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Summary Halicioglu O, Aksit S, Koc F, Akman SA, Albudak E, Yaprak I, Coker I, Colak A, Ozturk C, Gulec ES. Vitamin D deficiency in pregnant women and their neonates in spring time in western Turkey. Paediatric and Perinatal Epidemiology 2012; 26: 53-60. Although Turkey is located in a sunny region, vitamin D deficiency is still a serious health problem in pregnant women and their infants, especially among the low socio-economic status Turkish population. This study was carried out in order to measure serum 25-hydroxyvitamin D3 [25(OH)D] concentrations of the pregnant women in the last trimester and in their neonates at delivery and to determine the factors associated with maternal serum 25(OH)D concentrations. Among the patients visiting the Ege Obstetrics and Gynecology Hospital in the period March to May 2008, 258 healthy pregnant women ≥37 weeks of gestation were included in this study. The information on different characteristics such as the number of pregnancies and births, nutritional status, vitamin and mineral support during gestation, educational status, clothing style and the economic level of the family was collected from women. Blood samples from the mothers and umbilical cord of the newborns were taken to measure 25(OH)D. The mean 25(OH)D concentrations of the mothers and their infants were 11.5 ± 5.4 ng/mL and 11.5 ± 6.8 ng/mL, respectively. We found a strong positive correlation between maternal serum and umbilical cord blood 25(OH)D concentrations ( r = 0.651, P < 0.001). The concentration of 25(OH)D was ≤20 ng/mL in 233 mothers (90.3%) and ≤10 ng/mL in 130 mothers (50.4%). Maternal serum 25(OH)D concentrations related strongly to factors such as uncovered dressing style, sufficient consumption of dairy products and multivitamin use during gestation ( P < 0.05). About half (52.7%) of these women had a covered dressing style. 25(OH)D concentrations of these covered dressing mothers and their infants were 9.7 ± 5.1 ng/mL and 9.7 ± 5.6 ng/mL, respectively, which were significantly lower compared with those of uncovered mothers and their babies ( P < 0.001). This study showed that, despite a sunny environment, vitamin D deficiency and insufficiency are highly prevalent among the mothers and their neonates. This is generally due to the life style and nutritional status of the mothers. These findings suggest that much more effective vitamin D prophylaxis programmes should be implemented for pregnant women as well as for their babies. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate nursing students' knowledge about risk factors for cervical cancer and prophylactic HPV vaccine. The nursing students in a nursing school in Turkey were asked to complete a self administered questionnaire evaluating the knowledge of students regarding STDs, cervical cancer and HPV vaccine. From a total of 650 female nursing students, 400 agreed to fill in the questionnaire. While 98% of the students defined HIV infection as STD, only 37% of them indicated that HPV is one of the STDs. About one-third of the students reported that HPV is a risk factor for the cervical cancer. Only 16% of the students had heard of HPV vaccine for the prevention of cervical cancer. Most of the students had no sexual intercourse before. In conclusion, nursing students' knowledge especially on the association of HPV and cervical cancer is not satisfactory. [ABSTRACT FROM AUTHOR]

One of the problems in the care of healthy children is that mothers often give infant formulae to their normally growing infants in the first 4 months of life because they believe that they are unable to satisfy them. However, the association of fat content in breast milk with the sucking pattern of the infant is not clearly known. In order to determine whether the fat concentration of human milk was associated with sucking characteristics of the infants, 80 healthy 2-month-old babies and their mothers were included in the study. Milk creamatocrit was assessed at the beginning, at the first, fifth and 10th minutes and at the end of breast feeding. The creamatocrit values increased as the time elapsed from the beginning of breast feeding. There was an inverse relationship between milk volume and creamatocrit at both the beginning and the end of breast feeding (P < 0.05). The mean milk volume was higher and the mean creamatocrit at the end of breast feeding was lower in the infants whose 2-month weight gain was higher than the 75th percentile (75P) compared with those whose 2-month weight gain was lower than the 25th percentile (25P) (for milk volume 105 +/- 36 mL vs. 76 +/- 30 mL, respectively, P < 0.05; and for creamatocrit value 11.4 +/- 4.0 vs. 14.3 +/- 3.8, respectively, P < 0.05). Milk volume is the most important factor affecting weight gain of exclusively breast-fed babies, and fat concentration of human milk is not a primary determining factor in individual differences in weight gain of the infants and appears to be secondary to factors such as number of feeds per day, duration of breast feeding and the volume of milk sucked. [ABSTRACT FROM AUTHOR]

