Despite the fact that vaccines save 2–3 million lives worldwide every year, a percentage of children are not getting appropriately vaccinated, thus leading to disease outbreaks. One of the major ...reasons of low vaccine uptake in Europe is vaccine hesitancy, contributing to the recent measles outbreaks. Monitoring of vaccine hesitancy is valuable in early identification of vaccine concerns.
We performed an eighteen country European survey on parents’ attitudes and behaviors regarding their children’s immunization. Parents having at least one child 1–4 years old were mostly recruited by primary care paediatricians to reply to a web-based questionnaire.
The questionnaire was developed by the European Academy of Paediatrics Research in Ambulatory Setting Network steering committee, based on similar surveys. An individual level hesitancy score was constructed using the answers to 21 questions, and correlations of the score with socio-demographic characteristics and types of providers were explored. To assess inter country differences, a country level self -reported confidence was defined.
Fifty six percent and 24% of 5736 respondents defined themselves as “not at all hesitant”, and “somewhat hesitant”, respectively. Parents who consulted general practitioners were more hesitant than parents who consulted pediatricians (p < 0.05). Consultation with homeopathists was associated with the highest reported hesitancy (p < 0.05). Vaccine confidence was highest in Portugal and Cyprus, and lowest in Bulgaria and Poland.
The majority of parents in Europe believe in the importance of childhood vaccination. However, significant lack of confidence was found in certain European countries, highlighting the need for continuous monitoring, awareness and response plans. The possible influence of different types of healthcare providers on parental decisions demonstrated for the first time in our survey, calls for further research. Monitoring and continuous medical education efforts aimed mostly at those professionals who might not be likely to recommend vaccination are suggested.
Vaccination has a significant impact on morbidity and mortality. High vaccination coverage rates are required to achieve herd protection against vaccine-preventable diseases. However, limited vaccine ...access and hesitancy among specific communities represent significant obstacles to this goal. This review provides an overview of critical factors associated with vaccination among disadvantaged groups in World Health Organisation European countries. Initial searches yielded 18,109 publications from four databases, and 104 studies from 19 out of 53 countries reporting 22 vaccine-preventable diseases were included. Nine groups representing the populations of interest were identified, and most of the studies focused on asylum seekers, refugees, migrants and deprived communities. Recall of previous vaccinations received was poor, and serology was conducted in some cases to confirm protection for those who received prior vaccinations. Vaccination coverage was lower among study populations compared to the general population or national average. Factors that influenced uptake, which presented differently at different population levels, included health service accessibility, language and vaccine literacy, including risk perception, disease severity and vaccination benefits. Strategies that could be implemented in vaccination policy and programs were also identified. Overall, interventions specific to target communities are vital to improving uptake. More innovative strategies need to be deployed to improve vaccination coverage among disadvantaged groups.
Objective To evaluate differences in child health care service delivery in Europe based on comparisons across health care systems active in European nations. Study design A survey involved experts in ...child health care of 40 national pediatric societies belonging both to European Union and non-European Union member countries. The study investigated which type of health care provider cared for children in 3 different age groups and the pediatric training and education of this workforce. Results In 24 of 36 countries 70%-100% of children (0-5 years) were cared for by primary care pediatricians. In 12 of 36 of countries, general practitioners (GPs) provided health care to more than 60% of young children. The median percentage of children receiving primary health care by pediatricians was 80% in age group 0-5 years, 50% in age group 6-11, and 25% in children >11 years of age. Postgraduate training in pediatrics ranged from 2 to 6 years. A special primary pediatric care track during general training was offered in 52% of the countries. One-quarter (9/40) of the countries reported a steady state of the numbers of pediatricians, and in one-quarter (11/40) the number of pediatricians was increasing; one-half (20/40) of the countries reported a decreasing number of pediatricians, mostly in those where public health was changing from pediatric to GP systems for primary care. Conclusions An assessment on the variations in workforce and pediatric training systems is needed in all European nations, using the best possible evidence to determine the ideal skill mix between pediatricians and GPs.
Objective To describe current practice among European paediatricians regarding diagnosis and management of urinary tract infections in children aged 1–36 months and to compare these practices with ...recently published guidelines. Design Web-based large scale survey evaluating knowledge of, attitudes towards and the methods for diagnosing, treating and managing urinary tract infections in children. Setting Primary and secondary care practices in Europe. Sample 1129 paediatricians. Results A diagnosis of urinary tract infection is considered by 62% of the respondents in children aged 1–36 months with unexplained fever. The preferred method of urine collection is use of a bag (53% for infants <3 months and 59% for children 4–36 months of age). 60% of paediatricians agree that oral and parenteral antibiotics have equal efficacy. Co-amoxiclav is the antibiotic of choice for 41% of participants, while 9% prescribe amoxicillin. 80% of respondents prescribe ultrasound in all children with a confirmed urinary tract infection. 63% of respondents prescribe a cystography when abnormalities are revealed during ultrasound evaluation. A quarter of respondents recommend antibiotic prophylaxis for all children with any vesicoureteral reflux. The data among European countries are very heterogeneous. The three most recent urinary tract infection guidelines (the National Institute for Health and Care Excellence (NICE), the American Academy of Paediatrics and the Italian Society of Paediatric Nephrology) are not followed properly. Conclusions Management of febrile urinary tract infections remains controversial and heterogeneous in Europe. Simple, short, practical and easy-to-remember guidelines and educational strategies to ensure their implementation should be developed.
