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Aradottir L, Wellman L, Göransson C. Specialist nurse's health promotion work with the national childhood immunization programme: A qualitative study. J SPEC PEDIATR NURS 2024; 29:e12427. [PMID: 38779985 DOI: 10.1111/jspn.12427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Childhood immunizations have proven to be one of the most beneficial interventions to promote public health and prevent childhood deaths due to disease. However, global coverage of childhood immunization has decreased throughout the world due to guardians' growing hesitancy towards immunizations. This study aims to describe how specialist nurses promote legal guardians to adhere to national childhood immunization programmes. DESIGN AND METHODS This study had a qualitative design. Semistructured interviews with 11 specialist nurses, who were paediatric primary care nurses or nurse practitioners, were conducted. Data were analysed using qualitative content analysis. RESULTS The findings, with four main categories including four subcategories, showed nurses using both local guidelines and national guidelines to promote guardians to adhere to the childhood immunization programme. The main intervention the nurses did to promote childhood immunization coverage was giving legal guardians general information about the programme. With hesitant guardians, adopting a person-centred approach towards the legal guardian improved adherence. PRACTICE IMPLICATIONS Further research should focus on how specialist nurses can respond to guardians who decline immunization for their children, as this study identified difficulties in this area. Furthermore, research on guardians' perspectives towards childhood immunization may also help generate further effective guidance on how to promote immunization coverage among children.
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Affiliation(s)
- Louis Aradottir
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Linnea Wellman
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Carina Göransson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Chinawa AT, Ossai EN, Onukwuli VO, Nduagubam OC, Uwaezuoke NA, Okafor CN, Chinawa JM. Willingness to accept malaria vaccines amongst women presenting at outpatient and immunization clinics in Enugu state, Southeast Nigeria. Malar J 2024; 23:117. [PMID: 38664783 PMCID: PMC11044559 DOI: 10.1186/s12936-024-04914-1] [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: 09/12/2023] [Accepted: 03/21/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND There are giant steps taken in the introduction of the novel malaria vaccine poised towards reducing mortality and morbidity associated with malaria. OBJECTIVES This study aimed to determine the knowledge of malaria vaccine and factors militating against willingness to accept the vaccine among mothers presenting in nine hospitals in Enugu metropolis. METHODS This was a cross-sectional study carried out among 491 mothers who presented with their children in nine hospitals in Enugu metropolis, South-East Nigeria. A pre-tested and interviewer-administered questionnaire was used in this study. RESULTS A majority of the respondents, 72.1% were aware of malaria vaccine. A majority of the respondents, 83.1% were willing to receive malaria vaccine. Similarly, a majority of the mothers, 92.9%, were willing to vaccinate baby with the malaria vaccine, while 81.1% were willing to vaccinate self and baby with the malaria vaccine. The subjects who belong to the low socio-economic class were five times less likely to vaccinate self and baby with malaria vaccine when compared with those who were in the high socio-economic class (AOR = 0.2, 95% CI 0.1-0.5). Mothers who had good knowledge of malaria vaccination were 3.3 times more likely to vaccinate self and baby with malaria vaccine when compared with those who had poor knowledge of malaria vaccination (AOR = 3.3, 95% CI 1-6-6.8). CONCLUSION Although the study documented a high vaccine acceptance among the mothers, there exists a poor knowledge of the malaria vaccine among them.
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Affiliation(s)
- Awoere T Chinawa
- Department of Community Medicine, College of Medicine ESUT, Enugu, Nigeria
| | - Edmund N Ossai
- Department of Community Medicine, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
| | | | - Obinna C Nduagubam
- Department of Paediatrics, College of Medicine, Enugu State University of Technology, Enugu, Nigeria
| | | | - Chinyere N Okafor
- Department of Community Medicine, College of Medicine UNEC, Enugu, Nigeria.
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Chinawa AT, Ossai EN, Onukwuli VO, Nduagubam OC, Uwaezuoke NA, Okafor CN, Chinawa JM. Willingness to accept malaria vaccines amongst women presenting at outpatient and immunization clinics in Enugu state, Southeast Nigeria. Malar J 2024; 23:117. [DOI: https:/doi.org/10.1186/s12936-024-04914-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/21/2024] [Indexed: 04/30/2024] Open
Abstract
Abstract
Background
There are giant steps taken in the introduction of the novel malaria vaccine poised towards reducing mortality and morbidity associated with malaria.
Objectives
This study aimed to determine the knowledge of malaria vaccine and factors militating against willingness to accept the vaccine among mothers presenting in nine hospitals in Enugu metropolis.
Methods
This was a cross-sectional study carried out among 491 mothers who presented with their children in nine hospitals in Enugu metropolis, South-East Nigeria. A pre-tested and interviewer-administered questionnaire was used in this study.
Results
A majority of the respondents, 72.1% were aware of malaria vaccine. A majority of the respondents, 83.1% were willing to receive malaria vaccine. Similarly, a majority of the mothers, 92.9%, were willing to vaccinate baby with the malaria vaccine, while 81.1% were willing to vaccinate self and baby with the malaria vaccine. The subjects who belong to the low socio-economic class were five times less likely to vaccinate self and baby with malaria vaccine when compared with those who were in the high socio-economic class (AOR = 0.2, 95% CI 0.1–0.5). Mothers who had good knowledge of malaria vaccination were 3.3 times more likely to vaccinate self and baby with malaria vaccine when compared with those who had poor knowledge of malaria vaccination (AOR = 3.3, 95% CI 1–6–6.8).
Conclusion
Although the study documented a high vaccine acceptance among the mothers, there exists a poor knowledge of the malaria vaccine among them.
