Cervical cancer and its precursors low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) are associated with infection by human papillomavirus (HPV), in particular HPV 16 and 18. The distribution of the HPV genotype varies with the severity of cervical disease, age and the geographic location of the patients. We report the results of a population study carried out in a region of north-western (NW) Spain aimed at determining the prevalence of single and multiple infections by 35 types of HPV using low-density microarrays for 113 cases with negative for intraepithelial lesions or malignancies; 588 with atypical squamous cells of undetermined significance (ASCUS)/LSIL; 183 with HSIL; and seven cases of squamous cell carcinomas. Of the 891 patients analysed, 50.2% had single infections and 49.8% had multiple HPV infections. In women aged below 30 years, there was a predominance of multiple infections (p = 0.027). ASCUS/LSIL was associated with multiple and HSIL with single infections (p = 0.025). We observed significant increases in the percentage of infections due to a high-risk (HR) type of HPV when the severity of the cytological lesion increased (p = 0.001). No relationship was found between greater aggressiveness in the cytological diagnosis and a higher number of HPV types involved in multiple infections. The five most frequent genotypes were HPV 16 (26.3%), 53 (18.2%), 51 (17.3%), 6 (14.8%) and 66 (13.1%). The prevalence of HPV 16, 33 and 58 increased significantly from ACUS/LSIL to HSIL and the prevalence of HPV 51, 53 and 66 decreased. HPV 16 was the only genotype that showed a significant increase in prevalence when the severity of the cytological disease increased in single infections (p = 0.0001). The implementation of bivalent prophylactic vaccination could potentially lead to prevention in 32% of the population included in the study - in at least a quarter of patients with ACUS/LSIL (26.7%), and in half of HSIL (50.2%).
Los autores declaran que no existen conflictos de interés.
RESUMENFundamentos: La cobertura de vacunación antigripal en personal sanitario es baja. Este estudio se realizó con la finalidad de conocer las razones por las que los estudiantes de medicina tienen previsto vacunarse o no de gripe cuando sean trabajadores sanitarios así como los factores asociados con dicha intención.
Métodos:Estudio transversal en el que se incluyó a todos los alumnos matriculados en la Facultad de medicina de una Universidad española durante el curso académico 2011-2012. La información se obtuvo mediante un cuestionario autocumplimentado que recogía la intención de vacunación, motivos para ello y 8 preguntas sobre conocimientos de la vacuna. Se calcularon frecuencias absolutas y relativas. Para estudiar las asociaciones se utilizó la prueba chi-cuadrado y regresión logística múltiple.
Resultados:De los 1.130 estudiantes respondieron el cuestionario 654 (57,9%). El 63,0% manifestaron tener intención de vacunarse. Las principales razones para prever vacunarse fueron: considerarlo conveniente (68,2%), riesgo de transmitir gripe a pacientes (65,5%) y riesgo de que los pacientes pudieran transmitírsela a ellos (64,8%). Las razones más frecuentes para no prever vacunarse fueron: bajo riesgo de padecer gripe (41,7%) y evitar inyecciones/medicación (27,7%). Conocer especí-ficamente que la vacuna está indicada en trabajadores sanitarios se asoció con prever vacunarse (p=0,000).Conclusiones: La intención de vacunación fue elevada con respecto a la cobertura actual. El nivel de conocimientos fue mejorable. Conocer la indicación de la vacunación en trabajadores sanitarios se asoció con la intención de vacunarse.
ABSTRACT
Attitudes of Medical Students about Influenza VaccinationBackground: Vaccination coverage against seasonal influenza virus among healthcare personnel is low. The aim of this study was to know the reasons for which the medical students have intention to be vaccinated against influenza when they become healthcare workers (HCWs), and to identify its determining factors.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.