Bebek ve çocuklarda pandemik ınfluenza aşısının otitis media ya olan etkinliği

Otitis mediaya en sık neden olan bakteriyel patojenler, Streptococcus pneumoniae, tiplendirilemeyen Haemophilus influenzae ve M.catarrhalis olmakla birlikte akut otitis media (AOM) ataklarının viral enfeksiyonlarla iliĢkili olduğunu gösteren kanıtlar önemli oranda artmıştır. Viral ajanlar ve özellikle influenza virüsü, östaki tüpü işlevlerini bozarak solunum sistemi epitel hücrelerinde yapısal ve işlevsel kayıplar meydana getirerek, lökosit işlevlerini değiştirerek ve bakterilerin solunum yolu hücrelerine adezyonunu kolaylaştırarak AOM ya eğilimini artırmaktadır. Daha önce, mevsimsel grip aşısının tekrarlayan otitis mediaya etkiniği gösterilmiştir. 2009 yılında tüm dünya ile birlikte ülkemizde de H1N1 pandemisi olmuştur, buna bağlı olarak otitis media sıklığının artmasını bekleriz. Bu çalışmanın amacı; 2009 yılında uygulanmaya başlanan pandemik H1N1 aşısının da, mevsimsel Ġnfluenza aşısında olduğu gibi, sağlıklı çocuklarda otitis media ataklarını önleyebileceğini göstermektir. Ancak aşılı ve aşısız grup arasında yapılan, AOM, EOM ve otit sıklığını karşılaştıran çalışmamızda, her 2 grup arasında istatistiksel olarak anlamlı fark saptanamamıştır. Otit geçiren ve geçirmeyen hastalarda, logistik regresyon analizi yapıldığında, pandemik H1N1 aşısı yapılmamış olmanın otit olma durumunu 2.9 kat etkilediği saptanmıştır. Ek olarak orta kulak boşluğunda efüzyona ve enfeksiyonu gösteren C2 ve B tipi eğri sıklığı da aşılı ve aşısız grup arasında istatistiksel olarak anlamlı fark göstermemiştir. Bu sonuçlarla başlanan pandemik H1N1 aşısının, mevsimsel influenza aşısından farklı olarak sağlıklı çocuklarda otitis media ataklarına etkinliğinin olmadığı söylenebilir.Although Streptococcus pneumoniae, non-typable Haemophilus influenzae and Moraxella catarrhalis are the most common bacterial pathogens in the etiology of otitis media, there is some evidence that the acute otitis media (AOM) attacks are associated with viral enfections, are significantly increasing. Viral agents, especially influenzae virus, predispose to development of AOM by inducing some ciliary and mucinous changes in the respiratory system epithelial cells that affect middle ear pressure and cause tube dysfunction and by changing the leucocyte functions and enable to the adhesion of bacterias to the respiratory system cells. In previous studies, the effectiveness of seasonal influenza vaccine has been shown in the otitis media. In 2009, in our country, as well as in the world, there had been H1N1 pandemia, and therefore we expect an increase the frequency of otitis media. We sought to determine the efficacy of the pandemic H1N1 vaccine in our population, against pandemic influenza-associated otitis media attacks, in the healthy children, similarly seasonal influenza vaccine. In our study, there were no differences between the frequencies of AOM, otitis media with effusion (OME) and total otitis media episodes in vaccinated and unvaccinated groups, and the differences were not statistically significant. But logistic regression analysis showed that in unvaccinated group had a risk for otitis media 2.9 fold compared with vaccinated group. Additionally, frequency of C2 and B type curve, which shows the effusion and enfection of middle ear cavity, were not statistically significant difference between vaccinated and unvaccinated groups. In the children we studied, we were not able to show that the difference in the pandemic H1N1 vaccine efficacy against otitis media, differently from seasonal influenza vaccine

Syrian refugee mothers’ knowledge levels of childhood wellness: a program evaluation

Background: Children are most affected by migration and wars. The health of child asylum seekers is adversely affected due to poor nutrition, malnutrition, insufficient vaccinations, and a lack of preventive health-care services (PHCS). The aim of this study was to determine the knowledge levels of the refugee mothers of child wellness monitoring, child vaccinations, and the importance of breastfeeding before and after implementation of an educational program. Materials and Methods: A questionnaire consisting of 12 statements about the importance of child wellness monitoring, child vaccinations, and breastfeeding was prepared and translated into Arabic. Refugee mothers were asked to complete the questionnaire before and after the education program. Results: Thirty-one (72.1%) of the 43 participating mothers had their children vaccinated regularly. Vitamin D supplementation was given to 58.1%, and 23.1% were started on iron supplementation. The rate of vitamin D supplementation was higher in the literate mothers (P = 0.010). The least correctly answered statement before the education program was related to iron supplementation (n = 24, 55.8%). The mean (standard deviation) number of correct answers given by the participating mothers to the 12 statements before the seminar was 9.16 (±2.05), this increased to 11.16 (±0.99) after the seminar. Conclusion: The results of this study show that refugee mothers’ knowledge levels about vitamin D and iron supplementation are quite low. Their knowledge levels can be increased in the short term by providing information in the mothers’ native languages