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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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Cheng L, Zhong S, Xu X, Li J, Xie F, Lin Y, Zhang D. Chinese parents' intention to vaccinate their 0-5-year-old children with the EV-71 vaccine against hand, foot, and mouth disease and willingness-to-pay. Front Public Health 2024; 12:1336687. [PMID: 38525345 PMCID: PMC10958786 DOI: 10.3389/fpubh.2024.1336687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/31/2024] [Indexed: 03/26/2024] Open
Abstract
Background This study aimed to determine the intention and willingness-to-pay (WTP) of Chinese parents/guardians to vaccinate their children with the EV-71 vaccine. Knowledge levels about hand, foot, and mouth disease (HFMD) and the EV-71 vaccine were also investigated. Methods A cross-sectional, self-administered online survey was conducted between November 2022 and March 2023. A stratified multi-stage random sampling method was used to recruit parents/guardians of children aged 0-5 years in southeastern China. Results A total of 3,626 complete responses were received. The mean knowledge score of HFMD was 9.99 (±4.23) out of a total of 14 points. The majority of the participants reported a somewhat willing intent (58.8%), followed by an extremely willing intent (28.9%). Participants who did not consider the EV-71 vaccine expensive (OR = 2.94, 95%CI 2.45-3.53) perceived that the EV-71 vaccine is effective (OR = 2.73, 95%CI 1.52-4.90), and a high knowledge level of HFMD (OR = 1.90, 95%CI 1.57-2.29) had the highest significant odds of having an extremely willing intent to vaccinate their children with the EV-71 vaccine. The median (interquartile range [IQR]) of WTP for the EV-71 vaccine was CNY¥200/USD$28 (IQR CNY¥100-400/USD$14-56). The highest marginal WTP for the vaccine was mainly influenced by the perceived high cost of the vaccine. Those participants who did not consider the EV-71 vaccine expensive had more than 10 times higher odds of vaccinating their children (OR = 10.86, 95%CI 8.49-13.88). Perceived susceptibility, perceived benefits, and perceived barriers were also significant influencing factors in the highest marginal WTP. Conclusion The findings demonstrate the importance of improving health promotion and reducing the barriers to EV-71 vaccination. Therefore, it is important to improve health promotion and reduce the barriers to EV-71 vaccination.
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Affiliation(s)
- Lu Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Sumei Zhong
- Vaccine Clinical Trial Center, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian, China
| | - Xiaonan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Junrong Li
- Vaccine Clinical Trial Center, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian, China
| | - Fangqin Xie
- Vaccine Clinical Trial Center, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian, China
| | - Yulan Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Dongjuan Zhang
- Vaccine Clinical Trial Center, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian, China
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Tahan L, Habchy P, Moussi C, Khadra T, Jawich M, Njeim A, Kattan O, Abou Habib L, El Bitar W, El Asmar B, Chahine MN. A National School Health Campaign in Lebanon on Children Aged between 3 and 12 Years Old: Concordance Level between Parents' Reports and Medical Visit Findings about Physical and Mental Health. CHILDREN (BASEL, SWITZERLAND) 2024; 11:214. [PMID: 38397326 PMCID: PMC10887313 DOI: 10.3390/children11020214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/27/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
A school's commitment to promoting health extends beyond students' efforts to encompass parental involvement and must recognize the critical role of parents in enhancing overall student well-being. This study, conducted in 27 schools across Lebanon, assessed parents' awareness of their children's physical and mental health. A school health campaign involved direct medical interventions on 7184 students, followed by phone interviews with 3880 parents to compare their responses with the medical findings. Discordances ranged from extreme mismatches (≥50%) to mild mismatches (<15%), with notable disparities in incomplete vaccination (67.8%), BMI (59%), and mental health indicators (expressions of sadness (69.1%), loneliness (61.0%), and anxiety (53.4%)). Factors such as school type, child's age, governorate, family income, parents' occupation, education level, and marital status significantly influenced discordance rates. Notably, mental health aspects exhibited higher disparities, emphasizing the need for improved communication between parents, physicians, and children. Bridging these gaps could empower parents with better knowledge, fostering environments conducive to lifelong healthy behaviors in children. The study underscores the urgency for enhanced communication strategies to bridge discrepancies and ensure a more comprehensive understanding of children's physical and mental well-being.
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Affiliation(s)
- Léa Tahan
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Peter Habchy
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Charbel Moussi
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Tia Khadra
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Melissa Jawich
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Alain Njeim
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Ogarite Kattan
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Leila Abou Habib
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
| | - Wassim El Bitar
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
- Department of Pediatrics, Bellevue Medical Center University Hospital, Mansourieh P.O. Box 295, Lebanon
| | - Béchara El Asmar
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
- Faculty of Medicine, Saint Joseph University, Beirut P.O. Box 17-5208, Lebanon
- Department of Cardiology, Hotel-Dieu de France Hospital, Achrafieh, Beirut P.O. Box 11-5190, Lebanon
| | - Mirna N. Chahine
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
- Basic Sciences Department, Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon
- Foundation-Medical Research Institutes (F-MRI®), Achrafieh, Beirut P.O. Box 64, Lebanon
- Foundation-Medical Research Institutes (F-MRI®), 1211 Geneva, Switzerland
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Habchy P, Tahan L, Moussi C, Barakat MA, Ghanem L, Kattan O, Njeim A, Abou Habib L, El Bitar W, El Asmar B, Chahine MN. Referrals and Determinant Factors of a National School Health Campaign in Lebanon on Children Aged between 3 and 12 Years Old. CHILDREN (BASEL, SWITZERLAND) 2024; 11:175. [PMID: 38397287 PMCID: PMC10886849 DOI: 10.3390/children11020175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/20/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
In this extensive study examining the health of 7184 school children aged 3 to 12 in 27 Lebanese schools, screenings involved medical evaluation and interviews, complemented by phone interviews with 3880 parents. Notably, one in two students received a medical referral, revealing prevalent issues such as dental cavities (33%), under-vaccination (25%), undetected vision problems (13%), abnormal growth (6%), underweight (27%), and overweight (33%). Additional concerns encompassed abnormal vital signs (3%), abuse signs (0.6%), infectious skin lesions (1.6%), scoliosis (1.7%), abnormal auscultation (heart 1.1%, lungs 1.2%), ear problems (3.3%), precocious puberty (0.7%), and neurologic signs (0.6%). Mental health challenges affected 20-25% of students. Public schools and Beirut exhibited higher referral rates, with girls, older children, overweight students, those lacking regular pediatrician visits, and children of self-employed or less educated parents facing elevated referral rates. In contrast, children of healthcare workers experienced fewer referrals. Against this backdrop, the study emphasizes the imperative for targeted health initiatives, particularly in marginalized areas and for socioeconomically disadvantaged students. Priority areas include dental care, weight issues, mental health, vaccination compliance, and addressing vision problems to enhance learning outcomes.
