Why do we not want to recommend influenza vaccination to young children? A qualitative study of Australian parents and primary care providers

IntroductionInfluenza vaccination has been shown to be safe and effective against influenza and in the prevention of complicating secondary respiratory illnesses. However, its uptake in young children remains low. This study explored the views, attitudes and practices of parents and primary care providers (PCPs) on their knowledge and acceptance of influenza vaccination in children under 5.MethodsUsing a cross-sectional qualitative research design, we conducted 30 in-depth interviews with PCPs (i.e., general practitioners, practice nurses, maternal and child health nurses, and pharmacists) and five focus groups with parents (n = 50) between June 2014 and July 2015 in Melbourne, Australia. Data were thematically analysed.ResultsParents thought the vaccine could cause influenza, and influenza vaccination was not necessary for their children as they needed to build their own ‘immunity’. Parents said that they would consider vaccinating their children if recommended by their GP and if the influenza vaccine was part of the immunisation schedule. PCPs also expressed concerns regarding the efficacy of the vaccine as well as out-of-pocket costs incurred by families, and uncertainty regarding the mortality and morbidity of influenza in otherwise healthy children. However, they said they would recommend the vaccine to high-risk groups (e.g. children with chronic disease(s), and asthma).ConclusionDespite the established safety of influenza vaccines, barriers to uptake include concerns regarding the iatrogenic effects of vaccination, its administration schedule, and knowledge of influenza severity. Updated information on influenza and the efficacy of the vaccine, and incorporating influenza vaccination into the immunisation schedule may overcome some of these barriers to increase influenza vaccination in this vulnerable cohort.     

社区围绝经期妇女生殖道感染现状及干预评价

目的分析社区围绝经期妇女生殖道感染（RTIs）状况,评估综合干预效果,为建立和完善社区卫生服务体系提供基层资料。方法随机选取45—65岁925名围绝经期妇女为研究对象,采取临床筛查和问卷的形式,对生殖道感染的知识、态度和行为;RTIs症状;医疗费用、妇科检查、医疗技术水平、服务态度、保健服务及时性和便利性等进行调查。了解和分析其生殖道感染状况及其影响因素。应用方差和多因素Logistic的方法对数据进行统计分析。在基线调查的基础上,实施为期1年的社区综合干预。结果RTIs患病率为31．89％,依次为萎缩性阴道炎（9．30％）、宫颈炎（5．51％）、附件炎（4．97％）、外阴阴道假丝酵母菌病（4．54％）、慢性盆腔炎（3．78％）、滴虫阴道炎（292％）;经Logistic分析表明：年龄、不良卫生习惯和丈夫RTIs自觉症状是RTIs发生的危险因素,文化程度和公费医疗则是其保护因素。干预1年后,有关RTIs知识、态度、行为正确率及总患病率情况均有所改善（x2值分别为27．948、16．750、82．137、8．256,均P〈0．01）。结论重视围绝经期RTIs,加强社区综合干预,有助于改善围绝经期妇女的生活质量,提高健康水平。     

流动育龄妇女避孕方法的使用与生殖道感染疾病的相关性分析

目的:了解银川市流动育龄女性的避孕方法使用情况、生殖道感染患病情况以及避孕方法的使用对生殖道感染患病率的影响。方法:在银川市采用多阶段整群随机抽样,对符合条件的育龄女性流动人口开展问卷和实验室检测相结合的方式调查,χ~2检验和Logistic回归相结合分析数据。结果:本次共调查752名育龄女性流动人口,RTIs患病率为36.97%,以细菌性阴道病(16.36%)居多。有82.31%的调查对象在近3个月采用避孕节育方法,其中选择避孕套(50.4%)的对象,其RTIs患病率为29.81%,低于没有避孕和选择其他避孕方法者。多因素逐步Logistic回归分析发现,未使用避孕套者患RTIs的可能性大于使用者(OR=1.62,95%CI 1.10~2.37)。结论:性生活时未使用避孕套是女性RTIs患病的危险因素。应增加避孕套发放渠道,并采取一定的宣教措施提高育龄妇女对避孕套预防RTIs的知晓率和正确使用率。     

在妇女生殖道感染防治中引入社会性别视角的实践和思考

目的探索在生殖道感染防治项目中如何提高社会性别敏感性的方法。方法需求评估后,采用参与式培训的方法,对云南省弥勒县、乡两级计划生育服务提供者和管理者25人、农村社区16对夫妇分别进行了两个层次的社会性别培训。结果通过提升社会性别意识培训,把妇女和其配偶自始至终作为行动研究的主体,倡导男女共同参与;服务提供者可根据妇女的需求调整服务取向,确保在生殖道感染防治中具有脆弱性的妇女能够有足够机会获取正确信息。结论在农村社区中积极营造性别平等氛围,可充分动员和发挥家庭及个人的参与性。     

