engagement, and (4) use of an incentive to motivate participation (ie, gift cards). CONCLUSIONS: This study demonstrated the processes of gathering culturally relevant information to develop a mobile phone text messaging intervention and incorporating the target population's perspectives into the development of the intervention. The findings of the study could help guide future intervention development targeting different types of cancer screening in other underserved racial or ethnic groups.


Assuntos
Emigrantes e Imigrantes/psicologia , Teste de Papanicolaou/psicologia , Vacinas contra Papillomavirus/uso terapêutico , Adulto , Americanos Asiáticos/psicologia , Americanos Asiáticos/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Grupos Focais/métodos , Promoção da Saúde/métodos , Promoção da Saúde/normas , Promoção da Saúde/estatística & dados numéricos , Humanos , Imunização/psicologia , Imunização/estatística & dados numéricos , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pesquisa Qualitativa , Telemedicina/métodos , Mensagem de Texto/normas , Mensagem de Texto/estatística & dados numéricos , Estados Unidos
11.
Afr Health Sci ; 19(1): 1582-1593, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31148987

RESUMO

Background: Childhood immunization rate is lowest in the core-North Nigeria. We examined the relationship between inequality in household wealth and complete childhood immunization in that part of the country. Methods: A cross-sectional survey was conducted among 4079 mothers with children 12-23 months of age. Children were considered 'fully-immunized' if they received all the vaccines included in the immunization schedule. Data were analyzed using descriptive statistics and logistic regression models (α=5.0%). Results: About 39% and 5.0% children of the rich and poor received complete immunization respectively. Also, 64.2% and 49.6% children of the rich women received BCG and DPT 3 compared to 15.9% and 8.7% observed among the children of the poor. Higher proportion of children from poor households (40.6%) received no immunization than 20.8% found from the rich households. The likelihood of receiving complete immunization was 1.95(C.I=1.35-2.80, p<0.001) times higher among the children of the rich than the poor. Other important predictors of childhood immunization were age, religion, media access, working status, husband's education, prenatal attendants and delivery place. Conclusion: Disparities existed in childhood immunization between the poor and rich in the core-North part of Nigeria. Policy makers should institute effective interventions that will assist children from poor households to improve their immunization access.


Assuntos
Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde , Imunização/estatística & dados numéricos , Pobreza , Adulto , Criança , Pré-Escolar , Estudos Transversais , Características da Família , Feminino , Humanos , Programas de Imunização , Renda , Masculino , Mães , Nigéria , Fatores Socioeconômicos , Adulto Jovem
12.
Pan Afr Med J ; 32: 28, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31143333

RESUMO

Introduction: The protracted war in South Sudan has led to severe humanitarian crisis with high level of malnutrition and disruption of the health systems with continuous displacement of the population and low immunization coverage predisposing the population to vaccine preventable diseases. The study aimed at evaluating the effect of integrating immunization services with already established nutrition services on immunization coverage in resource-constrained humanitarian response. Methods: A community and health facility based interventional study involving integration of immunization into nutrition services in two Outpatient Therapeutic Program(OTP)centers in Bentiu PoC between January-December 2017. The main hypothesis was that inclusion of immunization services during nutrition services both at the OTP and community outreaches be an effective strategy for reducing missed opportunity for immunizing all eligible children accessing nutrition services. Data analyzed using STATA version 15 and bivariate analysis using logistic regression was conducted to identify predictor of missed vaccinations. Results: Integration of immunization into the nutrition services through the OTP centres increased the number of children immunized with various antigens and the dropout rate was much lower and statistically significant among children who received immunization at the OTP centers than those in the Primary Health Care Centers (PHC Centers) in the study sites. Children who were vaccinated at the OTP centre in sector 2 were 45% less likely to miss vaccination than those vaccinated at the PHCC (OR: 0.45; 95%CI:0.36- 0.55), p<0.05 while those vaccinated at the OTP sector in sector 5 were 27% less likely to miss vaccination than those vaccinated at the PHCC (OR: 0.27; 95%CI: 0.20 -0.35) p<0.05). Conclusion: This study indicated that immunization coverage improved effectively with integration with nutrition services as a model of an integrated immunization programme for child health in line with the Integrated Management of Childhood Illnesses (IMCI) and the Global Immunization Vision and Strategy (GIV).