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Affiliation(s)
- Peter Habchy
- Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon; (P.H.); (L.T.); (C.M.); (M.A.B.); (L.G.); (O.K.); (A.N.)
| | - Léa Tahan
- Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon; (P.H.); (L.T.); (C.M.); (M.A.B.); (L.G.); (O.K.); (A.N.)
| | - Charbel Moussi
- Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon; (P.H.); (L.T.); (C.M.); (M.A.B.); (L.G.); (O.K.); (A.N.)
| | - Muhammad A. Barakat
- Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon; (P.H.); (L.T.); (C.M.); (M.A.B.); (L.G.); (O.K.); (A.N.)
| | - Laura Ghanem
- Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon; (P.H.); (L.T.); (C.M.); (M.A.B.); (L.G.); (O.K.); (A.N.)
| | - Ogarite Kattan
- Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon; (P.H.); (L.T.); (C.M.); (M.A.B.); (L.G.); (O.K.); (A.N.)
| | - Alain Njeim
- Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon; (P.H.); (L.T.); (C.M.); (M.A.B.); (L.G.); (O.K.); (A.N.)
| | - Leila Abou Habib
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
| | - Wassim El Bitar
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
- Department of Pediatrics, Bellevue Medical Center University Hospital, Mansourieh P.O. Box 295, Lebanon
| | - Béchara El Asmar
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
- Faculty of Medicine, Saint Joseph University, Beirut P.O. Box 17-5208, Lebanon
- Department of Cardiology, Hotel-Dieu de France Hospital, Achrafieh, Beirut 1100, Lebanon
| | - Mirna N. Chahine
- Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon; (P.H.); (L.T.); (C.M.); (M.A.B.); (L.G.); (O.K.); (A.N.)
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
- Basic Sciences Department, Faculty of Medical Sciences, Lebanese University, Hadath 1519, Lebanon
- Foundation-Medical Research Institutes (F-MRI), Achrafieh, Beirut 1100, Lebanon
- Foundation-Medical Research Institutes (F-MRI), 1211 Geneva, Switzerland
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Danso SE, Frimpong A, Seneadza NAH, Ofori MF. Knowledge, attitudes, and practices of caregivers on childhood immunization in Okaikoi sub-metro of Accra, Ghana. Front Public Health 2023; 11:1230492. [PMID: 37780451 PMCID: PMC10540614 DOI: 10.3389/fpubh.2023.1230492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023] Open
Abstract
Background Immunization remains one of the most cost-effective health interventions. However, there are still issues of vaccine hesitancy especially in caregivers who are required to protect their children from vaccine-preventable diseases. This thwarts the overall vaccine coverage in disease-endemic areas such as sub-Saharan Africa. Therefore, to determine the factors that promote vaccine hesitancy in caregivers, this study sought to assess the knowledge, attitude, and practices of caregivers on childhood immunization in Okaikoi, a sub-metro of Accra in Ghana. Methods A cross-sectional study on childhood immunization was conducted to determine the knowledge, attitudes, and practices of caregivers. A total of 120 caregivers with infants aged 12 months to 23 months were interviewed with a structured questionnaire containing open-ended and closed-ended queries. Results From the community, infants whose caregivers had adhered completely to immunization constituted 53.3% while the rest were partially immunized. The two main deterrents to complete immunization were time constraints (25.8%) and forgetfulness (17.5%). It was observed that vaccination uptake and maternal level of education, as well as vaccination adverse reaction, did not impact the completion of the EPI program by these caregivers. Unfortunately, it was noted that caregivers with higher education levels were unable to complete their vaccination schedules due to their busy work schedules. Nonetheless, the main deterrent to adhering to complete childhood immunization was poor maternal knowledge (58%). Conclusion The study revealed that, the caregivers in the community had poor knowledge on vaccination and its benefits, and therefore, with no strict adherence to vaccination schedules. This promoted the incomplete immunization of children in the community by their caregivers. Also, since the main source of information with regard to immunization in the sub-metro was through the antenatal and postnatal child welfare clinics and the media, we recommend that the health workers collaborate with media personnel to ensure that standardized information is disseminated.
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Affiliation(s)
- Samuel E. Danso
- Department of Community Health, University of Ghana Medical and Dental School, College of Health Science, Accra, Ghana
- GA East Hospital, Accra, Ghana
| | - Augustina Frimpong
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Nana A. H. Seneadza
- Department of Community Health, University of Ghana Medical and Dental School, College of Health Science, Accra, Ghana
| | - Michael F. Ofori
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
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Batool R, Yousafzai MT, Qureshi S, Muhammad S, Qazi I, Sadaf T, Ashorn P, Qamar FN. Parental acceptance of typhoid conjugate vaccine for children aged 6 months to 15 years in an outbreak setting of Lyari Town Karachi, Pakistan. Vaccine 2023; 41:5376-5382. [PMID: 37463829 PMCID: PMC10448379 DOI: 10.1016/j.vaccine.2023.07.003] [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: 04/04/2023] [Revised: 05/18/2023] [Accepted: 07/02/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND This study aimed to evaluate the parental acceptance of Typhoid Conjugate Vaccine (TCV) and to determine the predictors of TCV vaccination status among children in an outbreak setting of extensively drug resistant (XDR) typhoid fever in Karachi, Pakistan. METHODS A cross-sectional survey using the WHO recommended rapid vaccine coverage assessment technique was conducted. Out of 11, four union councils (UCs) in Lyari Town were randomly selected. A parent or primary caretaker from the eligible household was interviewed. Data were collected using a locally validated vaccine attitudes scale (VAS). Sum of scores was calculated for VAS. A higher score denoted negative attitudes and perceptions regarding TCV and vice versa. Multivariable logistic regression was performed to determine the predictors of TCV vaccination status. RESULTS Based on the 14-item parental VAS, 78.0 % of the parents had a score between 0 to <40 and 22 % had a score ≥40. VAS score of <40 was significantly associated with higher odds of receiving TCV during the campaign setting (adjusted Odds Ratio (aOR): 1.30; 95 % Confidence Interval (CI): 1.02, 1.66). The odds of receiving TCV vaccination were higher among children whose parents were aware of the ongoing vaccination campaign in the area (aOR: 4.57; 95 % CI: 2.93, 7.12) and expressed willingness to get their child vaccinated against typhoid fever (aOR: 2.54; 95 % CI: 1.82, 3.55). CONCLUSION Parental awareness of the ongoing vaccination campaign, positive perception and attitudes towards vaccine were found to be significantly associated with TCV vaccination among children. Appropriately structured pre-vaccination awareness campaigns focused on childhood vaccination targeted towards parents are necessary to improve parental awareness, attitude and behavior towards vaccination.
