(An item from the ISHN Member information service) An article in Issue #6, 2013 of the American Journal of Tropical Diseases & Hygiene describes the contributions of non-governmental organizations to WHO targets for control of soil-transmitted helminthiases. The authors note that Soil-transmitted helminthiases (STH) may affect up to 1 billion children globally. They estimate that "In 2010, NGOs delivered 65.4 million STH treatments, which is an estimated 25.1% of the total delivered. Of these treatments, 23.3 million (35.6%) were not reported to the WHO; 22.3 million (95.7%) were from countries that had not submitted STH treatment reports to the WHO. Read more>>
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(An item from the ISHN Member information service) Several articles in Issue #4, 2013 of the Journal of School Nursing provide insights into school-located immunization programs. The editorial notes that: " The development of immunizations is considered 1 of the 10 great accomplishments of public health in the first decade of the 21st century (Morbidity and Mortality Weekly, 2011). School nurses are inextricably associated with the substantial declines in vaccine-preventable diseases, and five of the original research articles in this issue provide evidence of the actual and potential school nursing contributions." The articles examine immunization programs in different contexts, including minority communities, private schools and other contexts. Another examines how five school districts in the USA strengthened their programs in diverse ways. Read more>>
(An item from the ISHN Member information service) An article in the April 2013 Issue of BMC Public Health explores the process, reception and reactions to school closings during an outbrerak of influenza or other diseases. School closings, if done quickly and effectively, may disrupt the disease transmission vectors in such outbreaks. The authors note that "Drawing on Thompson et al’s ethical framework for pandemic planning, we show that considerable variation existed between and within schools in their attention to ethical processes and values. In all schools, health officials and school leaders were strongly committed to providing high quality care for members of the school community. There was variation in the extent to which information was shared openly and transparently, the degree to which school community members considered themselves participants in decision-making, and the responsiveness of decision-makers to the changing situation. Reservations were expressed about the need for closures and quarantine and there was a lack of understanding of the rationale for the closures. In our study, trust was the foundation upon which effective responses to the school closure were built. Trust relations within the school were the basis on which different values and beliefs were used to develop and justify the practices and strategies in response to the pandemic. Read more>>
(An item from ISHN Member information service) An article in the February 2013 Issue of PLOS Neglected Tropical Diseases reviews the impact of school-based deworming programs and found that they can be effective in reducing the infection rates among those children. However, the authors caution that the overall impact of such school programs on the community may be lessened if the proportion of people in the community who are infected are adults rather than children. Really? Who would have thought that school programs do not reach adults? Really Read more>
(An item from ISHN Member information service) An article in Issue #4, 2012 of International Health provides a summary of the reasons why children afe not vaccinated. The authors prove this summary based on a review of the grey literature. "In collaboration with WHO, IMMUNIZATION-basics analyzed 126 documents from the global grey literature to identify reasons why eligible children had incomplete or no vaccinations.The main reasons for under-vaccination were related to immunization services and to parental knowledge and attitudes. The most frequently cited factors were: access to services, health staff attitudes and practices, reliability of services, false contraindications, parents’ practical knowledge of vaccination, fear of side effects, conflicting priorities and parental beliefs. Some family demographic characteristics were strong, but underlying, risk factors for under-vaccination. Studies must be well designed to capture a complete picture of the simultaneous causes of under-vaccination and to avoid biased results. Although the grey literature contains studies of varying quality, it includes many well-designed studies. Every immunization program should strive to provide quality services that are accessible, convenient, reliable, friendly, affordable and acceptable, and should solicit feedback from families and community leaders. Every program should monitor missed and under-vaccinated children and assess and address the causes. Although global reviews, such as this one, can play a useful role in identifying key questions for local study, local enquiry and follow-up remain essential. Read more.
