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He R, Ren X, Huang K, Lei J, Niu H, Li W, Dong F, Li B, Wang Y, Yang T, Wang C. Influenza and pneumococcal vaccination coverage and associated factors in patients hospitalized with acute exacerbations of COPD in China: Findings from real-world data. Chin Med J (Engl) 2024; 137:1179-1189. [PMID: 37488669 PMCID: PMC11101230 DOI: 10.1097/cm9.0000000000002790] [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: 02/24/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Influenza and pneumococcal vaccination are a priority in patients with chronic obstructive pulmonary disease (COPD). However, limited information is available on vaccination coverage among patients with acute exacerbations of COPD (AECOPD) in China. This study aimed to determine the rates and associated factors of influenza and pneumococcal vaccination in patients hospitalized with AECOPD. METHODS Baseline data from a national, multicenter, hospital-based study that included adult inpatients with AECOPD between 2017 and 2021 were analyzed. The outcomes of interest were the influenza vaccination in the past year and the pneumococcal vaccination in the past 5 years. To ensure national representativeness, rates were weighted according to the distribution of hospital levels and types enrolled in this study. Multivariable Poisson regression based on mixed-effects models were used to determine the associated factors. The independent variables included the region and hospital features where the participants were located, sociodemographic characteristics (age, sex, rural/urban residence, education, etc.), and clinical indicators (COPD disease history, lung function parameters, comorbidities, etc.). The treatment profiles of the vaccinated and unvaccinated participants were compared. RESULTS Of 6949 eligible participants, the weighted rates of influenza/pneumococcal, influenza, and pneumococcal vaccination were 2.72% (95% confidence interval [CI]: 2.34%-3.10%), 2.09% (95% CI: 1.76%-2.43%), and 1.25% (95% CI: 0.99%-1.51%), respectively. In multivariable models, age ≥60 years (60-69 years, odds ratio [OR]: 1.90, 95% CI: 1.11-3.25; ≥80 years, OR: 2.00, 95% CI: 1.06-3.78), geographical regions (Northern China relative to Eastern China, OR: 5.09, 95% CI: 1.96-13.21), urban residence (OR: 1.69, 95% CI: 1.07-2.66), a higher education level (junior high school, OR: 1.77, 95% CI: 1.21-2.58; senior high school or above, OR: 2.61, 95% CI: 1.69-4.03), former smoking (OR: 1.79, 95% CI: 1.15-2.79), and regular inhaled medication treatment (OR: 3.28, 95% CI: 2.29-4.70) were positively associated with vaccination. Patients who had experienced severe exacerbations in the past year were less likely to be vaccinated (OR: 0.65, 95% CI: 0.45-0.96). Compared with unvaccinated participants, vaccinated participants adhered better to pharmacological and non-pharmacological treatment. CONCLUSIONS Influenza and pneumococcal vaccination coverage are extremely low. Urgent measures are necessary to increase vaccination coverage among inpatients with AECOPD in China.
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Affiliation(s)
- Ruoxi He
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Xiaoxia Ren
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
- National Center for Respiratory Medicine, Beijing 100029, China
- National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
| | - Ke Huang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
- National Center for Respiratory Medicine, Beijing 100029, China
- National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
| | - Jieping Lei
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
- National Center for Respiratory Medicine, Beijing 100029, China
- National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
- Department of Clinical Research and Data Management, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China
| | - Hongtao Niu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
- National Center for Respiratory Medicine, Beijing 100029, China
- National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
| | - Wei Li
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
- National Center for Respiratory Medicine, Beijing 100029, China
- National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
| | - Fen Dong
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
- National Center for Respiratory Medicine, Beijing 100029, China
- National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
- Department of Clinical Research and Data Management, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China
| | - Baicun Li
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
- National Center for Respiratory Medicine, Beijing 100029, China
- National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
| | - Ye Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Ting Yang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
- National Center for Respiratory Medicine, Beijing 100029, China
- National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
| | - Chen Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
- National Center for Respiratory Medicine, Beijing 100029, China
- National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
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Simon S, Joean O, Welte T, Rademacher J. The role of vaccination in COPD: influenza, SARS-CoV-2, pneumococcus, pertussis, RSV and varicella zoster virus. Eur Respir Rev 2023; 32:230034. [PMID: 37673427 PMCID: PMC10481333 DOI: 10.1183/16000617.0034-2023] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/20/2023] [Indexed: 09/08/2023] Open
Abstract
Exacerbations of COPD are associated with worsening of the airflow obstruction, hospitalisation, reduced quality of life, disease progression and death. At least 70% of COPD exacerbations are infectious in origin, with respiratory viruses identified in approximately 30% of cases. Despite long-standing recommendations to vaccinate patients with COPD, vaccination rates remain suboptimal in this population.Streptococcus pneumoniae is one of the leading morbidity and mortality causes of lower respiratory tract infections. The Food and Drug Administration recently approved pneumococcal conjugate vaccines that showed strong immunogenicity against all 20 included serotypes. Influenza is the second most common virus linked to severe acute exacerbations of COPD. The variable vaccine efficacy across virus subtypes and the impaired immune response are significant drawbacks in the influenza vaccination strategy. High-dose and adjuvant vaccines are new approaches to tackle these problems. Respiratory syncytial virus is another virus known to cause acute exacerbations of COPD. The vaccine candidate RSVPreF3 is the first authorised for the prevention of RSV in adults ≥60 years and might help to reduce acute exacerbations of COPD. The 2023 Global Initiative for Chronic Lung Disease report recommends zoster vaccination to protect against shingles for people with COPD over 50 years.