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Affiliation(s)
- Rabab Batool
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Stadium Rd, PO Box 3500 Karachi 74800, Pakistan; Centre for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, Tampere 33520, Finland
| | - Mohammad Tahir Yousafzai
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Stadium Rd, PO Box 3500 Karachi 74800, Pakistan; The Kirby Institute, UNSW Sydney, Wallace Wurth Building High Street, UNSW Sydney, Kensington, NSW 2052, Australia
| | - Sonia Qureshi
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Stadium Rd, PO Box 3500 Karachi 74800, Pakistan
| | - Sajid Muhammad
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Stadium Rd, PO Box 3500 Karachi 74800, Pakistan
| | - Ibtisam Qazi
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Stadium Rd, PO Box 3500 Karachi 74800, Pakistan
| | - Tahira Sadaf
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Stadium Rd, PO Box 3500 Karachi 74800, Pakistan
| | - Per Ashorn
- Centre for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, Tampere 33520, Finland
| | - Farah Naz Qamar
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Stadium Rd, PO Box 3500 Karachi 74800, Pakistan.
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Nassar O, Alshahwan S, Alshahwan R, Halasa S, Alashhab S, Alnajar M. Determinants of Parents’ Knowledge, Attitudes, and Practice toward Childhood Vaccination: A National Study. Open Nurs J 2023. [DOI: 10.2174/18744346-v17-230223-2022-88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Background:
Childhood vaccination is one of the World Health Organization's strategies to reduce vaccine-preventable diseases and children's mortality and morbidity rates. Adequate and accurate knowledge, as well as positive attitudes regarding vaccination, may increase parents’ compliance with their children’s vaccines.
Objective:
This study aimed to identify the determinants of parents’ knowledge, attitude, and practice toward childhood vaccination in Jordan.
Methods:
This is a descriptive cross-sectional study. The stratification method of sampling technique was used to split Jordan into three regions. The sample included 1477 participants. A total number of eleven Maternal and Child Health Care centers were selected as the study’s site.
Results:
Results showed that parents have sufficient knowledge regarding the importance of vaccines in maintaining a child’s health, with a mean percentage of correctly answered questions of 78.7%. However, they have inadequate knowledge regarding the adverse reactions (57.5%) and the contraindications of vaccines (61.8%). Parents had positive attitudes regarding the National Immunization Program where 97% agreed with it. However, 83% of parents had negative attitudes toward vaccine safety. Parents’ work, residency, income, and age are significant determinants of parents’ attitudes, knowledge, and practice regarding children's vaccines.
Conclusion:
The study may motivate nurses to implement more educational interventions regarding children’s vaccination to upgrade parents' knowledge with particular emphasis on parents with a low level of education and the residents of rural areas.
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Simegn W, Diress M, Gela YY, Belay DG, Ayelign Kibret A, Chilot D, Sinamaw D, Abdu Seid M, Andualem AA, Anmut Bitew D, Eshetu HB, Mohammed Seid A. Childhood vaccination practices and associated factors among mothers/caregivers in Debre Tabor town, Northwest Ethiopia: A cross-sectional study. Front Pediatr 2023; 11:1070722. [PMID: 36793335 PMCID: PMC9922988 DOI: 10.3389/fped.2023.1070722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/02/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Incomplete immunization and non-immunization increase the risk of disease and death among children. This study aims to assess childhood vaccination practices and associated factors among mothers and caregivers in Debre Tabor town, Amhara region, Ethiopia. METHODS A community-based cross-sectional study design was conducted between February 30 and April 30, 2022. The study participants were proportionally allocated to all six kebeles found in the town. A systematic random sampling technique was used to select the study participants. The collected data were checked and coded and then entered into EpiData Version 3.1 and exported into SPSS Version 26. The results were organized using frequency tables, graphs, and charts, and bivariate and multivariable logistic regression were used to test the association of covariates with childhood vaccination practices. RESULT Approximately 422 study mothers and caregivers participated in the study, with a response rate of 100%. The mean age was 30.63 years (11.74), which ranged from 18 to 58 years. More than half of the study participants (56.4%) expressed fears about the side effects of vaccination. A majority (78.4%) of the study participants availed of counseling services about vaccination, and 71.1% of them received regular antenatal care. This study found that approximately 280 [66.4%, 95% confidence interval (CI): 61.8-70.6] mothers/caregivers had a history of good childhood vaccination practices. The factors of the fear of side effects [adjusted odds ratio (AOR) = 3.34; 95% CI: 1.72-6.49], no workload (AOR = 6.08; 95% CI: 1.74-21.22), medium workload (AOR = 4.80; 95% CI: 1.57-14.71), being a mother of child/children (AOR = 2.55; 95% CI: 1.27-5.13), positive attitude (AOR = 2.25; 95% CI: 1.32-3.82), and sound knowledge (AOR = 3.88; 95% CI: 2.26-6.68) were significantly associated with childhood vaccination practices. CONCLUSION More than half of the study participants had a history of good childhood vaccination practices. However, the rate of such practices was low among mothers and caregivers. The fear of side effects, workload, motherhood, attitude, and knowledge were all factors associated with childhood vaccination practices. Awareness creation and a consideration of the workload of mothers would be helpful in dispelling fears and increasing the rate of good practices among mothers and caregivers.
