1
|
Gozdzielewska L, Kc D, Butcher J, Molesworth M, Davis K, Barr L, DiBari C, Mortgat L, Deeves M, Kothari KU, Storr J, Allegranzi B, Reilly J, Price L. Interventions for preventing or controlling health care-associated infection among health care workers or patients within primary care facilities: A scoping review. Am J Infect Control 2024; 52:479-487. [PMID: 37944755 DOI: 10.1016/j.ajic.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/27/2023] [Accepted: 10/29/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND This review aimed to synthesize the evidence on infection prevention and control interventions for the prevention of health care-associated infection among health care workers or patients within primary care facilities. METHODS PubMed, CINAHL, EMBASE, and CENTRAL databases were searched for quantitative studies published between 2011 and 2022. Study selection, data extraction, and quality assessment using Cochrane and Joanna Briggs tools, were conducted by independent review with additional sensitivity checking performed on study selection. RESULTS Four studies were included. A randomized trial and a cross-sectional survey, respectively, found no statistical difference in laboratory-confirmed influenza in health care workers wearing N95 versus medical masks (P = .18) and a significant inverse association between the implementation of tuberculosis control measures and tuberculosis incidence (P = .02). For the prevention of surgical site infections following minor surgery, randomized trials found nonsterile gloves (8.7%; 95% confidence interval, 4.9%-12.6%) to be noninferior to sterile gloves (9.3%; 95% confidence interval, 7.4%-11.1%) and no significant difference between prophylactic antibiotics compared to placebo (P = .064). All studies had a high risk of bias. CONCLUSIONS Evidence for infection prevention and control interventions for the prevention of health care-associated infection in primary care is very limited and insufficient to make practice recommendations. Nevertheless, the findings highlight the need for future research.
Collapse
Affiliation(s)
- Lucyna Gozdzielewska
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland.
| | - Deepti Kc
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - John Butcher
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Mark Molesworth
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Katie Davis
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Lisa Barr
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Carlotta DiBari
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Laure Mortgat
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Miranda Deeves
- Infection Prevention and Control Hub, Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Kavita U Kothari
- Consultant to Library & Digital Information Networks / Quality Assurance, Norms and Standards / Science Division, World Health Organization, Kobe, Japan
| | - Julie Storr
- Infection Prevention and Control Hub, Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Hub, Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Jacqui Reilly
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Lesley Price
- SHIP Research Group, Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| |
Collapse
|
2
|
López-Zambrano MA, Pita CC, Escribano MF, Galán Meléndez IM, Cebrián MG, Arroyo JJG, Huerta C, Cuadrado LM, Ruiperez CM, Núñez C, Zapata AP, de la Pinta MLR, Uriz MAS, Conejo ISA, Gomila CM, Carbajo MDL, Gómez AS. Factors associated to influenza vaccination among hospital's healthcare workers in the Autonomous Community of Madrid, Spain 2021-2022. Vaccine 2023; 41:6719-6726. [PMID: 37806803 DOI: 10.1016/j.vaccine.2023.09.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/12/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023]
Abstract
Influenza vaccination (IV) aims primarily to protect high-risk groups against severe influenza-associated disease and death. It is recommended in Spain for high-risk groups, including Healthcare workers (HCWs). However, vaccination uptake has been consistently below desirable levels. The objective of this study were to evaluate influenza vaccination coverage using data from the regional vaccination registry, during 2021-2022 season, among HCWs in public hospitals in Autonomous Community of Madrid (CAM) and to explore factors associated with influenza vaccination. We conducted a cross-sectional study using administrative data retrieved from the Regional Department of Health data repositories. A multilevel logistic regression model was designed to estimate Level 1 (individual) and Level 2 (contextual) variables that are associated with HCẂs vaccination. The study population was HCWs from 25 public hospitals in CAM who were active during the period of the influenza 2021-2022 vaccination campaign. The global influenza vaccination coverage (IVC) was 52.1 %. All study Level 1 variables were significantly associated with vaccine uptake. Greater IVC is associated with individual characteristics: female (OR1.14; 95 %CI 1.09-1.19), older age 59-69 years old (OR1.72; 95 %CI 1.60-1.84), born in Spain, medical staff, more than one high-risk condition (OR1.24; 95 %CI 1.10-1.40; respectively) and vaccinated in two previous campaigns (OR25.64; 95 %CI 24.27-27.09). IVC was highest among HCWs celiac disease (65.5 %) followed by diabetes mellitus (65.1 %) and chronic inflammatory disease (64.3 %). The hospital where the study subject worked also showed an effect on the vaccination uptake, although Level 2 variable (hospital complexity) was not positively associated. IVC in HCWs remains suboptimal. These findings may prove useful to tailor strategies to reach specific groups. It is recommended to delve into the identification of factors associated with the HCWs workplace that may have a positive impact on IV.
