30 research outputs found
A pneumococcus infekciók jelentősége a gyermekkori felső légúti és invazív bakteriális fertőzésekben
Védőoltásokkal kapcsolatos kételyek és elkötelezettség a magyarországi egészségügyi alapellátásban dolgozók körében = Vaccine hesitancy among primary healthcare professionals in Hungary
Absztrakt:
Bevezetés: Az Európai Betegségmegelőzési és Járványvédelmi
Központ (European Centre for Disease Prevention and Control, ECDC) korábbi
nemzetközi felmérése az egészségügyi dolgozók védőoltásokkal kapcsolatos
fenntartásait, vakcinációs bizonytalanságát tárta fel.
Célkitűzés: A magyar alapellátásban dolgozó felnőtt-,
vegyes és gyermek- (háziorvosi praxisban dolgozó) szakorvosok, valamint a
védőnők védőoltásokkal kapcsolatos attitűdjeinek vizsgálata.
Módszer: Az egészségügyi szakemberek védőoltással
kapcsolatos fenntartásait saját fejlesztésű kérdőívvel vizsgáltuk, amelynek
alapjául az ECDC négy országos nemzetközi kutatása szolgált. Az adatfelvétel
2017 májusától júliusáig zajlott, online kérdőíves megkereséssel. A kérdőívet
összesen 765 egészségügyi szakember: 189 házi gyermekorvos, 375 felnőtt-,
illetve vegyes praxisú háziorvos, valamint 201 védőnő töltötte ki. A mintát a
munkavégzés helyének régiója, településtípusa, valamint a szakember életkora
szerint súlyozással igazítottuk az országos megoszláshoz az egyes szakmai
csoportokon belül, így ezen szempontok mentén reprezentatívnak tekinthető.
Eredmények: Megállapítható volt, hogy a vizsgált
témakörökben kapott válaszok nem különböztek érdemben az ECDC hasonló, más
országokban talált eredményeitől. Az alapellátó orvosok mintegy 2/3-a, a védőnők
fele van meggyőződve a védőoltások nyújtotta előnyökről és értékekről.
Megnyugtatóan alacsony arányban vannak fenntartásaik a védőoltások
biztonságosságát illetően, bár az ajánlott védőoltásoknál az értékek némileg
magasabbak voltak az életkor szerint kötelezőkhöz – a Nemzeti Immunizációs
Programban adott oltásokhoz – képest. A szakirodalomból is jól ismert kifejezett
oltásellenes rémhírek – autizmus–MMR stb. – fellelhetők ugyan, de elenyésző
arányban, ám ez összefüggésben állhat a vizsgálatban való önkéntes részvétellel
is. Az életkor szerint előírt oltások közül a leginkább elutasított a BCG-oltás,
míg a legtöbb kétely az MMR-oltást övezi. Következtetés: Az
alapellátók védőoltásokkal kapcsolatos kommunikációs készségeinek fejlesztését
szolgáló képzésekre igény van, mind a graduális, mind a posztgraduális
stúdiumokban. Orv Hetil. 2019; 160(48): 1904–1914.
|
Abstract:
Introduction: The attitude to immunization and the issue of
vaccine hesitancy in health care workers (HCWs) have been studied in a former
survey performed by ECDC (European Centre for Disease Prevention and Control).
Aim: Our aim was to study the immunization attitude of
primary care paediatricians, general practitioners and primary care nurses in
Hungary. Method: We studied vaccine hesitancy in HCWs by way of
a questionnaire, developed on the basis of a recent similar survey by ECDC in
four countries. The online survey has been performed between May and July 2017.
Altogether 765 questionnaires have been returned: 189 primary care
paediatricians, 375 general practitioners working in adult or mixed practices,
and 201 primary care nurses. The sample has been weighted to the
country-specific features – e.g., location of the practice,
residence and age of the HCWs – within each of the three groups, so from this
aspect it can be considered representative. Results: Our
results did not differ substantially from the international ECDC data.
Approximately 2/3 of the primary care doctors and about 50% of the primary care
nurses were convinced of the benefit and value of vaccines. Data on vaccine
hesitancy were consolingly low, though the data on recommended vaccines were
somewhat higher compared to the age related/NIP (National Immunization Plan)
vaccines. The well-known vaccine scares – e.g., autism–MMR,
etc., known also from the literature – could hardly been
detected, and it can be explained by the voluntary participation in the study.
