Investigation of predictors of vaccination status associated with measles, mumps, rubella in Serbia

Ciljevi sprovedene studije preseka bili su: 1. Ispitivanje znanja, stavova i ponašanja roditelja u vezi sa vakcinacijom njihove dece protiv malih boginja, zaušaka i rubele; 2. Ispitivanje korelacije izmedju nivoa znanja roditelja o vakcinaciji i vakcinalnog statusa njihove dece; 3. Ispitivanje prediktora vakcinalnog statusa povezanog sa imunizacijom protiv malih boginja, zaušaka i rubele. Materijal i metod: Selekcija ispitanika je sprovedena po principu formiranja višestepenog uzorka. Uzorak je činilo 568 ispitanika, roditelja dece uzrasta do sedam godina koji su posetili izabranog pedijatra na dan sprovedenog ispitivanja u 17 domova zdravlja u Srbiji. Osnovni instrument za prikupljanje podataka je bio strukturirani upitnik, koji je sastavljen na bazi literaturnih podataka. Rezultati: U istraživanju je učestvovalo ukupno 568 roditelja, od toga 141 (24,8%) roditelj muškog pola i 427 (75,2%) roditelja ženskog pola, prosečnog uzrasta 34,3±5,7 godina. Većina roditelja bila je u braku (87,3%). U pogledu radnog statusa, većina roditelja, 78,9% je bila zaposlena, dok je 21,1% bilo van radnog odnosa u trenutku ispitivanja. Najveća proprocija roditelja imala je završenu srednju školu (43,3%), zatim slede roditelji sa visokim obrazovanjem (35,2%). Mala proporcija roditelja imala je završenu osnovnu školu (3,5%), magisterijum (4,8%) ili doktorat (1,4%). U urbanim sredinama živelo je 82,4% roditelja, a 17,6% je živelo u ruralnim područjima. Više od polovine roditelja (53,2%) imalo je dvoje dece, 25,6% roditelja imalo je jedno dete, a 9,5% troje dece. Kada se analiziraju ukupni mesečni prihodi, većina roditelja (37,7%) je izjavila da oni iznose 50-100.000 dinara. Ukupno 76,8% roditelja je izjavilo da su vakcinisani protiv malih boginja, 7,9% je bilo nevakcinisano, a 15,3% nije znalo svoj vakcinalni status. Većina roditelja je izjavila da nije preležala male boginje (53,3%), a podatak o preležanoj infekciji dalo je 22,2% roditelja, dok 24,5% roditelja nije znalo da li su imali nekada ovo oboljenje...The objectives of this cross-sectional study were: 1. Investigation of the knowledge, attitudes and behavior of parents regarding the vaccination of their children against measles, mumps and rubella; 2. Investigation of the correlation between the level of parents' knowledge about vaccination and the vaccination status of their children; 3. Investigation of the predictors of vaccination status associated with measles, mumps, and rubella immunization. Material and method: The selection of participants was carried out according to the principle of forming a multi-stage sample. The sample consisted of 568 subjects, parents of children up to the age of seven who visited a selected pediatrician on the day of the survey conducted in 17 public health centers in Serbia. The basic instrument for data collection was a structured questionnaire, which was compiled on the basis of literature data. Results: A total of 568 parents participated in the study, of which 141 (24.8%) were male parents and 427 (75.2%) were female parents, with an average age of 34.3±5.7 years. Most parents were married (87.3%). In terms of employment status, the majority of parents, 78.9%, were employed, while 21.1% were out of employment at the time of the survey. The largest proportion of parents had completed high school (43.3%), followed by parents with higher education (35.2%). A small proportion of parents had completed only primary school (3.5%), master's degree (4.8%) or doctorate (1.4%). 82.4% of parents lived in urban areas, and 17.6% lived in rural areas. More than half of parents (53.2%) had two children, 25.6% of parents had one child, and 9.5% had three children. When analyzing the total monthly income, the majority of parents (37.7%) stated that it amounts to 50-100,000 dinars. A total of 76.8% of parents stated that they were vaccinated against measles, 7.9% were unvaccinated, and 15.3% did not know their vaccination status. The majority of parents stated that they had not had measles (53.3%), and 22.2% of parents provided information about the infection, while 24.5% of parents did not know if they had ever had this disease. The distribution of correct answers to the part of questions related to vaccination knowledge showed that the highest proportion of correct answers (98%) was recorded for the statements that vaccination prevent disease and that vaccination can be temporarily postponed in case of fever..