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Affiliation(s)
- Susanne Simon
- Department of Respiratory Medicine and Infectious Disease, Hannover Medical School, Hannover, Germany
| | - Oana Joean
- Department of Respiratory Medicine and Infectious Disease, Hannover Medical School, Hannover, Germany
| | - Tobias Welte
- Department of Respiratory Medicine and Infectious Disease, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease, Member of the German Center for Lung Research, Hannover, Germany
| | - Jessica Rademacher
- Department of Respiratory Medicine and Infectious Disease, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease, Member of the German Center for Lung Research, Hannover, Germany
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Seyman D, Keskin AS, Küçükateş E, Ceylan MR, Kul G, Tosun S, Oğuzöncül AF, Gazel ÖZ, Uzar H, Uysal S, Aliravcı ID, Kaya SY, Uğuz M, Can M, Demirkıran BÇ, Kul H, Şölen EY, Can H, Deniz M, Altuntaş B. Healthcare personnel's attitude and coverage about tetanus vaccination in Turkey: a multicenter study. Hum Vaccin Immunother 2022; 18:2014732. [PMID: 35172681 PMCID: PMC8973359 DOI: 10.1080/21645515.2021.2014732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The tetanus vaccine is not routinely given to Turkish adults. Protective tetanus immunity decreases with age. Health-care personnel (HCPs), who are role models in the field of health, are a target group in order to achieve a higher rate of tetanus vaccination in the community. This study was designed to evaluate attitudes and coverage regarding tetanus vaccination among a large sample of Turkish HCPs. This cross-sectional epidemiologic study was conducted from July to August 2019. A questionnaire was sent to HCPs using social media. Of the 10,644 HCPs included in the study, 65% were female. Overall, the tetanus vaccination coverage (TVC) among HCPs was 78.5% (95% CI: 77.7%-79.3%). TVC was significantly higher among physicians [83.4% (95% CI: 82%-84.6%); p < .001] compared with all other HCPs except nurses. Older age (≥40 years) and length of professional experience were significantly correlated with TVC. Of the 8353 HCPs who received tetanus vaccines during their lifetime, 73.03% received tetanus vaccination in the past 10 years. The self-vaccination rate for protection against tetanus was 13.1%. Acute injuries (25.42%) and pregnancy (23.9%) were the most common reasons for having the tetanus vaccine. One-third (33.7%) of HCPs did not have information about whether pregnant women could receive tetanus vaccinations. This survey study provided excellent baseline information about HCPs’ coverage rates and attitudes regarding tetanus vaccination. The present results suggested that tetanus boosters for HCPs should be established as soon as possible, and revealed that the HCPs younger than 30 years with relatively less professional experience and all other HCPs except nurses and physicians should be identified as the target population for future intervention programs.