The least supported vaccine is BCG, while the highest hesitancy rates are
related to MMR in Hungary. Conclusion: The need to improve
immunization-related communication among primary HCWs could clearly been
detected – both in gradual and in post-gradual training programs. Orv Hetil.
2019; 160(48): 1904–1914
Burden of varicella in Central and Eastern Europe : findings from a systematic literature review
Funding Information: The authors take full responsibility for the scope, direction, and content of the manuscript, and have approved the submitted manuscript. Medical writing assistance was provided by Eleanor Finn of PAREXEL International and was funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. The authors wish to thank the following for contributions in development of the manuscript: Barbara J. Kuter, PhD, MPH, Global Vaccines Medical Affairs, and Tracey J. Weiss, Center for Observational and Real-World Evidence (CORE), Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. Funding Information: The study was funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. Funding Information: J. Wysocki received travel grants to attend international scientific conferences and fees for lectures from Pfizer and payment from a grant sponsored by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. I. Ivaskeviciene has received a USA travel grant to attend international scientific meeting, from Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth. M. Pokorn has received a research grant from Pfizer and payment for lectures from Pfizer, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA and GSK. L. Jancoriene has received travel grants to attend international scientific conferences and fees for lectures from Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, AbbVie and Pfizer and payment for a clinical study sponsored by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. J. Pluta and L.J. Wolfson are employees of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, and stockholders of Merck & Co., Inc., Kenilworth, NJ, USA. Publisher Copyright: © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Introduction: Vaccination against varicella rapidly reduces disease incidence, resulting in reductions in both individual burden and societal costs. Despite these benefits, there is no standardization of varicella immunization policies in Europe, including countries in Central and Eastern Europe (CEE). Areas covered: This systematic literature review identified publications on the epidemiology of varicella, its associated health and economic burden, and vaccination strategies within the CEE region, defined as Albania, Bosnia-Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Serbia, Slovakia, and Slovenia. Twenty-six studies were identified from a search of PubMed, Embase®, and MEDLINE® biomedical literature databases, supplemented by gray literature and country-specific/global websites. Expert commentary: Limited information exists in published studies on the burden of varicella in CEE. The wide variability in incidence rates between countries is likely explained by a lack of consistency in reporting systems. Funded universal varicella vaccination (UVV) in CEE is currently available only in Latvia as a one-dose schedule, but Hungary together with Latvia are introducing a two-dose strategy in 2019. For countries that do not provide UVV, introduction of vaccination is predicted to provide substantial reductions in cases and rates of associated complications, with important economic benefits.publishersversionPeer reviewe
Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for influenza vaccination in children
<p>Abstract</p> <p>Background</p> <p>Influenza vaccination in infants and children with existing health complications is current practice in many countries, but healthy children are also susceptible to influenza, sometimes with complications. The under-recognised burden of disease in young children is greater than in elderly populations and the number of paediatric influenza cases reported does not reflect the actual frequency of influenza.</p> <p>Discussion</p> <p>Vaccination of healthy children is not widespread in Europe despite clear demonstration of the benefits of vaccination in reducing the large health and economic burden of influenza. Universal vaccination of infants and children also provides indirect protection in other high-risk groups in the community. This paper contains the Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for the vaccination of infants and children against influenza. The aim of CEVAG is to encourage the efficient and safe use of vaccines to prevent and control infectious diseases.</p> <p>Summary</p> <p>CEVAG recommends the introduction of universal influenza vaccination for all children from the age of 6 months. Special attention is needed for children up to 60 months of age as they are at greatest risk. Individual countries should decide on how best to implement this recommendation based on their circumstances.</p
Comparative epidemiologic characteristics of pertussis in 10 Central and Eastern European countries, 2000-2013
