1
|
Zaitoon H, Cohen S, Lahoud D, Srugo I, Chistyakov I, Bamberger E. Paediatric hospital visit with laboratory-confirmed influenza improved family members' influenza vaccination. Cent Eur J Public Health 2023; 31:97-102. [PMID: 37451241 DOI: 10.21101/cejph.a7468] [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: 05/11/2022] [Accepted: 04/22/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Vaccination is the primary intervention to prevent influenza infection, yet vaccine uptake remains low among children and other at-risk patients. The aim of the study is to investigate the impact of a paediatric hospital visit with laboratory-confirmed influenza on the influenza vaccination behaviour of participants and their family members in the subsequent influenza season. METHODS This study compared the influenza vaccination coverage for participants < 18 years of age with a clinical suspicion of influenza in 2017-2018 during a hospital visit, in two subsequent influenza seasons. Data was retrieved from the hospital electronic medical record and a follow-up questionnaire (2018-2019) to ascertain the common reason(s) that families did not vaccinate their children the following year (2018-2019). The children were distributed into positive- (antigen and/or PCR) and negative-influenza groups. RESULTS A total of 133 children were enrolled in our study. Participants' mean age was 4.6 years and 74 (55.6%) were males. Overall, 47 (35.3%) had confirmed influenza virus. A significant increase in influenza immunization was found among both positive- and negative-influenza participants between 2017-2018 and 2018-2019 (6.4% vs. 27.7%, p < 0.001; 8.1% vs. 29.1%, p < 0.001, respectively), as well as among family members of positive-influenza participants - siblings and parents (6.4% vs. 19.6%, p = 0.003; 0% vs. 17%, p < 0.001, respectively). Common reasons for failure to vaccinate included doubt in vaccine effectiveness, unlikely to get "flu", busy, and side effects. CONCLUSIONS Our findings suggest that a paediatric hospital visit with laboratory-confirmed influenza increases vaccine uptake among families. Future studies should aim to evaluate evidence-based interventions to improve influenza vaccine uptake among children.
Collapse
Affiliation(s)
- Hussein Zaitoon
- Department of Paediatrics, Bnai Zion Medical Centre, Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | | | - Dana Lahoud
- Department of Paediatrics, Bnai Zion Medical Centre, Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Isaac Srugo
- Department of Paediatrics, Bnai Zion Medical Centre, Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Clinical Microbiology Laboratory, Bnai Zion Medical Centre, Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Irina Chistyakov
- Department of Paediatrics, Bnai Zion Medical Centre, Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Ellen Bamberger
- Department of Paediatrics, Bnai Zion Medical Centre, Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| |
Collapse
|
2
|
Zaitoon H, Hanna S, Bamberger E. Impact of rotavirus vaccine implementation on Israeli children: a comparison between pre- and post-vaccination era. World J Pediatr 2022; 18:417-425. [PMID: 35389194 DOI: 10.1007/s12519-022-00547-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Worldwide rotavirus vaccination has resulted in a substantial decrease in rotavirus-induced severe gastroenteritis and related hospitalizations among children. Still, the characterization of patients warranting hospitalization needs to be further elucidated. The purpose of the study is to compare the clinical and laboratory features of children hospitalized with acute rotavirus infection before and after the introduction of routine vaccination. METHODS This is a retrospective observational study. Participants were pediatric patients who presented to the Bnai Zion Medical Center pediatric emergency department and were diagnosed with rotavirus acute gastroenteritis between 2017 and 2019. RESULTS During the pre-vaccination period (2007-2009), 114 infants and young children (median age: 14 months, range: 1-72 months; 59 male, 55 female) were hospitalized for rotavirus-induced acute gastroenteritis with a rate of 11.71 positive rotavirus tests per 1000 emergency room visits. In the post-vaccination period (2012-2019), 168 infants and young children (median age: 17 months, range: 0-84 months; 90 male, 78 female) were hospitalized with a rate of 4.18 positive rotavirus tests per 1000 emergency room visits. There were no statistical differences between the two groups in gender, breast-feeding rates and sibling(s). The proportion of cases with moderate-to-severe dehydration was higher in the post-vaccination children than in the pre-vaccination children. CONCLUSIONS Rates of rotavirus-attributed acute gastroenteritis hospitalizations declined from the pre- to the post-vaccination period. Higher rates of dehydration were found in the post-vaccination children. Ongoing surveillance is warranted to better understand the implications of the vaccine.