Collapse
Affiliation(s)
- María Alejandra López-Zambrano
- Subdirección General de Prevención y Promoción de la Salud, Consejería de Sanidad de la Comunidad Autónoma de Madrid, Spain.
| | - Covadonga Caso Pita
- Servicio de Prevención de Riesgos Laborales, Hospital Clínico San Carlos, Madrid, Spain.
| | | | - Isabel Mª Galán Meléndez
- Servicio de Prevención y Salud Laboral, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
| | - Manuela García Cebrián
- Servicio de Prevención de Riesgos Laborales, Hospital Universitario de La Princesa, Hospital Infantil Universitario Niño Jesús, Hospital Universitario Santa Cristina, Madrid, Spain.
| | | | - Carmen Huerta
- Servicio de Prevención Riesgos Laborales, Hospital Universitario de Móstoles, Madrid, Spain.
| | - Luis Mazón Cuadrado
- Servicio de Prevención de Riesgos Laborales, Hospital Universitario de Fuenlabrada, Madrid, Spain.
| | - Carmen Muñoz Ruiperez
- Servicio de Medicina del Trabajo y Prevención de Riesgos Laborales, Hospital Universitario 12 de octubre, Madrid, Spain.
| | - Concha Núñez
- Servicio de Prevención Riesgos Laborales, Hospital U. La Paz-Carlos III-Cantoblanco, Madrid, Spain.
| | - Aurora Pérez Zapata
- Servicio de Prevención de Riesgos Laborales - Salud Laboral, Hospital Universitario Príncipe de Asturias, Madrid, Spain.
| | | | - Mª Angeles Sánchez Uriz
- Servicio de Prevención Mancomunado de Grupo, Hospital Universitario Infanta Leonor, Madrid, Spain.
| | | | | | - Mª Dolores Lasheras Carbajo
- Subdirección General de Prevención y Promoción de la Salud, Consejería de Sanidad de la Comunidad Autónoma de Madrid, Spain.
| | - Amaya Sánchez Gómez
- Subdirección General de Prevención y Promoción de la Salud, Consejería de Sanidad de la Comunidad Autónoma de Madrid, Spain.
| |
Collapse
|
3
|
Gümüştakım RŞ, Bilgili P, Çevik M, Başer DA, Doğaner A, Saper SHK, Kanevetci Z, Özçelebi E. A Double-Sided View to Adult Vaccination: The Opinions and Attitudes of Patients and Health Workers. Health (London) 2018. [DOI: 10.4236/health.2018.1012128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
4
|
Fernández-Villa T, Molina AJ, Torner N, Castilla J, Astray J, García-Gutiérrez S, Mayoral JM, Tamames S, Domínguez Á, Martín V. Factors associated with acceptance of pandemic flu vaccine by healthcare professionals in Spain, 2009-2010. Res Nurs Health 2017; 40:435-443. [PMID: 28805243 DOI: 10.1002/nur.21815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 06/29/2017] [Indexed: 11/11/2022]
Abstract
The A(H1N1)pdm09 influenza virus reached pandemic level in Spain in 2009, prompting a national vaccination campaign. To avoid transmission to patients, healthcare professionals' vaccination against pandemic influenza is crucial. The main objective of this study was to analyze factors associated with the failure by healthcare professionals to accept the pandemic vaccination in 2009. A cross-sectional survey was conducted of healthcare professionals in seven of Spain's autonomous regions. A questionnaire was used to collect information about personal and professional details, the respondents' flu vaccination status in the 2008-2009 and 2009-2010 seasons (seasonal and pandemic vaccines), and their knowledge and attitudes. A total of 1,661 professionals completed the survey. In the 2009-2010 season, 38.2% had both the seasonal and the pandemic vaccine, 22.1% had had only the seasonal, and 4.7% only the pandemic vaccine. The strongest predictor of not receiving the pandemic vaccine was not having had seasonal vaccinations in that year or the previous year. Those who had not received the pandemic vaccine were more often female; nurses; under 45; denied contact with at-risk groups; and had negative beliefs about the vaccine effectiveness and little concern for getting the disease, being infected at work, or passing it on to patients. It would be prudent to direct preventive campaigns not only at individuals at risk of catching flu but also at health professionals with a negative view of flu vaccine, with a particular focus on nurses, who have a key role in recommending flu vaccine.
