RESUMO
OBJECTIVES: The aim of the study was to assess the association between sociodemographic characteristics and attitudes according to health belief model (HBM) attributes with the intention to vaccinate children in cases of non-mandatory vaccination to support informed decisions in planned revision of our vaccination policy. STUDY DESIGN: This is a cross-sectional study carried out on a random sample of 3,854 women with young children in Slovenia. METHODS: The participants' attitudes were grouped within six HBM attributes (perceived susceptibility, severity, benefits, barriers, clue to action and self-efficacy). Possible associations between the intention to vaccinate children in cases of non-mandatory vaccination and sociodemographic characteristics or attitudinal attributes according to HBM were explored in univariate analyses by calculating odds ratios (ORs) with 95% confidence interval (CI) estimates. RESULTS: Just more than half (56.2%; 95% CI: 53.8-58.5%) of the women reported on their intention to vaccinate their children in the case of non-mandatory vaccination, and 23.4% (95% CI: 21.4-25.5%) were undecided. There were no significant sociodemographic predictor variables in relation to this intention. Those who perceived higher susceptibility to vaccine-preventable diseases or the benefits of vaccination were more likely to intend to vaccinate in the case of non-mandatory vaccination (OR = 5.70; 95% CI: 4.64-7.00) and (OR = 7.62; 95% CI: 5.96-9.76). Perceived barriers to vaccinate (fear of side-effects or lack of comprehensive information from physicians) and parents not getting enough useful information in general as a clue to action were significant predictors of an intention not to vaccinate. CONCLUSIONS: Our results show that a mandatory vaccination policy is an important factor in ensuring high levels of vaccination coverage in Slovenia. In future, more comprehensive communication activities focused on vaccine-preventable diseases and the benefits and safety of vaccination (for the education of parents and their healthcare providers) are needed to diminish the reliance on a mandatory vaccination policy.
Assuntos
Política de Saúde , Programas Obrigatórios , Mães/psicologia , Vacinação/psicologia , Programas Voluntários , Adulto , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Intenção , Masculino , Mães/estatística & dados numéricos , Eslovênia , Adulto JovemAssuntos
Aglomeração , Surtos de Doenças/prevenção & controle , Cães , Vírus do Sarampo/isolamento & purificação , Sarampo/transmissão , Sarampo/virologia , Adulto , Animais , Humanos , Sarampo/diagnóstico , Sarampo/epidemiologia , Vírus do Sarampo/classificação , Vírus do Sarampo/genética , Pessoa de Meia-Idade , Eslovênia/epidemiologia , ViagemRESUMO
Haemorrhagic fever with renal syndrome is endemic in parts of Slovenia. Since 1999, in January to April each year, the number of notified cases has generally been low (n=0-6). A high number of cases (n=26) in the first four months of 2012 has been observed, similar to that seen in the same period in 2008 (n=14). Given the increase in the number of cases at the start of 2012, we can expect a high number of cases this year.
Assuntos
Surtos de Doenças/estatística & dados numéricos , Febre Hemorrágica com Síndrome Renal/epidemiologia , Vigilância da População , Adulto , Idoso , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Eslovênia/epidemiologiaRESUMO
After ten years of being measles free, Slovenia experienced a cluster with secondary transmission in a hospital setting in March 2010. The index case, a resident of Ireland, was hospitalised on the day after his arrival to Slovenia and diagnosed with measles two days later. After his discharge, two cases of measles were notified, a hospital staff member and a visitor to the clinic, suggesting transmission in a hospital setting.
