Control of meningitis epidemics is based on early case detection followed by mass campaigns of immunisation. However, this strategy showed severe inadequacies during recent outbreaks in Africa. In Niamey, Niger, menin...
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Control of meningitis epidemics is based on early case detection followed by mass campaigns of immunisation. However, this strategy showed severe inadequacies during recent outbreaks in Africa. In Niamey, Niger, meningococcal vaccinations began in 1978 and detailed bacteriological and epidemiological surveillance of meningitis started in 1981. When vaccine coverage rates were higher than 50%, the prevalences of Neisseria meningitidis A meningitis were low in Niamey, although there was a concurrent epidemic in rural Niger. A massive outbreak of meningitis in Niamey in 1994-1995 followed a 6-year period during which the mean rate of vaccine coverage remained < 25%. The data indicate that, in the meningitis belt, preventive immunisation should avoid a great number of deaths and be less expensive than mass immunisation campaigns performed after epidemics have begun.
This study was conducted to ascertain the vaccination beliefs and practices of physicians who provide care for low income children. Sixty-two (56.9%) of a sample of 109 physicians in suburban Cook County, Illinois res...
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This study was conducted to ascertain the vaccination beliefs and practices of physicians who provide care for low income children. Sixty-two (56.9%) of a sample of 109 physicians in suburban Cook County, Illinois responded to a mail survey. A majority of physicians reported a willingness to immunize during well child care, follow-up, and chronic illness visits;yet, a substantial lack of willingness to immunize given certain acute mild illnesses was reported. Twenty-six percent of providers did not routinely identify children who were behind in immunizations and only 16% had completed a chart audit in the past three years. Seventy-four percent were willing to provide all shots needed at a single visit. Misconceptions regarding true contraindications was found among the group. Missed well child visits were identified as the greatest barrier to complete immunization. Improvements in vaccination rates are expected if physicians utilize all types of medical encounters to monitor the immunization status of patients and provide vaccines using only true medical contraindications.
Objective: To identify barriers to immunisation in general practice. Method: The study was conducted in Perth, Western Australia, as a cross-sectional postal survey between November 1996 and January 1997. Questionnair...
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Objective: To identify barriers to immunisation in general practice. Method: The study was conducted in Perth, Western Australia, as a cross-sectional postal survey between November 1996 and January 1997. Questionnaires were sent to all known GPs in three of the seven metropolitan Divisions of General Practice, of whom 301 (72%) responded. Results: When a child presented with a minor illness and there were no contraindications to immunisation, 62% of GPs said they would always or frequently offer immunisation. Immunisation would be withheld incorrectly because of an upper respiratory tract infection by 43% of GPs and because of antibiotics by 50%. Combined diphtheria-tetanus vaccine (CDT) would be substituted incorrectly for diphtheria-tetanus-pertussis vaccine (DTP) by 41% if there was an unexplained temperature of 38 degrees C following a previous dose of DTP While more than half (56%) reported that vaccines were correctly stored, only 26% reported that the refrigerator temperature was checked daily. Eighty per cent reported that they completed an Australian Childhood Immunisation Register notification form. Conclusions: GPs require ongoing education about contra-indications to immunisation and when substitution of CDT for DTP is required. There is room for increased opportunistic immunisation and encouragement to notify the Australian Childhood Immunisation Register when they immunise a child. Implications: A major challenge is to find an innovative approach that would encourage and enable GPs to assess immunisation status and offer immunisation where appropriate at every clinical encounter.
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