Physician perspectives on vaccination and diagnostic testing in children with gastroenteritis: A primary care physician survey

Sperou, A.J.; Dickinson, James A; Lee, Bonita; Louie, Marie; Pang, Xiaoli; Chui, Linda; Vanderkooi, Otto G; Freedman, Stephen B.

doi:10.1093/pch/pxx078

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…When comparing the performance of our proposed rectal swab test and commonly used noninvasive tests (e.g., FIT), indeed, this pilot study did not present an improved performance in CRC detection or data of reduction in mortality. However, rectal swab remains valuable as a potential screening test: a previous small-scale survey has suggested that rectal swab could be more preferable than stool test by the participants and may promote collection rate [98]. Such swab specimens are self-collectable or can be assisted by healthcare staffs if patients face difficulty [99].…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study Investigating the Expression Levels of Pluripotency-Associated Genes in Rectal Swab Samples for Colorectal Polyp and Cancer Diagnosis and Prognosis

Sin

Foo

Iyer

et al. 2021

Stem Cells International

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Change in gene expression is inevitable in cancer development. With more studies demonstrating the contributions of cancer stem cells (CSCs) in colorectal cancer (CRC) development, this study is aimed at investigating whether rectal swab specimen serves as a tool for detection of dysregulation of CSC or stem cell (SC) markers and at evaluating its potential as a new promising screening method for high-risk patients. Expression levels of 15 pluripotency-associated genes were assessed by quantitative PCR in 53 rectal swab specimens referred for endoscopic screening. Dysregulated genes and joint panels based on such genes were examined for their diagnostic potentials for both polyp and CRC. Out of 15 genes, Oct4, CD26, c-MYC, and CXCR4 showed significantly differential expression among normal, polyp, and CRC patients. A panel of Oct4 and CD26 showed an AUC value of 0.80 ( p = 0.003 ) in identifying CRC patients from polyp/normal subjects, with sensitivity and specificity of 84.6% and 69.2%. A panel of c-MYC and CXCR4 achieved CRC/polyp identification with an AUC value of 0.79 ( p = 0.002 ), with a sensitivity of 82.8% and specificity of 80.0%. The sensitivity for polyp and CRC was 80.0% and 85.7%, respectively. Further analysis showed that higher c-MYC and CXCR4 level was detected in normal subjects who developed polyps after 5-6 years, in comparison with subjects with no lesion developed, and the AUC of the c-MYC and CXCR4 panel increased to 0.88 ( p < 0.001 ), with sensitivity and specificity of 84.4% and 92.3%, respectively, when these patients were included in the polyp group. This study suggests that the Oct4 and CD26 panel is a promising biomarker for distinguishing CRC from normal and polyp patients, whereas the c-MYC and CXCR4 panel may identify polyp and CRC from normal individuals.

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Section: Discussionmentioning

confidence: 99%

A Pilot Study Investigating the Expression Levels of Pluripotency-Associated Genes in Rectal Swab Samples for Colorectal Polyp and Cancer Diagnosis and Prognosis

Sin

Foo

Iyer

et al. 2021

Stem Cells International

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“…69.7% of the participants thought that the rotavirus vaccine should be included in the national vaccination schedule. In a study conducted by Sperou et al (2017) in 2017, 573 physicians supported future vaccines for pathogens that cause gastroenteritis, and in another study by O'Leary et al (2013), 65% of family physicians in the USA were pediatricians. It was reported that 95% of them routinely recommend rotavirus vaccine.…”

Section: Rotavirus Vaccinementioning

confidence: 99%

Knowledge, attitudes and behaviors of family physicians about childhood vaccinations that are not in the routine vaccination schedule: a cross-sectional study