Publisher Copyright: © 2016 Heininger et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.We undertook an epidemiological survey of the annual incidence of pertussis reported from 2000 to 2013 in ten Central and Eastern European countries to ascertain whether increased pertussis reports in some countries share common underlying drivers or whether there are specific features in each country. The annual incidence of pertussis in the participating countries was obtained from relevant government institutions and/or national surveillance systems. We reviewed the changes in the pertussis incidence rates in each country to explore differences and/or similarities between countries in relation to pertussis surveillance; case definitions for detection and confirmation of pertussis; incidence and number of cases of pertussis by year, overall and by age group; population by year, overall and by age group; pertussis immunization schedule and coverage, and switch from whole-cell pertussis vaccines (wP) to acellular pertussis vaccines (aP). There was heterogeneity in the reported annual incidence rates and trends observed across countries. Reported pertussis incidence rates varied considerably, ranging from 0.01 to 96 per 100,000 population, with the highest rates generally reported in Estonia and the lowest in Hungary and Serbia. The greatest burden appears for the most part in infants (<1 year) in Bulgaria, Hungary, Latvia, Romania, and Serbia, but not in the other participating countries where the burden may have shifted to older children, though surveillance of adults may be inappropriate. There was no consistent pattern associated with the switch from wP to aP vaccines on reported pertussis incidence rates. The heterogeneity in reported data may be related to a number of factors including surveillance system characteristics or capabilities, different case definitions, type of pertussis confirmation tests used, public awareness of the disease, as well as real differences in the magnitude of the disease, or a combination of these factors. Our study highlights the need to standardize pertussis detection and confirmation in surveillance programs across Europe, complemented with carefully-designed seroprevalence studies using the same protocols and methodologies.publishersversionPeer reviewe
Pneumococcusprevenció a kora csecsemőkortól az időskorig | Pneumococcal disease prevention from early infancy to the elderly
A Streptococcus pneumoniae fertőzések valódi jelentőségét világszerte mind a laikus, mind az általános orvosi közvélemény messze alulértékeli. Csecsemő- és kisgyermekkorban a pneumococcus otitis media a leggyakrabban antibiotikum adását igénylő kórkép, míg a lényegesen ritkább pneumococcuspleuropneumonia, szepszis, pneumococcusmeningitis még akkor is nagy kockázatú, potenciálisan halálos végű kórforma, ha nem multirezisztens a kórokozó. Életkortól függetlenül számolni kell súlyos pneumococcusfertőzéssel a krónikus betegséggel, illetve lép nélkül élőkben, a bármilyen okból immunszuppresszív terápiát igénylőkben is. Időskorúakban a leggyakoribb kórforma a pneumococcuspneumonia, amelynek halálozása az elérhető terápiás lehetőségek mellett az elmúlt évtizedekben sem csökkent számottevően. Jelenleg a pneumococcusfertőzések jelentős hányada megelőzhető lehetne aktív immunizációval. A szerző vázolja a rendelkezésre álló, 10-valens, 13-valens fehérjével konjugált és 23-valens poliszacharid pneumococcusvakcinákkal elért eddigi globális és hazai eredményeket. Ismerteti a 13-valens konjugált pneumococcusvakcina új, minden életkorra vonatkozó indikációit és a pneumococcusprevenciós programok jövőbeli kihívásait. Orv. Hetil., 2014, 155(7), 243–247.
|
The real disease burden due to Streptococcus pneumoniae infections are underrecognised worldwide both by the lay public and by the medical community in general. In infants and children pneumococcal otitis media is the most common reason for antimicrobial treatment, while the far less frequent, though potentially life threatening pneumococcal pleuropneumonia, sepsis and pneumococcal meningitis are high risk conditions even if the causative pneumococcus is not multiresistant. Asplenic patients, patients with chronic underlying conditions, and/or those receiving immunosuppressive therapy are at risk of serious pneumococcal disease regardless of age. Morbidity and mortality due to pneumococcal pneumonia is most common in the elderly, and has not changed during the last decades in spite of all efforts in improving therapy and care. Presently the majority of the pneumococcal infections are preventable by active immunization. In this work the author briefly outlines the results of the pneumococcal prevention programs worldwide and in Hungary using presently available 10-valent, 13-valent protein conjugate and 23-valent polysaccharide pneumococcal vaccines. Also, the author describes the recently approved indications of the 13-valent pneumococcal conjugate vaccine such as its use in all age groups, discusses future challenges of these prevention programs. Orv. Hetil., 2014, 155(7), 243–247