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Affiliation(s)
- Wudneh Simegn
- Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengistie Diress
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yibeltal Yismaw Gela
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagmawi Chilot
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia
| | - Deresse Sinamaw
- Department of Biomedical Science, Debre Markos University, Debre Markos, Ethiopia
| | - Mohammed Abdu Seid
- Unit of Human Physiology, Department of Biomedical Science, College of Health Sciences, Debre Tabor University, Debre tabor, Ethiopia
| | | | - Desalegn Anmut Bitew
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abdulwase Mohammed Seid
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Osman M, Kassem II, Dabboussi F, Cummings KJ, Hamze M. The indelible toll of enteric pathogens: Prevalence, clinical characterization, and seasonal trends in patients with acute community-acquired diarrhea in disenfranchised communities. PLoS One 2023; 18:e0282844. [PMID: 36913372 PMCID: PMC10010529 DOI: 10.1371/journal.pone.0282844] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/23/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND There is little information on the epidemiology of enteric pathogens in Lebanon, a low- and middle-income country that suffers from a myriad of public health challenges. To address this knowledge gap, we aimed to assess the prevalence of enteric pathogens, identify risk factors and seasonal variations, and describe associations between pathogens among diarrheic patients in the Lebanese community. METHODOLOGY AND PRINCIPAL FINDINGS A multicenter cross-sectional community-based study was conducted in the north of Lebanon. Stool samples were collected from 360 outpatients suffering from acute diarrhea. Based on fecal examination using the BioFire® FilmArray® Gastrointestinal Panel assay, the overall prevalence of enteric infections was 86.1%. Enteroaggregative Escherichia coli (EAEC) was the most frequently identified (41.7%), followed by enteropathogenic E. coli (EPEC) (40.8%) and rotavirus A (27.5%). Notably, two cases of Vibrio cholerae were identified, while Cryptosporidium spp. (6.9%) was the most common parasitic agent. Overall, 27.7% (86/310) of the cases were single infections, and the majority, 73.3% (224/310), were mixed infections. Multivariable logistic regression models showed that enterotoxigenic E. coli (ETEC) and rotavirus A infections were significantly more likely to occur in the fall and winter compared to the summer. Rotavirus A infections significantly decreased with age but increased in patients living in rural areas or suffering from vomiting. We identified strong associations in the co-occurrence of EAEC, EPEC, and ETEC infections and a higher percentage of rotavirus A and norovirus GI/GII infections among EAEC-positive cases. CONCLUSIONS Several of the enteric pathogens reported in this study are not routinely tested in Lebanese clinical laboratories. However, anecdotal evidence suggests that diarrheal diseases are on the rise due to widespread pollution and the deterioration of the economy. Therefore, this study is of paramount importance to identify circulating etiologic agents and prioritize dwindling resources to control them and limit outbreaks in the future.
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Affiliation(s)
- Marwan Osman
- Cornell Atkinson Center for Sustainability, Cornell University, Ithaca, NY, United States of America
- Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Issmat I. Kassem
- Center for Food Safety and Department of Food Science and Technology, University of Georgia, Griffin, GA, United States of America
| | - Fouad Dabboussi
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Kevin J. Cummings
- Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States of America
| | - Monzer Hamze
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
- * E-mail:
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Alabadi M, Alashoor T, Aldawood O, Qanbar Z, Aldawood Z. Exploring Critical Factors Associated with Completion of Childhood Immunisation in the Eastern Province of Saudi Arabia. Vaccines (Basel) 2022; 10:vaccines10122147. [PMID: 36560557 PMCID: PMC9784112 DOI: 10.3390/vaccines10122147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/30/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
(1) Background: surveillance data from the Saudi Ministry of Health shows that the Kingdom’s large-scale immunisation programme has significantly reduced the mortality and morbidity of the target diseases among children. In this study, we review relevant literature and test a number of hypotheses related to the association between demographic, socio-economic, clinic-related, and parents-related variables and completion of childhood immunisation. In doing so, this study identifies critical factors associated with completion of childhood immunisation and presents important implications to healthcare practitioners, particularly in Saudi Arabia; (2) Literature review: a systematic literature review was conducted to understand what is currently published concerning parents’ immunisation compliance in Saudi Arabia and the factors associated with immunisation compliance. (3) Methods: from March to May 2022, an online survey was administered to parents attending one of the 27 primary health care (PHC) centres in Qatif. Data from parents (n = 353) were analysed using exploratory factor analysis, correlation, and a series of OLS and logistic regression models; (4) Results: parental (child) age was negatively (positively) associated with the completion status of childhood immunisation (both p < 0.05). Parents with positive attitudes, social norms, perceptions towards immunisation, and those working in private companies were more likely to immunise their children (all p < 0.05). Conversely, living in an apartment building, walking to PHCs, waiting longer at PHCs, and having higher knowledge of immunisation were negatively associated with the completion of childhood immunisation (all p < 0.05); (5) Conclusions: several factors that positively or negatively influence the completion of childhood immunisation have been identified. Future studies may investigate the causal link between these factors and parental decision-making regarding childhood immunisation.
