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Mbonigaba E, Yu F, Reñosa MDC, Cho FN, Chen Q, Denkinger CM, A McMahon S, Chen S. Knowledge and trust of mothers regarding childhood vaccination in Rwanda. BMC Public Health 2024; 24:1067. [PMID: 38632541 PMCID: PMC11022416 DOI: 10.1186/s12889-024-18547-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 04/08/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Knowledge and trust are some of the contributing factors to vaccine acceptance(VA) and Vaccine hesitancy (VH) is one of the top threats to global health. A significant drop in childhood vaccination has been observed in recent years. One important reason that influences mothers' choice to either postpone or avoid children's vaccinations is knowledge and trust in childhood vaccines. This study aimed to assess mothers' knowledge and trust on vaccination of their children, and to examine the association between vaccination knowledge and selected socio-demographic factors. METHODS A cross-sectional survey was conducted from January 2022 to March 2022 to assess the knowledge and trust of mothers regarding childhood vaccination. Data was collected with self-administered questionnaires. Multivariable logistic regression analysis was employed to assess factors associated with childhood vaccine knowledge and trust. RESULTS Of the 2,126 Rwandan parents who participated in the study, the proportions with good knowledge of - and good trust in childhood vaccination were 95.5% and 91.4%, respectively. The popular sources of information about childhood vaccination were health care professionals (91.8%) and mass media (28.9%). Multinomial logistic regression analysis showed that good knowledge of - and trust in childhood vaccination were associated with the relationship with child(ren), education, occupation, and monthly income. The Multinomial logistic regression also revealed that the determinants of good knowledge of - and trust in childhood vaccination were; caregiver (p = 4.0 × 10-4, adjusted Odds Ratio (aOR); 1.7, 95%C.I; 1.3 - 2.3), no formal educational status (p = 3.3 × 10-2, aOR; 1.7, 95%C.I; 1.0 - 3.0), the unemployed occupational status (p = 2.4 × 10-2, aOR; 1.2, 95%C.I; 1.0 - 1.4), and persons on more than $401 per month (p = 2.0 × 10-4, aOR; 3.5, 95%C.I; 1.8 - 6.8). CONCLUSION The majority of parents in Rwanda had both good knowledge of-and good trust regarding childhood vaccination. Public health strategies to promote vaccination, education programmes as well as improved communication tools between health care professionals/traditional leaders/religious leaders and parents need to be considered to achieve favourable vaccination attitudes and practices for all parents in Rwanda.
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Affiliation(s)
- Edward Mbonigaba
- Centre of Infectious Diseases, Division of Infectious Disease and Tropical Medicine, Universität Heidelberg, Heidelberg, Germany.
- College of Medicine and Health Sciences, School of Public, Health- University of Rwanda, Kigali, Rwanda.
| | - Fengyun Yu
- Interdisciplinary Centre for Scientific Computing, Universität Heidelberg, Heidelberg, Germany
| | - Mark Donald C Reñosa
- Heidelberg Institute of Global Health, Universität Heidelberg, Heidelberg, Germany
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Frederick Nchang Cho
- , Buea, Cameroon
- Infectious Disease Laboratory, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Qiushi Chen
- Department of Industrial and Manufacturing Engineering, The Harold and Inge Marcus, The Pennsylvania State University, University ParkHarrisburg, PA, USA
| | - Claudia M Denkinger
- Centre of Infectious Diseases, Division of Infectious Disease and Tropical Medicine, Universität Heidelberg, Heidelberg, Germany
| | - Shannon A McMahon
- Centre of Infectious Diseases, Division of Infectious Disease and Tropical Medicine, Universität Heidelberg, Heidelberg, Germany
| | - Simiao Chen
- Centre of Infectious Diseases, Division of Infectious Disease and Tropical Medicine, Universität Heidelberg, Heidelberg, Germany
- Chinese Academy of Medical Sciences and Peking Union Medical College, Peking, China
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Habib MA, Tabassum F, Hussain I, Khan TJ, Syed N, Shaheen F, Soofi SB, Bhutta ZA. Exploring Knowledge and Perceptions of Polio Disease and Its Immunization in Polio High-Risk Areas of Pakistan. Vaccines (Basel) 2023; 11:1206. [PMID: 37515022 PMCID: PMC10386680 DOI: 10.3390/vaccines11071206] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/15/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
Pakistan is one of the few countries where poliovirus transmission still persists, despite intensive efforts to eradicate the disease. Adequate vaccination coverage is essential to achieve polio eradication, but misconceptions about polio vaccines have hindered vaccination efforts. To address this issue, we conducted a mixed-methods study to explore knowledge and perceptions regarding polio disease and immunization in high-risk areas of Pakistan. We collected quantitative data from 3780, 1258, and 2100 households in Karachi, Bajaur, and Pishin, respectively, and supplemented this with qualitative data from focus group discussions and in-depth interviews. Our findings reveal a high level of awareness about polio and its immunization; however, misperceptions about the polio vaccine persist, leading to refusal for both polio vaccines and routine immunizations. Our study provides up-to-date data on knowledge and perceptions of polio and its immunization and identifies critical gaps. These findings can inform the development of future strategies and innovative approaches to improve the success of the polio program in Pakistan.
