BackgroundIn Greece, several new childhood vaccines were introduced recently but were reimbursed gradually and at different time points. The aim of this study was to assess immunization coverage and identify factors influencing complete and age-appropriate vaccination among children attending public nurseries in the municipal district of Athens.MethodsA cross-sectional study, using stratified sampling was performed. Immunization history was obtained from vaccination booklets. Demographic and socioeconomic data were obtained from school registries and telephone interviews. Vaccination rates were estimated by sample weighted proportions while associations between complete and age-appropriate immunization and potential determinants by logistic regression analysis.ResultsA total of 731 children (mean age: 46, median: 48, range: 10–65 months) were included. Overall immunization coverage with traditional vaccines (DTP, polio, Hib, HBV, 1st dose MMR) was satisfactory, exceeding 90%, but the administration of booster doses was delayed (range: 33.7- 97.4%, at 60 months of age). Complete vaccination rates were lower for new vaccines (Men C, PCV7, varicella, hepatitis A), ranging between 61-92%. In addition, a significant delay in timely administration of Men C, PCV7, as well as HBV was noted (22.9%, 16.0% and 27.7% at 12 months of age, respectively). Child’s age was strongly associated with incomplete vaccination with all vaccines (p< 0.001), while as immigrant status was a predictor of incomplete (p=0.034) and delayed vaccination (p<0.001) with traditional vaccines. Increasing household size and higher maternal education were negatively associated with the receipt of all and newly licensed vaccines, respectively (p=0.035).ConclusionsOur findings highlight the need to monitor uptake of new vaccines and improve age- appropriate administration of booster doses as well as early vaccination against hepatitis B. Immigrant status, increased household size and high maternal education may warrant targeted intervention.
The increasing trend of administering nonprescribed medicines in children is a significant public health issue. The aim of the present study was to assess the use of medication without a prescription (MWP), including both nonprescribed medication (NPM) and prescription-only medication (POM), and identify associated factors, among preschoolers in Athens, Greece. A predesigned questionnaire was distributed to parents from May through June 2011. Multivariable binary logistic regression analysis models were used to assess associations of interest. Results showed that 95.1% of parents reported administering at least one MWP, during the previous 12 months. Antipyretics (91%) were the most commonly NPM and bronchodilators (24.8%) and antibiotics (16.4%) the most common POM dispensed. Child's increased age group, lack of parental information, higher paternal education, and mother's foreign nationality were associated with increased antipyretic use (p < 0.05), while father's foreign nationality and parental age were positive predictors of antibiotic administration (p < 0.05). The likelihood of consuming antipyretics and antibiotics significantly increased when information was provided by a pharmacist (p = 0.017 and p = 0.054, resp.). Conclusively, most parents have administered at least one MWP, including antibiotics, to address symptoms of common childhood diseases, highlighting the need of information campaigns concerning the consequences of their improper use.
Nursery schools serve as reservoirs of transmission of infectious diseases, and teachers should be able to implement and monitor hygiene measures to prevent them. The aim of the present study was to assess the compliance of nursery school teachers on promoting preventive interventions and to identify associated factors, during the novel H1N1 influenza pandemic. A secondary objective was to evaluate their knowledge and vaccination status regarding the novel virus. A cross-sectional study was performed, with the use of a predesigned anonymous, questionnaire, and distributed to all public nursery teachers of Athens, Greece. General etiquette practices were highly acceptable to over 92% of teachers. Those with longer teaching experience promoted simple preventive measures, such as hand washing and use of hand sanitizer, more often while older children were more likely to familiarize with them. However, teachers presented inadequate knowledge concerning the novel virus and their vaccination rates with the pandemic vaccine were unacceptably low (1.1%). Our study showed that promotion of simple preventive measures is feasible and may contribute to the prevention of outbreaks in nursery schools, although knowledge gaps and fear concerning the pandemic vaccine highlight communication issues.
In Greece, the illegal dispensing of prescription-only medicines, including antibiotics, by pharmacies without the necessary medical prescription, remains standard practice (1,2). This has continued, despite the fact that the country has the highest rates of antibiotic consumption, both in hospitals and the community, as well as antibiotic resistance, compared to other European countries (3).The frequency of antibiotic administration without a prescription, and the factors associated with this practice, was evaluated in a sample of preschool children under the age of six years (range 10-65 months) in the Municipality of Athens, Greece. Data on this practice were collected by using a questionnaire that was distributed over a two-month period from May to June 2011 to all the parents and guardians of children attending public kindergartens in the Municipal Nursery of Athens. This comprised 98 kindergartens with 5401 registered pupils from middle-and low-income families. Parents were advised of the aims of the study before the questionnaire was administered, and returning a completed questionnaire was regarded as informed consent. The study protocol was approved by the Review Board of the Municipal Nursery of Athens. Associations of interest were explored using multivariable logistic regression analysis.A total of 1985 questionnaires were returned, which equated to a response rate of 43.1%. The mean age of the parents was 36.6 years (AE5.2), 88.0% were married, 74.3% were both Greek nationals, and the majority of the respondents were mothers (79.0%). Most respondents were secondary school graduates -46.3% of the fathers and 44.7% of the mothers and 29.0% of the parents had a higher education degree.We found that 16.4% of the parents reported administering at least one antibiotic without a medical prescription to their child in the previous 12 months to treat upper respiratory infections (45.5%), common cold symptoms (18.6%) and fever or cough (14.5%). Amoxicillin was the preferred antimicrobial (41.4%) for common colds, while second-generation cephalosporins (30.1%) and amoxicillin/clavulanate acid (29.2%) were mainly used to treat upper respiratory tract infections.Following multivariable analysis, the positive predictors for unprescribed antibiotic administration were the fathers foreign nationality, with an odds ratio (OR) of 2.22 and 95% confidence interval (95% CI) of 1.62-3.04 or their refusal to provide an answer regarding their citizenship (OR 2.62, 95% CI: 1.27-5.41). Parents were less likely to administer antibiotics if they did not agree with buying medicines using a previous prescription for the child's similar health problems (OR 0.61, 95% CI: 0.45-0.83) and those who disagreed that familiarity of a brand name should drive its purchase without a prescription, (OR 0.60, 95% CI: 0.45-0.81). Those who disagreed that medicines should only be administered following a paediatric consultation were 2.8 times more likely to use unprescribed antibiotics (OR 2.81, 95% CI: 1.98-3.98). Moreover, the probability of an...
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