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Affiliation(s)
- Marwa Alabadi
- School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Tawfiq Alashoor
- Department of Digitalization, Copenhagen Business School, Howitzvej 60, 2000 Frederiksberg, Denmark
| | - Omran Aldawood
- Primary Health Care Division, Ministry of Health, Riyadh 12271, Saudi Arabia
| | - Zainab Qanbar
- Primary Health Care Division of Qatif City, General Directorate of Health Affairs in the Eastern Region, Ministry of Health, Qatif 31911, Saudi Arabia
| | - Zakariya Aldawood
- Primary Health Care Division of Qatif City, General Directorate of Health Affairs in the Eastern Region, Ministry of Health, Qatif 31911, Saudi Arabia
- Correspondence: ; Tel.: +61-451287443
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Balgovind P, Mohammadnezhad M. Factors affecting childhood immunization: Thematic analysis of parents and healthcare workers' perceptions. Hum Vaccin Immunother 2022; 18:2137338. [PMID: 36494999 PMCID: PMC9746479 DOI: 10.1080/21645515.2022.2137338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Immunization against common childhood diseases is an important strategy as it is critical for reducing the global child morbidity and mortality. This review explores the perceptions of parents and HCWs toward childhood immunization. The PRISMA guideline was used to search and include the studies. Relevant electronic databases were systemically searched for the years ranging from 2000 to 2021 to identify studies reported in English. Themes were then identified using thematic analysis. A total of 44 studies met the review criteria and were summarized and categorized into 4 themes: barriers to immunization, parental knowledge, attitude and behavior (KAB), health system factors and HCWs' KAB. This review found that immunization decision-making is a complex process. Parental KAB leads to immunization decisions. HCWs were also noted to be the trusted sources of immunization information. Further research can be conducted on how to improve parents' perceptions of immunization and immunization practices.
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Affiliation(s)
- Preeti Balgovind
- School of Public Health and Primary Care, Fiji National University, Suva, Fiji Islands
| | - Masoud Mohammadnezhad
- School of Nursing and Healthcare Leadership, University of Bradford, Bradford, UK,CONTACT Masoud Mohammadnezhad School of Nursing and Healthcare Leadership, University of Bradford, Bradford, West YorkshireBD7 1DP, UK
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Perceptions of the safety of vaccines and vaccine associated knowledge levels in Europe: A 2019 cross-sectional study in 28 countries. Prev Med 2022; 159:107071. [PMID: 35460716 DOI: 10.1016/j.ypmed.2022.107071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/18/2022] [Accepted: 04/18/2022] [Indexed: 11/21/2022]
Abstract
Vaccination has saved millions of lives. Vaccine hesitancy was recently declared a major threat to health by the World Health Organisation. Sociodemographic variables and knowledge level about vaccines have been suggested previously to affect vaccine uptake. This study aimed to investigate how levels of vaccination knowledge and concerns around safety of vaccines varied across sociodemographic factors in the European Union and United Kingdom. Levels and sources of knowledge and vaccine attitude patterns were examined across different areas of Europe. Data from the March 2019 Eurobarometer survey was used in this study which had 27,524 participants across the European Union and the United Kingdom. Two-level logistic and linear regressions were used to look for associations between sociodemographic variables, vaccine attitudes and knowledge level. Those who trusted information from healthcare workers and healthcare authorities were most likely to have positive vaccine attitudes; those trusting internet sources the most were the least likely. Those with greater vaccine related knowledge were more likely to report positive vaccination attitudes. Healthcare workers are key to dissemination of vaccination advice however many are becoming hesitant themselves. An increasing number of people are seeking online sources for vaccination information, and this has implications with information accuracy and vaccine hesitancy. A considerable proportion of the adult population in the European Union and the United Kingdom was concerned about the safety or side effects of vaccines. Continued efforts to increase trust in vaccines both in whole populations and specific groups are needed.
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Sinuraya RK, Kusuma ASW, Pardoel ZE, Postma MJ, Suwantika AA. Parents' Knowledge, Attitude, and Practice on Childhood Vaccination During the COVID-19 Pandemic in Indonesia. Patient Prefer Adherence 2022; 16:105-112. [PMID: 35068926 PMCID: PMC8766251 DOI: 10.2147/ppa.s339876] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/30/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Vaccination is known to have an enormous impact on improving child health. In Indonesia, the government has included several vaccines in the national immunization program. OBJECTIVE This study aimed to investigate parents' knowledge, attitude, and practice on childhood immunization during the COVID-19 pandemic in Indonesia. METHODS A valid and reliable questionnaire was delivered to approximately 276 parents in Jakarta and Bandung, representing the epicenter of the pandemic. This study was conducted from June 2020 to February 2021. The correlations between parents' knowledge, attitudes, and practice with the characteristics of the respondents were investigated. In addition, multiple regression analysis was performed to identify the variables associated with good vaccination practice. RESULTS The results showed that the mean scores of parents' knowledge, attitude, and practice on childhood vaccinations were 7.22 (± 1.30) out of 9 points, 3.93 (± 0.31) out of 4 points, and 3.59 (± 0.97) out of 5 points, respectively. Respondents graduated from university were more knowledgeable than those graduated from senior high school (p-value <0.05). Employed participants had better scores in knowledge and practice, compared to unemployed participants (p-value <0.05). CONCLUSION In conclusion, this study found positive correlations between participants' knowledge and attitude, knowledge and practice, and attitude and practice on childhood vaccination during the COVID-19 pandemic in Indonesia.
