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At least 1,513 records · Page 84Linked to original sources
PubMed1998

Immunogenicity of a low-cost hepatitis B vaccine in the South African Expanded Programme on Immunisation.

BACKGROUND: A low-cost, 'flash' heat-inactivated hepatitis B vaccine with enhanced immunogenicity allowing for a relatively low dose (Hepaccine B; Cheil Foods and Chemicals, Korea) was introduced into the South African Expanded Programme on Immunisation during 1995 to immunise infants against hepatitis B. To determine the seroresponse of this vaccine in South Africa, a country with a high hepatitis B virus (HBV) prevalence, a field trial was conducted in a rural health clinic. METHODS: The immunogenicity of Hepaccine B, containing 1.5 micrograms/0.5 ml, was studied in 186 black infants attending the Soshanguve III clinic, north-west of Pretoria. Infants receiving three consecutive doses in the anterolateral thigh at 6, 10 and 14 weeks were monitored. The doses were administered concurrently with their routine oral polio vaccine (OPV) and diphtheria, pertussis and tetanus (DPT) immunisations. Vaccine side-effects were recorded. Blood specimens were collected 3 months after the final vaccination. Sera were tested for antibodies to hepatitis B surface antigen (anti-HBs) by IMx AUSAB (Abbott Laboratories, USA). Levels of anti-HBs were determined by comparison with standard reference preparations and expressed in mlU/ml. RESULTS: Side-effects of the vaccine were minor, with limited local reaction at the site of administration. The anti-HBs seroconversion rate was 93.0%, based on a titre of > or = 10 mlU/ml with a geometric mean titre of 257.58 mlU/ml. CONCLUSIONS: Administration of 1.5 micrograms dose of Hepaccine B at 6, 10 and 14 weeks is safe and highly immunogenic in black South African infants, and this vaccine is suitable for use in countries with high HBV prevalences such as in Africa. The use of an economical hepatitis B vaccine would greatly facilitate the prevention of hepatitis B in these countries.

Female↗
PubMed1998

[Influenza vaccination].

In view of its high morbidity and substantial mortality in risk subjects, influenza has been a focus of attention for decades. The special ability of influenza viruses to change their genetic codes and hence their antigenicity--thereby constantly cancelling out our specific acquired immunity--poses and annually recurring threat of local epidemics and pandemics potentially fatal for large sections of the population. Influenza vaccination can significantly lower morbidity and mortality. It involves few side effects, is efficacious and cost effective . It is one of the most efficient primary preventive measures in all of medicine. The present state of knowledge is reviewed.

Adolescent↗
PubMed1998

Prevention of neonatal group B streptococcal infections. Is there a rational prevention strategy?

Clinicians, both obstetric and pediatric, are currently faced with the need to choose treatment strategies to reduce the persistent high incidence of early-onset GBS neonatal disease without being equipped with adequate data to choose conclusively which of the proposed strategies is ideal. There is an urgent need for well-designed prospective randomized trials comparing the various prevention protocols so as to resolve conclusively the controversy. The ultimate prevention strategy may well be a successful maternal immunization program.

Cost-Benefit Analysis↗
PubMedDate not supplied

[Impact of mass media on the use of health services. A systematic review of the literature].

BACKGROUND: Mass media may influence the use of health services either through campaigns promoting the use of specific procedures or through the coverage of health related issues outside the context of a planned intervention. To assess their effect on the utilization of health services a systematic overview of primary research was undertaken. METHODS: Experimental and quasi experimental studies meeting pre defined entry criteria and providing information on the impact of mass media on objective measures on health services utilization were searched through Medline, Embase, Psychlit, Eric, as well as handsearching key journals. Data on the detail and content of interventions were abstracted and raw data describing health services utilization obtained. Effect sizes were calculated for each study and then pooled across studies on the same topic using a random effects model. RESULTS: Out of 69 papers providing information on the impact of mass media on aspects of health services utilization, 17 interrupted time series met our quality criteria. Fourteen evaluated the impact of formal mass media campaigns, 3 of media coverage of health related issues. The overall methodological quality was rather variable, with 6 studies not performing any statistical analysis, and 7 using inadequate statistical tests (i.e. not taking into account the effect of time trend). All the studies but the concluded positively on the effect of mass media. These positive findings were confirmed by our re-analysis in 7, while in the remaining the effect of mass media was not statistically significant. The direction of effect was consistent across individual studies and the pooled effect sizes revealed an effect upon the utilization of health services that could not be explained by chance alone, ranging from -1.96 (95% CI: -1.19, -2.73) for campaigns promoting immunization programs, to -1.12 (95% CI: -0.49, -2.46) for those concerning cancer screening. CONCLUSIONS: Despite the overall limited quality of primary research, this review supports the view that these channels of communication may have an important role in influencing the use of health care interventions. Mass media should be considered as one of the tools that may encourage the use of effective services and discourage those of unproved effectiveness.

Data Interpretation, Statistical↗
PubMedDate not supplied

More on measles.

Explore the source record for details and available documents.

