ORIGINAL ARTICLE

Evaluation of Influenza, Pneumococcus, Zoster, Measles, Diphtheria, and Pertussis Vaccination Rates in Patients with Type 1 and Type 2 Diabetes Mellitus; a Single-Center Experience From Turkey
Diabetes Mellitus Tanılı Hastalarda İnfluenza, Pnömokok, Zoster, Kızamık, Difteri ve Boğmaca Aşılama Oranlarının Değerlendirilmesi; Türkiye'den Tek Merkez Deneyimi
Received Date : 07 Oct 2020
Accepted Date : 26 Nov 2020
Available Online : 19 Jan 2021
Doi: 10.25179/tjem.2020-79458 - Makale Dili: EN
Turk J Endocrinol Metab; 2021;25:68-77
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: Several vaccines have been recommended for adults with diabetes. This study aimed to determine the rates of uptake of recommended vaccines in diabetic adults and estimate their association with sociodemographic and clinical factors. Material and Methods: This was a cross-sectional study conducted on patients with either type 1 or type 2 diabetes, who had attended the outpatient clinics of internal medicine and endocrinology. The patients were inquired about their immunization status against influenza, pneumococcus, zoster, measles, pertussis, and diphtheria. Results: Among the 350 diabetic patients, 38 (10.8%) had received a vaccine against pneumococcus, 90 (26%) against seasonal influenza, and only one patient had been administered the zoster vaccine. None of the patients had been vaccinated against measles, diphtheria, and pertussis. The rate of pneumococcal vaccination (PV) increased with age (65.5±9.7 vs. 57±9.1 [OR 2.9 (95% CI=14.3- 2.67], p=0.005), although there was no such association between influenza vaccination (IV) and age (p=0.456). The rate of PV increased with the number of routine follow-up visits per year (10/38 vs. 28/38 [OR 4 (95% CI=0.994-16.096], (p=0.039). The rates of PV and IV were significantly higher in diabetic patients with chronic pulmonary disease (21/38 vs. 14/312 [OR 52.80 (95% CI 8.4- 333.1], p=0.005 and 31/90 vs. 4/260 [OR 29.15 (95% CI 3.37- 252.28], p=0.001) respectively. The rates of IV in diabetic patients with chronic renal failure were also significantly different from those without (27/90 vs. 8/260, [OR 14.28 95% CI 1.51-133.74], p=0.013). Conclusion: We observed low rates of vaccination against influenza, pneumococcus, and zoster in patients with diabetes, which were below the targets recommended by the World Health Organization.
ÖZET
Amaç: Diyabetik hastalarda çeşitli aşıların yapılması önerilmektedir. Bu çalışmada diyabetik hastalarda aşılanma oranlarının belirlenmesi ve sosyodemografik ve klinik faktörlerle ilişkilerinin saptanması amaçlanmaktadır. Gereç ve Yöntemler: Çalışma, İç Hastalıkları ve Endokrinoloji Kliniğine başvuran tip 1 ve tip 2 DM’li hastalar üzerinde kesitsel-gözlemsel olarak yapıldı. Hastaların influenza, pnömokok, zoster, kızamık, boğmaca ve difteri enfeksiyonlarına karşı aşılanma durumları sorgulandı. Bulgular: Çalışmaya tip 1 ve tip 2 diabetli, toplam 350 hasta dahil edildi. Hastaların 38 (%10,8)’i pnömokok, 90 (%26) mevsimsel grip ve sadece bir hasta zoster enfeksiyonuna karşı aşılanmıştı. Hastaların hiçbirinde kızamık, diphetria ve boğmaca aşısı yapılmamıştı. Pnömokok aşılanma (PA) oranı yaşla birlikte artmış bulundu (65,5±9,7 vs 57±9,1 [OR 2,9 (%95 CI-14,3-2,67], p=0,005). Ancak influenza aşısı (IA) ile yaş arasında böyle bir ilişki saptanmadı (p=0,456). PA oranı, yıllık rutin poliklinik vizit sayısı ile ilişkili olarak artmış görüldü (10/38 vs 28/38 [OR 4 (%95 CI -0,994-16,096], (p=0,039). PA ve IA oranları kronik akciğer hastalığı olan diabetes mellituslu hastalarda anlamlı olarak daha yüksekti (sırasıyla 21/38 vs 14/312 [veya 52,80 (%95 CI 8,4-333,1], p=0,005 ve 31/90 vs 4/260 [veya 29,15 (%95 CI 3,37-252,28], p=0,001). Kronik böbrek yetmezliği olan ve olmayan diyabetik hastalarda IV oranları arasında istatistiksel olarak anlamlı bir fark saptandı (27/90 vs 8/260, [OR14,28 %95 CI 1,51-133,74], p=0,013). Sonuç: Diyabetik hastalarda influenza, pnömokok ve zona aşılanma oranları Dünya Sağlık Örgütü tarafından belirlenen hedeflerin altında saptandı.
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