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Affiliation(s)
- Rano K Sinuraya
- Unit of Global Health, Department of Health Sciences, University of Groningen/University Medical Center Groningen, Groningen, the Netherlands
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Arif S W Kusuma
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Department of Pharmaceutical Biology, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Zinzi E Pardoel
- Unit of Global Health, Department of Health Sciences, University of Groningen/University Medical Center Groningen, Groningen, the Netherlands
| | - Maarten J Postma
- Unit of Global Health, Department of Health Sciences, University of Groningen/University Medical Center Groningen, Groningen, the Netherlands
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Department of Economics, Econometrics & Finance, Faculty of Economics & Business, University of Groningen, Groningen, the Netherlands
- Unit of Pharmacotherapy,-Epidemiology &-Economics, University of Groningen, Department of Pharmacy, Groningen, the Netherlands
| | - Auliya A Suwantika
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Center for Health Technology Assessment, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Correspondence: Auliya A Suwantika Faculty of Pharmacy, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang Km. 21, Jatinangor, Sumedang, 45363, Indonesia Email
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Adeyanju GC, Sprengholz P, Betsch C, Essoh TA. Caregivers' Willingness to Vaccinate Their Children against Childhood Diseases and Human Papillomavirus: A Cross-Sectional Study on Vaccine Hesitancy in Malawi. Vaccines (Basel) 2021; 9:vaccines9111231. [PMID: 34835162 PMCID: PMC8623298 DOI: 10.3390/vaccines9111231] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/06/2021] [Accepted: 10/20/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Vaccines are among the most effective and cost-efficient public health interventions for promoting child health. However, uptake is considerably affected by vaccine hesitancy. An example is Malawi, with a decline in second vaccine doses and the highest cervical cancer incidence and mortality rate in Sub-Saharan Africa. Understanding vaccine hesitancy is especially important when new vaccines are introduced. This study explores factors contributing to vaccine hesitancy for routine childhood immunization and the human papillomavirus vaccine in Malawi. Methods: The study used a cross-sectional survey design targeting caregivers of children under five years old and adolescent girls. The sample population was derived using three inclusion criteria: one district with low vaccine uptake (Dowa), one district with high vaccine uptake (Salima), and one district where human papillomavirus vaccine was piloted earlier (Zomba). A convenience sample of one primary and one secondary health facility was selected within each district, and participants were systematically included (n = 600). The measures were based on 5C scale for measuring vaccine hesitancy. Multiple regression analyses were performed to explore vaccination intention predictors. Results: Confidence in vaccine safety was the strongest predictor of routine childhood immunization, followed by constraints due to everyday stress. Caregivers had lower confidence in vaccine safety and efficacy when they believed rumors and misinformation and were unemployed. Confidence was higher for those who had more trust in healthcare workers. Age, gender, religion, education, employment, belief in rumors, and trust in healthcare workers were considered predictors of vaccination intention. A husband’s positive attitude (approval) increased childhood vaccination intention. For human papillomavirus, vaccination intentions were higher for those with lower education, more trust in healthcare workers, lower complacency, and a lower tendency toward calculating the benefits and risks of vaccination. Knowledge of human papillomavirus did not increase vaccination intention, but the need to attain a husband’s approval did. Being a young adult and unemployed increased belief in rumors, while trust in healthcare workers reduced the belief. Conclusions: This study provides good insights into the drivers of vaccine hesitancy across different contexts in Malawi. However, further studies are necessary to understand low risk perception among elderly people and the declining trend in second vaccine doses.
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Affiliation(s)
- Gbadebo Collins Adeyanju
- Psychology and Infectious Disease Lab (PIDI), Media and Communication Science, University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany; (P.S.); (C.B.)
- Centre for Empirical Research in Economics and Behavioral Science (CEREB), University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany
- Correspondence: ; Tel.: +49-152-1638-1976
| | - Philipp Sprengholz
- Psychology and Infectious Disease Lab (PIDI), Media and Communication Science, University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany; (P.S.); (C.B.)
- Centre for Empirical Research in Economics and Behavioral Science (CEREB), University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany
| | - Cornelia Betsch
- Psychology and Infectious Disease Lab (PIDI), Media and Communication Science, University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany; (P.S.); (C.B.)
- Centre for Empirical Research in Economics and Behavioral Science (CEREB), University of Erfurt, Nordhäuser Straße 63, 99089 Erfurt, Germany
| | - Tene-Alima Essoh
- Agence de Médecine Préventive, Regional Directorate for Africa, Abidjan 08 BP 660, Côte d’Ivoire;
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Chinawa AT, Chinawa JM, Ossai EN, Obinna N, Onukwuli V, Aronu AE, Manyike CP. Maternal level of awareness and predictors of willingness to vaccinate children against COVID 19; A multi-center study. Hum Vaccin Immunother 2021; 17:3982-3988. [PMID: 34613862 DOI: 10.1080/21645515.2021.1963172] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Several controversies surround mothers' willingness to vaccinate against the COVID-19 pandemic especially when mortality is not frequently reported in children.Objectives: This study aimed to ascertain the willingness of mothers of children attending two institutions in Southeast Nigeria to accept the COVID-19 vaccine and factors that may be associated with their choices. METHODOLOGY This was a cross-sectional study carried out among 577 mothers who presented with their children in two tertiary health institutions in southeast Nigeria. RESULTS Majority of the respondents (93.9%) were aware of the COVID-19 vaccine. Majority of the respondents, 89.4%, noted that children were not in high priority groups for COVID-19 vaccination in Nigeria. Only 6.9% of the respondents intend to receive the COVID-19 vaccination. Also, a minor proportion of the respondents (4.9%) were willing to vaccinate their children with the COVID-19 vaccine. The odds of receiving the Covid-19 vaccine were four times greater in those who believed that they could be infected than in those who believed that they could not be infected (AOR = 4.0. 95% CI:1.8-8.7). The odds of receiving the Covid-19 vaccine were six times greater in those who were aware of someone that died from COVID-19 than in those who did not know anyone who died from COVID-19 (AOR = 5.7, 95% CI: 2.1-15.8). CONCLUSION A high level of awareness but low acceptance level for COVID-19 vaccination for mothers and their children was noted. Socioeconomic class, maternal age, and level of education did not influence the willingness of the mother to receive COVID vaccination. Having a belief of possibility of infection with the COVID-19 as well as being aware of someone who died from the disease were important positive variables that could predict vaccine acceptance from this study.