Avcı¹,

Kuş

Gümüştakım

et al. 2023

Prim Health Care Res Dev

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Aim: In our country, there are childhood vaccinations that are not included in the routine vaccination schedule and that families have to buy and have for a fee. In addition to income level, family physicians’ recommendations also play a major role in getting these vaccines. Our study was planned to determine the level of knowledge, attitudes and behaviors of family physicians about rotavirus, HPV and meningococcal vaccines, which are not included in the routine vaccination scheme of the Ministry of Health. Materials and Methods: Our cross-sectional and descriptive study was carried out between May and July 2019. The population of our study consists of approximately 30 000 family physicians working as Family Physicians in Turkey. When the sample size is calculated with 5% margin of error and 95% confidence interval, it turns out to be 381. A 15-question questionnaire prepared by scanning the literature and including socio-demographic characteristics was presented to the participants. The Likert scale, which includes 12 questions about rotavirus, meningococcus, HPV and vaccines developed for these microorganisms, was administered to physicians either face-to-face or via the internet. In our study, the statistical significance level was accepted as P < 0.05, and the SPSS statistical package program was used in the calculations. Results: 81 Research Assistants, 62 Family Medicine Specialists and 234 Family Physicians participated in our study, and the participants were determined by simple random sampling method. The mean age of the participating physicians was 37.96 ± 9.3 (min: 25 and max: 68). 50.9% of the physicians were women, 79.8% were married, 85.1% were in the city center, and 62.1% were practicing family medicine as general practitioners. 74.82% of the participating physicians recommend rotavirus and 56.2% HPV vaccines to their patients. 10.6% (40 people) of the physicians participating in our study did not recommend any of the rotavirus, HPV, meningococcal, influenza and adult pertussis vaccines to their patients. In the evaluation of the reason for this, 58.7% (27 people) of physicians who did not recommend special vaccines state that they did not recommend vaccines because they are not included in the routine vaccination schedule of the Ministry of Health. Another important reason was that the vaccines are paid (30.4%, 14 people). To the question of having sufficient information about special vaccines that are not included in the routine vaccination schedule, 26% of the participants stated that they have sufficient knowledge, and 56.5% stated that they have partial knowledge. The Likert knowledge questions total score of those who recommended at least one vaccine to their patients was significantly higher than those who did not recommend it at all. Likert knowledge questions total score of those who had at least one vaccination was significantly higher than those who never had it (P = 0.001). Conclusion: In general, as the level of knowledge about private vaccines decreases, the rates of self-vaccination, recommending it to their patients, and asking it to be included in the national vaccine schedule decrease. For this reason, increasing the knowledge of physicians about vaccines not included in the national vaccination schedule will contribute to the dissemination of vaccines, thus increasing immunity and reducing mortality and morbidity.

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“…Difficulty in specimen collection likely contributes to reduced specimen submission in the setting of diarrhea, and transfer of the specimen into a sterile cup can also pose a substantial biohazard risk. Physicians have noted rectal swabs to be a preferable specimen type and suggest that the ability to routinely submit rectal swab specimens rather than bulk fecal specimens could potentially increase the rate of specimen submission (8). Further, the relative ease of collection and transport has also made rectal swabs a preferable specimen for outbreak investigations in the public health setting (9,10).…”

mentioning

confidence: 99%

Culture of Rectal Swab Specimens for Enteric Bacterial Pathogens Decreases Time to Test Result While Preserving Assay Sensitivity Compared to Bulk Fecal Specimens

2019

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Diarrheal illness is a major cause of morbidity and mortality throughout the world, yet the etiologic agent of many cases of gastrointestinal illness remains unspecified, often due to the lack of convenient, timely, and sensitive diagnostic testing. Although bulk fecal specimens remain the recommended specimen type for enteric culture, rectal swabs may be an option preferred by clinicians and patients due to the convenience and timing of collection. However, the lack of data evaluating the sensitivity of rectal swabs compared to fecal specimens for detection of enteric pathogens precludes this specimen type from being recommended by national guidelines. In this study, we retrospectively reviewed 480 paired rectal swab and fecal specimens submitted for enteric culture to the Barnes-Jewish Hospital and St. Louis Children’s Hospital microbiology laboratories in St. Louis, MO, from 2002 to 2017. We report 32% positivity of paired specimens with an overall agreement of 93% and Cohen's κ of 0.84 (95% confidence interval, 0.78 to 0.89). Additionally, we evaluated the time to result from the time of patient presentation to the health care setting and demonstrate that rectal swabs have a significantly shorter time to an actionable result than bulk fecal specimens (median, 67.4 h versus 78.4 h, respectively; P < 0.001). These findings indicate that rectal swabs facilitate on-demand culture-based testing with a sensitivity comparable to that of fecal specimens and thus should be recommended for enteric bacterial culture when bulk fecal specimens are unavailable.

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Physician perspectives on vaccination and diagnostic testing in children with gastroenteritis: A primary care physician survey

Abstract: Simplification of diagnostic testing and stool sample collection could contribute to improved pathogen identification rates. Implementation of an enteric vaccine into the routine paediatric vaccination schedule is supported by the majority of respondents.

Cited by 4 publications

References 15 publications

A Pilot Study Investigating the Expression Levels of Pluripotency-Associated Genes in Rectal Swab Samples for Colorectal Polyp and Cancer Diagnosis and Prognosis

A Pilot Study Investigating the Expression Levels of Pluripotency-Associated Genes in Rectal Swab Samples for Colorectal Polyp and Cancer Diagnosis and Prognosis

Knowledge, attitudes and behaviors of family physicians about childhood vaccinations that are not in the routine vaccination schedule: a cross-sectional study

Culture of Rectal Swab Specimens for Enteric Bacterial Pathogens Decreases Time to Test Result While Preserving Assay Sensitivity Compared to Bulk Fecal Specimens

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