Mothers and vaccination: knowledge, attitudes, and behaviour in Italy

The study evaluates knowledge, attitudes, and behaviour of mothers regarding the immunization of 841 infants who attended public kindergarten in Cassino and Crotone, Italy. Overall, 57.8% of mothers were aware about all four mandatory vaccinations for infants (poliomyelitis, tetanus, diphtheria, hepatitis B). The results of a multiple logistic regression analysis showed that this knowledge was significantly greater among mothers with a higher education level and among those who were older at the time of the child's birth. Respondents' attitudes towards the utility of vaccinations for preventing infectious diseases were very favourable. Almost all children (94.4%) were vaccinated with all three doses of diphtheria-tetanus (DT), oral poliovirus vaccine (OPV), and hepatitis B. The proportion of children vaccinated who received all three doses of OPV, DT or diphtheria-tetanus-pertussis (DTP), and hepatitis B vaccines within 1 month of becoming age-eligible ranged from 56.6% for the third dose of hepatitis B to 95.7% for the first dose of OPV. Results of the regression analysis performed on the responses of mothers who had adhered to the schedule for all mandatory vaccinations indicated that birth order significantly predicted vaccination nonadherence, since children who had at least one older sibling in the household were significantly less likely to be age-appropriately vaccinated. The coverage for the optional vaccines was only 22.5% and 31% for measles-mumps-rubella and for all three doses against pertussis, respectively. Education programmes promoting paediatric immunization, accessibility, and follow-up should be targeted to the entire population.     

江西省乙肝高发地区育龄妇女KAP调查与分析

目的:了解江西省育龄妇女对乙肝的认知水平、态度及行为,分析其影响因素,为今后有针对性地开展宣传教育提供科学依据。方法:对江西省乙肝高发地区18～49岁育龄妇女进行乙肝防治知识-态度-行为问卷调查并对结果进行统计分析。结果:1 161名育龄妇女乙肝防治知识知晓率为45.76%,对乙肝的传播途径有一定的了解,但仍存在误区。被调查妇女乙肝防治知识平均得分(11.44±5.10)分,妇女年龄、文化程度、职业得分组间差别有统计学意义(P<0.01);只有不到1/3的调查对象愿意与乙肝患者/携带者交往;文化程度和是否注射疫苗是影响乙肝防治知识、态度、行为的主要因素。乙肝防治知识、态度及行为三者之间存在相关性。结论:江西省育龄妇女乙肝防治知识知晓率较低,对乙肝患者/携带者有一定的歧视现象,今后应针对低文化、高年龄、农民加强健康教育,提高乙肝防治基本知识和自我防护意识,最终控制乙肝传播。     

Hepatitis B immunisation coverage of infants born to chronic carrier mothers in Victoria

Abstract: Infants born to HBsAg– (hepatitis B surface antigen) carrier mothers are highly likely to become chronic hepatitis B (HB) carriers themselves unless their status is recognised at birth and they are immunised with three doses of HB vaccine, the first within 48 hours of birth, concurrent with hepatitis B immune globulin (HBIG). This study was designed to determine how many infants born in Victoria to carrier mothers completed three doses of HB vaccine. We sent the names of all infants of HBsAg–carrier mothers notified in Victoria between 1.7.91 and 30.6.92 to the appropriate local government immunisation providers and requested information on how many doses of HB vaccine, DTP (diphtheria–tetanus–pertussis) or CDT (combined diphtheria–tetanus), and OPV (oral polio vaccine) they had received. The HBsAg–carrier prevalence of women giving birth in Victoria in 1991–92 was at least 0.52%. Of the 336 infants notified, 239 (71.1%) were recorded in local government records. Of these 239, 90.8% received at least two doses and 80.8% received at least three doses of hepatitis B vaccine. There was no significant difference in the number who received three doses of HB vaccine compared with three doses of DTP or CDT vaccine. Of the entire cohort of 336, only 57.4% were documented as being completely immunised against hepatitis B. HB immunisation coverage for these infants needs to be improved. The high rate of loss to follow–up, especially between the maternity hospital and the community, is disturbing. Mechanisms for intensive prospective follow–up of these infants should be developed to prevent loss to follow–up and to encourage full immunisation against HB. Improving HB immunisation coverage of infants in high HBsAg–prevalence ethnic groups and introduction of universal infant HB immunisation may lead to increased coverage of infants of carriers by serving as back–up mechanisms for those lost to follow–up.     

