Background: Timely detection of cervical cells infected with high-risk human papillomavirus (HPV) improves cervical cancer prevention. In Bolivia, actual screening coverage only reaches 33.3% of the target population aged between 25 and 64 years despite free cytology screening. Furthermore, 50% to 80% screened women are lost during follow-up. This study aimed at identifying factors explaining this lack of follow-up care. Method: During the first phase, face-to-face semi-structured interviews were conducted with HPV-positive women. Secondly, we explored the reasons for the non-adherence to the follow-up care: knowledge, perceptions and beliefs about HPV, as well as barriers to healthcare access, using a structured survey on Cochabamba women and healthcare professionals. Results: Barriers to effective follow-up of the targeted populations were associated with health system shortcomings, including poor service delivery at the front- and second-line, health providers shortage, inadequate training, waiting time, high direct and indirect costs of care seeking and care, complex procedures to obtain HPV screening results and poor patient–provider communication. The follow-up was perceived as extremely stressful by the participants. Conclusion: Improved communication on HPV and HPV-related cancers in terms of representation in the general population and among the health professional’s population is vital to improve access for HPV infection follow-up care.

Herpes zoster (HZ) is caused by reactivation of the varicella-zoster virus. The life-time risk of developing HZ is similar to 30%. Management of HZ can be challenging due to limited efficacy of oral antivirals on pain control, and neuropathic pain that may require aggressive management. Post-herpetic neuralgia (PHN) can cause substantial pain and occurs in up to one-quarter of patients with HZ. Up to 48,000 HZ cases are estimated to occur annually in Belgium, estimated to cost almost 7 million euros in treatment. The recombinant zoster vaccine (RZV, Shingrix, GSK) was approved in Europe in 2017. In 2022, the Belgian Superior Health Council recommended vaccination with RZV for immunocompetent adults aged >= 60 years, and immunocompromised patients aged >= 16 years, including those receiving immunosuppressive therapy, in particular Janus kinase inhibitors. RZV showed high age-independent efficacy in preventing HZ infection and in clinical trials that has since been confirmed in real-world effectiveness studies. In clinical trials, protection was sustained for at least 10 years after vaccination. As of 1 November 2023, RZV is reimbursed for three immunocompromised patient groups aged >= 18 years: malignancy treated in the past 5 years, HIV infection, and organ or haematological stem cell transplantation or are a transplant candidate. HZ is vaccine-preventable and RZV provides a highly effective tool for HZ prevention. While reimbursement for some at-risk groups is welcomed, reimbursement currently falls well short of Superior Health Council recommendations. Adult immunisation strategies should be promoted to achieve high vaccination coverage against HZ, contributing to healthy aging in Belgium. [GRAPHICS] .

The COVID-19 vaccination campaign in several European countries involved collaboration between public health and Primary Health Care (PHC). To highlight the role of PHC professionals in the COVID-19 vaccination rollout, specifically in terms of vaccine administration, communication and contributing to vaccination population coverage. A descriptive retrospective study of the COVID-19 vaccination campaign across 28 European countries was conducted, covering data from December 2020 to November 2021. Data were collected by key informants recruited from each country, who were health professionals involved in their national vaccination campaigns. Utilising an ad-hoc semi-structured questionnaire, information was gathered on organisation, communication strategies, priority groups, vaccine types, and vaccination pathways in PHC. PHC participated in communication strategies in 10 out of 28 countries, and vaccination was voluntary in most of them. The priority groups for vaccination varied across Europe, and the availability of vaccines in PHC differed between countries within the European Union (EU) and non-EU countries. The BioNTech Pfizer vaccine was the most widely available vaccine in most countries, followed by Moderna and AstraZeneca. PHC administered COVID-19 vaccines to the population, being the nurses the most involved, followed by general practitioners. Vaccination appointments were available online in 18/28 or by phone in 15/28, direct appointments at health centres were available in 8/28. In several countries, healthcare professionals who administered vaccines were given extra compensation for their role. PHC professionals played a crucial role in the successful distribution and administration of COVID-19 vaccines in European countries.

Background: Physical activity (PA) reduces 19.5% of the attributable burden of chronic diseases (CDs), i.e. healthy life years lost due to morbidity and mortality. In addition, 29.5% of Belgians self-declared having at least one chronic disease. Moreover, almost 30% of the population above 15 years old is at health risk due to physical inactivity. Evidence shows physical activity on prescription (PAP) has a positive impact on PA level and metabolic health. General Practitioners (GPs) can use PAP as a prevention intervention. In Belgium, overall 94,1% of citizens have a referring General Practitioner (GP) or are affiliated with a general practice. There is no national policy on PAP, only a regional policy in Flanders. Therefore, the aim of the study is to investigate the perception and the (potential) provision of PAP by Belgian GPs. Methods: A cross-sectional survey was conducted in Belgian GPs between January and end of March 2023. The survey has 41 (ordinal or multiple choice) questions. Descriptive statistics were performed. Results: 134 GPs completed the survey of which 56% were female. 66.4% work in Flanders, 19.4% in Wallonia and 14.2% in Brussels-Capital region. Among respondents, 44% only discuss the benefits of PA with patients with a CD. Interestingly, less than 2% never discuss PA. 86.8% (would) prescribe if patients’ health status would be remedied by increasing PA, while 35.8% (would) use PAP if patients are inactive, regardless of their health status. About 75% identified chronic disease and exercise initiation as incentives for PAP. 41% would refer to PA (motivational) coaches, 55.2% to (adapted) PA courses. Lack of training (12.7%), time (49.3%), and knowledge of local PA offer (74%) were cited as barriers to using PAP. Conclusions: The majority of responding GPs linked PAP with CD. Although there is no national implementation and regulation of PAP, GPs used (were ready to use) PAP in their practice. However, several barriers still hinder the use of PAP. Key messages: • PAP is identified by Belgian GPs as a non-medical therapeutic strategy to counter health risks due to inactivity. • There is a need to harmonise and facilitate PAP in Belgian primary care.

Breast cancer is the commonest cancer in women, and screening can allow earlier-stage diagnosis. While there are European recommendations on the age-range and frequency of breast cancer screening, participation in these programmes varies substantially, and this could be due to differences in how they are organised and implemented. The role that primary healthcare professionals play in the process is unclear.We aimed to describe the breast cancer screening programmes in European countries and investigate how primary healthcare professionals are involved in this screening process. A cross-sectional survey in 32 countries. Key informants with relevant expertise answered online questions about the characteristics of their screening programmes and general practitioners' (GPs') roles in this. Responses were refined through an iterative consensus process. Data were examined to identify patterns in GP engagement. We found important differences between European breast cancer screening systems. While most had population-based screening, four countries relied on opportunistic screening. In 15 countries GPs had little or no involvement in the process of breast cancer screening, and in 13 countries GPs had some involvement, including identifying eligible patients, issuing referrals, and following-up results. Screening uptake rates tended to be higher in countries with well-established population-based screening programmes which give little or no GP involvement. Few countries linked GP engagement to incentives or performance measures. Countries with lower screening uptake should consider either enhancing GP involvement or transitioning to a structured, population-based screening system. Further research should explore how best to integrate primary care within national screening strategies.