Immunogenicity of a Haemophilus influenzae type b–tetanus conjugate vaccine when administered separately or in combined vaccines for primary immunization in two consecutive national schedules in Turkey

SummaryBackgroundIn Turkey, the Haemophilus influenzae type b–tetanus toxoid conjugate vaccine (Hib) was replaced by the combined diphtheria–tetanus–acellular pertussis and inactivated polio vaccine (DTaP–IPV/Hib) in 2008. This shift to the new schedule created different cohorts of vaccinated children as a consequence of the different schedules used. We evaluated the immunogenicity of the Hib vaccine in infants vaccinated with these different schedules.MethodsThree groups of children were evaluated: group 1 comprised 145 infants vaccinated with diphtheria, tetanus, and whole cell pertussis (DTwP), oral polio vaccine (OPV), and Hib vaccines simultaneously at separate sites; group 2 comprised 204 infants vaccinated with the DTaP–IPV/Hib combined vaccine; group 3 comprised 100 infants vaccinated with a mixed schedule of DTwP, OPV, and Hib for the first one or two doses, followed by DTaP–IPV/Hib vaccine to complete the series.ResultsAnti-polyribosylribitol phosphate (anti-PRP) titers ≥0.15μg/ml were similar in groups 1, 2, and 3. However, in group 1, who received all the vaccines at separate sites, ≥ l.0μg/ml long-lasting antibody titers and anti-PRP geometric mean titers were higher (p=0.001).ConclusionThis study showed that even one dose administered in combination with other vaccines in a primary series decreased the level of anti-PRP

The Rate of Seasonal Influenza Vaccination in Diabetic Children, the Effect of Recommendation and the Factors Influencing the Acceptance of Recommendation: An Interventional Study

Objective: To investigate the vaccination rate of influenza in diabetic children and the effect of recommendation and other factors on vaccination rate.Material and Methods: On July 2011, 144 diabetic children and their families were informed about and were recommended to receive the influenza vaccine every year, in September. On December 2011, parents were questioned about the vaccination.Results: Influenza vaccination rate of the previous season (28.3%) increased to 50.0% (p<0.05). Receiving the vaccine in 2010 was the only contributing factor to the recommendation success. The reasons given by the non-receivers were; forgetting (50.0%), fear of adverse-effects (26.4%), not believing in usefulness (15.2%), rejection by the child (4.2%) and effects of media (4.2%). 88.9% of those who forgot declared that they would receive if they were reminded at the beginning of the season.Conclusion: The rate of influenza vaccination was low. The majority of those who didn’t recieve the vaccination declared that they would if they were reminded at the beginning of the season and the fact that “receiving the vaccine in 2010” was the only factor influencing the recommendation success indicate that recommending isn’t enough but that reminding and giving detailed information about the vaccine will increase vaccination rates independent of other factors

The Importance of Family Interview for Shaken Baby Syndrome

Shaken baby syndrome (SBS) is caused by vigorous shaking of an infant by the arms, legs, chest, or shoulders. It must be thought when there is a suspicious story, subdural hemorrhage, bilateral retinal hemorrhage, cranial bone and or skeletal fracture, and ecchymosis. Here, we report a patient, who presented with seizures, with a family history of similar findings in his brother. Most of the efforts were given to find an organic reason to explain the patient’s findings due to the history of similar presentation of the sibling with an impression of inherited neuro-metabolic disorders and a negative result of a previous evaluation of the patient and the family for SBS at another hospital. Striking findings of SBS including subdural hematomas of different ages, occipital bone fracture, and retinal hemorrhages directed us to re-evaluate the family for SBS. After multiple episodes of family interviews, clues leading to injury through SBS were discovered. A single family interview may not be sufficient to exclude SBS especially in the presence of clinical findings. SBS is a diagnosis that should always be kept in mind in such patients, especially those with no organic cause

Determination of depression, anxiety, and hopelessness levels in adolescents with refractive errors after the COVID-19 pandemic

