[Requests for HIV tests and their performance in primary health care. Study of the Sentinel Physician Network of Castilla y León in Spain, 1990-1996]. / Solicitud y realización del test del VIH en atención primaria. Estudio de la Red de Médicos Centinelas de Castilla y León 1990-1996.

AIM: To describe the patterns of requests for and the carrying out of the HIV test in Primary Health Care and the epidemological characteristics of the individuals who have undergone the test. METHOD: A retrospective descriptive study of requests for the HIV test in Primary Health Care, in the area covered by the Sentinel Network of Castile and Leon between 1991 and 1996. The validity of the results was assured through an initial study of geographical representativity and populational diversity, with periodical adjustments. The information was obtained through weekly reports from Sentinel doctors. RESULTS: The request rate per 100.000 inhabitants showed a tendency to increase until 1993, levelling off in 1995 and 1996. There were significant differences between percentage of test requested by doctors (55.9%) and patients (40%), as well as between males/females and average for age of these. Of the 63.1% of patients with known risk factor: 17.5% were injected drug users (IDUs) and 11.2% were through unsafe heterosexual contact; these factors being modified over time. The predominant risk factors among males were: heterosexual contact (31.1%) and the use of injected drugs (27.9%). The case was similar for females: 22.7% and 6.9% respectively. The results were positive in 3.2% of the HIV tests. CONCLUSIONS: An increase in requests and tests carried out between 1991 and 1993 was detected. The figures later stabilized and, in general, they were lower than in other studies. The doctor was predominantly the origin of the request. A decrease in IDUs and an increase in the percentage of unsafe heterosexual contact, were detected, both in line with data from other research. Primary Health Care had a predominant place in early detection of risk practice and in the areas of prevention, education and information.

[Documented immunization coverage in second-year primary schoolchildren from the province of Valladolid]. / Cobertura vacunal documentada en los escolares de segundo curso de educación primaria de la provincia de Valladolid.

OBJECTIVE: To estimate the documented immunization coverage and degree to which schoolchildren's vaccination cards are kept up to date. METHODS: Transversal descriptive study of children in the second year of primary education in the province of Valladolid during the 1999-2000 academic year. The sample consisted of 698 children with a participation rate of 82%. The percentage of children whose immunization schedule was up to date in accordance with their age, that of children with additional vaccinations and the accuracy of the vaccination cards was quantified. Information was collected through a questionnaire on vaccination cards or, for children without one, from their medical history. RESULTS: The documented immunization coverage was 99.3% (95% CI: 98.6-99.9) for the first three dose of diphtheria toxoid, tetanus toxoid and pertussis vaccine and poliomyelitis vaccine, 98.9% (95% CI: 97.7-99.5) for the measles, mumps and rubella vaccine and 95% (95% CI: 93.4-96.7) for all doses up to the age of six. In addition, 7.2% (95% CI: 5.3-9.2) were immunized against hepatitis B, 14.4% (95% CI: 11.6-17) against Haemophilus influenzae type B and 90.3% (95% CI: 88-92.5) against meningococal A + C. A total of 84.4% of vaccination cards were correctly filled in (95% CI: 81.7-87.2). CONCLUSIONS: Systematic immunization coverage in the schoolchildren was high. Because of their accuracy, vaccination cards were a useful tool for determining immunization coverage. Both the accuracy of the vaccination card and the incidence of non-systematic immunization were higher in urban areas.

Cobertura vacunal documentada en los escolares de segundo curso de educación primaria de la provincia de Valladolid / Documented immunization coverage in second-year primary schoolchildren from the province of Valladolid [Spain]

Objetivo: Estimar la cobertura vacunal documentada y la calidad de cumplimentación de la cartilla de vacunación en escolares. Métodos: Estudio descriptivo transversal en escolares de segundo de educación primaria de la provincia de Valladolid durante el curso 1999-2000. Se seleccionaron mediante muestreo por conglomerados 698 sujetos, y se alcanzó una participación del 82 por ciento. Se cuantificó el porcentaje de escolares con calendario completo de acuerdo con su edad, porcentaje de vacunas adicionales y calidad de cumplimentación de la cartilla. La información se obtuvo a partir de la cartilla de vacunación mediante un cuestionario, y a través de la historia clínica en aquellos que no la presentaron. Resultados: La cobertura documentada para las tres primeras dosis de DTP y polio es del 99,3 por ciento (intervalo de confianza [IC] del 95 por ciento: 98,6-99,9), para triple viral es del 98,9 por ciento (IC del 95 por ciento: 97,7-99,5) y para el total de dosis hasta los 6 años es del 95 por ciento (IC del 95 por ciento: 93,4-96,7). De manera adicional, un 7,2 por ciento (IC del 95 por ciento: 5,3-9,2) está vacunado de la hepatitis B, un 14,4 por ciento (IC del 95 por ciento: 11,6-17) de Haemophilus influenzae tipo b y un 90,3 por ciento (IC del 95 por ciento: 88-92,5) de antimeningocócica A + C. La calidad de cumplimentación se consideró buena en el 84,4 por ciento (IC del 95 por ciento: 81,7-87,2) de las cartillas. Conclusiones: En escolares la cobertura vacunal sistemática y la antimeningocócica A + C es alta. La buena calidad de la cartilla permite utilizarla para determinar la cobertura vacunal. Tanto la calidad del documento como el hecho de haber recibido alguna vacuna no sistemática es mayor en el área urbana (AU)