Epidemiological, clinical and laboratory characteristics of the measles resurgence in the Republic of Serbia in 2014-2015

The Republic of Serbia is a country with ongoing endemic transmission of measles. The aim of this study is to summarize the main characteristics of the measles resurgence that occurred in Serbia in 2014-2015. The national surveillance data on measles was analysed in relation to the clinical, epidemiological and laboratory data. Between November 2014 and December 2015 a measles resurgence with 420 cases was observed in Serbia. Measles virus was initially introduced by and spread among citizens of Bosnia and Herzegovina with temporary residence in Serbia, before spreading to the resident population. Of the 223 patients with available medical records, 173 (77.6%) were unvaccinated. The overall measles incidence during the outbreak was 5.8/100.000. The highest age-specific incidence rate was recorded in children aged lt = 4 years (25.9/100.000), but most cases (67.9%) were gt = 20 years old. Hospitalization rate was high (32.9%) and included two cases of encephalitis associated with measles. In total, 42 health-care workers and 22 related cases including hospitalized patients (n = 13) contracted measles. The overall percentage of laboratory confirmed cases was 81.7% (n = 343/420). All measles virus sequences except one (D9) belonged to genotype D8, suggesting interruption of transmission after the previous outbreak in 2010-2011 caused by genotype D4 viruses. The growing number of adult patients as compared to previous epidemics, suggests an urgent need for supplementary immunization activities targeting susceptible health care workers, unvaccinated or incompletely vaccinated adults as well as people without vaccination records. The comprehensive investigation of the 2014/2015 measles resurgence will contribute to decisions about appropriate countermeasures to stop the future measles resurgences in Serbia

Understanding vaccination communication between health workers and parents: a Tailoring Immunization Programmes (TIP) qualitative study in Serbia

Vaccine communication between health workers and parents affects parental acceptance, so understanding this is particularly important when vaccination rates drop. This paper presents the findings of a qualitative research study conducted in Serbia as part of a Tailoring Immunization Programmes (TIP) project. The aims were to explore the process of vaccination communication between health workers and parents (accepting, indecisive, delaying, refusing), and identify barriers and drivers to effective communication. In-depth interviews with 14 health workers were supplemented and qualified by observations of 40 consultations, using thematic analysis. Study sites were two community health centers in two Belgrade municipalities where a significant drop in childhood vaccination rates had occurred. Key findings were: (1) communication mainly took place between pediatricians and parents, while nurses focused on administering vaccines. (2) Health workers were confident in their skills to communicate and address concerns of accepting and indecisive parents, successfully applying specific strategies. (3) When interacting with delaying and refusing parents, they sometimes agreed to delay vaccination to maintain relationships, confident that most parents would vaccinate in due course. (4) Some refusing parents asked questions grounded in a socio-political agenda regarding vaccines or vaccination. Such questions exceeded the domain of health workers’ expertise, which affected the communication between them. (5) Health workers’ behavior in consultations was sometimes affected by parents’ (dis) trust in their recommendations about vaccination. The study revealed that health workers in Serbia require additional skills and techniques to respond to parents who refuse and wish to delay vaccination, to secure timely vaccination

Measles situation in Serbia in an era of measles elimination (2007-2009)

Following the introduction of measles immunization in Serbia in 1971, measles outbreaks were recorded every 3 to 5 years until 1997. The outbreak in 1997 with 4000 cases was the last large outbreak in Serbia. In 2007, an outbreak with 191 laboratory confirmed or epidemiologically linked cases was reported in Vojvodina. In 2008 and 2009, only 3 cases were confirmed. From 2007-2009, measles infections were most frequently detected in the Roma population but also in non-immunized or partially immunized persons from the general population

Investigation of predictors of vaccination status associated with measles, mumps, rubella in Serbia