合肥地区15210例育龄妇女乙肝病毒感染现状

目的调查合肥地区育龄妇女乙型肝炎病毒（HBV）感染状况,分析其分布特征,为防治乙型肝炎提供依据。方法选择在合肥市妇幼保健院体检的年龄在18～48岁的育龄妇女15 210例,采用酶联免疫吸附试验（ELISA）对其进行乙肝感染指标检测。结果合肥地区育龄妇女HB-sAg阳性率为9.717%,农村妇女HBsAg阳性率（16.612%）明显高于城市妇女（6.434%）,育龄妇女在年龄、城乡之间差异有统计学意义;共检测出乙肝五项感染模式22种。结论应加强育龄妇女健康知识特别是乙肝知识的教育、防治项目宣传,对易感的女童和育龄妇女进行乙肝疫苗接种,对育龄妇女进行HBV感染筛查、管理和监测,建立完善的围产期保健制度,打破乙肝病毒的母婴垂直传播链。     

南宁市某医学高校大学生乙型肝炎知识态度行为的调查

目的调查分析南宁市某医学高校大学生对乙型肝炎的知识、态度和行为。方法使用随机分层抽样的方法对南宁市某医学高校临床医学、预防医学、护理学三个专业,大一至大四年级的学生进行乙型肝炎知识、态度、行为的问卷调查。结果在校医学生对乙型肝炎知识的了解不够深入和全面;不同专业及年级的学生对乙型肝炎的认知存在差异(P≤0.05);有不少学生对乙肝患者及病毒携带者仍存在歧视;乙肝疫苗的接种率(83.5%)有待提高。结论学校应针对不同学生的特点,加强乙型肝炎知识的宣传和教育,以消除学生对乙肝患者的歧视。学生应该提高自我保护意识,主动接种乙肝疫苗。     

Hepatitis B Awareness,Testing, and Knowledge among Vietnamese American Men and Women

Southeast Asians have higher rates of liver cancer than any other racial/ethnic group in the United States. Chronic carriage of hepatitis B virus (HBV) is the most common underlying cause of liver cancer in the majority of Asian populations. Our objectives were to describe Vietnamese Americans’ awareness of hepatitis B, levels of HBV testing, and knowledge about hepatitis B transmission; and to compare the HBV knowledge and practices of men and women. A community-based, in-person survey of Vietnamese men and women was conducted in Seattle during 2002. Seven hundred and fifteen individuals (345 men and 370 women) completed the questionnaire. Eighty-one percent of the respondents had heard of hepatitis B (76% of men, 86% of women) and 67% reported HBV testing (66% of men, 68% of women). A majority of the participants knew that HBV can be transmitted during sexual intercourse (71% of men, 68% of women), by sharing toothbrushes (67% of men, 77% of women), and by sharing razors (59% of men, 67% of women). Less than one-half knew that hepatitis B is not spread by eating food prepared by an infected person (46% of men, 27% of women), nor by coughing (39% of men, 25% of women). One-third of our respondents did not recall being tested for HBV. Important knowledge deficits about routes of hepatitis B transmission were identified. Continued efforts should be made to develop and implement hepatitis B educational campaigns for Vietnamese immigrant communities. These efforts might be tailored to male and female audiences. Victoria M. Taylor is Full Member, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington. John H. Choe is Acting Instructor, Department of Medicine, University of Washington, Seattle, Washington. Yutaka Yasui is Professor, Department of Public Health Sciences, University of Alberta, Edmonton, Alberta. Lin Li is Research Associate, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington. Nancy Burke is Assistant Professor, Comprehensive Cancer Center, University of California, San Francisco, California; and J. Carey Jackson is Associate Professor, Department of Medicine, University of Washington, Seattle, Washington.     

