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乙型肝炎:对经筛查发现HBV呈阴性的高危个体是否进行了疫苗接种?在六个欧盟国家进行的一项在线调查结果

Hepatitis B: are at-risk individuals vaccinated if screened and found negative for HBV? Results of an online survey conducted in six EU countries.

作者信息

Levi Miriam, Ahmad Amena, Bechini Angela, Boccalini Sara, Nguyen Quang Vinh, Veldhuijzen Irene, Richardus Jan Hendrik, Reintjes Ralf, Bonanni Paolo

机构信息

Department of Health Sciences, University of Florence, Florence, Italy.

Department of Health Sciences, Hamburg University of Applied Sciences, Hamburg, Germany.

出版信息

Vaccine. 2014 Nov 12;32(48):6415-20. doi: 10.1016/j.vaccine.2014.09.042. Epub 2014 Oct 1.

Abstract

INTRODUCTION

Vaccination is the best way to prevent hepatitis B infection and its consequences. The aim of the present study is to analyze the current vaccination practices within various population subgroups who are offered screening for hepatitis B, when found negative, in Germany, Hungary, Italy, the Netherlands, Spain and the UK.

METHODS

Online surveys were conducted in the six countries. In total, 1181 experts from six different health professions were invited to participate. Descriptive analyses of data were performed.

RESULTS

Less than half of the respondents in the Netherlands, only about 1/4 in Germany and none in Hungary reported that the vaccine is commonly offered to people who inject drugs. Less than half of the respondents in Germany reported vaccinating sex workers or HIV positive patients against hepatitis B as common practice. None in Hungary stated that vaccinating sex workers is common practice, and only according to a minority (17%) HIV patients are commonly vaccinated. 1/4 to 1/3 of respondents in Germany, the Netherlands, Italy, Hungary and the UK, indicated that HCV positive patients are only sporadically immunized. Only in Spain almost half of the respondents reported that migrants from hepatitis B endemic areas who are screened negative are commonly vaccinated. Widespread uncertainty about vaccination practices for asylum seekers was reported.

CONCLUSIONS

By showing the gaps between current practices and policies in place, our findings can help to increase the success of future vaccination programmes. Implementation of training for health care professional, e.g. introducing vaccinology and vaccination policy courses in the medical and paramedical curriculum, could contribute to a more homogenous application of the recommendations regarding immunization against hepatitis B. Our results show, nonetheless, that the universal vaccination approach, coupled with targeted programmes for immigrants, represents the only way to make the elimination of hepatitis B a foreseeable, realistic objective.

摘要

引言

接种疫苗是预防乙型肝炎感染及其后果的最佳方法。本研究的目的是分析在德国、匈牙利、意大利、荷兰、西班牙和英国,为乙型肝炎筛查呈阴性的不同人群亚组提供疫苗接种的现状。

方法

在这六个国家开展了在线调查。总共邀请了来自六个不同卫生专业的1181名专家参与。对数据进行了描述性分析。

结果

荷兰不到一半的受访者、德国仅约四分之一的受访者以及匈牙利没有受访者表示,通常会为注射毒品者提供疫苗接种。德国不到一半的受访者报告称,为性工作者或艾滋病毒阳性患者接种乙型肝炎疫苗是常见做法。匈牙利没有受访者表示为性工作者接种疫苗是常见做法,只有少数人(17%)表示通常会为艾滋病毒患者接种疫苗。德国、荷兰、意大利、匈牙利和英国四分之一至三分之一的受访者表示,丙型肝炎病毒阳性患者只是偶尔接种疫苗。只有在西班牙,几乎一半的受访者报告称,对来自乙型肝炎流行地区且筛查呈阴性的移民通常会接种疫苗。据报告,对于寻求庇护者的疫苗接种做法普遍存在不确定性。

结论

通过揭示当前做法与现行政策之间的差距,我们的研究结果有助于提高未来疫苗接种计划的成功率。为医护人员开展培训,例如在医学和辅助医疗课程中引入疫苗学和疫苗接种政策课程,可能有助于更统一地应用关于乙型肝炎免疫接种的建议。然而,我们的结果表明,普遍接种疫苗的方法,再加上针对移民的针对性计划,是使消除乙型肝炎成为一个可预见、现实目标的唯一途径。

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