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Affiliation(s)
- Derya Seyman
- Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Antalya, Turkey
| | - Ayşegül Seremet Keskin
- Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Antalya, Turkey
| | - Emine Küçükateş
- Cerrahpasa Cardiology Institution, Department of Medical Microbiology, Istanbul University, Istanbul, Turkey
| | - Mehmet Reşat Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Harran University Medical Faculty, Şanlıurfa, Turkey
| | - Gülnur Kul
- Department of Infectious Diseases and Clinical Microbiology, Kırıkhan State Hospital, Hatay, Turkey
| | - Selma Tosun
- Department of Infectious Diseases and Clinical Microbiology, Bozyaka Education and Research Hospital, İzmir, Turkey
| | | | - Özlem Zanapalıoğlu Gazel
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep Cengiz Gökçek Maternity and Children Hospital, Gaziantep, Turkey
| | - Hanife Uzar
- Department of Infectious Diseases and Clinical Microbiology, Viranşehir State Hospital, Şanlıurfa, Turkey
| | - Serhat Uysal
- Department of Infectious Diseases and Clinical Microbiology, Balıkesir University Medical Faculty, Balıkesir, Turkey
| | - Işıl Deniz Aliravcı
- Department of Infectious Diseases and Clinical Microbiology, Manavgat State Hospital, Antalya, Turkey
| | - Sibel Yıldız Kaya
- Department of Infectious Diseases and Clinical Microbiology, Sungurlu State Hospital, Çorum, Turkey
| | - Mustafa Uğuz
- Department of Infectious Diseases and Clinical Microbiology, Mersin City Education and Research Hospital, Mersin, Turkey
| | - Müçteba Can
- Department of Anaesthesiology and Intensive Care Medicine, Ankara City Hospital, Ankara, Turkey
| | - Burcu Çalışkan Demirkıran
- Department of Infectious Diseases and Clinical Microbiology, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Halil Kul
- Department of Neurosurgery, Hatay State Hospital, Hatay, Turkey
| | - Emine Yeşilyurt Şölen
- Department of Medical Microbiology, Bozok University Medical Faculty, Yozgat, Turkey
| | - Hüseyin Can
- Departments of Family Medicine, Private Aymira Nursing Home and Elderly Care Center, İzmir, Turkey
| | - Mustafa Deniz
- Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Antalya, Turkey
| | - Bülent Altuntaş
- Departments of Family Medicine, Şişli Hamidiye Etfal Education and Research Hospital, İstanbul, Turkey
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Africano HF, Serrano-Mayorga CC, Ramirez-Valbuena PC, Bustos IG, Bastidas A, Vargas HA, Gómez S, Rodriguez A, Orihuela CJ, Reyes LF. Major Adverse Cardiovascular Events During Invasive Pneumococcal Disease Are Serotype Dependent. Clin Infect Dis 2021; 72:e711-e719. [PMID: 32964223 DOI: 10.1093/cid/ciaa1427] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/17/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Up to 30% of patients admitted to hospitals with invasive pneumococcal disease (IPD) experience major adverse cardiovascular event (MACE) including new/worsening heart failure, new/worsening arrhythmia, and/or myocardial infarction. Streptococcus pneumoniae (Spn) is the most frequently isolated bacterial pathogen among community-acquired pneumonia (CAP) patients and the only etiological agent linked independently to MACE. Nevertheless, no clinical data exist identifying which serotypes of Spn are principally responsible for MACE. METHODS This was an observational multicenter retrospective study conducted through the Public Health Secretary of Bogotá, Colombia. We included patients with a confirmed clinical diagnosis of IPD with record of pneumococcal serotyping and clinical information between 2012 and 2019. Spn were serotyped using the quellung method by the National Center of Microbiology. MACE were determined by a retrospective chart review. RESULTS The prevalence of MACE was 23% (71/310) in IPD patients and 28% (53/181) in patients admitted for CAP. The most prevalent S. pneumoniae serotype identified in our study was the 19A, responsible for the 13% (42/310) of IPD in our cohort, of which 21% (9/42) presented MACE. Serotypes independently associated with MACE in IPD patients were serotype 3 (odds ratio [OR] 1, 48; 95% confidence interval [CI] [1.21-2.27]; P = .013) and serotype 9n (OR 1.29; 95% CI [1.08-2.24]; P = .020). Bacteremia occurred in 87% of patients with MACE. Moreover, serum concentrations of C-reactive protein were elevated in patients with MACE versus in non-MACE patients (mean [standard deviation], 138 [145] vs 73 [106], P = .01). CONCLUSIONS MACE are common during IPD with serotype 3 and 9n independently of frequency.