Assuntos
Programas de Imunização/organização & administração , Imunização/métodos , Refugiados , Cobertura Vacinal/estatística & dados numéricos , Pré-Escolar , Serviços de Saúde Comunitária/organização & administração , Assistência Alimentar/organização & administração , Humanos , Imunização/estatística & dados numéricos , Modelos Logísticos , Atenção Primária à Saúde/organização & administração , Sudão do Sul , Vacinas/administração & dosagem
13.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(5): 534-539, 2019 May 06.
Artigo em Chinês | MEDLINE | ID: mdl-31091616

RESUMO

Maternal immunization is an immune strategy that protects both mothers and early-life infants from disease by the vaccination of pregnant women. The effect of maternal immunization is influenced by the types of vaccines, the timing of vaccination, the subtypes of antibodies induced by vaccines, and the health status of mothers themselves. Inactivated influenza vaccination during pregnancy and DPT vaccination during the third trimester of pregnancy have been widely used in the world, while Hepatitis B vaccine, pneumococcal and meningococcal vaccines also show good efficacy and safety in pregnant women. This article reviews the research progress of Maternal Immunization in order to provide a reference for Maternal Immunization planning and policymaking in China.


Assuntos
Imunização/estatística & dados numéricos , Gestantes , China , Feminino , Humanos , Gravidez
14.
Ann Afr Med ; 18(2): 97-102, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31070152

RESUMO

Introduction: Father's involvement is essential for the successful immunization of the child, as man is the head of the family and he takes responsibility for all decisions including health and financial issues. This study aimed to assess the knowledge of fathers, uptake of routine immunization (RI), and its associated factors in a rural community of North West Nigeria. Materials and Methods: The study was a community-based cross-sectional study conducted among the male heads of households residing in a rural community of Sokoto state. Systematic sampling was used to recruit 276 respondents. Data were obtained using a structured interviewer-administered questionnaire. Data obtained was entered into the IBM Software package and subsequently analyzed. Level of significance was set at 5%. Results: Only 2.5% and 1.4% of the respondents knew the age measles and yellow fever vaccines were given, respectively. Majority (75.4%) of the respondents' last-born child did not receive bacillus Calmette-Guérin at birth. Only (7.6%) of their last-born child were completely immunized for age. Majority of the respondents that had poor knowledge of RI had no formal education (P = 0.043). Conclusion: The study reported the knowledge of RI among fathers was poor. Having formal education and perception that children should be allowed to receive RI were correlates of good knowledge and uptake of RI. Parents, fathers, in particular, should be educated on the schedule of RI.


Assuntos
Pai/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Esquemas de Imunização , Imunização/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Estudos Transversais , Inquéritos Epidemiológicos , Humanos , Programas de Imunização , Lactente , Masculino , Pessoa de Meia-Idade , Nigéria , População Rural , Inquéritos e Questionários
15.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(4): 382-387, 2019 Apr 06.
Artigo em Chinês | MEDLINE | ID: mdl-30982272

