An australian audit of vaccination status in children and adolescents with inflammatory bowel disease
The primary aim of this study was to describe compliance with current Australian guidelines for vaccination of children and adolescents diagnosed with IBD. A secondary aim was to review the serological screening for VPD. Methods A random sample of patients (0-18 years at diagnosis), were selected from the Victoria Australia state based Pediatric Inflammatory Bowel Disease Register. A multi-faceted retrospective review of immunization status was undertaken, with hospital records audited, a telephone interview survey conducted with consenting parents and the vaccination history was checked against the primary care physician and Australian Childhood Immunization Register (ACIR) records. The routine primary childhood vaccinations and administration of the recommended additional influenza and pneumococcal vaccines was clarified. Results This 2007 audit reviewed the immunization status of 101individuals on the Victorian Pediatric IBD database. Median age at diagnosis was 12.1 years, 50% were on active immunosuppressive therapy. 90% (38/42) [95% confidence intervals (CI) 77%; 97%] with complete immunization information were up-to-date with routine primary immunizations. Only 5% (5/101) [95% CI 2%; 11%] received a recommended pneumococcal vaccine booster and 10% (10/101) [95% CI 5%; 17%] had evidence of having ever received a seasonal influenza vaccine. Those living in rural Victoria (p = 0.005) and younger at the age of diagnosis (p = 0.002) were more likely to have ever received an influenza vaccine Serological testing, reviewing historical protection from VPD, identified 18% (17/94) with evidence of at least one serology sample. Conclusion This study highlights poor compliance in IBD patients for additional recommended vaccines.
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Borody MD PhD FRACP, a graduate of the University of New South Wales, from which he holds a doctorate in medicine, will be presenting his findings in an open forum at: The Suffolk Y Jewish Community Center 74 Hauppauge Road in Commack, Long Island March 20, 2006 from 7-9 PM. Suggested donation $3 As the founder and current Medical Director of the Centre for Digestive Diseases (CDD), Dr. Borody has created a unique medical institution, internationally regarded for its novel approaches in research, diagnosis and the treatment of gastrointestinal conditions. He has been a recipient of the Winthrop Traveling Fellowship, the Neil Hamilton Fairly Fellowship and the Marshall & Warren Prize, and was a Clinical Fellow in Gastroenterology at the Mayo Clinic in Rochester in 1983. He is a member of the Australian Medical Association, the Gastroenterological Society of Australia, the European Gastroenterology Society, the Functional Brain-Gut Research Group and Fellow of the American College of Gastroenterology and the American College of Physicians. Prof. Borody supervises a number of major research programs as well as being involved as a reviewer for the American Journal of Gastroenterology, Digestive Diseases and Sciences, Endoscopy, Journal of Gastroenterology and Hepatology, Medical Journal of Australia and Digestive and Liver Diseases. He has published in excess of 120 scientific papers. In 2004 he was appointed an Adjunct Professor of the Faculty of Science at the University of Technology, Sydney. The Suffolk Y JCC is an agency of UJA Federation and affiliated with JCC Association. Additional funding is provided by the United Way of Long Island and the Townwide Fund of Huntington. The Suffolk Y JCC takes no position on the efficacy of Dr. Borody’s treatment. There are no references listed for this article. Article adapted by Medical News Today from original press release. Visit our Crohn’s / IBD category page for the latest news on this subject.
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Crohn’s Disease – Professor Thomas Borody Of Australia Comes To New York To Discuss Significant New Findings
The RCH patient’s hospital laboratory results were reviewed to identify if any baseline serological testing was performed to review the requirement for additional protection against VPD such as varicella and hepatitis B. Multiple sources were reviewed for any vaccine safety concerns or reports of adverse events following immunization, including: hospital records, general practitioner records and parent reports through interviews. A random sample of 101 participants was taken from the IBD register. The random sample was generated using the statistical software STATA Version 10.0 (StataCorp, TX), which was also used for data analysis. This overall sample size calculation was based on the outcome of routine immunization up-to-date status by hospital medical record audit and allowed a determination of proportions within +/- 10% with 95% confidence. Proportions of up-to-date status and additional vaccines administered were compared using a Pearson chi-square test with point estimate odds ratios (OR) and 95% confidence intervals determined and a p value < 0.05 considered statistically significant. The study was approved by the Royal Children's Hospital Human Research Ethics Committee. Results The study was conducted between July-November 2007. The participant demographics are detailed in Table 2 . There only difference at baseline between those selected for the study, compared with the rest of the IBD database (N = 534), was proportionally more cases of indeterminate colitis in the database group [11% versus 3%; P = 0.01]. Participants had a median age at diagnosis of 12.1 years [range 1.9 to 17.8 years], 50% were female, and 75% had Crohn's disease. At the time of the immunization audit 43 participants were on 5-ASA derivatives: sulphasalazine (17), mesalazine (21), besalazine (4) and osalazine (1). Reviewing ongoing immunosuppressive therapies, there were 39 participants, some on multiple medications including: oral corticosteroids (7), azathioprine (36) and infliximab (7). Table 2.
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