天津市城乡居民防治乙型肝炎健康教育需求评估

目的了解天津市城乡居民乙型肝炎（乙肝）防治知识水平和健康教育需求，为倡导城乡居民科学防治乙肝提供相关依据。方法采用自行设计的问卷对858位居民就乙肝防治知识、信念、行为、知识获取途径及健康教育需求进行面对面调查。结果被调查居民乙肝防治知识知晓率为45．3％，79．8％的调查对象希望继续了解乙肝防治知识，希望了解乙肝预防知识的人最多，占90．2％，不同人口学特征人群对乙肝防治知识的需求差异有统计学意义（P〈0．05），知识的实际与希望获取途径间的差异具有统计学意义（P〈0．05）。结论天津市城乡居民乙肝防治知识水平偏低，应大力开展以大众媒体为主的多元化的健康教育工作。     

婴儿出生后24小时内乙型肝炎疫苗低接种率的原因及居民教育

为防止乙型肝炎 (乙肝 )病毒 (HBV)母婴传播 ,婴儿出生后 2 4h内接种乙肝疫苗 (HepB)非常重要 ,但其接种率很低。为探讨接种率低的原因及其对策 ,在甘肃省访问了承担预防接种的工作人员 ,并对婴儿家长及乡村医生进行了小组访谈。调查结果显示 ,几乎所有婴儿家长对乙肝知识了解甚少或有错误。本次调查中 ,2 4h内接种HepB的婴儿全部在医院出生 ,2 4h内未接种的全部在家出生。即使及时接种的婴儿家长亦不知 2 4h内接种HepB的重要性 ,只不过是因为在医院出生才偶然做到了 2 4h内接种。另外 ,在家分娩且非乡村医生接生时 ,婴儿家长即使知道 2 4h内接种的重要性 ,但如不及时通知乡村医生 ,乡村医生也不能及时到家接种。因此 ,为提高婴儿出生后 2 4h内HepB接种率 ,对婴儿家长的宣传教育 ,特别是对孕妇和新婚夫妇的教育非常必要。     

普陀区外来务工人员乙肝认知程度及影响因素调查分析

目的了解普陀区外来务工人员乙肝认知程度和疫苗接种情况及其影响因素,并提出相关建议。方法在普陀区20个工厂中进行配额采样,随机调查了605名外来务工人员。了解他们的乙肝认知情况和疫苗接种率,分析其与出生年月、受教育程度、家庭月收入之间的关系。结果乙肝认知较高者(答对题>50.0%以上)占总人数的22.3%,乙肝疫苗接种率44.8%;家庭月收入对乙肝的整体认知程度有显著影响(P<0.05)。其中,文化程度对乙肝传播途径认知有显著影响(P<0.05)。出生年月和家庭月收入分别对乙肝症状认知有显著和极显著影响(P<0.05,P<0.01)。出生年月和乙肝整体认知程度对疫苗接种率有极显著影响(P<0.01,P<0.01)。结论普陀区外来务工人员对乙肝的认知程度普遍较低,疫苗接种率较低。需要有关部门加强外来务工人员传染病知识教育与宣传,提供支持,做好乙肝防治工作。     

四川省阿坝州在校大学生病毒性肝炎知识调查结果分析

目的了解大学生对病毒性肝炎的认知情况,为进一步采取干预措施提供依据。方法在阿坝州高校随机抽取部分大学生进行病毒性肝炎知识问卷调查。调查结果采用SAS9.1软件进行分析。结果本次实际调查1 524人。有22.38%的学生知道病毒性肝炎常见有五种类型,有58.79%的学生知道乙肝是由病毒引起的,有68.77%的学生认为慢性乙肝可发展为肝硬化、肝癌。有4.13%的学生了解甲肝的传播途径是水和食物传播,有34.36%的学生认为不洁饮食不容易感染乙肝病毒,有45.75%的学生知道乙肝不会通过蚊虫叮咬传播,有22.90%的学生能正确认识丙肝的传播途径。有87.93%的学生能正确认识到预防乙肝最有效的措施是接种乙肝疫苗。有78.74%的学生认为与乙肝病毒携带者同学可保持交往,但需注意防护。大学生获取肝炎知识最多的渠道是广播、电视,占62.27%,获得渠道比较差异有统计学意义（χ2=1 487.75,P〈0.01）,学生最喜欢的宣传方式是广播、电视,占63.91%,对不同方式的喜爱差异有统计学意义（χ2=1 511.45,P〈0.01）。结论大学生对病毒性肝炎防治知识认识水平较低,同时还对病毒性肝炎的传播途径、危害性存在不同程度的误区,需要从多方面加强对大学生的健康教育。     

