Vaccination coverage in systemic lupus erythematosus-a cross-sectional analysis of the German long-term study (LuLa cohort).
Identifieur interne : 000034 ( Main/Exploration ); précédent : 000033; suivant : 000035Vaccination coverage in systemic lupus erythematosus-a cross-sectional analysis of the German long-term study (LuLa cohort).
Auteurs : Gamal Chehab [Allemagne] ; Jutta G. Richter [Allemagne] ; Ralph Brinks [Allemagne] ; Rebecca Fischer-Betz [Allemagne] ; Borgi Winkler-Rohlfing [Allemagne] ; Matthias Schneider [Allemagne]Source :
- Rheumatology (Oxford, England) [ 1462-0332 ] ; 2018.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Allemagne (épidémiologie), Couverture vaccinale (statistiques et données numériques), Enquêtes et questionnaires (MeSH), Facteurs temps (MeSH), Femelle (MeSH), Grippe humaine (prévention et contrôle), Grippe humaine (épidémiologie), Grippe humaine (étiologie), Humains (MeSH), Immunocompétence (MeSH), Incidence (MeSH), Infections à pneumocoques (prévention et contrôle), Infections à pneumocoques (épidémiologie), Jeune adulte (MeSH), Lupus érythémateux disséminé (complications), Lupus érythémateux disséminé (immunologie), Lupus érythémateux disséminé (épidémiologie), Mâle (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Vaccination (statistiques et données numériques), Vaccins antigrippaux (MeSH), Vaccins antipneumococciques (MeSH), Études de suivi (MeSH), Études rétrospectives (MeSH), Études transversales (MeSH).
- MESH :
- immunologie : Lupus érythémateux disséminé.
- prévention et contrôle : Grippe humaine, Infections à pneumocoques.
- statistiques et données numériques : Couverture vaccinale, Vaccination.
- épidémiologie : Allemagne, Grippe humaine, Infections à pneumocoques, Lupus érythémateux disséminé.
- étiologie : Grippe humaine.
- Adolescent, Adulte, Adulte d'âge moyen, Enquêtes et questionnaires, Facteurs temps, Femelle, Humains, Immunocompétence, Incidence, Jeune adulte, Lupus érythémateux disséminé, Mâle, Sujet âgé, Sujet âgé de 80 ans ou plus, Vaccins antigrippaux, Vaccins antipneumococciques, Études de suivi, Études rétrospectives, Études transversales.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Cross-Sectional Studies (MeSH), Female (MeSH), Follow-Up Studies (MeSH), Germany (epidemiology), Humans (MeSH), Immunocompetence (MeSH), Incidence (MeSH), Influenza Vaccines (MeSH), Influenza, Human (epidemiology), Influenza, Human (etiology), Influenza, Human (prevention & control), Lupus Erythematosus, Systemic (complications), Lupus Erythematosus, Systemic (epidemiology), Lupus Erythematosus, Systemic (immunology), Male (MeSH), Middle Aged (MeSH), Pneumococcal Infections (epidemiology), Pneumococcal Infections (prevention & control), Pneumococcal Vaccines (MeSH), Retrospective Studies (MeSH), Surveys and Questionnaires (MeSH), Time Factors (MeSH), Vaccination (statistics & numerical data), Vaccination Coverage (statistics & numerical data), Young Adult (MeSH).
- MESH :
- chemical : Influenza Vaccines, Pneumococcal Vaccines.
- complications : Lupus Erythematosus, Systemic.
- epidemiology : Germany, Influenza, Human, Lupus Erythematosus, Systemic, Pneumococcal Infections.
- etiology : Influenza, Human.
- immunology : Lupus Erythematosus, Systemic.
- prevention & control : Influenza, Human, Pneumococcal Infections.
- statistics & numerical data : Vaccination, Vaccination Coverage.
- Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Immunocompetence, Incidence, Male, Middle Aged, Retrospective Studies, Surveys and Questionnaires, Time Factors, Young Adult.
Abstract
Objectives
Vaccinations are an important measure to prevent infections in immunocompromised patients. The knowledge of vaccination coverage and reasons for non-vaccination in patients with SLE is scarce. The aim of this study was to assess coverage rates of selected vaccinations in a representative sample of SLE patients and to identify predictors for non-vaccination.