Collapse
Affiliation(s)
- Tania Fernández-Villa
- Grupo de Investigación en Interacción Gen - Ambiente y Salud (GIIGAS), Facultad de Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - Antonio J Molina
- Grupo de Investigación en Interacción Gen - Ambiente y Salud (GIIGAS), Facultad de Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - Nuria Torner
- Agencia de Salud Pública de Cataluña, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jesus Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Instituto de Salud Pública de Navarra, Pamplona, Spain
| | - Jenaro Astray
- Área de Epidemiología, Comunidad de Madrid, Madrid, Spain
| | | | | | - Sonia Tamames
- Dirección General de Salud Pública, Investigación, Desarrollo e Innovación, Junta de Castilla y León, León, Spain
| | | | - Vicente Martín
- Grupo de Investigación en Interacción Gen - Ambiente y Salud (GIIGAS), Facultad de Ciencias de la Salud, Departamento de Ciencias Biomédicas, Área de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | |
Collapse
|
5
|
Toledo D, Soldevila N, Guayta-Escolies R, Lozano P, Rius P, Gascón P, Domínguez A. Knowledge of and Attitudes to Influenza Vaccination among Community Pharmacists in Catalonia (Spain). 2013-2014 Season: A Cross Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070756. [PMID: 28696401 PMCID: PMC5551194 DOI: 10.3390/ijerph14070756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 06/30/2017] [Accepted: 07/06/2017] [Indexed: 11/25/2022]
Abstract
Annual recommendations on influenza seasonal vaccination include community pharmacists, who have low vaccination coverage. The aim of this study was to investigate the relationship between influenza vaccination in community pharmacists and their knowledge of and attitudes to vaccination. An online cross-sectional survey of community pharmacists in Catalonia, Spain, was conducted between September and November 2014. Sociodemographic, professional and clinical variables, the history of influenza vaccination and knowledge of and attitudes to influenza and seasonal influenza vaccination were collected. The survey response rate was 7.33% (506 out of 6906); responses from 463 community pharmacists were included in the final analyses. Analyses were performed using multivariable logistic regression models and stepwise backward selection method for variable selection. The influenza vaccination coverage in season 2013–2014 was 25.1%. There was an association between vaccination and correct knowledge of the virus responsible for epidemics (adjusted Odds Ratio (aOR) = 1.74; 95% CI 1.03–2.95), recommending vaccination in the postpartum (aOR = 3.63; 95% CI 2.01–6.55) and concern about infecting their clients (aOR = 5.27; 95% CI 1.88–14.76). In conclusion, community pharmacists have a very low influenza vaccination coverage, are not very willing to recommend vaccination to all their customers but they are concerned about infecting their clients.
Collapse
Affiliation(s)
- Diana Toledo
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain.
- Departament de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain.
| | - Núria Soldevila
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain.