Assuntos
Infecção Hospitalar/etiologia , Hospitais , Sarampo/transmissão , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Lactente , Sarampo/epidemiologia , Morbillivirus/isolamento & purificação , Eslovênia/epidemiologia , Viagem , Adulto JovemRESUMO
The objectives of our study were to describe the epidemiology of invasive Haemophilus influenzae disease from 1993 to 2008 in Slovenia, a country with routine H. influenzae serotype b (Hib) conjugate vaccination since the year 2000. A total of 292 isolates of H. influenzae, recovered from a normally sterile site, were collected in the study period. The isolates were serotyped by slide agglutination and antibiotic susceptibility was determined. One hundred and eight isolates received after the year 2000 were serotyped by slide agglutination and by polymerase chain reaction (PCR) capsule typing, and both methods were compared. After the introduction of the routine Hib vaccination, the incidence of H. influenzae disease in children under the age of 5 years has decreased by 87.6% and type b was replaced by non-typeable H. influenzae as the predominant serotype. The proportion of serotype b decreased from 85.3% in the pre-vaccination period to 13.0% in the vaccination period and the proportion of non-capsulated isolates increased from 12.0 to 85.2%. The study of genetic relatedness by pulsed-field gel electrophoresis (PFGE) demonstrated that the isolates of serotypes b and f were genetically homogeneous within the serotype. The results of our national surveillance showed that the vaccine has been very efficient in preventing Hib invasive disease in Slovenia. Nevertheless, we see a need for further monitoring of invasive H. influenzae infections at a national level.
Assuntos
Infecções por Haemophilus/epidemiologia , Infecções por Haemophilus/microbiologia , Haemophilus influenzae/classificação , Haemophilus influenzae/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Testes de Aglutinação , Antibacterianos/farmacologia , Criança , Pré-Escolar , Análise por Conglomerados , Impressões Digitais de DNA , Eletroforese em Gel de Campo Pulsado , Feminino , Haemophilus influenzae/efeitos dos fármacos , Haemophilus influenzae/imunologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Sorotipagem , Eslovênia/epidemiologia , Adulto JovemRESUMO
Haemorrhagic fever with renal syndrome (HFRS) is an acute zoonotic viral disease, caused by hantaviruses. Hantaviruses infect rodents worldwide. They are transmitted to humans by aerosol from rodent excreta. Several hantaviruses are known to infect humans with varying severity.
Assuntos
Surtos de Doenças/estatística & dados numéricos , Febre Hemorrágica com Síndrome Renal/epidemiologia , Vigilância da População , Medição de Risco/métodos , Adulto , Idoso , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Eslovênia/epidemiologiaAssuntos
Infecções por Caliciviridae/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Gastroenterite/epidemiologia , Norovirus/isolamento & purificação , Casas de Saúde/estatística & dados numéricos , Vigilância da População , Medição de Risco/métodos , Idoso , Idoso de 80 Anos ou mais , Infecções por Caliciviridae/microbiologia , Feminino , Gastroenterite/microbiologia , Humanos , Incidência , Masculino , Fatores de Risco , Eslovênia/epidemiologiaAssuntos
Surtos de Doenças , Febre Q/epidemiologia , Febre Q/veterinária , Faculdades de Medicina Veterinária , Doenças dos Ovinos/transmissão , Doenças dos Trabalhadores Agrícolas/diagnóstico , Doenças dos Trabalhadores Agrícolas/epidemiologia , Animais , Vetores de Doenças , Feminino , Humanos , Masculino , Febre Q/diagnóstico , Febre Q/transmissão , Ovinos , Doenças dos Ovinos/diagnóstico , Eslovênia/epidemiologiaAssuntos
Cárie Dentária/etiologia , Permeabilidade do Esmalte Dentário/efeitos dos fármacos , Oxidantes/toxicidade , Peróxidos/toxicidade , Clareamento Dental/efeitos adversos , Ureia/análogos & derivados , Animais , Peróxido de Carbamida , Combinação de Medicamentos , Masculino , Ratos , Ratos Wistar , Estatísticas não Paramétricas , Ureia/toxicidadeRESUMO
A one-day survey was conducted in all (19) Slovenian acute-care hospitals in October 2001 to estimate the prevalence of all types of hospital-acquired infections (HAIs) and to identify predominant micro-organisms and risk factors. Among 6695 patients surveyed, the prevalence of patients with at least one HAI was 4.6%. The prevalence of urinary tract infections was highest (1.2%), followed by pneumonia (1.0%), surgical wound infection (0.7%), and bloodstream infection (0.3%). In intensive care units (ICUs) the prevalence of patients with at least one HAI was 26.9% and the ratio of episodes of HAI per number of patients was 33.3%. One or more pathogens were identified in 55.8% of HAIs episodes. Among these, the most frequently single isolated micro-organisms were Staphylococcus aureus (18.2%) and Escherichia coli (10.2%). Risk factors for HAI included central intravascular catheter (adjusted odds ratio (OR) 3.2; 95% confidence intervals (CI) 2.1-4.9), peripheral intravascular catheter (adjusted OR 1.7; 95% CI 1.2-2.4), urinary catheter (adjuster OR 2.4; 95% CI 1.6-3.4), and hospitalization in ICUs (adjusted OR 2.5; 95% CI 1.4-4.3). The results provide the first national estimates for Slovenia.