Methods
In 2013, information on selected vaccinations (coverage, application and reservations) and on demographics, clinical parameters and health beliefs was assessed by means of a self-reported questionnaire among a representative sample of SLE patients in Germany (LuLa cohort).
Results
Five hundred and seventy-nine patients participated. Vaccination status was primarily checked by their general practitioner (57.3%). Of all the patients, 24.9% did not get their vaccination status checked at all, 16.1% had generally been advised against the use of vaccinations by a physician, and 37.5% stated that they had rejected vaccinations themselves. Their main reasons were fears of developing a lupus flare (21.8%) or adverse events (13.5%). A greater belief by patients in the doctor controlling one's health and the general benefit of medication prevented the rejection of vaccines. Vaccination coverage was low for all recorded vaccinations (tetanus 65.8%, influenza 45.2%, pneumococcus 32.2% and meningococcus 6.1%). Older age was predictive of receiving influenza and pneumococcal vaccination. The same applies for CSs >7.5 mg for receiving influenza vaccination.
Conclusion
Vaccination coverage in SLE patients is poor and reflects insufficient implementation of national and international recommendations. Rheumatologists need to recognize patients' reservations against vaccinations, to communicate their importance and safety and to give individual recommendations to patients and their health-care providers.
Trial registration
German Clinical Trials Register, www.germanctr.de, DRKS00011052.
DOI: 10.1093/rheumatology/key120
PubMed: 29757414
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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(MeSH)</term><term>Cross-Sectional Studies (MeSH)</term><term>Female (MeSH)</term><term>Follow-Up Studies (MeSH)</term><term>Germany (epidemiology)</term><term>Humans (MeSH)</term><term>Immunocompetence (MeSH)</term><term>Incidence (MeSH)</term><term>Influenza Vaccines (MeSH)</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (etiology)</term><term>Influenza, Human (prevention & control)</term><term>Lupus Erythematosus, Systemic (complications)</term><term>Lupus Erythematosus, Systemic (epidemiology)</term><term>Lupus Erythematosus, Systemic (immunology)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pneumococcal Infections (epidemiology)</term><term>Pneumococcal Infections (prevention & control)</term><term>Pneumococcal Vaccines (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Surveys and Questionnaires (MeSH)</term><term>Time Factors (MeSH)</term><term>Vaccination (statistics & numerical data)</term><term>Vaccination Coverage (statistics & numerical data)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Allemagne (épidémiologie)</term><term>Couverture vaccinale (statistiques et données numériques)</term><term>Enquêtes et questionnaires (MeSH)</term><term>Facteurs temps (MeSH)</term><term>Femelle (MeSH)</term><term>Grippe humaine (prévention et contrôle)</term><term>Grippe humaine (épidémiologie)</term><term>Grippe humaine (étiologie)</term><term>Humains (MeSH)</term><term>Immunocompétence (MeSH)</term><term>Incidence (MeSH)</term><term>Infections à pneumocoques (prévention et contrôle)</term><term>Infections à pneumocoques (épidémiologie)</term><term>Jeune adulte (MeSH)</term><term>Lupus érythémateux disséminé (complications)</term><term>Lupus érythémateux disséminé (immunologie)</term><term>Lupus érythémateux disséminé (épidémiologie)</term><term>Mâle (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Vaccination (statistiques et données numériques)</term><term>Vaccins antigrippaux (MeSH)</term><term>Vaccins antipneumococciques (MeSH)</term><term>Études de suivi (MeSH)</term><term>Études rétrospectives (MeSH)</term><term>Études transversales (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Influenza Vaccines</term><term>Pneumococcal Vaccines</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Lupus Erythematosus, Systemic</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Germany</term><term>Influenza, Human</term><term>Lupus Erythematosus, Systemic</term><term>Pneumococcal Infections</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Lupus érythémateux disséminé</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Lupus Erythematosus, Systemic</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Influenza, Human</term><term>Pneumococcal Infections</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Grippe humaine</term><term>Infections à pneumocoques</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Vaccination</term><term>Vaccination Coverage</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Couverture vaccinale</term><term>Vaccination</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Allemagne</term><term>Grippe humaine</term><term>Infections à pneumocoques</term><term>Lupus érythémateux disséminé</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cross-Sectional