ABSTRACT
AIM: Streptococcus pneumoniae commonly causes respiratory tract infections including acute otitis media and pneumonia. In this study, we evaluated the impact of general infant pneumococcal vaccination, introduced in Sweden in 2009, on respiratory tract infections. METHODS: We studied the incidence of respiratory tract infections and antibiotic consumption in Västerbotten County, Sweden, during 2005-2014 using the County Council's diagnosis register. RESULTS: Comparing the prevaccination period of 2005-2008 to 2014, the incidences of all-cause acute otitis media decreased significantly in children aged 0-4 and five years to 17 years, by 41.5% and 20.9%, respectively. In addition, we also noted significant reductions in sinusitis and other upper respiratory tract infections, and some reductions in adults. Antibiotic consumption for upper respiratory tract infections decreased by 37.1%, with the largest decrease occurring in children aged 0-4 years. For pneumonia, the incidence significantly decreased by 28.6% for children aged 0-4 years, with no significant changes in older children or adults. CONCLUSION: Pneumococcal vaccination was followed by reduced incidence of upper respiratory tract infections and antibiotic consumption in vaccinated children, with some indications of possible herd immunity. For pneumonia, a major reduction was noted limited to the youngest children.
ABSTRACT
In the year 2000, 804 adults were in coercive care for a maximum of 6 months under the Swedish Act on Care of Addicts in Certain Cases, which has both paternalistic and utilitarian motives. The extensive rights of the state to intervene in the private lives of its citizens seem to have a solid support in society. The article describes the present system and offers some explanations for its acceptance by looking at history. The fact that compulsory decisions have been made within the social administration has meant that such measures grew with the welfare system and could benefit from its goodwill. The medical profession provided motivation for preventive compulsory measures for social or individual reasons and gave hope for a cure. The crucial involvement of laypersons and non-governmental organisations in decision-making and provision of compulsory treatment has given compulsory treatment a high political legitimacy. Compulsion became 'internalised' in the Swedish society. The economic and political liberalisation of today may pose a threat to the Swedish compulsory treatment of substance misusers.