Background/Aim: The prevalence of myopia is increasing worldwide especially among adolescents. Changes in living conditions such as reduced engagement in outdoor activities as well as increased activities near the workplace like reading, writing, and screen exposure are thought to be responsible for this increase. Adolescence is a sensitive period of rapid changes in psychological, physiological, and social aspects. Mental health issues such as anxiety and depression are common during this period. During the pandemic, mental health issues among children and adolescents increased due to stress caused by the disease, social isolation, disruption of routines, and the loss of loved ones. With the rapid increase in myopia among adolescents, there is a need to investigate the effects of myopia on mental health. The aim of this study is to evaluate anxiety, depression, and hopelessness levels in adolescents with myopia after the COVID-19 pandemic and to examine the relationship between myopia and anxiety, depression, and hopelessness.Methods: This was a case-control study that included 40 myopic adolescents aged 16-19 with a spherical refractive degree of -2 diopters (D) and above and 40 emmetropic (no refractive error). Participants who had previously undergone refractive surgery, had binocular visual acuity less than 1.0, had strabismus and amblyopia, had a diagnosis of glaucoma, had undergone ocular surgery for any reason, had retinopathy, or had an astigmatic refractive degree greater than ±0.50 were excluded from the study. The study did not include patients with chronic physiological or psychiatric diseases. Both groups were administered the Automatic Thoughts Questionnaire (ATQ), Coronavirus Anxiety Scale (CAS), Beck Hopelessness Scale (BHS), and Beck Depression Inventory (BDI). The groups were compared according to the scales. Myopic degrees were compared with mixed-effect linear models according to scale categories, and the relationship between ATS scores and myopia degrees was evaluated using the Spearman correlation coefficient.Results: The mean (SD) spherical refractive power of myopic adolescents was -3.156 (1.40) diopters; 62.5% of participants with myopia had been exposed to COVID-19, and the anxiety rate in myopic participants compared to controls was 15% (P=0.026). However, no significant difference was found between the myopia and control groups in terms of automatic thoughts, hopelessness, and depression inventory scores when comparing the groups. No correlation was found between the CAS (F=1.098), BHS (F=1.610), BDI (F=1.699), and ATQ (r=0.151) scales and the increase in myopia when we performed linear mixed model analysis and Spearman correlation analysis. There was no significant relationship between the degree of myopia and automatic thoughts, hopelessness anxiety, and depression.Conclusion: The results indicate that adolescents with myopia had higher levels of anxiety after the COVID-19 pandemic. There was no significant correlation between the degree of myopia and anxiety, depression, hopelessness, and automatic thoughts. It is important to monitor adolescents with myopia carefully during pandemics and provide the necessary mental health support. This is because offering mental health support to myopic young people may protect them from potential lasting emotional problems in adulthood during potential future pandemics. It may be beneficial for adolescents to increase their engagement in outdoor activities to reduce myopia and anxiety.</jats:p

Attitudes of physicians concerning vaccines not included in the national immunization schedule

The aim of this study was to identify attitudes of family physicians and pediatricians working in sub-provinces of central Ankara concerning rotavirus (RV), human papilloma virus (HPV), meningococcal conjugate vaccine (MenACWY-MCV4) and adolescent and adult pertussis (Tdap) vaccines which are not included in the National Immunization Schedule (NIS). Questionnaires were conducted with 300 family physicians and 230 pediatricians who were selected by random sampling. RV vaccine is the most commonly recommended vaccine by physicians (60.5\%). It is the vaccine they want to be added to the NIS the most (48.5\%). Tdap vaccine is the least recommended vaccine (24.1\%) and the least preferred for inclusion in the NIS (19.6\%). Of the physicians recommending the RV vaccine 94.0\% believe that ``RV-related diarrhea cases exhibit a severe course of illness in children younger than two years old.{''} Pediatricians recommend RV, meningoccocal and Tdap vaccines more than family physicians (p<0.05). Of the physicians who do not recommend RV, HPV, and conjugated meningococcal vaccine 87.5\%, 96.7\% and 27.6\% found the vaccines expenive, respectively. Of the physicians who do not recommend Tdap vaccine 90.4\% think that ``Tdap vaccination is not a health problem of priority for their country.{''} In conclusion physicians are recommending vaccines which are not included in the NIS. Their common concern for not recommending these vaccines is expensive price

Evaluation of perinatal and intrafamilial hepatitis B prevention programmes in a well child clinic: 9-year follow-up study in Turkey

Evaluating the performance of well child clinics on adherence to recommended perinatal hepatitis B prevention programmes as well as assessing the outcome of infants living with hepatitis B surface antigen (HBsAg)-positive parents is important. A retrospective study was performed of 336 babies who had at least one HBsAg-positive parent and were followed-up in the well child clinic of Gazi University Hospital (Ankara, Turkey) between 2001 and 2009. Rates of passive immunisation in 109 babies with HBsAg-positive mothers and initiation of hepatitis B vaccination of all 336 babies with HBsAg-positive parents were 98.8% and 100% respectively. Ninety-two babies (27.4%) were lost to follow-up before completing primary immunisation. The recommended perinatal hepatitis B prevention programme was performed successfully in 194 of the 306 infants who were old enough for post-vaccination serotesting (63.4%). One baby became HBsAg-positive, and 88.1% of babies were seroprotected. Hepatitis B surface antibody (anti-HBs) levels were found to be increased if the HBsAg-positive parent was the father. There was a negative correlation between serotesting time and anti-HBs titres. The study infants had a total of 187 siblings and 123 (65.8%) were serotested after completing primary immunisation with 108 found to be seropositive. Although the vaccination rate in the perinatal hepatitis B prevention programme is satisfactory, post-vaccination serotesting and evaluation of infants and their siblings are still deficient. (C) 2010 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved

Quality-of-life Evaluation of Healthy Siblings of Children with Chronic Illness

Chronic disease of children can cause changes in the health-related quality of life (HrQoL) of the family members