Studies</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Immunocompetence</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Surveys and Questionnaires</term><term>Time Factors</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Enquêtes et questionnaires</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Immunocompétence</term><term>Incidence</term><term>Jeune adulte</term><term>Lupus érythémateux disséminé</term><term>Mâle</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Vaccins antigrippaux</term><term>Vaccins antipneumococciques</term><term>Études de suivi</term><term>Études rétrospectives</term><term>Études transversales</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Objectives</b></p><p>Vaccinations are an important measure to prevent infections in immunocompromised patients. The knowledge of vaccination coverage and reasons for non-vaccination in patients with SLE is scarce. The aim of this study was to assess coverage rates of selected vaccinations in a representative sample of SLE patients and to identify predictors for non-vaccination.</p></div><div type="abstract" xml:lang="en"><p><b>Methods</b></p><p>In 2013, information on selected vaccinations (coverage, application and reservations) and on demographics, clinical parameters and health beliefs was assessed by means of a self-reported questionnaire among a representative sample of SLE patients in Germany (LuLa cohort).</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>Five hundred and seventy-nine patients participated. Vaccination status was primarily checked by their general practitioner (57.3%). Of all the patients, 24.9% did not get their vaccination status checked at all, 16.1% had generally been advised against the use of vaccinations by a physician, and 37.5% stated that they had rejected vaccinations themselves. Their main reasons were fears of developing a lupus flare (21.8%) or adverse events (13.5%). A greater belief by patients in the doctor controlling one's health and the general benefit of medication prevented the rejection of vaccines. Vaccination coverage was low for all recorded vaccinations (tetanus 65.8%, influenza 45.2%, pneumococcus 32.2% and meningococcus 6.1%). Older age was predictive of receiving influenza and pneumococcal vaccination. The same applies for CSs >7.5 mg for receiving influenza vaccination.</p></div><div type="abstract" xml:lang="en"><p><b>Conclusion</b></p><p>Vaccination coverage in SLE patients is poor and reflects insufficient implementation of national and international recommendations. Rheumatologists need to recognize patients' reservations against vaccinations, to communicate their importance and safety and to give individual recommendations to patients and their health-care providers.</p></div><div type="abstract" xml:lang="en"><p><b>Trial registration</b></p><p>German Clinical Trials Register, www.germanctr.de, DRKS00011052.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">29757414</PMID><DateCompleted><Year>2018</Year><Month>08</Month><Day>10</Day></DateCompleted><DateRevised><Year>2018</Year><Month>08</Month><Day>10</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1462-0332</ISSN><JournalIssue CitedMedium="Internet"><Volume>57</Volume><Issue>8</Issue><PubDate><Year>2018</Year><Month>Aug</Month><Day>01</Day></PubDate></JournalIssue><Title>Rheumatology (Oxford, England)</Title><ISOAbbreviation>Rheumatology (Oxford)</ISOAbbreviation></Journal><ArticleTitle>Vaccination coverage in systemic lupus erythematosus-a cross-sectional analysis of the German long-term study (LuLa cohort).</ArticleTitle><Pagination><MedlinePgn>1439-1447</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/rheumatology/key120</ELocationID><Abstract><AbstractText Label="Objectives" NlmCategory="UNASSIGNED">Vaccinations are an important measure to prevent infections in immunocompromised patients. The knowledge of vaccination coverage and reasons for non-vaccination in patients with SLE is scarce. The aim of this study was to assess coverage rates of selected vaccinations in a representative sample of SLE patients and to identify predictors for non-vaccination.</AbstractText><AbstractText Label="Methods" NlmCategory="UNASSIGNED">In 2013, information on selected vaccinations (coverage, application and reservations) and on demographics, clinical parameters and health beliefs was assessed by means of a self-reported questionnaire among a representative sample of SLE patients in Germany (LuLa cohort).</AbstractText><AbstractText Label="Results" NlmCategory="UNASSIGNED">Five hundred and seventy-nine patients participated. Vaccination status was primarily checked by their general practitioner (57.3%). Of all the patients, 24.9% did not get their vaccination status checked at all, 16.1% had generally been advised against the use of vaccinations by a physician, and 37.5% stated that they had rejected vaccinations themselves. Their main reasons were fears of developing a lupus flare (21.8%) or adverse events (13.5%). A greater belief by patients in the doctor controlling one's health and the general benefit of medication prevented the rejection of vaccines. Vaccination coverage was low for all recorded vaccinations (tetanus 65.8%, influenza 45.2%, pneumococcus 32.2% and meningococcus 6.1%). Older age was predictive of receiving influenza and pneumococcal vaccination. The same applies for CSs >7.5 mg for receiving influenza vaccination.