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Affiliation(s)
- Muhammad Atif Habib
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Farhana Tabassum
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Imtiaz Hussain
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Tooba Jawed Khan
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Nazia Syed
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Fariha Shaheen
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Sajid Bashir Soofi
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
- Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
| | - Zulfiqar A Bhutta
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
- Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
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Wahid B, Kumari B, Saifullah KM, Idrees M. The History and Current Killings of Polio Vaccinators in Pakistan: A Need for Targeted Surveillance Strategy. Asia Pac J Public Health 2023; 35:183-188. [PMID: 36856226 DOI: 10.1177/10105395231158866] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Poliomyelitis has been eliminated from all countries of the world except Pakistan and Afghanistan. One of the major reasons is the stigmas associated with the polio vaccine that has been repetitively discussed in literature, and governments of both the countries are already making serious efforts to control this public health challenge, but till this moment, the state officials have not introduced any surveillance strategy for the security of polio workers in National Emergency Action Plan (NEAP) for Polio Eradication. This report highlights the issue of targeted killing and terrorism attacks on polio vaccinators in Pakistan and also devises a surveillance strategy to provide security to polio workers at immediate possible because the current chaos in Afghanistan will ultimately lead to more terrorist attacks on polio vaccinators.
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Affiliation(s)
- Braira Wahid
- Department of Microbiology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia
| | - Babita Kumari
- Department of Microbiology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia
| | - Khaled Mohammed Saifullah
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Brisbane, Queensland, Australia
| | - Muhammad Idrees
- Division of Molecular Virology, Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
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Shafique F, Hassan MU, Nayab H, Asim N, Akbar N, Shafi N, Manzoor S, Eeden FV, Ali S. Attitude and perception towards vaccination against poliomyelitis in Peshawar, Pakistan. Rev Saude Publica 2021; 55:104. [PMID: 34910031 PMCID: PMC8647985 DOI: 10.11606/s1518-8787.2021055003478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 04/04/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE: This research aimed to quantitatively assess the general public's awareness, attitude and perception of polio and its vaccination in Peshawar KPK, Pakistan. METHODS: We conducted a survey-based study to understand the surge in polio cases from 2015 to 2019 in the Peshawar city of the Khyber Pakhtunkhwa (KPK), Pakistan. A pre-tested questionnaire-based study was conducted in 2019 to assess the attitude and general perception of residents of Peshawar KPK towards polio vaccination. RESULTS: Out of 241 country-wide polio cases, 63 (26.1%) polio cases were reported in Peshawar city from 2015–2019. The questionnaire revealed that individuals between 18–30 years of age had sufficient knowledge (65.1%) about polio. Male and female participants had equal awareness (~ 43%). Participants with higher education (45.9%), those with better financial status (49.5%), individuals with children < 5 years of age (46.4%), and those who had experience of a polio patient (63.1%) had better knowledge. Participants inhabiting the central city were better aware (50.5%) of polio than individuals living in the outskirts. CONCLUSION: The data indicated that poor knowledge and negative attitudes of people towards polio vaccination are the main causes of the polio eradication program's failure. Moreover, religious beliefs, unchecked migration between the Pak-Afghan border, and lack of knowledge about polio vaccination are identified as critical barriers to polio eradication.