Ciljevi sprovedene studije preseka bili su: 1. Ispitivanje znanja, stavova i ponašanja roditelja u vezi sa vakcinacijom njihove dece protiv malih boginja, zaušaka i rubele; 2. Ispitivanje korelacije izmedju nivoa znanja roditelja o vakcinaciji i vakcinalnog statusa njihove dece; 3. Ispitivanje prediktora vakcinalnog statusa povezanog sa imunizacijom protiv malih boginja, zaušaka i rubele. Materijal i metod: Selekcija ispitanika je sprovedena po principu formiranja višestepenog uzorka. Uzorak je činilo 568 ispitanika, roditelja dece uzrasta do sedam godina koji su posetili izabranog pedijatra na dan sprovedenog ispitivanja u 17 domova zdravlja u Srbiji. Osnovni instrument za prikupljanje podataka je bio strukturirani upitnik, koji je sastavljen na bazi literaturnih podataka. Rezultati: U istraživanju je učestvovalo ukupno 568 roditelja, od toga 141 (24,8%) roditelj muškog pola i 427 (75,2%) roditelja ženskog pola, prosečnog uzrasta 34,3±5,7 godina. Većina roditelja bila je u braku (87,3%). U pogledu radnog statusa, većina roditelja, 78,9% je bila zaposlena, dok je 21,1% bilo van radnog odnosa u trenutku ispitivanja. Najveća proprocija roditelja imala je završenu srednju školu (43,3%), zatim slede roditelji sa visokim obrazovanjem (35,2%). Mala proporcija roditelja imala je završenu osnovnu školu (3,5%), magisterijum (4,8%) ili doktorat (1,4%). U urbanim sredinama živelo je 82,4% roditelja, a 17,6% je živelo u ruralnim područjima. Više od polovine roditelja (53,2%) imalo je dvoje dece, 25,6% roditelja imalo je jedno dete, a 9,5% troje dece. Kada se analiziraju ukupni mesečni prihodi, većina roditelja (37,7%) je izjavila da oni iznose 50-100.000 dinara. Ukupno 76,8% roditelja je izjavilo da su vakcinisani protiv malih boginja, 7,9% je bilo nevakcinisano, a 15,3% nije znalo svoj vakcinalni status. Većina roditelja je izjavila da nije preležala male boginje (53,3%), a podatak o preležanoj infekciji dalo je 22,2% roditelja, dok 24,5% roditelja nije znalo da li su imali nekada ovo oboljenje...The objectives of this cross-sectional study were: 1. Investigation of the knowledge, attitudes and behavior of parents regarding the vaccination of their children against measles, mumps and rubella; 2. Investigation of the correlation between the level of parents' knowledge about vaccination and the vaccination status of their children; 3. Investigation of the predictors of vaccination status associated with measles, mumps, and rubella immunization. Material and method: The selection of participants was carried out according to the principle of forming a multi-stage sample. The sample consisted of 568 subjects, parents of children up to the age of seven who visited a selected pediatrician on the day of the survey conducted in 17 public health centers in Serbia. The basic instrument for data collection was a structured questionnaire, which was compiled on the basis of literature data. Results: A total of 568 parents participated in the study, of which 141 (24.8%) were male parents and 427 (75.2%) were female parents, with an average age of 34.3±5.7 years. Most parents were married (87.3%). In terms of employment status, the majority of parents, 78.9%, were employed, while 21.1% were out of employment at the time of the survey. The largest proportion of parents had completed high school (43.3%), followed by parents with higher education (35.2%). A small proportion of parents had completed only primary school (3.5%), master's degree (4.8%) or doctorate (1.4%). 82.4% of parents lived in urban areas, and 17.6% lived in rural areas. More than half of parents (53.2%) had two children, 25.6% of parents had one child, and 9.5% had three children. When analyzing the total monthly income, the majority of parents (37.7%) stated that it amounts to 50-100,000 dinars. A total of 76.8% of parents stated that they were vaccinated against measles, 7.9% were unvaccinated, and 15.3% did not know their vaccination status. The majority of parents stated that they had not had measles (53.3%), and 22.2% of parents provided information about the infection, while 24.5% of parents did not know if they had ever had this disease. The distribution of correct answers to the part of questions related to vaccination knowledge showed that the highest proportion of correct answers (98%) was recorded for the statements that vaccination prevent disease and that vaccination can be temporarily postponed in case of fever..

Active epidemiological surveillance in the program of poliomyelitis eradication in Serbia

The main strategy of the worldwide Program of Poliomyelitis Eradication is based on immunization with oral poliovirus vaccine and active epidemiological surveillance aimed to demonstrate the absence of wild poliovirus circulation. The specification of the surveillance in the program, reporting and investigation of certain syndrome – the acute flaccid paralysis - as a specific feature of surveillance of poliomyelitis, is a new experience both for clinicians and epidemiologists. Along with the achieved results, problems in conducting the active epidemiological surveillance in Serbia, applied measures, and suggestions for improving its quality were presented. This experience might help in implementing the active surveillance for some other diseases that could be prevented by vaccine immunization

Public health preparedness for two mass gathering events in the context of pandemic influenza (H1N1) 2009-Serbia, July 2009

Preparedness planning for two large mass gatherings events were considered in Serbia in the context of pandemic influenza (H1N1) 2009. Planning included approaches to prevention, detection and response in order to mitigate the situation at this early stage of the epidemic in Serbia. Cases of influenza A(H1N1) v were identified nationally immediately prior to the mass gatherings but also identified in association with both events, as expected in the context of the pandemic situation. This article describes the experiences of planning and the epidemiological situation during the period of the mass gathering events