ABSTRACT
INTRODUCTION: no one can deny that vaccination against several serious diseases in the world, and particularly in Morocco, has given very satisfactory protective results. The extension of the COVID-19 pandemic in our country has led to a significant decline in childhood immunization, which could have severe repercussions increasing the risk of future outbreaks. Hence, the measures of the Ministry of Health to correct the situation. The purpose of this study was to highlight the extent of vaccine release during COVID-19 pandemic and to make recommendations to restore vaccination programmes. METHODS: we conducted a cross-sectional study of the effect of containment measures during this pandemic on the monitoring of children´s vaccinations. We conducted a national survey of pediatricians using an electronic questionnaire administered via Google Forms. We collected, analyzed and interpreted the results. RESULTS: one hundred and three Moroccan pediatricians answered the questionnaire. More than 2-thirds (78.6%) of pediatricians practiced in the private sector and delivered vaccines in the immunization schedule. The majority of pediatricians (95%) were asked about parental vaccine concerns. We noted that 82.5% of parents were reluctant to go to the local health department and 5.8% refused to take vaccination during COVID-19 pandemic. About 22% of pediatricians completely stopped immunization services and 72.8% delayed immunizations from 3 to 4 weeks. Vaccination stoppage involved older children in two thirds of cases. CONCLUSION: it is essential to maintain public confidence in vaccination. Ongoing and timely assessment of vaccine coverage as well as clear recommendations and broad public awareness are essential to respond to vaccine changes during the COVID-19 pandemic.
Subject(s)
COVID-19 , Immunization Schedule , Vaccination/statistics & numerical data , Vaccines/administration & dosage , Adult , Cross-Sectional Studies , Female , Humans , Immunization Programs , Male , Middle Aged , Morocco , Parents , Pediatricians/statistics & numerical data , Surveys and Questionnaires , Vaccination CoverageABSTRACT
BACKGROUND AND AIMS: There is growing evidence that the 2019 coronavirus disease (COVID-19) is emerging as a potential trigger virus for the development of diabetes mellitus in children. This can occur even in patients without factors predisposing to impaired glucose metabolism. Here, we report two rare cases of diabetic ketoacidosis revealing new-onset diabetes and precipitated by COVID-19. These cases are reported in view of their rarity and originality. The relationship between type 1 diabetes mellitus and COVID-19 is discussed. RESULTS: Two children developed symptoms suggestive of diabetic ketoacidosis preceded by polyuria, polydipsia, and asbestos. There is a documented COVID-19 infection in the parents of the 2 children. An asymptomatic infection was detected in the 2 patients on the basis of a reverse transcription polymerase chain reaction (RT-PCR) test. Thoracic imaging and inflammatory workup were negative in both cases. Both patients responded well to treatment, including rehydration regimens and intravenous insulin. On the 2nd day of their hospitalization, they were transferred to several injections of subcutaneous insulin with therapeutic and nutritional education from the parents. After about 4 weeks, their insulin requirements probably decreased due to the diabetes honeymoon. CONCLUSION: COVID-19 can induce acute onset diabetes and diabetic ketoacidosis in children. More research data are needed to improve our knowledge of this constellation and to guide the most appropriate therapies.