Knowledge and Attitudes of Postpartum Mothers towards Immunization of Their Children in a Lithuanian Tertiary Teaching Hospital.

Background: Sufficient vaccination coverage among children depends on parents' knowledge and attitudes towards immunization and their intention to have their children vaccinated. The objective of the study was to evaluate postpartum mothers' knowledge and attitudes towards children's immunization. Methods: It was a cross-sectional survey. The anonymous questionnaire was handed out to postpartum mothers selected at random in the Hospital of Lithuanian University of Health Sciences Kauno Klinikos from March to July of 2014. In total, 300 women were surveyed. Results: The majority (63%) of respondents had higher education. The child was the first one for 49.7% of the mothers. The women indicated that their main sources of information about children's vaccination were the doctor, the Internet and mass media. Most respondents (87.3%) considered vaccine-preventable diseases to be dangerous but only 57.3% of them knew that vaccines provided efficient protection. Only 57% of the respondents considered vaccines to be safe but 75.3% thought that the benefits of vaccines were greater than the risks. We evaluated the knowledge as good in 36.3%, average in 41.3% and poor in 22.3% of mothers. Most of the respondents (81.3%) planned to immunize their child in the future with all the vaccines included in the national immunization program, however, 72.7% were worried about possible adverse events following vaccination. Of the mothers whose knowledge was evaluated as good, 74.8% had never refused or had doubts about having their child immunized (τ = -0.198, p < 0.001). The mothers with better knowledge were also less likely to be concerned (τ = 0.211, p < 0.001). Conclusions: Evaluation of postpartum mothers' knowledge and attitudes towards children's immunization could be the tool for better communication between health professionals and parents leading to increased vaccination rates.

A Retrospective Analysis of Tick-borne Encephalitis in Children Treated in Kaunas Hospital During 2012 to 2019.

BACKGROUND: Lithuania has the highest tick-borne encephalitis (TBE) rates in Europe. Although TBE incidence in children is lower, it may still cause long-term consequences. So far pediatric epidemiological and clinical characteristics of TBE in Lithuania were not described. METHODS: We performed a retrospective analysis of 87 cases of children who were hospitalized for TBE in Kaunas Hospital of the Lithuanian University of Health Sciences from 2012 to 2019. Each case was identified with neurological symptoms and positive serological tests. RESULTS: Around half of the children (50.6%) reported having a tick bite, whereas 6.9% stated having exposure to unpasteurized milk. Biphasic course of the disease occurred in 70.1% of the cases. The most common clinical symptoms were headache (100%), fever (100%), nausea (85.1%), vomiting (78.2%), drowsiness (67.8%) and general weakness (66.7%). Meningeal symptoms were present in 93.1% of the cases, and 93.1% of the children had at least one focal neurological sign (tremor 82.3%, impaired balance 73.6%). Isolated meningitis was diagnosed in 57.5%, meningoencephalitis in 41.4% and meningoencephalomyelitis in 1.1% of the cases. Majority of younger children (1-8 years old) had meningitis (77.3%), whereas 49.2% of older children (9-17 years old) had more severe forms of TBE. Cerebrospinal fluid pleocytosis was found in 94.3% of cases (average white blood cell count: 111.7 per µL, protein: 0.5 g/L). Higher levels of cerebrospinal fluid protein were associated with more severe forms of TBE and older age. Duration of the symptomatic disease lasted ≈11 days. Early residual signs were observed in 75.9% of all cases. CONCLUSIONS: The epidemiological and clinical characteristics of TBE in children in Lithuania are similar to those described in other countries. Only half of the subjects reported having a tick bite. Younger children tend to suffer from meningoencephalitis and meningoencephalomyelitis less frequently than elder ones. Focal neurological signs were commonly observed. Majority of children had lasting symptoms of TBE upon discharge from the hospital.

Alveolar Echinococcosis in Children.

Alveolar echinococcosis (AE) is an infectious zoonotic disease that is caused by Echinococcus multilocularis. The disease is generally identified accidentally because of the long asymptomatic period, has a malignant behaviour, and mainly occurs in the liver. Usually it is diagnosed in adults and is very rare in pediatric patients. We report two cases of AE and 1 differential case between AE and cystic echinococcosis (CE) in children: two of them had lesions in the liver and one had rare extrahepatic presentation of a cyst in the spleen. All our patients received chemotherapy with albendazole because surgical treatment was not recommended. The children were followed-up from 10 to 30 months and no significant improvement was seen. In this report we discuss the difficulties we faced in the treatment and follow-up of these patients. We also review the main clinical manifestations, general diagnostic methods, and treatment options of AE according to the current literature.