云南农村孕产妇艾滋病、梅毒和乙型肝炎知识知晓情况及影响因素

目的:了解云南农村孕产妇艾滋病、梅毒和乙型肝炎(乙肝)知识知晓情况及其影响因素。方法:在云南省艾滋病高、中流行区各选择两个县,问卷调查农村孕28周至产后6个月671名妇女。结果:农村孕产妇对艾滋病、梅毒和乙肝相关知识知晓率分别为71.9%、66.1%和63.3%,各知识点知晓率均为艾滋病高于梅毒和乙肝(P<0.05),且3个病均以三大主要传播途径知晓率高,而预防母婴传播措施的知晓率较低;免费咨询检测知晓中艾滋病高于梅毒和乙肝(P<0.05)。研究对象的艾滋病、梅毒和乙肝综合知识得分分别为13.00±4.00、12.00±4.00和12.00±5.00,多因素Logistic回归结果显示孕产妇及其丈夫文化程度低、家距离县城远和未参加过乡村级宣传是艾滋病知识知晓的主要影响因素,孕产妇文化程度低和未参加过乡村级宣传活动是梅毒知识知晓的主要影响因素,而乙肝知识知晓的主要影响因素是孕产妇及其丈夫文化程度低。结论:孕产妇对艾滋病的知识知晓率较高,但对梅毒和乙肝知晓率较低。应加强对文化程度低、居住偏远的农村妇女艾滋病、梅毒和乙肝知识的宣教,提高她们知识知晓水平。     

乙肝病毒携带产妇感染状态与新生儿发生宫内感染的相关性分析

目的 探讨孕妇乙肝感染状态与新生儿宫内感染的关系.方法 将115例乙肝表面抗原(hepatitis B surface antigen,HBsAg)阳性的孕妇分为A组(乙肝HBsAg,HBeAg,HBcAb阳性组)、B组(乙肝HBsAg,HBeAb,HBcAb阳性组)、C组(HBsAg,HBcAb阳性组)、D组(HBsAg,HBeAg阳性组).对上述部分孕妇进行乙肝两对半及PCR-HBV-DNA值的检测,对其所生的新生儿在出生后24h内进行乙肝两对半的检测.结果 乙肝大三阳(HBsAg,HBeAg,HBcAb阳性)孕妇与乙肝小三阳(HBsAg,HBeAb,HBcAb阳性)孕妇比较,新生儿发生宫内感染差异无统计学意义(P=0.256),乙肝孕妇体内HBV-DNA值＞105基因拷贝/ml时发生新生儿宫内感染高于体内HBV-DNA值＜105基因拷贝/ml(P=0.001).结论 乙肝大三阳孕妇或体内HBV-DNA载量高是新生儿宫内感染的危险因素,应及时给予阻断,产后及时采取联合免疫措施,减少乙肝患儿的发生.     

The sustainability of hepatitis B immunization within the Universal Immunization Programme in India

Based on the recommendations of the World Health Organization, India as a member-state is likely to implement universal immunization against hepatitis B through the existing Universal Immunization Programme (UIP). A pilot project is already under progress in two municipal zones of Delhi. This paper begins by reviewing epidemiological features of hepatitis B in India, some established aspects and other emerging trends. The gaps in the existing knowledge base are also given due consideration. The current recommendation is to deliver the vaccine at zero-day for infants in the absence of facilities for antenatal screening and immunoglobulin administration. The paper explores the potential pitfalls for integrating the proposed hepatitis B vaccination with the DPT (diphtheria/pertussis/tetanus) schedule. Based on the findings of the National Family Health Survey, the likely coverage for the states is estimated for both the schedules--zero-day and with DPT. The performance of the pilot phase is reviewed through the results of a coverage survey. The paper also estimates the resources that should be committed to launch the universal immunization of hepatitis B vaccination and the sustainability issues thereof. The paper finally concludes with the position that hepatitis B immunization will 'sink or sail' with the UIP. Further, this should act as an engine for recharging the infrastructure and functioning of the public health system and promote general preventive practices like universal precautions.     