Collapse
Affiliation(s)
- Hussein Zaitoon
- Department of Pediatrics, Bnai Zion Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 47 Golomb St., 31048, Haifa, Israel.
| | - Shaden Hanna
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ellen Bamberger
- Department of Pediatrics, Bnai Zion Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 47 Golomb St., 31048, Haifa, Israel
| |
Collapse
|
3
|
Bobo FT, Asante A, Woldie M, Dawson A, Hayen A. Child vaccination in sub-Saharan Africa: Increasing coverage addresses inequalities. Vaccine 2022; 40:141-150. [PMID: 34794824 DOI: 10.1016/j.vaccine.2021.11.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Vaccines have substantially contributed to reducing morbidity and mortality among children, but inequality in coverage continues to persist. In this study, we aimed to examine inequalities in child vaccination coverage in sub-Saharan Africa. METHODS We analysed Demographic and Health Survey data in 25 sub-Saharan African countries. We defined full vaccination coverage as a child who received one dose of bacille Calmette-Guérin vaccine (BCG), three doses of diphtheria, pertussis, and tetanus vaccine (DTP 3), three oral polio vaccine doses (OPV 3), and one dose of measles vaccine. We used the concentration index (CCI) to measure wealth-related inequality in full vaccination, incomplete vaccination, and zero-dose children within and between countries. We fitted a multilevel regression model to identify predictors of inequality in receipts of full vaccination. RESULTS Overall, 56.5% (95% CI: 55.7% to 57.3%) of children received full vaccination, 35.1% (34.4% to 35.7%) had incomplete vaccination, while 8.4% (95% CI: 8.0% to 8.8%) of children remained unvaccinated. Full vaccination coverage across the 25 sub-Saharan African countries ranged from 24% in Guinea to 93% in Rwanda. We found pro-rich inequality in full vaccination coverage in 23 countries, except for Gambia and Namibia, where we found pro-poor vaccination coverage. Countries with lower vaccination coverage had higher inequalities suggesting pro-rich coverage, while inequality in unvaccinated children was disproportionately concentrated among disadvantaged subgroups. Four or more antenatal care contracts, childbirth at health facility, improved maternal education, higher household wealth, and frequently listening to the radio increased vaccine uptake. CONCLUSIONS Continued efforts to improve access to vaccination services are required in sub-Saharan Africa. Improving vaccination coverage and reducing inequalities requires enhancing access to quality services that are accessible, affordable, and acceptable to all. Vaccination programs should target critical social determinants of health and address barriers to better maternal health-seeking behaviour.
Collapse
Affiliation(s)
- Firew Tekle Bobo
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia; Department of Public Health, Institute of Health Sciences, Wollega University, Nekmete, Ethiopia.
| | - Augustine Asante
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Mirkuzie Woldie
- Department of Health Policy and Management, Jimma University, Jimma, Ethiopia; Fenot Project of Harvard T.H. Chan School of Public Health, Addis Ababa, Ethiopia
| | - Angela Dawson
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Andrew Hayen
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| |
Collapse
|
4
|
Ogokeh CE, Campbell AP, Feldstein LR, Weinberg GA, Staat MA, McNeal MM, Selvarangan R, Halasa NB, Englund JA, Boom JA, Azimi PH, Szilagyi PG, Harrison CJ, Williams JV, Klein EJ, Stewart LS, Sahni LC, Singer MN, Lively JY, Payne DC, Patel M. Comparison of Parental Report of Influenza Vaccination to Documented Records in Children Hospitalized With Acute Respiratory Illness, 2015-2016. J Pediatric Infect Dis Soc 2021; 10:389-397. [PMID: 33043965 PMCID: PMC9264279 DOI: 10.1093/jpids/piaa110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/01/2020] [Indexed: 11/13/2022]
Abstract
BACKGROUND Parent-reported influenza vaccination history may be valuable clinically and in influenza vaccine effectiveness (VE) studies. Few studies have assessed the validity of parental report among hospitalized children. METHODS Parents of 2597 hospitalized children 6 months-17 years old were interviewed from November 1, 2015 to June 30, 2016, regarding their child's sociodemographic and influenza vaccination history. Parent-reported 2015-2016 influenza vaccination history was compared with documented vaccination records (considered the gold standard for analysis) obtained from medical records, immunization information systems, and providers. Multivariable logistic regression analyses were conducted to determine potential factors associated with discordance between the 2 sources of vaccination history. Using a test-negative design, we estimated VE using vaccination history obtained through parental report and documented records. RESULTS According to parental report, 1718 (66%) children received the 2015-2016 influenza vaccine, and of those, 1432 (83%) had documentation of vaccine receipt. Percent agreement was 87%, with a sensitivity of 96% (95% confidence interval [CI], 95%-97%) and a specificity of 74% (95% CI, 72%-77%). In the multivariable logistic regression, study site and child's age 5-8 years were significant predictors of discordance. Adjusted VE among children who received ≥1 dose of the 2015-2016 influenza vaccine per parental report was 61% (95% CI, 43%-74%), whereas VE using documented records was 55% (95% CI, 33%-69%). CONCLUSIONS Parental report of influenza vaccination was sensitive but not as specific compared with documented records. However, VE against influenza-associated hospitalizations using either source of vaccination history did not differ substantially. Parental report is valuable for timely influenza VE studies.