Assuntos
Infecção Hospitalar/epidemiologia , Infecção Hospitalar/etiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Cateterismo Venoso Central/efeitos adversos , Cateterismo Periférico/efeitos adversos , Criança , Pré-Escolar , Infecção Hospitalar/prevenção & controle , Infecções por Escherichia coli/epidemiologia , Feminino , Humanos , Lactente , Controle de Infecções , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pneumonia/epidemiologia , Vigilância da População , Prevalência , Fatores de Risco , Sepse/epidemiologia , Distribuição por Sexo , Eslovênia/epidemiologia , Infecções Estafilocócicas/epidemiologia , Infecção da Ferida Cirúrgica/epidemiologia , Cateterismo Urinário/efeitos adversos , Infecções Urinárias/epidemiologiaRESUMO
Invasive strains of Neisseria meningitidis isolated from sterile body fluids of children aged 0-14 years were intentionally collected in nine Slovenian laboratories, and sent to the laboratory of the National Institute of Public Health, Ljubljana for final evaluation. From 1993-1999 we collected 53 invasive strains from children presented in this study. The incidence rate of invasive diseases in children shows that there is a rapid fall from 4.74/100,000 in 1993 to 0.90/100,000 in 1999. Invasive diseases predominated in children in the age group 0-1 year (19.6 cases per 100,000 children); followed by the age groups 2-4 years, 5-9 years and 10-14 years. The results of serogrouping indicate that the largest proportion of meningococci isolated (90%) were group B, while 8% of isolates were group C and only 2% group Y. The serotype/serosubtype distribution shows that the most frequent serotype (excluding 19 non-typable NT strains) was serotype 22, which was expressed in 9 strains and the most frequent serosubtype (excluding 11 NST strains) was P1.5,2 found in 7 strains. The most frequently isolated strains (excluding NT/NST strains) were B:22:P1.14; B:NT:P1.5 and B:NT:P1.16. Thirty-one strains collected during 1993-1995 were analysed by multilocus enzyme electrophoresis (MEE). There were 25 electrophoretic types (ETs) among 31 strains; the strains were very heterogeneous with only four ETs being represented by more than one strain. Study shows that meningococcal disease is still endemic in Slovenia.
Assuntos
Infecções Meningocócicas/epidemiologia , Neisseria meningitidis/classificação , Adolescente , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Humanos , Incidência , Lactente , Recém-Nascido , Neisseria meningitidis/genética , Neisseria meningitidis/isolamento & purificação , Sorotipagem , Eslovênia/epidemiologiaRESUMO
Varicella is one of the most common childhood diseases. The course of the disease is usually mild and uncomplicated. In Slovenia, varicella is a notifiable communicable disease which must be reported. Data collected from 1979-98 were analysed. Over the 20-year period the number of varicella cases reported ranged from a low of 11,086 (in 1994) to a maximum of 21,141 (in 1987). During the last 10 years, the highest incidence of varicella was reported in children aged from 12 months to 2 years. In adults over 20, incidence has slightly but steadily increased over the 20 year period. Overall, the number of males with varicella exceeded that of females. The proportion of females was higher only in the 20-30-year age group, probably as a consequence of more frequent and closer contact with infected children by mothers. The highest number of reported cases was during winter and early spring.
