Concordance of TST and QFT-GIT results among referred individuals that came to BCHD for LTBI evaluation and had both tests performed.

†<p>Overall, 352 individuals had a TST and interpretable QFT-GIT result available. There was an overall concordance of 52.3%.</p>*<p>8 individuals with negative TST results were referred and evaluated by BCHD. 4 individuals with B-waivers had negative TST, but were referred due to an abnormal CXR; 4 individuals had both TST and QFT-GIT performed by referral source.</p

Factors associated with QFT-GIT test positivity among those tested at BCHD.

<p>Only individuals with QFT-GIT performed by BCHD are included. 11 individuals had blood drawn for QFT-GIT but did not have interpretable results due to insufficient blood volume during venipuncture, sample transportation issues, or processing error. There was 1 indeterminate result.</p><p>°p<0.001 for both univariate and multivariate analysis comparing foreign-born to US born individuals.</p><p>°° P = 0.042 comparing HIV positive to HIV negative individuals.</p>†<p>Referral source was omitted from multivariate regression model due to collinearity with birth country.</p>††<p>p = 0.001 comparing those referred from Refugee health services to those referred from primary care providers/other; p = 0.03 comparing those referred from local health departments to those referred from primary care providers/other.</p

Differences in LTBI diagnosis among referrals to BCHD between study periods and by QFT-GIT test status.

*<p>includes individuals that had QFT-GIT performed by referral source. 11/399 individuals in the post-QFT-GIT period had QFT-GIT drawn but no results available; there was 1 indeterminate result in the post-QFT-GIT-period.</p><p>°p<.001 comparing final diagnosis of LTBI between pre-QFT-GIT and post-QFT-GIT periods.</p><p>°°p = .827 for pre-QFT-GIT period comparing LTBI diagnosis between those with and without a QFT-GIT result; p<.001 in post-QFT-GIT period comparing LTBI diagnosis between those with and without QFT-GIT performed.</p>**<p>p = .81 comparing treatment initiation among those diagnosed with LTBI between pre-QFT-GIT and post-QFT-GIT periods; p = 0.690 comparing treatment initiation between those with and without QFT-GIT performed in the pre-QFT-GIT period; p = .349 comparing treatment intiation between those with and without QFT-GIT performed in the post-QFT-GIT period.</p>†<p>Analysis restricted to those who started an INH X 9 months regimen prior to Nov 30, 2010 or Rifampin X 4 months prior to March 30, 2011 to allow time for completion. p = .606 comparing overall treatment completion between pre-QFT-GIT period and post-QFT-GIT period. p = 0.101 comparing those with and without QFT-GIT performed in the post-QFT-GIT period; p = 0.70 comparing those with and without QFT-GIT in the pre-QFT-GIT period.</p

Characteristics of individuals referred to Baltimore City Health Department TB Clinic for evaluation of suspected <i>M. tuberculosis</i> infection, by study period.

<p>Abbreviations: SD, Standard Deviation. BCHD, Baltimore City Health Department.</p>*<p>Ethnicity data was based on referral documentation and/or initial evaluation at BCHD. P-value for global comparison of equality of proportions of ethnicities by χ² test.</p>†<p>HIV test results are available only for those that came to BCHD for evaluation. HIV status not available for those who did not complete an LTBI evaluation at BCHD.</p>**<p>Includes referrals from other local health departments in Maryland and other states, as well as employment TB testing conducted through other BCHD programs.</p

Do Thai Physicians Recommend Seasonal Influenza Vaccines to Pregnant Women? A Cross-Sectional Survey of Physicians’ Perspectives and Practices in Thailand

<div><p>Background</p><p>Physicians play a major role in influencing acceptance and uptake of vaccines. However, little is known about physicians’ perspectives on influenza vaccination of pregnant women in Thailand, for whom vaccine coverage is estimated at <1%.</p><p>Method</p><p>In 2013, a self-administered questionnaire on physicians’ perceptions, attitudes and practices related to influenza vaccination for pregnant women was distributed to 1,134 hospitals with an antenatal care clinic (ANC) in Thailand. At each hospital, one physician working at the ANC completed the survey. Predictors of routine recommendation of influenza vaccine were analyzed utilizing log-binomial regression.</p><p>Results</p><p>A total of 580 (51%) complete responses were received from physicians practicing at ANCs. A favorable attitude towards vaccination was expressed by 436 (75%) physicians, however only 142 (25%) reported routinely recommending influenza vaccine to pregnant women in their current practice. Physicians were more likely to recommend influenza vaccine routinely when they had more than three years of practice (prevalence ratio [PR] 1.9, 95% CI 1.2–2.3), had treated pregnant women for influenza (PR 1.8, 95% CI 1.3–2.7), perceived the influenza vaccine to be effective (moderate level: PR 1.6, 95% CI 1.1–2.4; high level: PR 1.9, 95% CI 1.3–2.9) and were aware of the Ministry of Public Health’s (MOPH) recommendation of influenza vaccination in pregnancy (PR 1.3, 95% CI 1.1–1.7). Vaccine not being available, perception that policy was ambiguous and lack of awareness of MOPH recommendations were the most commonly cited barriers to routine recommendation of influenza vaccine.</p><p>Conclusion</p><p>Despite a national policy to vaccinate pregnant women for influenza, only 25% of Thai physicians working in ANCs routinely recommend vaccination. Strategies are needed to increase vaccine availability and free vaccine services, address clinician concerns over vaccine effectiveness and expand healthcare provider awareness of MOPH recommendations.</p></div

Associated factors for vaccine recommendation among respondent physicians (N = 543).

<p>Associated factors for vaccine recommendation among respondent physicians (N = 543).</p

Key perceptions of Thai physicians related to influenza vaccination (N = 580).

<p>Key perceptions of Thai physicians related to influenza vaccination (N = 580).</p

Comparison of reasons for not recommending vaccines to pregnant women by Thai physicians in public and private hospitals (N = 401).

<p>Comparison of reasons for not recommending vaccines to pregnant women by Thai physicians in public and private hospitals (N = 401).</p

Comparison of key perceptions among Thai physicians who recommend influenza vaccine and those who don’t in hospitals with influenza vaccine services (N = 543).

<p>Comparison of key perceptions among Thai physicians who recommend influenza vaccine and those who don’t in hospitals with influenza vaccine services (N = 543).</p

Open-ended responses of Thai physician to perceived barriers of influenza vaccination of pregnant women.

<p>Open-ended responses of Thai physician to perceived barriers of influenza vaccination of pregnant women.</p