</AbstractText><AbstractText Label="Conclusion" NlmCategory="UNASSIGNED">Vaccination coverage in SLE patients is poor and reflects insufficient implementation of national and international recommendations. Rheumatologists need to recognize patients' reservations against vaccinations, to communicate their importance and safety and to give individual recommendations to patients and their health-care providers.</AbstractText><AbstractText Label="Trial registration" NlmCategory="UNASSIGNED">German Clinical Trials Register, www.germanctr.de, DRKS00011052.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Chehab</LastName><ForeName>Gamal</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Policlinic of Rheumatology and Hiller Research Unit Rheumatology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Richter</LastName><ForeName>Jutta G</ForeName><Initials>JG</Initials><AffiliationInfo><Affiliation>Policlinic of Rheumatology and Hiller Research Unit Rheumatology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brinks</LastName><ForeName>Ralph</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Policlinic of Rheumatology and Hiller Research Unit Rheumatology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fischer-Betz</LastName><ForeName>Rebecca</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Policlinic of Rheumatology and Hiller Research Unit Rheumatology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Winkler-Rohlfing</LastName><ForeName>Borgi</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Head Office Wuppertal, German Lupus Self-Help Community, Wuppertal, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schneider</LastName><ForeName>Matthias</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Policlinic of Rheumatology and Hiller Research Unit Rheumatology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Rheumatology (Oxford)</MedlineTA><NlmUniqueID>100883501</NlmUniqueID><ISSNLinking>1462-0324</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D022242">Pneumococcal Vaccines</NameOfSubstance></Chemical></ChemicalList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003430" MajorTopicYN="N">Cross-Sectional Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005858" MajorTopicYN="N">Germany</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007121" MajorTopicYN="Y">Immunocompetence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007252" MajorTopicYN="N">Influenza Vaccines</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008180" MajorTopicYN="N">Lupus Erythematosus, Systemic</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011008" MajorTopicYN="N">Pneumococcal Infections</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D022242" MajorTopicYN="N">Pneumococcal Vaccines</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014611" MajorTopicYN="N">Vaccination</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073887" MajorTopicYN="N">Vaccination Coverage</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2017</Year><Month>11</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2018</Year><Month>5</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2018</Year><Month>8</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2018</Year><Month>5</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">29757414</ArticleId><ArticleId IdType="pii">4994816</ArticleId><ArticleId IdType="doi">10.1093/rheumatology/key120</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Allemagne</li></country><region><li>District de Düsseldorf</li><li>Rhénanie-du-Nord-Westphalie</li></region><settlement><li>Düsseldorf</li></settlement></list><tree><country name="Allemagne"><region name="Rhénanie-du-Nord-Westphalie"><name sortKey="Chehab, Gamal" sort="Chehab, Gamal" uniqKey="Chehab G" first="Gamal" last="Chehab">Gamal Chehab</name></region><name sortKey="Brinks, Ralph" sort="Brinks, Ralph" uniqKey="Brinks R" first="Ralph" last="Brinks">Ralph Brinks</name><name sortKey="Fischer Betz, Rebecca" sort="Fischer Betz, Rebecca" uniqKey="Fischer Betz R" first="Rebecca" last="Fischer-Betz">Rebecca Fischer-Betz</name><name sortKey="Richter, Jutta G" sort="Richter, Jutta G" uniqKey="Richter J" first="Jutta G" last="Richter">Jutta G. Richter</name><name sortKey="Schneider, Matthias" sort="Schneider, Matthias" uniqKey="Schneider M" first="Matthias" last="Schneider">Matthias Schneider</name><name sortKey="Winkler Rohlfing, Borgi" sort="Winkler Rohlfing, Borgi" uniqKey="Winkler Rohlfing B" first="Borgi" last="Winkler-Rohlfing">Borgi Winkler-Rohlfing</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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