RESUMO

Objective: To analyze the changing epidemiological characteristics of hepatitis E cases in China, in order to promote in preventing and controlling hepatitis E. Methods: Data of hepatitis E and outbreaks reported through national notifiable diseases reporting system were analyzed from 2004 to 2017, but data of Hongkong, Macau and Taiwan were not included. Data of hepatitis E were divided into three phases as 2004-2007, 2008-2011 and 2012-2017, representing eight years before, four years before and years after the postmarketing of hepatitis E vaccine. Linear regression was used for analyzing the trend of hepatitis E, improved muster method was used for analyzing the seasonal intensity. Results: From 2004 to 2017, 329 519 hepatitis E cases were reported and the annual incidence were increasing from 1.27/100 000 to 2.10/100 000 (t=6.87, P<0.001). The concentrations of hepatitis E during 2004-2007, 2008-2011 and 2012-2017 were 17.43, 16.06, 11.17, respectively, with low seasonal intensity. Number of cases reported by Jiangsu, Guangdong and Zhejiang accounted for 31.54% of national cases. The incidence were lower in central (1.45/100 000) and western (1.11/100 000) region than that in eastern region (2.67/100 000), but were increasing continuously. There was an increasing trend of incidence with growing ages (t=7.85, P<0.001). The incidence was higher than 2/100 000 among cases aged ≥40, and was the highest (5.22/100 000) in the age group of 65-69 years old. Farmers, retired persons, houseworkers and unemployees accounted for 67.46% of total cases. A total of 7 outbreaks were reported, among which 3 were in nursing homes. Conclusion: The incidence of hepatitis E in central and western regions were increasing continuously and the surveillance should be strengthened. There was higher risk among middle-aged population, farmers and nursing homes, so strategy for immunization among those population was in great need.


Assuntos
Surtos de Doenças/prevenção & controle , Vírus da Hepatite E , Hepatite E/epidemiologia , Imunização/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Vacinas contra Hepatite Viral/administração & dosagem , Adolescente , Adulto , Idoso , China/epidemiologia , Feminino , Hepatite E/prevenção & controle , Hepatite E/terapia , Humanos , Programas de Imunização , Incidência , Masculino , Pessoa de Meia-Idade , Vigilância da População , Adulto Jovem
16.
BMC Infect Dis ; 19(1): 345, 2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31023269

RESUMO

BACKGROUND: Measles is one of the most contagious diseases caused by an acute viral illness called Morbillivirus that usually occurs as an outbreak in low-income countries. As of May 2016 measles suspected outbreak was reported from Sekota Zuria district. We investigated the outbreak to identify its possible sources and risk factors of acquiring the infection in the district. METHOD: We conducted a 1:2 unmatched case-control study in May 2016 in Sekota Zuria district, Northern Ethiopia. Cases involved in the study were lab confirmed and epidemiologically linked. Controls were those who had no clinical signs of measles and residing in the same communities where the cases were identified. An interviewer-administered questionnaire was used to collect the data. Data were cleaned and entered to Epi-info7 and analyzed using SPSS-20. A logistic regression analysis was conducted to identify risk factors associated with measles infection at a p-value ≤0.05. RESULTS: 29 cases were identified during the outbreak investigation. The probable source of an outbreak was an index case who had a travel history to a district with a measles epidemic. Five samples were collected for confirmation of the diagnosis. No measles-related deaths were reported. The median age of cases and controls was 15 years (SD ± 7.8) and 11 years (SD ± 9.8), respectively. More than 55% of the cases were in age ≥ 15 years. In the multivariable analysis, being previously vaccinated for measles reduced the risk of measles infection by 83% (AOR, 95%CI = 0.17, 0.05-0.53) and having a contact history increased the risk of measles infection by 3.44 times (AOR, 95%CI = 3.44, 1.26-9.38). CONCLUSION: We confirmed a measles outbreak in Sekota Zuria district. The majority of the cases were in age ≥ 15 years. Being un-vaccinated and having a contact history with confirmed or suspected cases were increased the risk of measles infection. To catch up with missed children at the time of the first dose of measles vaccine and reduce their susceptibility, supplementary immunization activities (SIAs) or immunization campaigns shall be strengthened.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Imunização/estatística & dados numéricos , Vacina contra Sarampo , Sarampo , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Etiópia/epidemiologia , Humanos , Sarampo/epidemiologia , Sarampo/prevenção & controle , População Rural , Adulto Jovem
17.
Pan Afr Med J ; 32(Suppl 1): 10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30949285