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Affiliation(s)
- Farheen Shafique
- University of Sheffield. Department of Biomedical Science. Sheffield, UK
| | - Mahreen Ul Hassan
- Shaheed Benazir Bhutto Women University. Department of Microbiology. Peshawar, Pakistan.,University of Sheffield. Department of Molecular Biology and Biotechnology. Sheffield, UK
| | - Hina Nayab
- Sarhad University of Science and Information Technology. Institute of Biological Sciences. Peshawar 25000, Pakistan
| | - Noreen Asim
- The University of Agriculture. Institute of Biotechnology and Genetic Engineering. Division of Genomics and Bioinformatics. Peshawar, Pakistan
| | - Nazia Akbar
- University of Azad Jammu and Kashmir. Department of Zoology. Muzaffarabad, Pakistan
| | - Nuzhat Shafi
- Hazara University Mansehra. Department of Biotechnology and Genetic Engineering. Hazara, Pakistan
| | - Sadaf Manzoor
- Islamia College University. Department of Statistics. Peshawar, Khyber Pakhtunkha, Pakistan
| | - Freek van Eeden
- University of Sheffield. Department of Biomedical Science. Sheffield, UK
| | - Shaukat Ali
- Government College University Lahore. Faculty of Science. Department of Zoology. Applied Entomology and Medical Toxicology Laboratory. Lahore, Pakistan
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Ataullahjan A, Ahsan H, Soofi S, Habib MA, Bhutta ZA. Eradicating polio in Pakistan: a systematic review of programs and policies. Expert Rev Vaccines 2021; 20:661-678. [PMID: 33896306 DOI: 10.1080/14760584.2021.1915139] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Established in 1994, Pakistan's polio program demonstrated early success. However, despite over 120 supplementary immunization activities in the last decade, polio eradication efforts in Pakistan have been unable to achieve their objective of halting polio transmission. Variable governance, and inconsistent leadership and accountability have hindered the success of the polio program and the quality of the campaigns. Insecurity and terrorism has interrupted polio activities, and community fears and misbeliefs about polio vaccinations continue to persist.Areas covered: The article consists of a systematic review of the barriers and facilitators associated with the delivery of polio eradication activities in Pakistan. We also provide a comprehensive review of the policy and programmatic decisions made by the Pakistan Polio Programme since 1994. Searches were conducted on Embase and Medline databases and 25 gray literature sources.Expert opinion: Polio eradication efforts must be integrated with other preventive health services, particularly immunization services. Addressing the underlying causes of polio refusals including underdevelopment and social exclusion will help counteract resistance to polio vaccination. Achieving polio eradication will require building health systems that provide comprehensive community-centered care, and improving governance and systems of accountability.
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Affiliation(s)
- Anushka Ataullahjan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Hanaa Ahsan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Sajid Soofi
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Muhammad Atif Habib
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.,Centre of Excellence in Women and Child Health, Aga Khan University South-Central Asia, East Africa & United Kingdom
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Basharat S, Shaikh BT. Polio immunization in Pakistan: ethical issues and challenges. Public Health Rev 2017; 38:6. [PMID: 29450078 PMCID: PMC5809887 DOI: 10.1186/s40985-017-0049-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 01/18/2017] [Indexed: 11/10/2022] Open
Abstract
Background Immunization should be considered a basic human right to health and well-being. It is everybody's business, and it is everybody's responsibility: the individual, the community, the health system and the state. This paper attempts to review some of the literature that highlights the ethical and religious concerns surrounding polio vaccination and what approaches may be used to counter the problems faced in Pakistan. Methods This paper is developed through a literature review on public health and polio in Pakistan, consulting local, regional and globally published peer reviewed articles focussing on religion, culture, ethics and public health. Discussion Human behaviour, including the utilization and acceptability of healthcare services, is greatly influenced by religious beliefs and dogmas. Immunization, specifically for the purpose of polio eradication, has been a topic under focus and in the news in Pakistan. The government is doing its best through a variety of interventions to increase access, inform the public and increase vaccination rates. Nevertheless, the country still faces a huge challenge from certain stern pockets of uncompromising populations who resist and refuse vaccination. Beliefs, practices and cultural norms overshadow public health priorities and ethics. Understanding of the context, therefore, is critical to determine the social hindrances in polio eradication and strategize thereon. Conclusion Having programmatic, system-wide, socio-cultural and of course ethical dimensions, the policy makers and the programme managers in Pakistan must attempt to address the multitude of challenges to polio vaccination, whereby the plan of action developed within the ethical norms could potentially lead to an ultimate success.
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Affiliation(s)
- Sarah Basharat
- Health Systems and Policy Department, Health Services Academy, Chak Shahzad, Park Road, Islamabad, 44000 Pakistan
| | - Babar Tasneem Shaikh
- Health Systems and Policy Department, Health Services Academy, Chak Shahzad, Park Road, Islamabad, 44000 Pakistan
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