Assuntos
Varicela/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , Métodos Epidemiológicos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Lactente , Masculino , Estações do Ano , Distribuição por Sexo , Eslovênia/epidemiologiaRESUMO
Adult patients hospitalised with community-acquired pneumonia were studied prospectively to determine the microbial aetiology of pneumonia. Between April 1996 and March 1997, blood and sputum samples were collected for culture. Throat swabs were obtained for isolation of viruses and for detection of antigens of Chlamydia pneumoniae, influenza viruses A and B, respiratory syncytial virus and parainfluenza virus. Antibodies against Legionella spp., Mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia psittaci, Coxiella burnetii, influenza viruses A and B, respiratory syncytial virus, adenovirus and parainfluenza virus were tested in serum samples. Two hundred eleven patients were included in the study; paired sera were available from 152 patients. Blood culture was positive in 23 (10.9%) patients, Streptococcus pneumoniae being the bacterium isolated most frequently. A fourfold or greater rise or fall in the Chlamydia pneumoniae IgG and/or IgM antibody titre was found in 20 (9.5%) patients and a high antibody titre (> or = 1:512) in the first and/or the second serum sample in 18 (18.5%) patients. Antibodies confirming acute Mycoplasma pneumoniae infection were found in 12 (5.7%) patients, Legionella spp. in six (2.8%), Chlamydia psittaci in two and Coxiella burnetii in one. Three patients had pulmonary tuberculosis. Only two patients had a virus present in the throat swab (adenovirus in one patient and echovirus in the other), and in nine patients, viral antigen was detected. Acute viral infection was confirmed in 51 (24.1%) patients. Bacterial pneumonia was diagnosed in 84 (39.8%) patients, 23 of whom had concurrent viral infection. Acute viral pneumonia without any other identified pathogen was diagnosed in 28 patients. Streptococcus pneumoniae and Chlamydia pneumoniae were the most frequently identified microorganisms.
Assuntos
Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/virologia , Pneumonia Bacteriana/microbiologia , Pneumonia Viral/virologia , Idoso , Antígenos de Bactérias/urina , Sangue/microbiologia , Sangue/virologia , Feminino , Hospitalização , Humanos , Legionella pneumophila/imunologia , Masculino , Pessoa de Meia-Idade , Faringe/virologia , Pneumonia Bacteriana/mortalidade , Pneumonia Viral/mortalidade , Estudos Prospectivos , Testes Sorológicos , Escarro/microbiologia , Escarro/virologiaRESUMO
Mumps is an acute infectious disease caused by a paramyxovirus. Although the disease is usually mild, up to 10% of patients can develop aseptic meningitis; a less common but more serious complication is encephalitis, which can result in death or disability. Permanent deafness, orchitis, and pancreatitis are other untoward effects of mumps. Based on data reported to WHO up to April 1998, mumps vaccine is routinely used by national immunization programmes in 82 countries/areas: 23 (92%) of 25 developed countries, 19 (86%) of 22 countries with economies in transition (mainly the Newly Independent States of the former Soviet Union), and 40 (24%) of 168 developing countries. Countries that have achieved high coverage have shown a rapid decline in mumps morbidity. Furthermore, in many of these countries, mumps-associated encephalitis and deafness have nearly vanished. This review considers the disease burden due to mumps; summarizes studies on the immunogenicity, efficacy, and safety of different strains of mumps vaccine; and highlights lessons learned about implementing mumps immunization in different countries. Countries already using mumps vaccine should monitor immunization coverage and establish routine mumps surveillance with investigation of outbreaks. Where mumps is targeted for elimination, countries need to add a second dose of mumps vaccine for children, keeping in mind that the disease may still occur in susceptible adults.