- Departament de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain.
| | - Rafel Guayta-Escolies
- Unitat de Projectes i Recerca, Consell de Col·legis Farmacèutics de Catalunya, 08009 Barcelona, Spain.
| | - Pau Lozano
- Unitat de Projectes i Recerca, Consell de Col·legis Farmacèutics de Catalunya, 08009 Barcelona, Spain.
| | - Pilar Rius
- Unitat de Projectes i Recerca, Consell de Col·legis Farmacèutics de Catalunya, 08009 Barcelona, Spain.
| | - Pilar Gascón
- Unitat de Projectes i Recerca, Consell de Col·legis Farmacèutics de Catalunya, 08009 Barcelona, Spain.
| | - Angela Domínguez
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain.
- Departament de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain.
| |
Collapse
|
6
|
Álvarez-Lerma F, Marín-Corral J, Vilà C, Masclans J, Loeches I, Barbadillo S, González de Molina F, Rodríguez A. Characteristics of patients with hospital-acquired influenza A (H1N1)pdm09 virus admitted to the intensive care unit. J Hosp Infect 2017; 95:200-206. [DOI: 10.1016/j.jhin.2016.12.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 12/20/2016] [Indexed: 10/20/2022]
|
7
|
Schmid P, Rauber D, Betsch C, Lidolt G, Denker ML. Barriers of Influenza Vaccination Intention and Behavior - A Systematic Review of Influenza Vaccine Hesitancy, 2005 - 2016. PLoS One 2017; 12:e0170550. [PMID: 28125629 PMCID: PMC5268454 DOI: 10.1371/journal.pone.0170550] [Citation(s) in RCA: 717] [Impact Index Per Article: 102.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 01/06/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Influenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake. OBJECTIVE This review aims to (1) identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and (2) map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area. METHODS Thirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years 2005 and 2016. Following the PRISMA approach, 470 articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention. The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination. RESULTS Most studies were conducted in the American and European region. Health care personnel (HCP) and the general public were the most studied populations, while parental decisions for children at high risk were under-represented. This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups. CONCLUSION Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified. While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity. Psychological determinants were meaningfully related to uptake and should therefore be measured in a valid and comparable way. A compendium of measurements for future use is suggested as supporting information.
Collapse
Affiliation(s)
- Philipp Schmid
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Dorothee Rauber
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Cornelia Betsch
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Gianni Lidolt
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Marie-Luisa Denker
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| |
Collapse
|
8
|
Domínguez A, Godoy P, Castilla J, María Mayoral J, Soldevila N, Torner N, Toledo D, Astray J, Tamames S, García-Gutiérrez S, González-Candelas F, Martín V, Díaz J. Knowledge of and attitudes to influenza in unvaccinated primary care physicians and nurses. Hum Vaccin Immunother 2015; 10:2378-86. [PMID: 25424945 PMCID: PMC4896788 DOI: 10.4161/hv.29142] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Primary healthcare workers, especially nurses, are exposed to the vast majority of patients with influenza and play an important role in vaccinating patients. Healthcare workers’ misconceptions about influenza and influenza vaccination have been reported as possible factors associated with lack of vaccination. The objective of this study was to compare the characteristics of unvaccinated physicians and unvaccinated nurses in the 2011–2012 influenza season. We performed an anonymous web survey of Spanish primary healthcare workers in 2012. Information was collected on vaccination and knowledge of and attitudes to the influenza vaccine. Multivariate analysis was performed using unconditional logistic regression. We included 461 unvaccinated physicians and 402 unvaccinated nurses. Compared with unvaccinated nurses, unvaccinated physicians had more frequently received seasonal influenza vaccination in the preceding seasons (aOR 1.58; 95% CI 1.11–2.25), and more frequently believed that vaccination of high risk individuals is effective in reducing complications (aOR 2.53; 95% CI 1.30–4.95) and that influenza can be a serious illness (aOR 1.65; 95% CI 1.17–2.32). In contrast, unvaccinated physicians were less concerned about infecting patients (aOR 0.62; 95% CI 0.40–0.96). Unvaccinated nurses had more misconceptions than physicians about influenza and the influenza vaccine and more doubts about the severity of annual influenza epidemics in patients with high risk conditions and the prevention of complications by means of the influenza vaccination. For unvaccinated physicians, strategies to improve vaccination coverage should stress the importance of physicians as a possible source of infection of their patients. The effectiveness of influenza vaccination of high risk persons should be emphasized in nurses.
