COVID-19 vaccination knowledge, attitudes and practices among the general population of Romania during the third wave of COVID-19 pandemic.

Objective: Romania began its COVID-19 immunization programme with approved vaccinations in three stages, as follows: The first step of vaccination is for health and social professionals, the second stage is for high-risk persons and the third stage is for the remainder of the general public. This study aims at assessment of knowledge, attitude and practice towards COVID-19 and vaccination against COVID-19 in the Romanian population during the third wave of the pandemic. Methods: This cross-sectional study was based on a Bosnian and Herzegovinian study on COVID-19 vaccination during the country's third wave of COVID-19 pandemic. Results: Our study sample, dominantly female (629; 61.0%), with a bachelor's degree (734; 71.2%), either single (539; 52.3%) or in a relationship (363; 35.2%), engaged in intellectual labour (910; 88.3%) and living in an urban environment (874; 84.8%) with a mean age of 25.07 ± 8.21 years, 294 (28.5%) people with COVID-19 symptoms and 86 (8.3%) were tested COVID-19 positive, had a mean knowledge score of 16.38 ± 4.0 with correct answer rates on questions ranging from 30.1% to 88.2%. Being single (odds ratio = 3.92, p = 0.029) or in a relationship (odds ratio = 3.79, p = 0.034), having a bachelor's degree and higher (odds ratio = 1.61, p = 0.006) and being COVID-19 tested (odds ratio = 1.82, p < 0.001) were associated with higher knowledge test scores. Our sample had relatively optimistic attitudes towards final COVID-19 disease containment (712; 69.1%) and vaccination programmes (679; 65.9%). The majority of the sample followed socio-epidemiological measures and did not visit places of mass social gatherings (666; 64.1%) and wore masks (992; 95.7%) while being outside their home. In terms of vaccination rates, 382 (37.0%) of the individuals were presently immunized against COVID-19. Higher knowledge test scores (>15 points) (odds ratio = 1.66, p = 0.002) and positive attitudes of this study (odds ratio = 1.59, p = 0.001, odds ratio = 4.16, p < 0.001) were identified as independent predictors for vaccinating against COVID-19. Conclusion: Romanian citizens have had good knowledge, optimistic attitudes and appropriate practices towards COVID-19 vaccination during the third wave of COVID-19 outbreak in the country. Higher knowledge regarding the disease and vaccination against it not only increased attitudes towards the end of the pandemic, but also increased the willingness to be vaccinated and to avoid infection risk factors.

Proposed model for a Romanian register of chronic diseases in children.

BACKGROUND AND OBJECTIVES: The prevalence of chronic diseases at children is increasing due to the progress made in medicine, which radically changed the evolution and the prognostics. Disease registers became important tools to register and monitor the chronic patients in order to asses their needs and improve their care. Disease registers are also very important for adjusting to population needs the actions in the public health field. The main objective for this research is to develop a model for a chronic disease register of children in Romania, taking into account the current situation of chronic diseases' registration and reporting, the specific requirements for such medical database and the particularities of the information systems in the Romanian healthcare system. METHODS: Our study was based on interviews with specialists and Health Ministry representatives, field observations, and analysis of published and unpublished data). RESULTS: We developed a platform for a chronic diseases register of children based on open EHR specifications and architecture, which respects the requirements for data security and the particularities of Romania's healthcare system. The model created is functioning on two levels. The first one is local and corresponds to a medical unit, while the second one represents the connection and the communication method within the entire national medical system. In order to achieve the highest level of interoperability at the semantic level, we used, for the communication module of a National Disease Register system, only EN 13606 or HL7 v3 and / or HL7 v3 CDA. CONCLUSIONS: This model is functional and can be applied initially at a clinical level for medical and administrative purposes. Its design allows a future development, integrated with the current informational systems and implemented at regional and national level. This will significantly improve the knowledge that may support good medical practice in this field, will enhance the coherence of data collection and, as a consequence, will impact positevely on the health of children diagnosed with chronic diseases.