Oral health is an essential component of children’s general health. The aim of this study is to evaluate the training, knowledge, attitudes and practices of primary care paediatricians in oral health ...in Europe. Paediatricians were invited to complete a survey on the web. There was a 54.3% response rate. The oral health education of the responders was received mainly through continuing medical education and practical experience (51%) rather than in medical school or during paediatric residency training (33%). Twenty-four percent of the responders did not know that the first signs of caries were white spots on the surfaces of teeth. Although 98.8% of paediatricians check the oral health status of children, only 52% feel confident enough to identify dental caries. A large proportion of the paediatricians (43%) recommended a first dental visit for children above the age of 3 years and only 7% under 1 year of age.
Conclusions
: Paediatricians are familiar with some aspects of the oral health but are not confident in identifying the risk factors. The current postgraduate curriculum in Paediatrics should incorporate training on basic oral healthcare. In addition, continuous educational programmes are needed to keep the knowledge of the paediatrician up to date.
What is Known:
• Oral health is an essential component of general health that influences the functional, psychological and social dimensions of a child’s well-being.
• Paediatricians are the leading providers of primary healthcare for children.
What is New:
• Paediatricians are familiar with some aspects of the oral health of children but are not confident in identifying the risk factors responsible for oral disease.
• The current postgraduate curriculum in Paediatrics should incorporate training on basic oral healthcare in children.
Human papillomavirus vaccination crisis in Japan Dornbusch, Hans Jürgen; Stiris, Tom; del Torso, Stefano ...
Journal of paediatrics and child health,
12/2015, Letnik:
51, Številka:
12
Journal Article
Recenzirano
The European Academy of Paediatrics (EAP) is gravely concerned about the human papillomavirus (HPV) vaccination crisis in Japan and particularly about the negative position taken by governmental ...authorities. Given that the HPV vaccine is both safe and effective, there is no recognizable reason to date to withhold this lifesaving and cost effective public health measure from a population. Therefore, the EAP strongly encourages the Japanese health authorities to actively support HPV vaccination for the future health of their children and adolescents.
Improving paediatric care in the community Stiris, Tom; Torso, Stefano del; Mercier, Jean-Christophe ...
The Lancet,
04/2015, Letnik:
385, Številka:
9977
Journal Article
Recenzirano
Odprti dostop
Any restriction of provision of appropriate care would contradict article 24 of the UN Convention on the Rights of the Child.3 Paediatric primary care is an academic and scientific discipline dealing ...with all issues affecting the health and wellbeing of infants, children, and adolescents from birth to adulthood (usually defined as age 18 years) in the context of their family, community, and culture.4 The primary clinician, ideally a paediatrician, is the first contact for children until they reach adulthood, and is thus responsible for provision of comprehensive and continuing care throughout infancy, childhood, and adolescence.
The rights of children arriving in Europe Ferrara, Pietro; Amato, Maria; Hadjipanayis, Adamos ...
The Lancet (British edition),
11/2015, Letnik:
386, Številka:
10007
Journal Article
Recenzirano
Odprti dostop
According to Save the Children Italy, 8715 children arrived in Italy without family or guardians since the start of the year.3 About a thousand people land on the Dodecanese islands every day.4 In ...June alone, 4270 children landed on the islands, and 86 of them were unaccompanied.4 Many of the children who travel unaccompanied come from Eritrea, Somalia, Egypt, and South Africa.
Antimicrobial stewardship (AMS) aims to optimise treatment, minimise the risk of adverse effects and reduce health care costs. In addition, it is recognised as a key component to stop the current ...spread of antimicrobial resistance in Europe. Educational programmes are particularly important for the successful implementation of AMS. Training should start during medical school, continue during clinical training and be reinforced throughout postgraduate training. National core curricula for paediatric training should include passive and active training of competencies needed for AMS and future paediatricians should be skilled in taking leadership roles in AMS initiatives. Other core members of the paediatric AMS team should also receive training focused on the unique medical needs of the paediatric patient.
Conclusion
: Ideally, all communities, hospitals and health regions in Europe should have AMS that serve all patient types, including children. We all have the responsibility to ensure that existing antibiotics remain effective.
What is Known
:
•
Antimicrobial stewardship (AMS) is a key component to stop the current spread of antimicrobial resistance
•
Educational programmes are particularly important for the successful implementation of AMS
What is New:
•
All medical doctors in Europe who will be undertaking significant practice in child health should master the competencies needed to prescribe antibiotics to children rationally as described in the European Academy of Paediatrics (EAP) Curriculum for Common Trunk Training in Paediatrics
•
Interdisciplinary approaches of education need to be developed, as all hospitals and health regions in Europe ideally should have AMS programmes that serve all patient types, including children
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