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

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 all 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 >= 035 mu g/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 all absent or dysfunctional spleen call be improved markedly in the Netherlands. (C) 2008 Elsevier Ltd. All rights reserved.