PIP: Mumps is an acute infectious disease caused by a paramyxovirus. While the disease is usually mild, up to 10% of patients can develop aseptic meningitis. A less common but more serious complication is encephalitis, which can result in death or disability. Permanent deafness, orchitis, and pancreatitis are other adverse effects of mumps. Based upon data reported to the World Health Organization (WHO) up to April 1998, mumps vaccine is routinely used by national immunization programs in 82 countries/areas: 23 of 25 developed countries, 19 of 22 countries with economies in transition, and 40 of 168 developing countries. Countries which have achieved high vaccine coverage have realized a rapid decline in mumps morbidity. Also in many such countries, mumps-associated encephalitis and deafness have almost vanished. The authors consider the disease burden due to mumps; summarize studies on the immunogenicity, efficacy, and safety of different strains of mumps vaccine; and note lessons learned about implementing mumps immunization in different countries. Countries already using mumps vaccine should monitor immunization coverage and establish routine mumps surveillance with investigation of outbreaks. Where mumps is targeted to be eliminated, countries need to add a second dose of mumps vaccine for children.
Assuntos
Vacina contra Caxumba , Caxumba/prevenção & controle , Adulto , Criança , Feminino , Saúde Global , Humanos , Incidência , Masculino , Caxumba/complicações , Caxumba/epidemiologia , Vacina contra Caxumba/efeitos adversos , GravidezRESUMO
Mumps is commonly considered a "mild" infectious disease in children because death due to mumps is very rare. However, mumps causes a high rate of complications in young adults, and its burden should not be underestimated. Before the introduction of vaccine, mumps was a common infectious disease with high incidence rates which exceeded 100 per 100,000 population in most countries. Poland continues to belong to the group of countries, which do not use mumps vaccine. In Poland, the number of reported mumps cases per year ranges from 40,000 to 220,000, yielding an annual incidence rates of 110 and 570 per 100,000 population. It is estimated that each year in Poland, mumps causes 1000 cases of aseptic meningitis (range 400 to 2,200), 100 cases of encephalitis, 250 to 1375 cases of epidymo-orchitis in post-pubertal men, 50-275 cases of oophoritis in women. The age distribution of mumps cases is characteristic for a country that does not use mumps vaccine. For more that 20 years, the highest mumps incidence has occurred in children aged 5-9 years. In many countries the number of reported cases has declined significantly following the introduction of mumps vaccine, and in several countries the incidence has fallen to less than 1 per 100,000 population. Several countries using mumps vaccine have reported a shift in the age distribution of mumps cases, with an increased incidence in older children and young adults. Countries with high levels of coverage with measles-mumps-rubella (MMR) vaccine have nearly eliminated encephalitis associated with these diseases. A few countries using mumps vaccine have experienced relative resurgence of the disease, either due to incomplete vaccine coverage of certain age groups (USA) or problems with the long-term immunogenicity of mumps vaccine based on the Rubini strain (Portugal, Switzerland).
Assuntos
Caxumba/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Caxumba/imunologia , Caxumba/prevenção & controle , Vacina contra Caxumba/uso terapêutico , Polônia/epidemiologiaRESUMO
Effective attenuated live virus mumps vaccines have been available for more than 30 years. Vaccine strains have been developed on various cell culture systems; the attenuated mumps virus strain most commonly used is the Jeryl Lynn strain. Various vaccines differ in their immunogenicity, efficacy and associated adverse events. It is estimated that the immunization coverage needed to block the transmission of mumps virus is at least 70%. Models indicate that low to moderate levels of mumps vaccine coverage may actually increase the number of susceptibles and the number of cases in older age groups. Benefit-cost analyses in a number of countries have found that the introduction of mumps vaccine is economically justifiable, as vaccination can avert the considerable medical and economic costs associated with mumps morbidity. Countries that do not immunize against mumps continue to register high mumps morbidity, and pay a high toll from neurological and other complications of mumps. Poland, which already has a high level of measles vaccine coverage, should make efforts to replace monovalent measles vaccine with trivalent measles-mumps-rubella (MMR) vaccine.