Collapse
Affiliation(s)
- Constance E Ogokeh
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education Fellowship Program, Oak Ridge, Tennessee, USA
| | - Angela P Campbell
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Leora R Feldstein
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Geoffrey A Weinberg
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Mary A Staat
- Department of Pediatrics, University of Cincinnati College of Medicine, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Monica M McNeal
- Department of Pediatrics, University of Cincinnati College of Medicine, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Rangaraj Selvarangan
- Department of Pathology and Laboratory Medicine, University of Missouri-Kansas City, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Natasha B Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Janet A Englund
- Department of Pediatrics, Seattle Children's Research Institute, Seattle, Washington, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Julie A Boom
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Texas Children's Hospital, Houston, Texas, USA
| | - Parvin H Azimi
- Department of Infectious Diseases, University of California, San Francisco Benioff Children's Hospital Oakland, Oakland, California, USA
| | - Peter G Szilagyi
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, California, USA
| | - Christopher J Harrison
- Department of Pediatrics, University of Missouri-Kansas City; Division of Infectious Diseases, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - John V Williams
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Eileen J Klein
- Department of Pediatrics, Seattle Children's Research Institute, Seattle, Washington, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Laura S Stewart
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Leila C Sahni
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Texas Children's Hospital, Houston, Texas, USA
| | - Monica N Singer
- Department of Infectious Diseases, University of California, San Francisco Benioff Children's Hospital Oakland, Oakland, California, USA
| | - Joana Y Lively
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- IHRC Inc, Atlanta, Georgia, USA
| | - Daniel C Payne
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Manish Patel
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | |
Collapse
|
5
|
Akinkugbe AA, Brickhouse TH, Bandyopadhyay D, Nascimento MM. Accuracy of Maternal Reports of Young Children's Dental Disease Status: Avon Longitudinal Study of Parents and Children. Dent J (Basel) 2020; 8:E8. [PMID: 31936716 PMCID: PMC7148443 DOI: 10.3390/dj8010008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/02/2020] [Accepted: 01/08/2020] [Indexed: 12/05/2022] Open
Abstract
Background: Parental reports of their children's health status is integral to pediatric medical and dental care. Therefore, understanding the accuracy of such reports is vital. Our objectives were to (1) assess the correlation between maternal reports of their children's indicators of caries experience (subjective assessment) and actual caries status determined by oral examination (objective assessment), and (2) identify potential modifiers of this correlation. Methods: Longitudinal data from the Avon longitudinal study of parents and children (n = 1429) was used to assess the correlation between maternal reports of the number of missing and filled teeth of children aged 38 months, 54 months, and 5.5 years and clinical oral examinations of decayed, missing and filled teeth conducted when the same children were 31, 43 months, and five years of age. Homogeneity chi-square tests assessed differences in correlations according to sociodemographic factors. Results: Overall, we found a statistically significant correlation that was weak to moderate in magnitude. Maternal reports of missing teeth at 38 months was significantly correlated with decayed teeth, 0.27 (p < 0.001); missing teeth, 0.23 (p < 0.001), and the decayed, missing and filled (dmft) index, 0.35 (p < 0.001) based on oral examination at 31 months. A maternal report of filled teeth at 54 months was significantly correlated with decayed teeth, 0.30 (p < 0.001); filled teeth 0.30 (p < 0.001), and dmft 0.40 (p < 0.001) at 43 months. Mothers tended to underestimate the extent of missing and filled teeth in their children irrespective of the child's age, but the extent of underestimation was greater among younger children. Maternal age, education level, and whether the child had ever visited a dentist were significant modifiers of subjective and objective caries assessments. Conclusions: From a clinical and dental public health perspective, our findings of a weak to moderate correlation of maternal assessments of their children's caries experience may be concerning when reporting the burden of dental diseases in large population studies or for surveillance purposes that rely on self-reported measures and must therefore be utilized with caution because of the potential to result in underestimated disease burden.
Collapse
Affiliation(s)
- Aderonke A. Akinkugbe
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23298, USA;
- Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Tegwyn H. Brickhouse
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23298, USA;
- Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Dipankar Bandyopadhyay
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA;
| | - Marcelle M. Nascimento
- Department of Restorative Dental Sciences, University of Florida College of Dentistry, Gainesville, FL 32610, USA;
| |
Collapse
|