RESUMO

Introduction: In November 2015 a measles outbreak was detected in several clustered settlements during the Northern Measles Supplementary Immunization Activities (SIAs) campaign in Gwagwalada, Nigeria, a measles outbreak was detected. Six weeks later another outbreak with 17 cases was reported in a different settlement in the same area council in December 2015 and January 2016. An outbreak investigation was initiated to characterize the outbreak in terms of time and person and implement prevention and control measures. Methods: Suspected cases were defined as any person in Gwagwalada with onset of fever and rash between 1st November 2015 and 12th January 2016. Probable cases were defined as suspected cases with 3 days of rash or known exposure to someone with laboratory-confirmed measles. Confirmed case patients were defined as suspected or probable cases with Koplik spots or positive titer for immunoglobulin (Ig) M antibody. We conducted house to house case search, contact tracing and reviewed hospital records at the health facilities to determine the socio-demographic characteristics, clinical presentation and vaccination status of the cases. Results: Active case search between November 2015 and January 2016 as well as record review from January 2015 to January 2016 showed that there were 109 suspected and 10 confirmed case patients. We identified 66 cases during the first reported outbreak with a case fatality rate of 6% (4 deaths) while 17 cases were identified 6 weeks later. The epidemic curve indicated a person-to-person transmission. Conclusion: There had been cases of measles from January 2015 to November 2015 prior to the reported measles outbreak. However there was an unusual increase in the number of measles cases during the measles SIAs in communities where children were missed. Vaccination of all eligible children in the affected wards was carried out. The area council authorities and primary healthcare team need to create awareness on the importance of measles vaccination and ensure that these communities are targeted and covered during subsequent SIAs.


Assuntos
Surtos de Doenças , Imunização/estatística & dados numéricos , Vacina contra Sarampo/administração & dosagem , Sarampo/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Programas de Imunização , Imunoglobulina M/sangue , Lactente , Masculino , Sarampo/prevenção & controle , Sarampo/transmissão , Nigéria/epidemiologia , Fatores de Tempo , Cobertura Vacinal , Adulto Jovem
18.
Aust N Z J Public Health ; 43(3): 214-220, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30959563

RESUMO

OBJECTIVE: Vaccinations in Australia are reportable to the Australian Immunisation Register (AIR). Following major immunisation policy initiatives, the New South Wales (NSW) Public Health Network undertook an audit to estimate true immunisation coverage of NSW children at one year of age, and explore reasons associated with under-reporting. METHODS: Cross-sectional survey examining AIR immunisation records of a stratified random sample of 491 NSW children aged 12≤15 months at 30 September 2017 who were >30 days overdue for immunisation. Survey data were analysed using population weights. RESULTS: Estimated true coverage of fully vaccinated one-year-old children in NSW is 96.2% (CI:95.9-96.4), 2.1% higher than AIR reported coverage of 94.1%. Of the children reported as overdue on AIR, 34.9% (CI:30.9-38.9) were actually fully vaccinated. No significant association was found between under-reporting and socioeconomic status, rurality or reported local coverage level. Data errors in AIR uploading (at provider level) and duplicate records contributed to incorrect AIR coverage recording. CONCLUSIONS: Despite incentives to record childhood vaccinations on AIR, under-reporting continues to be an important contributor to underestimation of true coverage in NSW. Implications for public health: More reliable transmission of encounters to AIR at provider level and removal of duplicates would improve accuracy of reported coverage.


Assuntos
Imunização/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Austrália , Criança , Pré-Escolar , Estudos Transversais , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Programas de Imunização/estatística & dados numéricos , Esquemas de Imunização , Lactente , Masculino , Sistema de Registros/estatística & dados numéricos , Inquéritos e Questionários
19.
BMC Health Serv Res ; 19(1): 229, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30992004