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Affiliation(s)
| | | | | | | | | | - Hernan A Vargas
- Grupo Laboratorio de Salud Pública de Bogotá; Secretaría de Salud de Bogotá, Colombia.,Laboratorio de salud pública del Tolima, Secretaria de salud del Tolima, Gobernación del Tolima
| | - Sandra Gómez
- Grupo Laboratorio de Salud Pública de Bogotá; Secretaría de Salud de Bogotá, Colombia
| | - Alejandro Rodriguez
- Hospital Universitari Joan XXIII, Critical Care Medicine, Rovira and Virgili University and CIBERES (Biomedical Research Network of Respiratory Disease), Tarragona, Spain
| | | | - Luis F Reyes
- Universidad de la Sabana, Chía, Colombia.,Clínica Universidad de La Sabana, Chía, Colombia
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Zhou M, Zhan J, Kong N, Campy KS, Chen Y. Factors associated with intention to uptake pneumococcal vaccines among Chinese elderly aged 60 years and older during the early stage of COVID-19 pandemic. PSYCHOL HEALTH MED 2021; 27:91-105. [PMID: 33769153 DOI: 10.1080/13548506.2021.1905862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Innoculation of pneumococcal vaccines among the elderly is an effective public health policy to prevent pneumococcal diseases and it is widely promoted by many developed countries. The pneumococcal vaccination rate among the elderly in China was only 3.7% in 2019, it grew rapidly during the early stage of the COVID-19 pandemic. The purpose of this cross-sectional study was to investigate the psychological and demographic-economic factors related to the uptake behavior of pneumococcal vaccination among the Chinese elderly by using an integrated model based on the unified theory of acceptance and use of technology (UTAUT), and knowledge, attitudes and practices (KAP). The theoretical model was tested via structural equation modeling (SEM) with data collected from 516 Chinese older adults aged 60 years and older. Our results suggested that knowledge, performance expectancy, effort expectancy, attitude, and trust had a significant correlation with behavioral intention; behavioral intention and trust had a positive correlation with the uptake behavior, gender, and and education level and chronic obstructive pulmonary disease exerted significant moderating effects. To increase the coverage of pneumococcal vaccination among the elderly, it is necessary to provide effective health education by authoritative experts, thereby enhancing their knowledge and positive attitude towardthe vaccination.
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Affiliation(s)
- Min Zhou
- International Business School, Hunan University of Technology and Business, Changsha, China.,Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Jiaying Zhan
- School of Accounting, Hunan University of Technology and Business, Changsha, China
| | - Nan Kong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Kathryn S Campy
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yan Chen
- International Business School, Hunan University of Technology and Business, Changsha, China
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Ozsurekci Y, Aykac K, Bal F, Bayhan C, Basaranoglu ST, Alp A, Cengiz AB, Kara A, Ceyhan M. Outcome predictors of influenza for hospitalization and mortality in children. J Med Virol 2021; 93:6148-6154. [PMID: 33512015 PMCID: PMC8014286 DOI: 10.1002/jmv.26833] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/18/2021] [Accepted: 01/22/2021] [Indexed: 01/09/2023]
Abstract
Severity of disease caused by influenza virus and the influencing factors that may be different. Moreover, the disease course actually may not be determined specifically in children because of lower seroprotection rates of children. Herein, the results clinic and outcome data of children with influenza from Turkey were reported. We present here the results from 2013 to 2017. Nasopharyngeal swab samples of the children with influenza were investigated via multiplex polymerase chain reaction. A total of 348 children were diagnosed with influenza; 143 (41.1%) were influenza A, 85 (24.4%) were influenza B, and 120 (34.5%) were mixt infection with other respiratory viruses. Fifty‐four percent of children admitted to intensive care unit (ICU) were under 2 years of age (p = .001). Having an underlying disease was detected as the main predictor for both hospitalization and ICU stay according to multiple logistic regression analysis (odds ratio [OR], 11.784: 95% confidence interval [CI], 5.212–26.643; p = .001 and OR, 4.972: 95% CI, 2.331–10.605; p = .001, respectively). Neurological symptoms most frequently seen in cases who died (44.4%; p = .02). Lymphopenia was relatively higher (55.6%) and thrombocytopenia was most frequently seen in cases who died (77.8%) with a significant ratio (p = .001). Underlying diseases was found a risk factor for influenza being hospitalized and being admitted to ICU. Children under 2 years of age and with underlying diseases should be vaccinated particularly in countries where the influenza vaccination is still not routinely implemented in the immunization schedule. Highlights Underlying diseases is a risk factor for influenza to be hospitalized and admitted to ICU. Influenza vaccination is of great importance to prevent life‐threatening complications of influenza, particularly in children require ICU admission. The possibility to reduce the outpatient visit number by vaccination has a great impact on disease burden in addition to the underestimated crucial social benefits, as well.
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Affiliation(s)
- Yasemin Ozsurekci
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kubra Aykac
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Fatma Bal
- Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Cihangul Bayhan
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sevgen T Basaranoglu
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Alpaslan Alp
- Department of Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Bulent Cengiz
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ates Kara
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Ceyhan
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
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