(An item from ISHN Member information service) An article in the November 2012 Issue of PLOS Neglected Tropical Diseases suggests that school or community-based vaccinations to prevent Schistosomiasis (infections from snails) is more effective than the current WHO treatment guidelines. The researchers report that "Our study used available field data to calibrate advanced network models of village-level Schistosoma transmission to project outcomes of six different community- or school age-based programs, as compared to the impact of current 2006 W.H.O. recommended control strategies. We then scored the number of years each of 10 typical villages would remain below 10% infection prevalence (a practicable level associated with minimal prevalence of disease). All strategies that included four annual treatments effectively reduced community prevalence to less than 10%, while programs having yearly gaps (‘holidays’) failed to reach this objective in half of the communities. Effective post-program suppression of infection prevalence persisted in half of the 10 villages for 7–10 years, whereas in five high-risk villages, program effects on prevalence lasted zero to four years only. At typical levels of treatment adherence (60 to 70%), current WHO recommendations will likely not achieve effective suppression of Schistosoma prevalence unless implemented for longer than years. Read More
(An item from ISHN Member information service) Four articles in the October 2012 issue of the Journal of School Nursing examine the costs, coordination and coverage of school-based influenza vaccination programs. The cost of school vaccination programs was calculated by estimating the time spent by school nurses outside their normal clinic duties (22 out of 69 hours). and the calculation estimates such costs at $15.36 per dose. A second article calculated the per dose during the recent H1N1 campaign to be $13.51. The third article examined feasibility and acceptability and reported that "school personnel and the vaccinator viewed the school-located vaccinations as feasible and beneficial. However, the vaccinator identified difficulties with third-party billing as a potential threat to sustainability. The fourth article examined the coordination of school and state immunization records in Washington state. Read more.
(An item taken from the daily/weekly/monthly ISHN Member information service) An article in Issue #4, 2012 of the Journal of School Nursing reports on the experiences of several stakeholders in using elementary schools as the place for influenza vaccinations. study examined the initiation and logistics, funding, perceived barriers and benefits, and disruption of school activities by school-located influenza vaccination (SLIV) programs conducted during the 2008–2009 influenza season. Seventy-two interviews using a structured protocol were conducted with 26 teachers, 16 school administrators, and 30 health care professionals from 34 schools in 8 school districts. Most respondents (96%) reported minimal school-day disruptions. The perception of most stakeholders is that SLIV programs can be relatively easy to initiate, minimally disruptive and can become more efficient with experience, especially with feedback from all stakeholders. Readers may also want to review the articles we collected as we monitored this issue during the H1N1 outbreak a year ago, where we cited studies showing that school-based vaccinations were also significantly more cost effective and efficient. Read more..
(An item taken from the daily/weekly/monthly ISHN Member information service) Immunization is discussed in four articles in Issue #6, 2012 of Pediatrics. Two of those articles once again demonstrate how school-based immunization programs cost less and are more effective in reaching youth. (Similar studies have shown that school-based immunization is less costly and more effective in initial campaigns.) The first article reports that immunization recalls to 800 adolescents in four Denver clinics. Post the recall, the intervention group had significantly higher proportions of receipt of at least 1 targeted vaccine (47.1% vs 34.6%, P < .0001) and receipt of all targeted vaccines (36.2% vs 25.2%, P < .0001) compared with the control group. Three of the four clinics made a profit from the recall, one did not. (Average costs for administering vaccines are usually about $15 in a physicians office). The other study, also in Denver, recalled 529 teens from four school-based health centres. At the end of the demonstration study, 77% of girls had received ≥1 vaccine and 45% had received all needed adolescent vaccines. At the end of the RCT, 66% of recalled boys had received ≥1 vaccine and 59% had received all study vaccines, compared with 45% and 36%, respectively, of the control group (P < .001). The cost of conducting recall ranged from $1.12 to $6.87 per recalled child immunized via school-based clinics. Read more...
(Posted by ISHN) April is Vaccinations month around the world, so it is fitting that this blog post discusses the school's critical role in vaccinations. This posting has been prompted by a series of excellent articles in the February 2012 issues (#6-10) of the journal Vaccine. These articles examine the attitudes and concerns of parents, community norms, factors that affected the uptake of vaccinations during the recent H1N1 outbreak. The International School Health Network has been tracking this issue in its monitoring of over 200 research journals, over 100 news media outlets and over 75 social media sources. A quick summary of some of those articles, reports and reviews can be found here. Read more.
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