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干细胞移植后再接种疫苗:印度当前实践情况调查。

Post stem cell transplantation revaccination: A survey of the current practices in India.

机构信息

Department of Clinical Haematology, Haemato-Oncology & Bone Marrow (Stem Cell), Transplantation, Christian Medical College, Ludhiana 141008, Punjab, India.

Pediatric Hematology, Oncology and Bone Marrow Transplantation, Mazumdar Shaw Cancer Centre, Narayana Health City, Bangalore, India.

出版信息

Vaccine. 2018 Apr 12;36(16):2176-2180. doi: 10.1016/j.vaccine.2018.02.084. Epub 2018 Mar 9.

Abstract

BACKGROUND

Hematopoietic stem cell transplant (HSCT) recipients are more susceptible to infections from vaccine preventable diseases (VPDs) than the general population. Indian stem cell transplant registry (ISCTR) post-BMT vaccination guidelines were formulated in 2015. The objective of the survey was to assess the compliance to these guidelines among transplant physicians in India.

MATERIALS AND METHODS

This is a cross-sectional survey executed as the quantitative research strategy to explore the various aspects of vaccination practices among transplant physicians in India. The 'data collection tool' included 36 predetermined questions related to vaccination of the patients and their close contacts. Theoretical construct of the questionnaire was face-validated and questionnaire survey forms were emailed individually as attachments or by google forms. This study is being reported based on the checklist for reporting results of internet e-surveys statement guidelines.

RESULTS

Survey forms were sent to 105 transplant physicians in India, 62% of whom responded representing 78.8% of transplant centers in India. More than 90% of allogeneic transplant physicians and 64% of autologous transplant physicians offered vaccination. Over two third of the physicians responded that they would discontinue vaccination at the onset of cGVHD. Fewer than one third physicians offered vaccination against Hepatitis A, Typhoid or Meningococcal infections. Forty two percent of respondents were unaware of the ISCTR post-BMT vaccination protocol. Only 47% of respondents reported complete adherence to any of the protocols they were following. Immune reconstitution to guide vaccination was available only to 13.3 percent of respondents.

CONCLUSION

There is a need to improve the implementation strategies of vaccination in HSCT recipients to increase the adherence and continuation of it even in the presence of GVHD. There is also a need to extend the vaccination among VPDs especially prevalent in India.

摘要

背景

与普通人群相比,造血干细胞移植(HSCT)受者更容易感染可通过疫苗预防的疾病(VPD)。印度干细胞移植登记处(ISCTR)制定了 post-BMT 疫苗接种指南。本研究的目的是评估印度移植医生对这些指南的依从性。

材料和方法

这是一项横断面调查,采用定量研究策略,旨在评估印度移植医生的疫苗接种实践。“数据收集工具”包括 36 个与患者及其密切接触者疫苗接种相关的预定问题。问卷的理论构建经过了表面效度验证,并通过电子邮件单独作为附件或通过谷歌表格发送问卷。本研究根据互联网电子调查结果报告清单声明指南进行报告。

结果

向印度的 105 名移植医生发送了调查问卷,其中 62%的人回复,代表了印度 78.8%的移植中心。超过 90%的异基因移植医生和 64%的自体移植医生提供疫苗接种。超过三分之二的医生表示,他们会在发生慢性移植物抗宿主病(cGVHD)时停止疫苗接种。只有不到三分之一的医生提供甲型肝炎、伤寒或脑膜炎球菌感染疫苗接种。42%的受访者不知道 ISCTR post-BMT 疫苗接种方案。只有 47%的受访者报告完全遵守他们正在遵循的任何协议。只有 13.3%的受访者可获得免疫重建以指导疫苗接种。

结论

需要改进 HSCT 受者疫苗接种的实施策略,以提高疫苗接种的依从性和持续性,即使在存在 GVHD 的情况下也是如此。还需要扩大 VPD 疫苗接种范围,特别是在印度流行的 VPD。

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