Parental Perceptions, Beliefs and Attitudes towards Routine Childhood Vaccinations – United Arab Emirates Experience

Background: Immunizations have been considered by many as one of the greatest inventions of the 20th century. Despite their success, there had been rising dispute in regards to vaccinations, which led to the emergence of skeptics all around the world who are questioning their efficacy and raising concerns about their safety.&#x0D; While increasing data are published internationally about this topic, little do we know about the figures in the United Arab Emirates (UAE)&#x0D; Objectives: This study aims to explore the attitudes, beliefs and perceptions of parents across different Emirates in UAE about the routine vaccinations. &#x0D; The results of the study will help health care providers have better understanding of the compliance to vaccinations in the area and therefore initiate targeted awareness campaigns to address main issues behind vaccine refusal and misconceptions around it.&#x0D; Methods: An observational, cross-sectional study was approved by the institutional review board in accordance with the regulations of the Health Authority in Abu Dhabi (HAAD). Survey questionnaires consisting of 26 questions of qualitative and quantitative aspects were distributed to randomly selected parents across five different cities in United Arab Emirates.&#x0D; Results: A total of 397 participants were included in our study. Parents have showed good perception of the effectiveness of vaccines as 90% agreed that vaccines are effective in preventing certain diseases. However, in regards to parents’ knowledge, 44% did not know that some vaccines prevent certain types of cancer. When looking at the rate of vaccination refusal in our study, we found that 10% of our population refuses to vaccinate their children. Three quarters of those did so because of either their belief that their child will develop his/her immunity naturally or that vaccinations are not safe. Also of note, one thirds of parents believed that vaccinations can cause serious side effects while 19% reported that they have not received sufficient information regarding vaccination from their child’s health care provider.&#x0D; Conclusion: In our study, parents have demonstrated adequate knowledge and attitudes towards vaccinations. However, there still remains parents who refuse to vaccinate their children. Reasons behind the refusal can be tackled by the primary health care providers through adequate counseling and community based campaigns which aims to educate families about the safety and importance of vaccination.</jats:p

Can infants develop meningitis in the absence of bacteremia in the first ninety days of life? A retrospective chart review

The overall incidence of meningitis in infants 0-90 days is low; however, it remains a serious cause of morbidity and mortality among affected patients. It is standard of care to perform lumbar punctures as part of the work-up of fever in the first four weeks of life and sick-looking babies up to the age of 90 days. This particular procedure is often refused by parents, and physicians are left to predict the possibility of meningitis based on blood culture results.The aim of this study is to determine whether it would be safe to rule out meningitis based on a negative blood culture in this age group

Can infants develop meningitis in the absence of bacteremia in the first ninety days of life? A retrospective chart review

The overall incidence of meningitis in infants 0-90 days is low; however, it remains a serious cause of morbidity and mortality among affected patients. It is standard of care to perform lumbar punctures as part of the work-up of fever in the first four weeks of life and sick-looking babies up to the age of 90 days. This particular procedure is often refused by parents, and physicians are left to predict the possibility of meningitis based on blood culture results. The aim of this study is to determine whether it would be safe to rule out meningitis based on a negative blood culture in this age group.</jats:p

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide. Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters. Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 per cent of patients (2901 of 4223). Major complication rates (Clavien–Dindo grade at least IIIa) were 24, 18, and 27 per cent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 per cent; however, it was 41 per cent in low-to-middle- compared with 19 per cent in very high-HDI countries. Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)