RESUMO

BACKGROUND: All healthcare professionals (HCPs) are at high risk of influenza infection. Therefore, immunization is recommended for all HCPs. Due to safety and effectiveness concerns, HCPs have a low vaccination rate. This study was designed to explore the attitude, awareness and knowledge of HCPs toward vaccination for influenza. METHOD: A cross-sectional study was performed during October-November 2016. A total of 405 questionnaires were distributed in 8 major hospitals in Saudi Arabia. A validated questionnaire consisting of 31 questions and 5 sections was administered. Statistical Analysis Software (SAS®) version 9.2 was used to analyze the data. RESULTS: A total of 364 HCPs responded to the study survey, which is a response rate of 90%. A large proportion (61.8%) of participants were female. The majority of the participants were nurses (60.4%). More than half of the respondents (57.7%) were working in government-run hospitals. Among all the participants, approximately 67.6% of HCPs were vaccinated. The majority (84.1%) of HCPs believed that influenza vaccine prevents the flu. Furthermore, approximately 75% of participants believed that HCPs can be more susceptible to influenza infections than other people. The majority of participants (89.6%) knew the proper signs and symptoms of influenza. HCPs' belief that vaccination prevents influenza infection (OR = 3.93, 95% CI = 1.97-7.82), their awareness of the Scientific Committee for Influenza and Pneumococcal Vaccination (SCIPV)'s guidelines (OR = 2. 13, 95% CI = 1.16-3.90) and the presence of the standing orders regarding influenza vaccine (OR = 1.57, 95% CI = 1.01-3.21), were the predictors for receipt of influenza vaccine by HCPs. Many (58.0%) respondents believed that vaccine safety concerns is a major barrier to the vaccination of HCPs. Some misconceptions, such as influenza infection due to vaccination (42.3%) and incorrect perceptions about the symptoms of influenza in adults (50.5%), were found. CONCLUSION: The acceptance of and participation in influenza vaccination by HCPs in Saudi Arabia appears to have markedly increased in the 2016 season. Continuing evaluation of vaccination practices is necessary, and more training programs are needed in the future.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Vacinas contra Influenza , Influenza Humana/prevenção & controle , Adulto , Estudos Transversais , Feminino , Pessoal de Saúde/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Humanos , Imunização/psicologia , Imunização/estatística & dados numéricos , Masculino , Arábia Saudita , Inquéritos e Questionários , Vacinação/psicologia , Vacinação/estatística & dados numéricos
20.
Med Care ; 57(6): 453-459, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31008897

RESUMO

BACKGROUND: Health plans often require that patients have a personal doctor. Older adults rely on specialists for much of their care and may use a specialist in this role, but little is known about how many or which Medicare beneficiaries use specialists as their personal doctor and how their care experiences differ from others'. OBJECTIVE: To examine the prevalence and characteristics of Medicare beneficiaries with a specialist as a personal doctor and compare their patient experiences and immunization to other beneficiaries'. RESEARCH DESIGN: Logistic regression predicted having a specialist as a personal doctor from beneficiary characteristics. Doubly-robust models compared 7 patient experience and 2 immunization measures for beneficiaries with and without a specialist as their personal doctor. Interactions of a specialist indicator and beneficiary characteristics tested for moderators. STUDY POPULATION: A total of 227,642 Medicare beneficiaries aged 65+ who reported having a personal doctor on the 2014 Medicare CAHPS survey. RESULTS: In total, 20% of beneficiaries reported that their personal doctor was a specialist, fewer than previously reported for the most frequently visited physician (43%); beneficiaries who were older, less healthy, less educated, racial/ethnic minorities, had fee-for-service coverage, or had lower income were more likely to do so. They also reported better patient experiences than those with nonspecialist personal physicians on 6 of 7 measures and more immunizations; the largest difference was for care coordination. Having a specialist personal doctor was associated with particularly positive patient experience for low income, Black, Hispanic, and less healthy beneficiaries. CONCLUSION: Future research should investigate whether specialists as personal doctors may reduce patient-experience disparities for vulnerable patients.


Assuntos
Medicare , Satisfação do Paciente , Relações Médico-Paciente , Especialização , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imunização/estatística & dados numéricos , Masculino , Inquéritos e Questionários , Estados Unidos
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