Adolescent↗
PubMedDate not supplied

A performance-based incentive program for influenza immunization in the elderly.

Our objective was to implement and evaluate performance-based reimbursement for influenza immunization of the elderly in physician offices. We performed a community-based quasi-experiment with historic and concurrent comparisons, using primary care physician offices in Monroe County, New York. Participants in the intervention group included 53 primary care physicians admitting to one hospital, and the comparison group included 82 primary care physicians admitting to other hospitals. All physicians participated in a Medicare-sponsored demonstration to increase influenza immunization rates, and, during the 1990-1991 immunization season, used a target-based poster to track immunization rates. Physicians in the intervention group were enrolled in a performance-based financial incentive program that rewarded immunization rates above 70%. A survey concerning influenza immunization practices and opinions was sent to all physicians. The average physician-specific immunization rate in the incentive group was 73.1% versus 55.7% in the comparison practices (P < .001). Eligibility for incentives, practice size, sex of physician, medical specialty, reminder postcards, and practice populations including medically indigent patients were associated with immunization level. Controlling for the above variables, we completed a regression analysis showing that eligibility for the incentive was still significant (P = .003). The survey responses were not predictive of performance or significantly different between the two groups, except for the negative influence of sending postcards. This study in a community setting suggests that linking reimbursement to performance may be a successful strategy to increase influenza immunization levels for the elderly.

Aged↗
PubMed1996

Assessment and related immunization issues in the Special Supplemental Nutrition Program for Women, Infants and Children: a status report.

This article reports the results of a survey undertaken to determine the current level of collaboration between Women, Infants and Children (WIC) programs and immunization services. While the results of this study are encouraging, WIC needs to continue to place emphasis on using written or computerized immunization records for client screening, utilize available computer hardware and software to assist assessments, and expand the use of food voucher incentives as a strategy to improve coverage.

Health Services Accessibility↗
PubMed1999

Cost of chickenpox in Canada: part II. Cost of complicated cases and total economic impact. The Immunization Monitoring Program-Active (IMPACT).

OBJECTIVE: Primarily, to determine the direct medical costs and productivity losses associated with complicated chickenpox (hospitalized cases) and, secondarily, to quantify the overall economic burden of chickenpox in Canada. METHODS: Direct medical resource consumption patterns were determined by chart review of 160 otherwise healthy children and 40 children with leukemia hospitalized for chickenpox. Children were selected from the database of the Immunization Monitoring Program Active (IMPACT), a network of 11 tertiary-care hospitals in Canada that collected information at the time of hospitalization from January 1991 to March 1996. An additional 26 healthy children hospitalized were recruited prospectively by IMPACT. Productivity losses (time lost from work and daily activities) were assessed by caregiver interviews. Treatment costs were determined from the patient, Ministry of Health, and societal perspectives. RESULTS: The average societal per case cost for complicated chickenpox in healthy children was $7060 and $8398, respectively, from the retrospective and prospective assessments. For children with leukemia, the direct medical cost was estimated at $7228. These costs were combined with a cost established previously for uncomplicated chickenpox. The estimated yearly overall economic impact of chickenpox in Canada was $122.4 million, with $24.0 million attributable to Ministry of Health costs, assuming an estimated yearly incidence of 346 527 cases and a 0.54% rate of hospitalization for healthy children. CONCLUSIONS: Direct medical costs are the major cost driver in the care of complicated chickenpox. However, in the context of the overall economic burden of the disease, uncomplicated chickenpox is the major cost driver, contributing 89% to the total cost.

Canada↗
PubMed2003

Hepatitis B vaccination: addressing a drug-related problem in hemodialysis outpatients with a collaborative initiative.

UNLABELLED: The CDC recommends that all hemodialysis (HD) patients be vaccinated against hepatitis B virus (HBV). In 1999, only 39 of our 134 (29%) HD patients had received HBV vaccine. Since the vaccine is indicated for all HD patients, this presented a drug-related problem (DRP): indication without treatment. In response, nurses and pharmacists initiated a proactive HBV vaccination program. METHODS: An immunization protocol based on then current CDC recommendations was developed. HBV vaccine (40 mcg i.m.; at 0, 1 and 6 months) was administered to consenting HD patients. Anti-hepatitis B surface antibody (anti-HBs) titers were monitored and booster doses were given per the protocol. RESULTS: By August 2001, all consenting HD patients (n = 110) had received > or = 1 dose of HBV vaccine and 90 (81.8%) had either received a full course (> or = 3 doses) or had received > or = 1 dose and developed a positive anti-HBs titer (> or = 10 mIU/mL). Of these 90 patients, 52 (58%) developed a positive anti-HBs titer, 33 (37%) responded to < or = 3 doses, and 19 (21%) following a booster. The DRP was significantly improved. CONCLUSION: Given CDC guidelines, HBV vaccine should be offered to all HD patients. This initiative demonstrates that with concerted effort all consenting HD patients can receive HBV vaccination, thereby addressing an important DRP.

Algorithms↗