Abstract Background: Measles outbreaks seem to occur every 2- to 3-year intervals in Turkey. However, sero-epidemiological studies are limited. Knowing the prevalence of measles susceptibility as measured either by serologic markers of immunity or surveys of vaccination coverage is an important tool to assess the risk for measles outbreaks. Methods: In order to determine the seroprevalence of measles antibodies among a 1 to 29-year-old population in İzmir (Turkey) and to develop the best vaccination policy for measles, a total of 600 people aged from 1 to 29 were selected for the study with cluster sampling. The information on sociodemographic characteristics, vaccination status and measles history was gathered for each participant. Measles-specific IgG antibodies were screened qualitatively by using microenzyme immune assay for 595 subjects. Results: Of the 595 participants screened for the measles antibodies, 56 (9.4%) were seronegative. The proportion of the susceptible individuals in the age groups of 1–4, 5–9, 10–14, 15–19 and 20–29 was 20.0, 10.4, 6.0, 10.3 and 3.0%, respectively. The logistic regression analysis showed that none of the independent characteristics (sex, socioeconomic status, past measles history, vaccination status) with the exception of age group, was significantly associated with measles seronegativity. Conclusion: The optimal measles vaccination policy for Turkey may be to increase vaccination coverage above 90%, to conduct a catch-up campaign covering persons aged 1–19, regardless of previous vaccination status. Another factor to consider is to adopt a routine two-dose vaccination, giving the first dose at 12_15 months of age and the second dose at school entry. [ABSTRACT FROM AUTHOR]

Summary: Objectives: We aimed to determine the rate of breakthrough varicella in Turkey, a country with low varicella vaccination coverage. Methods: This study was conducted between April 2008 and March 2009 at the Well-Child Clinic at Ege University and pediatricians’ offices. We collected information on vaccination status and varicella infection using a questionnaire. In order to elicit more details about the severity of illness, we interviewed all parents and reviewed the clinician records. Vaccination status was verified from the medical records or vaccination cards with dates. Results: A total of 2802 children were evaluated. Of these, 1683 had been vaccinated with a single dose of varicella vaccine and 1119 were unvaccinated. Among vaccinated children, 466 (27.7%) had breakthrough varicella. Vaccinated children tended to have mild varicella. However, about 25% of breakthrough cases had moderate or severe disease. Children who were vaccinated ≥5 years previously had a 3.7-fold higher risk of breakthrough disease than those who were vaccinated <5 years before. Vaccination at younger than 15 months of age was not significantly associated with an increased risk of breakthrough infection. Conclusions: Breakthrough varicella is not rare in Turkey where varicella infections are common. A longer interval since vaccination may be a risk factor for developing breakthrough varicella. Children who had been vaccinated >5 years previously were at risk for breakthrough disease. A two-dose varicella vaccine policy may be needed to provide improved protection. [ABSTRACT FROM AUTHOR]

Objective: To examine the vitamin D status of 4-month-old exclusively breastfed infants supplemented with 400 IU daily of vitamin D and to determine whether there was any seasonal variation in serum 25-hydroxyvitamin D (25(OH)D) levels of infants., Methods: In this cross-sectional study, serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone, and 25(OH)D levels of 143 exclusively breastfed 4-month-old infants supplemented daily with 400 IU of vitamin D were measured in a temperate latitude, Izmir, Turkey, between May 2008 and April 2009. A questionnaire on demographic characteristics of infants and mothers, vitamin D supplementation of infants after birth, mothers' multivitamin supplementation, dressing habits, and consumption of dairy products during pregnancy was used., Results: Vitamin D deficiency (≤ 50 nmol/L) and insufficiency (51-74 nmol/L) were determined in 40 (28%) and 55 (38.5%) infants, respectively. During winter days, serum 25(OH)D levels were <20 ng/mL in 45.4% of infants and <10 ng/mL in 10.6% of infants. Season of blood sampling, compliance of vitamin D supplementation, maternal education level, and consumption of dairy products were highly predictive of serum 25(OH)D levels in multiple linear regression analysis (P < .05). The use of the Pearson correlation test found a statistically significant negative correlation between 25(OH)D and parathyroid hormone levels (r = -0.419, P < .001)., Conclusions: Despite supplementation with 400 IU of vitamin D daily, the rate of vitamin D deficiency was worryingly high in 4-month-old exclusively breastfed infants living in Izmir, Turkey. So, additional studies are needed to clarify optimal amount of vitamin D supplementation to the infants, especially during winter days.

Aim: This study was conducted to determine the age-specific seroprevalence of varicella zoster virus (VZV) infection in Turkish population in Cyprus., Methods: A total of 600 unvaccinated individuals aged 1-30 years were selected for the study with cluster sampling. Information on socio-demographic characteristics was gathered for each participant and, anti-VZV antibodies were assayed by using enzyme immune assay., Results: Of the 578 assayed samples, 486 (84.1%) were seropositive. Varicella seroprevalence increased sharply with age from 25% for the 2-3 year olds to 55, 78 and 85% for 4-5, 6-7 and 8-9 year olds, respectively. More than 90% of individuals >16 years of age were seropositive. Varicella seroprevalence was higher in large families with five and more members (91.2%) than in small families with four or fewer members (80.2%)., Conclusion: The majority of varicella-zoster virus infections occur during preschool period and at the first years of schooling. Therefore, routine varicella vaccination of children would be logical in Northern Cyprus, as is currently recommended by the European Working Group on Varicella.