Missed opportunities for tetanus immunization of pregnant women in Juiz de Fora, Minas Gerais, Brazil]

OBJECTIVE: To estimate the missed opportunities for tetanus vaccination and to determine the immunization coverage at the end of pregnancy in women living in the city of Juiz de Fora, which is in the state of Minas Gerais, Brazil. METHODS: A cross-sectional study was carried out of 430 women who were randomly selected from all the maternity hospitals in the city, from February through August 1996. The women were interviewed regarding prenatal care, their knowledge of tetanus, and tetanus immunization before or during the latest pregnancy. RESULTS: The age of the participants ranged from 14 to 45 years (mean = 26.4 +/- 6.9 years); 420 women lived in urban areas and 10 in rural areas. Prenatal care was from the Brazilian public Unified Health System in 69.5% of the women (299 of 430); 27.6% (119) received prenatal care through other types of providers; and 2.8% (12) did not receive prenatal care. Of the 430 participants, 352 of them (81.8%) had their prenatal care card with them during the interview; 85.6% (368) had four or more prenatal care visits. Regarding their knowledge of tetanus, 92.1% (396) knew about the disease and its severity. Out of the 430 women, 359 of them (83.5%) started the latest pregnancy without having had a tetanus vaccination; 104 were vaccinated during the latest pregnancy, so 255 had not been vaccinated by the time of delivery. This was in spite of the significant increase in the opportunities for being vaccinated with an increase in the number of prenatal visits. The odds ratio for pregnant women with four or more prenatal visits being vaccinated by the end of the pregnancy was 2.7 times that of the women with zero to three visits. Seventy percent of the opportunities for tetanus immunization were missed in the study population. The overall tetanus immunization coverage was 40.6% by the end of pregnancy. CONCLUSIONS: The low immunization coverage was below the level recommended by the World Health Organization. In combination with the high rate of missed opportunities for vaccination, this points to the need to implement a tetanus vaccination promotion strategy directed at health professionals in general but especially at those who provide care for pregnant women, in both public and private health clinics. In addition, the vaccination practices in Juiz de Fora should be strengthened.     

Cluster survey for poliomyelitis and neonatal tetanus in Ilorin, Nigeria

The incidence of poliomyelitis and neonatal tetanus in Ilorin Local Government Area was estimated using a 40-cluster, retrospective survey of neonatal tetanus deaths and lameness from poliomyelitis in March and April 1988. The survey identified 19 neonatal tetanus deaths among 1601 livebirths, giving an incidence rate of 14.9/1000 livebirths. Some 31 residual paralytic polio cases were identified among 4576 children aged five to nine years, giving a prevalence rate of 6.8/1000 children in this age group and an annual incidence rate of 38.3/100,000 general population. Immunization of pregnant women with tetanus toxoid, had a greater impact on mortality from neonatal tetanus than delivery in hospital or birth at home attended by a traditional birth attendant. Antenatal coverage with two doses of tetanus toxoid was 62.6%. Poliomyelitis and neonatal tetanus still constitute important causes of childhood morbidity and mortality in Ilorin and antenatal tetanus immunization coverage is not yet sufficient to control neonatal tetanus in this population. The target age for immunization with tetanus toxoid should be extended to include all women of childbearing age. Further retrospective surveys from other Nigerian states are needed to determine the magnitude of the neonatal tetanus problem throughout the country.     