Collapse
Affiliation(s)
- Angela Domínguez
- a Departament de Salut Pública; Universitat de Barcelona; Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Antón-Ladislao A, García-Gutiérrez S, Soldevila N, González-Candelas F, Godoy P, Castilla J, Mayoral JM, Astray J, Martín V, Tamames S, Toledo D, Aguirre U, Domínguez A. Visualizing knowledge and attitude factors related to influenza vaccination of physicians. Vaccine 2014; 33:885-91. [PMID: 25529290 DOI: 10.1016/j.vaccine.2014.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 10/24/2014] [Accepted: 12/08/2014] [Indexed: 02/04/2023]
Abstract
PURPOSE To characterize groups of primary healthcare physicians according to sociodemographic data, years of professional experience and knowledge of and attitudes to influenza, and to evaluate differences between groups with respect to influenza vaccination in the 2011-2012 season. METHODS We carried out an anonymous web survey of Spanish primary healthcare physicians in 2012. Information on vaccination, and knowledge of and attitudes to influenza was collected. Multiple correspondence analysis and cluster analysis were used to define groups of physicians. RESULTS We included 835 physicians and identified three types. Type B were physicians with low professional experience of influenza. Types A and C were physicians with high professional experience with influenza, type A also had a high awareness of influenza and seasonal vaccination. Types A and C were older and more often male than type B (p<0.0001). Knowledge of influenza was greatest in type A and lowest in type B. Awareness of influenza was greatest in type A and lowest in type C. In type A, 71.0% of physicians were vaccinated in the 2011-2012 season, compared with 48.1% and 33.6% from types B and C, respectively (p<0.001). CONCLUSIONS Additional efforts should be made to increase interest and concerns about preventing the transmission of influenza in physicians who do not believe influenza is a severe disease and are not concerned about its transmission.
Collapse
Affiliation(s)
- Ane Antón-Ladislao
- Unidad de Investigación, Hospital Galdakao-Usansolo (Osakidetza), Galdakao, Bizkaia, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain
| | - Susana García-Gutiérrez
- Unidad de Investigación, Hospital Galdakao-Usansolo (Osakidetza), Galdakao, Bizkaia, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain
| | - Núria Soldevila
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Fernando González-Candelas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Unidad Mixta Genómica y Salud FISABIO-Salud Pública, Universidad de Valencia, Valencia, Spain
| | - Pere Godoy
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto de Salud Pública de Navarra, Pamplona, Spain
| | | | - Jenaro Astray
- Área de Epidemiología, Comunidad de Madrid, Madrid, Spain
| | - Vicente Martín
- Instituto de Biomedicina, Universidad de León, León, Spain
| | - Sonia Tamames
- Dirección General de Salud Pública, Investigación, Desarrollo e Innovación, Junta de Castilla y León, León, Spain
| | - Diana Toledo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
| | - Urko Aguirre
- Unidad de Investigación, Hospital Galdakao-Usansolo (Osakidetza), Galdakao, Bizkaia, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain
| | - Angela Domínguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
| | | |
Collapse
|
10
|
Domínguez A, Godoy P, Castilla J, Soldevila N, Toledo D, Astray J, Mayoral JM, Tamames S, García-Gutiérrez S, González-Candelas F, Martín V, Díaz J, Torner N. Knowledge of and attitudes to influenza vaccination in healthy primary healthcare workers in Spain, 2011-2012. PLoS One 2013; 8:e81200. [PMID: 24260560 PMCID: PMC3832596 DOI: 10.1371/journal.pone.0081200] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 10/09/2013] [Indexed: 01/08/2023] Open
Abstract
Annual influenza vaccination is recommended for healthcare workers, but many do not follow the recommendation. The objective of this study was to investigate the factors associated with seasonal influenza vaccination in the 2011–2012 season. We carried out an anonymous web survey of Spanish primary healthcare workers in 2012. Information on vaccination, and knowledge and attitudes about the influenza vaccine was collected. Workers with medical conditions that contraindicated vaccination and those with high risk conditions were excluded. Multivariate analysis was performed using unconditional logistic regression. We included 1,749 workers. The overall vaccination coverage was 50.7% and was higher in workers aged ≥ 55 years (55.7%), males (57.4%) and paediatricians (63.1%). Factors associated with vaccination were concern about infection at work (aOR 4.93; 95% CI 3.72–6.53), considering that vaccination of heathcare workers is important (aOR 2.62; 95%CI 1.83–3.75) and that vaccination is effective in preventing influenza and its complications (aOR 2.40; 95% CI 1.56–3.67). No association was found between vaccination and knowledge of influenza or the vaccine characteristics. Educational programs should aim to remove the misconceptions and attitudes that limit compliance with recommendations about influenza vaccination in primary healthcare workers rather than only increasing knowledge about influenza and the characteristics of the vaccine.
