Immunisation state and its documentation in hospital patients

Article Abstract:

Successful immunization programs rely on high levels of participation by preschool children. These programs have been instrumental in lowering child mortality rates as the incidences of measles, whooping cough, diphtheria and other formerly critical infectious childhood illnesses have sharply decreased. Nevertheless, significant numbers of preschool children are not being properly immunized, and health care providers must use all opportunities to ensure adequate immunization. One opportunity involves using the personal health record book, which has been issued to all mothers of new babies in New South Wales, Australia. The extent of childhood immunization and use of the personal health record for recording medical data were studied in children under two years of age, who were treated as hospital inpatients or outpatients. Results revealed that appropriate immunization occurred significantly less often among children who were admitted to the hospital (inpatients), and parents frequently recalled their children's immunization history incorrectly. Seventy-nine to 95 percent of the children treated as outpatients were immunized, depending on whether measles-mumps (lowest use) or polio (highest use) was the vaccine being considered. From 71 percent (DPT or diphtheria-pertussis-tetanus) to 86 percent (polio) of inpatients were immunized; the goal for effective immunization is 95 percent of all children for each vaccine. Personal health records accompanied only one-third of the children admitted for emergencies, while the parents of 59 percent of the children with elective admissions brought the records to the hospital. This problem was reflected in inaccurate information about the immunization status of children in 24 percent of their hospital records. The study concludes that parents need to be reminded to bring their children's personal health records whenever and wherever they seek health care. Health care providers should request these records at all visits, thus allowing deficiencies in a child's immunization status to be recognized and remedied. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Children, Medical records, Immunization of children

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Routine immunisation of preterm infants

Article Abstract:

Immunization programs for children have been very effective in reducing and even eliminating diseases such as whooping cough, polio and measles. Current guidelines exist for immunizing full-term and preterm children beginning at three months of age. Three months of age, however, can be interpreted to mean from the actual delivery date or from the expected delivery date, and therefore inconsistency in immunization coverage occurs. Although there is a sound theoretical basis, there is little evidence that suggests the immune system of the preterm infant responds the same way as the that of a full-term infant. Fifty preterm infants (26 to 36 gestational weeks) were observed, in order to evaluate their immune responses to diphtheria, tetanus, pertussis and polio vaccines and compare them with the full term responses. The immunization routine was initiated approximately three months after birth, the second and third doses were given six to eight weeks and four to six months later, respectively. Blood samples were collected from the baby about 8 to 12 weeks after the third dose and analyzed for antibodies to the organisms responsible for diphtheria, pertussis, polio, and tetanus. For purposes of control, blood samples were also collected from 21 children between the ages of 12 and 24 months who were in the hospital for unrelated reasons. The blood levels of specific antibodies in preterm infants was not different from levels in the control children, suggesting that immune responses in preterm and full-term infants are equivalent. Also, there appeared to be no relationship between the immune response and gestational or immunization age. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Chronic respiratory morbidity after prolonged and premature rupture of the membranes

Article Abstract:

Premature rupture of the membranes occurs in approximately two to three percent of all pregnancies and is defined as rupture of membranes surrounding the fetus before 37 weeks' gestation. A review of pregnancies that were complicated by premature rupture of membranes occurring before 32 weeks of gestation was conducted to follow-up infants for the presence of chronic respiratory disease. Twenty-one children were followed-up for a median of 15 months, with a range of 6 to 22 months. Rupture of the membranes occurred at a median age of 24 weeks' gestation. Five children had respiratory symptoms during the follow-up period consisting of either coughing, wheezing, or both. Three children required hospitalization because of chest-related disorders, which turned out to be respiratory infections. Previous studies have concluded that survivors of premature rupture of the membranes are at increased risk of chronic lung disease. Respiratory morbidity may be preventable by avoidance of preterm delivery and the use of neonatal ventilation. Chronic respiratory disease does occur after prolonged premature rupture of the membranes and is related to very preterm delivery. There also may be minor degrees of abnormal lung growth in surviving infants. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Premature rupture of membranes, Premature rupture of the membrane, Premature labor, Respiratory tract diseases

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