Vaccination programs for pregnant women in Europe, 2021

Vaccination during pregnancy is increasingly adopted worldwide in order to protect the mother and her offspring. We studied the current vaccination programs specifically for pregnant women in 42 European countries. Vaccination programs for pregnant women are in place in 37 countries, as follows: influenza (36 countries), pertussis (28), hepatitis B (12), tetanus (10), pneumococcal disease (10), meningococcal disease (10), rabies (8), tick-borne encephalitis (6), hepatitis A (5), poliomyelitis (4), diphtheria (3), Haemophilus influenzae (2), and human papilloma virus (1). Recommendations for vaccination against influenza and pertussis concern almost exclusively pregnant women regardless of high-risk conditions, however differences between vaccination recommendations are noted in terms of timing. Vaccinations against hepatitis B, hepatitis A, pneumococcal disease, meningococcal disease, poliomyelitis, H. influenzae, rabies, and tick-born encephalitis mainly concern pregnant women at high-risk for exposure or serious illness and post-exposure vaccinations. Overall, five European countries have no vaccination recommendations specifically for pregnant women. In conclusion, there are significant differences in vaccination programs for pregnant women in Europe. Vaccination programs for pregnant women should expand in order to protect maternal and infant health. A consensus-based vaccination program is needed.     

中国不同地区产妇住院分娩率与新生儿乙型肝炎疫苗接种率分析

目的分析新生儿乙型肝炎(乙肝)疫苗(HepB)接种率与产妇住院分娩率之间的关系,指导HepB预防接种工作。方法将2003年国家卫生服务调查的产妇住院分娩数据与2005年全国常规免疫接种报告的新生儿HepB接种数据进行配比分析。结果城市产妇住院分娩率高于农村,城市新生儿HepB接种率高于农村。在农村,产妇住院分娩率越高,新生儿HepB接种率越高,新生儿HepB接种率和产妇住院分娩率关系密切。结论为了提高新生儿HepB接种率,必须大力提倡产妇住院分娩,保证在医院出生的新生儿及时接种HepB;对在家出生的新生儿应采取特殊策略,保证及时接种HepB。     

Hepatitis B knowledge and practices among Chinese Canadian women in Vancouver,British Columbia

INTRODUCTION: Liver cancer rates are higher in North American Chinese than non-Asian ethnic/racial groups, largely due to chronic hepatitis B virus (HBV) infection. METHODS: A community-based survey of Chinese women (n = 147) was completed during 1999 to examine HBV knowledge and practices in Vancouver, British Columbia. RESULTS: Most women had heard of HBV (85%) but smaller proportions knew about some routes of transmission (e.g., sexual intercourse) and sequelae of infection. Knowledge about HBV was significantly associated with education level (p = 0.005), English fluency (p < 0.001) and household income (p = 0.007). Previous serologic testing for HBV infection was significantly associated with education level (p = 0.04), English fluency (p = 0.01), and level of knowledge about HBV (p < 0.001). CONCLUSIONS: Efforts to increase knowledge about HBV infection in this community should consider targeting less educated and less acculturated individuals.     

张家港市流动人口乙肝相关知识知晓率及健康教育需求调查分析

目的 了解张家港市流动人口乙肝相关知识知晓率和健康教育需求情况,为今后有针对性开展健康教育和健康促进活动提供科学依据。方法 根据国家科技重大专项项目办公室提供的调查问卷,在张家港市用工企业、建筑工地以及服务行业体检办证点等抽取流动人口,由经过统一培训的专业人员进行问卷调查。结果 张家港市流动人口乙肝相关知识总知晓率为41.82%;在乙肝基本知识方面流动人口对“目前没有治疗乙型肝炎的特效药物知晓率”仅为19.79%;在乙肝传播途径方面,“纹身、修脚、穿耳洞等”知晓率最低,只有16.53%;在乙肝非传播途径方面,“一起吃饭,拥抱、握手”、“共用工作和学习用具”知晓率均在30%～40%左右;在预防知识方面,只有约50%的流动人口知道接种疫苗是预防乙肝最主要的方法。单因素分析和多元线性回归分析结果表明文化程度和职业是影响流动人口乙肝相关知识得分的重要因素(P＜0.05)。结论 张家港市流动人口乙肝相关知识知晓率偏低,应通过丰富多样的、多渠道的健康宣教,提高流动人口的乙肝相关知识水平。