Vaccination coverage and awareness of infectious risks in patients with an absent or dysfunctional spleen in the Netherlands

Vaccine. 2008 Dec 9;26(52):6975-9. doi: 10.1016/j.vaccine.2008.09.052. Epub 2008 Oct 9.

Abstract

Objective: To evaluate the current practice to prevent infections in patients with an absent or dysfunctional spleen in a part of the Netherlands. To measure serum antibody levels against Streptococcus pneumoniae and Haemophilus influenzae type b.

Design: Observational study of vaccination coverage by analysis of questionnaires and serum antibody levels.

Setting: Primary care practices in the Utrecht area of the Netherlands, catchment area 750,000 inhabitants, period 2006-2007.

Participants: One hundred and thirty adult patients with an absent or dysfunctional spleen.

Main outcome measures: Percentage of patients informed about infectious risks and aware of the timely use of antimicrobial prophylaxis. Vaccine coverage against S. pneumoniae, H. influenzae type b and Neisseria meningitidis. Levels of serum antibodies against S. pneumoniae and H. influenzae type b.

Results: Fifty-six patients (43%) have not received up-to-date information about the infectious risks associated with their condition; 65 patients (50%) are not aware of the need to contact a physician immediately in case of high fever; 37 patients (28%) are keeping antimicrobial prophylaxis at home. Pneumococcal vaccination has been administered within the last 5 years to 103 of 130 patients, antibody levels above the threshold of > or =0.35microg/mL are found in 83 of the 101 patients (data lacking in 2 patients). Complete coverage against S. pneumoniae is only 64% (83/130). A minority of patients (respectively 32% and 27%) has been vaccinated against H. influenzae type b and N. meningitidis.

Conclusions: Vaccination coverage and education about infectious risks in patients with an absent or dysfunctional spleen can be improved markedly in the Netherlands.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies / analysis
  • Antibodies / immunology
  • Antibodies, Bacterial / analysis
  • Antibodies, Bacterial / biosynthesis
  • Databases, Factual
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Infections / epidemiology*
  • Infections / immunology
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Patient Education as Topic
  • Pneumococcal Vaccines / therapeutic use
  • Risk
  • Spleen / physiology*
  • Splenectomy
  • Splenic Diseases / complications
  • Splenic Diseases / epidemiology*
  • Surveys and Questionnaires
  • Vaccination / statistics & numerical data*
  • Young Adult

Substances

  • Antibodies
  • Antibodies, Bacterial
  • Pneumococcal Vaccines