社区围绝经期妇女生殖道感染现状及其需求的调查

目的了解社区围绝经期妇女生殖道感染现状及其保健需求,为构建新型社区生殖健康服务模式提供决策依据。方法用整群分层随机抽样方法,选择广州市、深圳市各1个社区,共808名45～65岁妇女为调查对象,对其进行问卷调查、妇科检查和有关实验室检查。有关数据应用SPSS11.0进行统计分析。结果生殖道感染率高达38.12%,其中18.50%的妇女患有2种以上生殖道感染疾病;了解生殖道感染的原因、性病危险因素及防治等方面知识的均低于22.90%;经多因素Logistic回归分析表明:年龄大、性病知识得分低、混用清洗外阴用具和自费医疗是诱发生殖道感染的危险因素。结论围绝经期妇女人群生殖道感染患病率较高,保健知识和个人保健行为有待改善,应提供相关的社区保健服务。     

Asymptomatic reproductive tract infections/sexually transmitted infections among HIV positive women

This study aims to highlight the importance of screening all HIV positive women for various reproductive tract infections/sexually transmitted infections (RTIs/STIs) irrespective of symptoms and to determine its occurrence in asymptomatic HIV positive women. Relevant specimens were collected for diagnosis of various RTIs/STIs. STIs were diagnosed in nearly one-third of the HIV positive asymptomatic patients which is quite high. The national strategy for STIs/RTIs control misses out large number of asymptomatic RTIs/STIs in HIV positive women which is responsible for silently transmitting these infections in the community. So this strategy should be modified to include screening of all HIV positives women irrespective of symptoms of STIs/RTIs.     

服务质量对农村妇女生殖道感染症状持续求医行为的影响

调查并分析了云南省通海县因生殖道感染症状而到各级医疗机构就医的农村妇女对其所接受的保健服务质量的评价,进而研究了对妇女持续利用保健服务的影响。结果表明,有生殖道感染症状的妇女就诊率仅为56.5%(309/547),其中51.8%的妇女没有再次就诊。Logistic回归分析结果显示,医务人员是否采用促进复诊的方式、医务人员的态度、医患间的信息交流程度对妇女是否持续就诊有密切关系。对上述结果的意义进行了阐述,对指导农村生殖道感染的正确治疗提供了依据。     

章丘农村已婚育龄妇女生殖道感染综合防治

目的探索在农村地区开展生殖道感染（RTIs）综合防治的效果。方法通过分层整群随机抽样对山东省章丘市农村已婚育龄妇女进行RTIs基线调查后开展宣教、综合性防治干预1年后复查，比较分析干预前后RTIs的患病率。结果干预前1292名已婚育龄妇女RTIs发生者占43．6％（563／1292），其中953例随访1年资料全程完整分析结果显示，RTIs发生睛况由干预前的40．0％（381／953）下降为31．6％（301／953），差异有显著性（X2=14．613，P〈0．0001）。但新发生病例占29．6％（155／523）。结论每年对已婚育龄妇女进行RTIs的宣教和防治可以有效减低RTIs的发生；但RTIs的再次感染率很高，防治RTIs是项长期任务。     

2093例生殖道感染病原体分析

目的:了解该地各年龄段妇女生殖道感染的病原体情况,为指导临床用药提供依据。方法:对2003年9月～2004年3月,确诊为生殖道感染的2093例患者进行生殖道分泌物涂片检查。结果:工人和农民为主要感染人群,占70%。病原体在<19岁组前3位依次是G+球菌、支原体、加德纳菌;19～49岁组依次是加德纳菌、念珠菌、支原体;≥49岁组依次是加德纳菌、支原体、念珠菌。结论:为做好生殖道感染的防治工作,工人和农民是防治的重点。为提高生殖道感染的治疗效果,必须针对病原体,合理用药。针对病原体对不同人群的感染比例,急需研发外用新的剂型。广泛开展对生殖道感染知识的健康教育,提高妇女自我保健意识。     

Female genital cutting in Kilimanjaro,Tanzania: changing attitudes?

OBJECTIVES: To study the prevalence, type, social correlates and attitudes towards female genital cutting (FGC) among urban women in Kilimanjaro, Tanzania; and to examine the association between FGC and gynaecological problems, reproductive tract infections (RTIs) and HIV. METHODS: In 1999, 379 women attending reproductive health care clinics were interviewed and underwent pelvic examination. Specimens for RTI/HIV diagnosis were taken. RESULTS: Seventeen per cent had undergone FGC, mostly clitoridectomy (97%). Female genital cutting prevalence was significantly lower among educated, Christian and Chagga women. Women aged >or=35 were twice as likely to be cut as those < 25 years. Seventy-six per cent of those who had undergone FGC intend not to perform the procedure on their daughters. Age < 25 years (P < 0.0001) and low parity (P < 0.01) were predictors of that intention. There was no association between RTIs, HIV or hepatitis B and FGC. CONCLUSION: FGC is still fairly common but there is evidence of a change of attitude towards the practice, especially among young women. The opportunity to educate women who attend reproductive health care facilities on FGC should be taken.