Collapse
Affiliation(s)
- Angela Domínguez
- Departamento de Salud Pública, Universidad de Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- * E-mail:
| | - Pere Godoy
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Agencia de Salud Pública de Cataluña, Barcelona, Spain
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Instituto de Salud Pública de Navarra, Pamplona, Spain
| | - Núria Soldevila
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Diana Toledo
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Servicio de Epidemiología, Agencia de Salud Pública de Barcelona, Barcelona, Spain
| | - Jenaro Astray
- Área de Epidemiología, Comunidad de Madrid, Madrid, Spain
| | | | - Sonia Tamames
- Dirección General de Salud Pública, Investigación, Desarrollo e Innovación, Junta de Castilla y León, León, Spain
| | | | | | - Vicente Martín
- Instituto de Biomedicina, Universidad de León, León, Spain
| | - José Díaz
- Servicio Andaluz de Salud, Sevilla, Spain
| | - Nuria Torner
- Departamento de Salud Pública, Universidad de Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Agencia de Salud Pública de Cataluña, Barcelona, Spain
| | | |
Collapse
|
11
|
Domínguez Á. ¿Qué nos enseñan los brotes de enfermedades inmunoprevenibles? GACETA SANITARIA 2013. [DOI: 10.1016/j.gaceta.2012.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
12
|
Estudio de actitudes y conocimientos sobre la vacunación antigripal en personal sanitario de atención primaria. Temporada 2011-2012. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.vacun.2013.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
13
|
Blasi F, Aliberti S, Mantero M, Centanni S. Compliance with anti-H1N1 vaccine among healthcare workers and general population. Clin Microbiol Infect 2012; 18 Suppl 5:37-41. [DOI: 10.1111/j.1469-0691.2012.03941.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
14
|
Rodríguez A, Alvarez-Rocha L, Sirvent JM, Zaragoza R, Nieto M, Arenzana A, Luque P, Socías L, Martín M, Navarro D, Camarena J, Lorente L, Trefler S, Vidaur L, Solé-Violán J, Barcenilla F, Pobo A, Vallés J, Ferri C, Martín-Loeches I, Díaz E, López D, López-Pueyo MJ, Gordo F, del Nogal F, Marqués A, Tormo S, Fuset MP, Pérez F, Bonastre J, Suberviola B, Navas E, León C. [Recommendations of the Infectious Diseases Work Group (GTEI) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) and the Infections in Critically Ill Patients Study Group (GEIPC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) for the diagnosis and treatment of influenza A/H1N1 in seriously ill adults admitted to the Intensive Care Unit]. Med Intensiva 2012; 36:103-37. [PMID: 22245450 DOI: 10.1016/j.medin.2011.11.020] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Accepted: 11/20/2011] [Indexed: 02/08/2023]
Abstract
The diagnosis of influenza A/H1N1 is mainly clinical, particularly during peak or seasonal flu outbreaks. A diagnostic test should be performed in all patients with fever and flu symptoms that require hospitalization. The respiratory sample (nasal or pharyngeal exudate or deeper sample in intubated patients) should be obtained as soon as possible, with the immediate start of empirical antiviral treatment. Molecular methods based on nucleic acid amplification techniques (RT-PCR) are the gold standard for the diagnosis of influenza A/H1N1. Immunochromatographic methods have low sensitivity; a negative result therefore does not rule out active infection. Classical culture is slow and has low sensitivity. Direct immunofluorescence offers a sensitivity of 90%, but requires a sample of high quality. Indirect methods for detecting antibodies are only of epidemiological interest. Patients with A/H1N1 flu may have relative leukopenia and elevated serum levels of LDH, CPK and CRP, but none of these variables are independently associated to the prognosis. However, plasma LDH> 1500 IU/L, and the presence of thrombocytopenia <150 x 10(9)/L, could define a patient population at risk of suffering serious complications. Antiviral administration (oseltamivir) should start early (<48 h from the onset of symptoms), with a dose of 75 mg every 12h, and with a duration of at least 7 days or until clinical improvement is observed. Early antiviral administration is associated to improved survival in critically ill patients. New antiviral drugs, especially those formulated for intravenous administration, may be the best choice in future epidemics. Patients with a high suspicion of influenza A/H1N1 infection must continue with antiviral treatment, regardless of the negative results of initial tests, unless an alternative diagnosis can be established or clinical criteria suggest a low probability of influenza. In patients with influenza A/H1N1 pneumonia, empirical antibiotic therapy should be provided due to the possibility of bacterial coinfection. A beta-lactam plus a macrolide should be administered as soon as possible. The microbiological findings and clinical or laboratory test variables may decide withdrawal or not of antibiotic treatment. Pneumococcal vaccination is recommended as a preventive measure in the population at risk of suffering severe complications. Although the use of moderate- or low-dose corticosteroids has been proposed for the treatment of influenza A/H1N1 pneumonia, the existing scientific evidence is not sufficient to recommend the use of corticosteroids in these patients. The treatment of acute respiratory distress syndrome in patients with influenza A/H1N1 must be based on the use of a protective ventilatory strategy (tidal volume <10 ml / kg and plateau pressure <35 mmHg) and positive end-expiratory pressure set to high patient lung mechanics, combined with the use of prone ventilation, muscle relaxation and recruitment maneuvers. Noninvasive mechanical ventilation cannot be considered a technique of choice in patients with acute respiratory distress syndrome, though it may be useful in experienced centers and in cases of respiratory failure associated with chronic obstructive pulmonary disease exacerbation or heart failure. Extracorporeal membrane oxygenation is a rescue technique in refractory acute respiratory distress syndrome due to influenza A/H1N1 infection. The scientific evidence is weak, however, and extracorporeal membrane oxygenation is not the technique of choice. Extracorporeal membrane oxygenation will be advisable if all other options have failed to improve oxygenation. The centralization of extracorporeal membrane oxygenation in referral hospitals is recommended. Clinical findings show 50-60% survival rates in patients treated with this technique. Cardiovascular complications of influenza A/H1N1 are common. Such problems may appear due to the deterioration of pre-existing cardiomyopathy, myocarditis, ischemic heart disease and right ventricular dysfunction. Early diagnosis and adequate monitoring allow the start of effective treatment, and in severe cases help decide the use of circulatory support systems. Influenza vaccination is recommended for all patients at risk. This indication in turn could be extended to all subjects over 6 months of age, unless contraindicated. Children should receive two doses (one per month). Immunocompromised patients and the population at risk should receive one dose and another dose annually. The frequency of adverse effects of the vaccine against A/H1N1 flu is similar to that of seasonal flu. Chemoprophylaxis must always be considered a supplement to vaccination, and is indicated in people at high risk of complications, as well in healthcare personnel who have been exposed.
Collapse
Affiliation(s)
- A Rodríguez
- Servicio de Medicina Intensiva, Hospital Universitario de Tarragona Joan XXIII, IISPV - URV - CIBER Enfermedades Respiratorias, Tarragona, España.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|