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医生对甲型肝炎的认知和态度,以及当前甲型肝炎疫苗接种的实施情况。

Physician Knowledge and Attitudes About Hepatitis A and Current Practices Regarding Hepatitis A Vaccination Delivery.

机构信息

Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, Ga.

Adult and Child Center for Outcomes Research and Delivery Sciences, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora; Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora.

出版信息

Acad Pediatr. 2017 Jul;17(5):562-570. doi: 10.1016/j.acap.2017.01.001. Epub 2017 Jan 9.

Abstract

OBJECTIVE

To assess physicians': 1) knowledge and attitudes about hepatitis A disease and hepatitis A (HepA) vaccine, 2) child care and school HepA vaccine mandates, 3) practices related to HepA vaccine delivery, 4) factors associated with strongly recommending HepA vaccine to all 1- to 2-year-olds, and 5) feasibility of implementing HepA catch-up vaccination at health maintenance visits.

METHODS

A national survey was conducted among representative networks of pediatricians and family medicine physicians (FMs) from March to June, 2014 via e-mail or mail on the basis of provider preference.

RESULTS

Response rates were 81% (356 of 440) among pediatricians and 75% (348 of 464) among FMs. Less than 50% correctly identified that hepatitis A virus (HAV) infection is usually asymptomatic in young children and that morbidity from HAV disease increases with age. Ninety-two percent of pediatricians and 59% of FMs strongly recommend HepA vaccine for all 1- to 2-year-olds. In addition to practice specialty, belief that HepA vaccine is required for kindergarten enrollment was the most robust predictor of strong physician recommendation.

CONCLUSIONS

Gaps in knowledge regarding HAV infection and hepatitis A recommendations and lack of a strong recommendation for routine HepA vaccination of young children among FMs likely contribute to suboptimal coverage. Closing knowledge gaps and addressing barriers that prevent all physicians from strongly recommending HepA vaccine to 1- to 2-year-olds could help increase HepA vaccine coverage and ultimately improve population protection against HAV infection.

摘要

目的

评估医生:1)对甲型肝炎疾病和甲型肝炎(HepA)疫苗的知识和态度,2)儿童保健和学校 HepA 疫苗强制接种,3)与 HepA 疫苗接种相关的实践,4)强烈建议为所有 1 至 2 岁儿童接种 HepA 疫苗的相关因素,以及 5)在维持健康就诊时实施 HepA 补种疫苗的可行性。

方法

2014 年 3 月至 6 月,根据提供者的偏好,通过电子邮件或邮件向儿科医生和家庭医学医生(FM)的代表性网络进行了一项全国性调查。

结果

儿科医生的回应率为 81%(356/440),家庭医生为 75%(348/464)。不到 50%的医生能够正确识别甲型肝炎病毒(HAV)感染在幼儿中通常无症状,并且 HAV 疾病的发病率随年龄增长而增加。92%的儿科医生和 59%的 FM 强烈建议为所有 1 至 2 岁儿童接种 HepA 疫苗。除了实践专业外,认为 HepA 疫苗是幼儿园入学的必要条件是医生强烈建议的最有力预测因素。

结论

在 HAV 感染和肝炎 A 建议方面存在知识差距,并且 FM 对为幼儿常规接种 HepA 疫苗的推荐不足,这可能导致疫苗接种率不理想。缩小知识差距并解决阻止所有医生强烈建议为 1 至 2 岁儿童接种 HepA 疫苗的障碍,可以帮助提高 HepA 疫苗的接种率,并最终提高人群对 HAV 感染的保护水平。

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