Background High confidence in vaccination programmes is crucial for maintaining high coverage rates. Across the European Union (EU), however, vaccine delays and refusals are contributing to declining immunisation rates in a number of countries and are leading to increases in disease outbreaks. Methods We assessed the overall state of confidence in vaccines among the public in all 28 EU member states and among general practitioners (GP) in ten EU member states, conducting the largest ever study on attitudes to vaccines and vaccination in the EU, eliciting the views of approximately 28,000 respondents across the 28 EU member states. Results We found that a number of member states (including France, Greece, Italy, and Slovenia) have become more confident in the safety of vaccines since 2015, but that the Czech Republic, Finland, Poland, and Sweden have become less confident. While GPs generally hold higher levels of vaccine confidence than the public, the survey found that 36% of GPs surveyed in Czech Republic and 25% in Slovakia do not agree that the MMR vaccine is safe and 29% and 19% respectively do not believe it is important. Countries whose GPs hold higher confidence in vaccines tend to have a larger proportion of the public expressing positive vaccination beliefs. Conclusions Even countries with well-established vaccination programmes and high levels of confidence are not immune to rising vaccine hesitancy. There is a need for continuous monitoring, preparedness and response plans to maintain and increase confidence in the importance, effectiveness and safety of vaccines, among both the public and health professionals.
Seckel syndrome is a rare genetic disorder with autosomal recessive inheritance. It is associated with many CNS anomalies along with involvement of other systems. We present a case of Seckel syndrome with semilobar holoprosencephaly as associated CNS anomaly, which to the best of our knowledge has not been reported earlier.
Aim To learn how to achieve high‐quality, effective coverage of Kangaroo Mother Care (KMC), defined as 8 hours or more of skin‐to‐skin contact per day and exclusive breastfeeding in district Sonipat in North India, and to develop and evaluate an implementation model. Methods We conducted implementation research using a mixed‐methods approach, including formative research, followed by repeated, rapid cycles of implementation, evaluation and refinement until a model with the potential for high and effective coverage was reached. Evaluation of this model was conducted over a 12‐month period. Results Formative research findings informed the final implementation model. Programme learning was critical to achieve high coverage. The model included improving the identification of small babies, creating KMC wards, modification in hospitalisation criteria, private sector engagement and in‐built programme learning to refine implementation progress. KMC was initiated in 87% of eligible babies. At discharge, 85% received skin‐to‐skin contact care, 60% effective KMC and 80% were exclusively breastfed. At home, 7‐day post discharge, 81% received skin‐to‐skin care and 79% were exclusively breastfed in the previous 24 hours. Conclusion Achieving high KMC coverage is feasible in the study setting using a model responsive to the local context and led by the Government.
The study was conducted in 2831 pregnant women with no diagnosed complication at the time of registration to obtain normal foetal growth pattern for clinical and ultrasonographic parameters. Normal values for maternal weight, fundal height and abdominal girth for clinical and biparietal diameter, abdominal circumferences and femoral length for ultrasonographic parameters are presented. Clinical and ultrasonographic parameters were compared for their efficacy in prediction of low birth weight. Neither clinical nor ultrasonographic parameters were found to be satisfactory in identifying the foetus at risk of low birth weight. It has been found that clinical parameters for routine monitoring are as effective as ultrasonographic parameters and have the added advantage of being easily replicable at the peripheral level of health care.
The outbreak of epidemic dropsy in the Indian capital, New Delhi, during the rainy season of 1998 was of one of the most severe forms and had repercussions in both health and political circles. Some 2552 cases were reported and 65 deaths occurred between 5 August and 12 October, causing untold misery and economic loss to the affected families. The actual figures are likely to be much higher due to non-reporting of milder cases to the hospitals. The aim of this article is to consolidate and update the available information on clinical aspects of epidemic dropsy.
Background Maternal COVID-19 infection acquired during late pregnancy carries a potential risk for adverse neonatal outcomes. There is still a paucity of data on its effect on the transition from intrauterine to extrauterine life. Objectives The objectives of this study were to determine the impact of maternal COVID-19 infection on neonates for the risk and need for resuscitation at birth, Apgar scores at 1- and 5-minutes, and the need of NICU admission during early neonatal period. Materials and method In this hospital-based prospective matched cohort study, 100 COVID-positive pregnant women presenting for delivery were enrolled. We also included 100 non-COVID pregnant women after the best possible matching of their major baseline parameters with the study group. Neonates of both groups were followed-up till 7 days of life. Results The two groups were comparable for all baseline variables except for the mode of delivery. The requirement of neonatal resuscitation was 30% and 21% in the study and control groups (RR = 1.429; 95% CI 0.88–2.32; p = 0.149). Apgar scores at 1- and 5- minutes were also unaffected by maternal COVID-19 infection with mean scores of 8.8 ± 0.651 vs. 8.87 ± 0.562 (p = 0.42) in the study and control groups, respectively. COVID-exposed neonates had a higher incidence of NICU admission when compared with the unexposed group (RR =1.616; 95% CI 1.002–2.606; p = 0.047). Among neonates born to COVID-positive mothers, 11% demonstrated evidence of SARS-CoV-2 positivity within first 5 days of life. The risk for need of resuscitation and mean Apgar scores were comparable among SARS-CoV-2 positive and negative neonates (p > 0.05). Conclusion COVID-19 infection in pregnant women is not associated with an increased risk of neonatal resuscitation.
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