TY  - JOUR
A1  - Rose, Markus A.
A1  - Damm, Oliver
A1  - Greiner, Wolfgang
A1  - Knuf, Markus
A1  - Wutzler, Peter
A1  - Liese, Johannes G.
A1  - Krüger, Hagen
A1  - Wahn, Ulrich
A1  - Schaberg, Tom
A1  - Schwehm, Markus
A1  - Kochmann, Thomas F.
A1  - Eichner, Martin
T1  - The epidemiological impact of childhood influenza vaccination using live-attenuated influenza vaccine (LAIV) in Germany: predictions of a simulation study
JF  - BMC Infectious Diseases
N2  - Background: Routine annual influenza vaccination is primarily recommended for all persons aged 60 and above and for people with underlying chronic conditions in Germany. Other countries have already adopted additional childhood influenza immunisation programmes. The objective of this study is to determine the potential epidemiological impact of implementing paediatric influenza vaccination using intranasally administered live-attenuated influenza vaccine (LAIV) in Germany.
Methods: A deterministic age-structured model is used to simulate the population-level impact of different vaccination strategies on the transmission dynamics of seasonal influenza in Germany. In our base-case analysis, we estimate the effects of adding a LAIV-based immunisation programme targeting children 2 to 17 years of age to the existing influenza vaccination policy. The data used in the model is based on published evidence complemented by expert opinion. 
Results: In our model, additional vaccination of children 2 to 17 years of age with LAIV leads to the prevention of 23.9 million influenza infections and nearly 16 million symptomatic influenza cases within 10 years. This reduction in burden of disease is not restricted to children. About one third of all adult cases can indirectly be prevented by LAIV immunisation of children. 
Conclusions: Our results demonstrate that vaccinating children 2-17 years of age is likely associated with a significant reduction in the burden of paediatric influenza. Furthermore, annual routine childhood vaccination against seasonal influenza is expected to decrease the incidence of influenza among adults and older people due to indirect effects of herd protection. In summary, our model provides data supporting the introduction of a paediatric influenza immunisation programme in Germany.
KW  - vaccination
KW  - live-attenuated influenza vaccine
KW  - children
KW  - transmission model
KW  - metanalysis
KW  - recommendations
KW  - hospitalizations
KW  - burden
KW  - infection
KW  - young children
KW  - seasonal influenza
KW  - United States
KW  - disease
KW  - efficacy
KW  - Germany
KW  - influenza
Y1  - 2014
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-117563
SN  - 1471-2334
VL  - 14
IS  - 40
ER  - 
TY  - JOUR
A1  - Wutzler, Alexander
A1  - Krogias, Christos
A1  - Grau, Anna
A1  - Veltkamp, Roland
A1  - Heuschmann, Peter U.
A1  - Haeusler, Karl Georg
T1  - Stroke prevention in patients with acute ischemic stroke and atrial fibrillation in Germany - a cross sectional survey
JF  - BMC Neurology
N2  - Background
Atrial fibrillation (AF) is present in 15–20% of patients with acute ischemic stroke. Oral anticoagulation reduces the risk of AF-related recurrent stroke but clinical guideline recommendations are rather vague regarding its use in the acute phase of stroke. We aimed to assess the current clinical practice of medical stroke prevention in AF patients during the acute phase of ischemic stroke.

Methods
In April 2017, a standardized anonymous questionnaire was sent to clinical leads of all 298 certified stroke units in Germany.

Results
Overall, 154 stroke unit leads participated (response rate 52%). Anticoagulation in the acute phase of stroke is considered feasible in more than 90% of AF patients with ischemic stroke. Clinicians assume that about two thirds of all AF patients (range 20–100%) are discharged on oral anticoagulation. According to local preferences, acetylsalicylic acid is given orally in the majority of patients with delayed initiation of oral anticoagulation. A non-vitamin K-dependent oral anticoagulant (NOAC) is more often prescribed than a vitamin K-dependent oral anticoagulant (VKA). VKA is more often chosen in patients with previous VKA intake than in VKA naive patients. In the minority of patients, stroke unit leads discuss the prescription of a specific oral anticoagulant with the treating general practitioner. Adherence to medical stroke prevention after hospital discharge is not assessed on a regular basis in any patient by the majority of participating stroke centers.

Conclusions
Early secondary stroke prevention in AF patients in German stroke units is based on OAC use but prescription modalities vary in clinical practice.
KW  - Ischemic stroke
KW  - Secondary stroke prevention
KW  - Atrial fibrillation
KW  - Survey
KW  - Oral anticoagulation
KW  - Stroke unit
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-201078
VL  - 19
ER  -