特发性肾病综合征患儿的流感疫苗接种：实践调查。
Influenza vaccination among children with idiopathic nephrotic syndrome: an investigation of practices.
机构信息
Néphrologie Pédiatrique, Centre de Référence du Syndrome Néphrotique Idiopathique de l'enfant et l'adulte, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Université Paris Descartes, Sorbonne paris Cité, 149 rue de Sèvres, 75015, Paris, France.
Pédiatrie Générale et Infectieuse, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Université Paris Descartes, Sorbonne paris Cité, Paris, France.
出版信息
BMC Nephrol. 2019 Feb 25;20(1):65. doi: 10.1186/s12882-019-1240-2.
BACKGROUND
Annual influenza vaccination is recommended for all children with idiopathic nephrotic syndrome (INS) in France. Consequently, the Social Security automatically sends prescriptions to all patients suffering from a chronic disease. The aim of this study was to evaluate the follow-up to these recommendations.
METHODS
We conducted a monocentric retrospective investigation of practices. We included all children with steroid-sensitive INS in remission who attended our clinics from January 1st 2015 to January 1st 2017, resided in France and had a valid phone number. Data were collected from May 2017 to June 2017 through a phone interview and review of clinical charts.
RESULTS
75 patients met the inclusion criteria. The parents of 57 children could be reached by phone and agreed to participate to the survey. 35/57 (61.4%) declared having received a prescription during the 2016-2017 campaign. Only 14 children (24.6%) were vaccinated. 17/43 (39.5%) parents of unvaccinated children had concerns about the safety of the vaccine, 16/43 (37.2%) were not aware of the recommendations, 5/43 (11.6%) had been recommended by their physician not to vaccinate their child, 3/43 (7%) forgot to have them vaccinated and 2/43 (4.6%) reported no reason. 13/43 (30%) unvaccinated children presented a relapse during the flu season - 2/13 during an influenza-like illness - whereas 1/14 (7%) immunized children presented a relapse during the six months of post-vaccination follow-up. Relapse rates were not increased in vaccinated children compared to unvaccinated children (p = 0.15), nor in the 6 months following vaccination compared to the 6 months prior (1/14 vs 5/14, p = 0.20).
CONCLUSIONS
1) < 2/3 patients were properly prescribed the recommended yearly influenza vaccination at our center 2) only 1/4 were vaccinated and most of their parents were misinformed. Physicians must be aware of this and should make every effort to better inform their patients on the risks of flu illness and the benefits and safety of the vaccination.
背景
法国建议所有特发性肾病综合征（INS）患儿每年接种流感疫苗。因此，社会保险机构会自动向所有慢性病患者开具处方。本研究旨在评估这些建议的实施情况。
方法
我们进行了一项单中心回顾性实践研究。我们纳入了所有于 2015 年 1 月 1 日至 2017 年 1 月 1 日在我院就诊且病情处于缓解期的儿童激素敏感性 INS 患者，这些患者居住在法国且拥有有效的电话号码。数据收集工作于 2017 年 5 月至 6 月期间通过电话访谈和病历回顾进行。
结果
75 名患者符合纳入标准。我们与 57 名患儿的家长取得了联系，其中 57 名患儿的家长中有 35 名（61.4%）同意接受调查。在 2016-2017 年流感疫苗接种季中，35 名患儿（24.6%）收到了处方。只有 14 名患儿（24.6%）接受了疫苗接种。在未接种疫苗的儿童中，17 名（39.5%）患儿的家长对疫苗的安全性表示担忧，16 名（37.2%）家长对疫苗接种的建议不知情，5 名（11.6%）患儿的医生建议他们不要为孩子接种疫苗，3 名（7%）患儿家长忘记带孩子去接种疫苗，2 名（4.6%）患儿家长没有给出原因。在流感季，13 名（30%）未接种疫苗的患儿出现了复发-2 名患儿出现了流感样疾病-而在接种疫苗后的 6 个月随访期间，仅 1 名（7%）接种疫苗的患儿出现了复发。与未接种疫苗的患儿相比，接种疫苗的患儿的复发率并未增加（p=0.15），且在接种疫苗后的 6 个月内也未增加（1/14 例比 5/14 例，p=0.20）。
结论
1）<2/3 的患者在我们中心得到了推荐的年度流感疫苗接种。2）只有 1/4 的患者接种了疫苗，且大多数家长对疫苗接种存在误解。医生必须意识到这一点，并努力向患者更好地宣传流感疾病的风险、疫苗接种的益处和安全性。
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