Impact of free on-site vaccine and/or healthcare workers training on hepatitis B vaccination acceptability in high-risk subjects: a pre-post cluster randomized study

AbstractDespite recommendations for adults at high-risk of hepatitis B virus (HBV) infection, HBV vaccine uptake remains low in this population. A pre-post randomized cluster study was conducted to evaluate the impact of on-site free HBV vaccine availability and/or healthcare worker training on HBV vaccination acceptability in high-risk adults consulting in 12 free and anonymous HIV and hepatitis B/C testing centres (FATC). The FATC were randomly allocated into three groups receiving a different intervention: training on HBV epidemiology, risk factors and vaccination (Group A), free vaccination in the FATC (Group B), both interventions (Group C). The main outcomes were the increase in HBV vaccination acceptability (receipt of at least one dose of vaccine) and vaccine coverage (receipt of at least two doses of vaccine) after intervention. Respectively, 872 and 809 HBV-seronegative adults at high-risk for HBV infection were included in the pre- and post-intervention assessments. HBV vaccination acceptability increased from 14.0% to 75.6% (p <0.001) in Group B and from 17.1% to 85.8% (p <0.001) in Group C and HBV vaccine coverage increased from 9.4% to 48.8% (p <0.001) in Group B and from 11.2% to 41.0% (p <0.001) in Group C. The association of training and free on-site vaccine availability was more effective than free on-site vaccine availability alone to increase vaccination acceptability (ratio 1.14; from 1.02 to 1.26; p 0.017). No effect of training alone was observed. These results support the policy of making HBV vaccine available in health structures attended by high-risk individuals. Updating healthcare workers’ knowledge on HBV virus and its prevention brings an additional benefit to vaccination acceptability

Direct Numerical Simulation of polydisperse evaporating sprays in 3D jet configuration using Euler-Euler and Euler-Lagrange formalisms

International audienceThe use of robust and accurate Eulerian/Eulerian formulations in the modeling of reactive two-phase flow would be a major step forward in the framework of turbulent combustion modeling with massively parallel supercomputers. In the present contribution we rely on the recent developments conducted in the framework of homogeneous isotropic turbulence (Fréret et al. 2010; Fréret et al. 2012) using the Eulerian multi-fluid model (MF) in the context of Direct Numerical Simulation (DNS) to capture all stages of turbulent spray combustion for polydisperse sprays, and set up a 3D free jet configuration, thus reaching the next step of turbulent shear flows. The robustness and accuracy of the model and related numerical methods are evaluated and assessed on two configurations with non-evaporating and evaporating spray injection. With MF, we obtain the same level of accuracy as a baseline solution obtained with Lagrangian droplet tracking for rather similar computational time on a few hundred processors. This study yields a solid premise for the future 3D reacting configurations