ROTAVIRUS VACCINE IMPLEMENTATION IN GEORGIA - IMPACT OF KNOWLEDGE, APPROACH, AND PRACTICES OF HEALTH CARE WORKERS.

Rotavirus (RV) is the most common cause of severe gastroenteritis in infants and young children worldwide. RV causes approximately half a million deaths each year among children aged <5 years. According to WHO estimates for 2008, there were approximately 10 to 50 deaths annually in young children due to rotavirus diarrhea in Georgia. The purpose of this study was to assess the knowledge, attitudes, and practices related to rotavirus diarrhea and the rotavirus vaccine among health care workers (HCWs). The National Center for Disease Control and Public Health (NCDC) conducted a cross-sectional survey of HCWs involved in the expanded program of immunization (EPI). The HCWs were selected by simple random sampling using employee lists, and questionnaires were hand-delivered to selected HCWs during working hours. The majority of HCWs (67.9%) recognized diarrhea as a frequent health-related problem in children under 2 years of age. However, 53.9% partially disagreed with the statement that rotavirus is the most common cause of all forms of diarrhea. Multivariable analysis revealed that the following perceptions among HCWs more than doubled the likelihood that they would not support adoption of the RV vaccine: no perception of need for this vaccine in Georgia specifically (OR=2.54, CI: 1.46-4.42), no perception of need to address burden of disease in developing countries (OR=2.75, CI: 1.59-4.75), and concerns about the vaccine's safety (OR=2.51, CI: 1.56-4.02). Concerns about vaccine safety, low awareness about the RV disease burden and the effectiveness of the RV vaccine, combined with a lack of communication skills represented the main predictors of RV vaccine uptake among HCWs. Intensive vaccine promotion interventions that focus on the epidemiology of disease and vaccine effectiveness are urgently needed.

Importance of correlations of gross motoric functions data and functional independence for management of children with motoric disabilities.

The aim of the rehabilitation therapy is to improve the level of functional independence and decrease degree of disability. The optimization of programs of rehabilitation means functional improvement of the person, and this approach is a basis of effective management. To evaluate the correlation of Gross Motoric Function Data and Functional Independence Measure for children with cerebral palsy. A total of 397 children with cerebral palsy aged 1 to 12 years at the onset of study were observed for up to 3.5 years during the period from 2002 to 2005. Children were assessed by GMFM-88 (Gross Motor Function Measure), by WeeFIM (Functional Independence Measure for Children). Over the course of the study 397 children had a total of 6875 GMFM assessments, or an average of 17.3 observations per child and 1518 -- WeeFIM, or an average of 3.8 observations per child. The values of GMFM-88 and WeeFIM are well correlated (p<0.01). At certain stage of rehabilitation treatment the rate of improvement of gross motoric function slows down and then practically stops. In patients with gross motoric function level IV-V its value remains especially low, and accordingly there is no improvement of functional abilities. This is the main reason of ineffectiveness of rehabilitation treatment and necessity of tertiary care preventive measures.