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Affiliation(s)
- Awoere T Chinawa
- Department of Community medicine, ESUCOM Parkalane, Enugu State University Teaching Hospital, Enugu, Nigeria
| | - Josephat M Chinawa
- Department of Paediatrics, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Edmund N Ossai
- Department of Community Medicine, College of Health Sciences, Ebonyi State University Abakaliki, Abakiliki, Nigeria
| | - Nduagubam Obinna
- Department of Paediatrics, Enugu State University Teaching Hospital, Enugu
| | - Vivian Onukwuli
- Department of Paediatrics, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Ann E Aronu
- Department of Paediatrics, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Chuka P Manyike
- Department of Paediatrics, College of Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakiliki
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19
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Ibraheem RM, Bello AO, Ibrahim OR, Garba BI, Aliu R, Abdulkadir MB, Hashim R, Ibrahim LM, Mohammed SS, Sambo AH, Ahmed G, Akintola MA. Willingness of Mothers to Receive Reminders for Routine Vaccination Appointments in Northern Nigeria: A Multi-Centre Cross-Sectional Study. J Trop Pediatr 2021; 67:6377122. [PMID: 34580717 DOI: 10.1093/tropej/fmab085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Routine vaccination, a cost-effective means of preventing deadly childhood disease, has a low coverage in Nigeria. The study assessed the willingness of mothers to receive reminder messages for routine vaccination appointments in Northern Nigeria. METHODS A multi-centre cross-sectional study involving at least 363 mother-infant pairs per centre from five states in Northern Nigeria. Data collected include the socio-demographic details, responses on parental phone ownership, mothers' willingness to receive reminders for immunization appointments and the reminder type characteristics. Data analysis was done with SPSS. RESULTS Of the 1952 mother-infant pairs, ownership of at least one household phone was 97.7%. In total, 1613 (82.6%) mothers were willing to receive reminders. A majority (62.2%) of mothers preferred phone calls. A day before the vaccination appointment was the preferred timing (78.1%), and the predominant communication language was the local language for each region.The odds of being willing to receive reminders were 3.1 times, 2.6 times and 1.8 times higher in those with no formal education, primary education and secondary education, respectively, compared with mothers with tertiary education, each p < 0.05. Mothers who delivered at home were significantly less likely to want reminder messages (p = 0.03). CONCLUSION Eight of 10 women in Northern Nigeria are willing to receive a reminder for their child. The predominant mode of reminder preferred is phone calls using the local language. Deployment of mobile phone reminders strategy in Northern Nigeria as a means to improve vaccination uptake is feasible. The institution of this strategy can be in collaboration with service providers.
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Affiliation(s)
- Rasheedat Mobolaji Ibraheem
- Department of Paediatrics & Child Health, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Kwara State PMB 1515, Nigeria
| | - Afeez Oyesola Bello
- Department of Paediatrics, Federal Medical Centre, Bida, Niger State 912231, PMB 14, Nigeria
| | - Olayinka Rasheed Ibrahim
- Department of Paediatrics, Federal Medical Centre, Katsina, Katsina State 820241, PMB 2121, Nigeria
| | - Bilkisu Ilah Garba
- Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital, Sokoto 840103, PMB 2370, Nigeria
| | - Rasaki Aliu
- Department of Paediatrics, Gombe State University/Federal Teaching Hospital, Gombe 760222, PMB. 0037, Nigeria
| | - Mohammed Baba Abdulkadir
- Department of Paediatrics & Child Health, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Kwara State PMB 1515, Nigeria
| | - Rabiu Hashim
- Department of Paediatrics, Ahmad Sani Yariman Bakura Specialist Hospital, Gusau, Zamfara State 860231, Nigeria
| | - Lawal Magaji Ibrahim
- Department of Paediatrics, Federal Medical Centre, Katsina, Katsina State 820241, PMB 2121, Nigeria
| | | | - Amina Hannatu Sambo
- Department of Paediatrics, Ahmad Sani Yariman Bakura Specialist Hospital, Gusau, Zamfara State 860231, Nigeria
| | - Grace Ahmed
- Department of Paediatrics, Federal Medical Centre, Bida, Niger State 912231, PMB 14, Nigeria
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GebreEyesus FA, Tarekegn TT, Amlak BT, Shiferaw BZ, Emeria MS, Geleta OT, Mewahegn AA, Feleke DG, Chanie ES. Knowledge, Attitude, and Practices of Parents About Immunization of Infants and Its Associated Factors in Wadla Woreda, North East Ethiopia, 2019. Pediatric Health Med Ther 2021; 12:223-238. [PMID: 34007240 PMCID: PMC8121275 DOI: 10.2147/phmt.s295378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/08/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Improving infant immunization coverage and timeliness is a key health policy objective in many developing countries such as Ethiopia. Despite this, full immunization coverage in Ethiopia becomes low with the concurrent significant burden of vaccine-preventable diseases among infants. A previously published study acknowledged that parental knowledge, attitude, and practice towards infant immunization are vital issues to improve coverage and influence uptake. OBJECTIVE To assess parents' knowledge, attitude, practice, and its associated factors regarding immunization of infants at Wadla Woreda, North East Ethiopia, 2019. MATERIAL AND METHODS A community-based cross-sectional study was employed among 418 parents from March to April 2019 in Wadla Woreda, North East Ethiopia. A stratified sampling technique was used to approach the study subjects. An interviewer-administered structured questionnaire was used. The collected data were cleaned, coded, and entered in EPI-Info 7.2 and transferred to SPSS version 25.0 for analysis. Binary logistic regression analyses were performed to identify variables having a significant association with parental knowledge, attitude, and practice. Variables with a p-value of ≤0.05 and AOR with 95% CI were declared as having a statistically significant association during multivariable logistic regression analysis. RESULTS In this study, 65.1%, 57.3%, and 55.3% of the parents had good knowledge, a favorable attitude, and good practice towards infant immunization, respectively. Parent's educational status (AOR=5.330), urban residency (AOR=2.788), favorable attitude (AOR=4.308) and got immunization service two-three times (AOR=3.227) and four-five times (AOR=2.254) were statistically associated with knowledge of parents. Parents who attend primary school [AOR=0.451) and secondary school [AOR=0.320), parents who were mothers of the child [AOR=3.813), and respondents who had good knowledge about infant immunization (AOR= 4.592) were significantly associated with a favorable parental attitude. Infant immunization practice was significantly associated with parental education who attend primary school (AOR=2.513), secondary school (AOR=2.546) and higher education (AOR=11.988), parents who had good knowledge of infant immunization (AOR= 4.206), and short waiting time (AOR=3.881). CONCLUSION AND RECOMMENDATION Parental KAP towards infant immunization was found to be lower than most of the study findings quoted in this study. Improving the knowledge, attitude, and practice of parents about immunization and vaccine-preventable diseases was recommended by providing health education and health promotion interventions.
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Affiliation(s)
- Fisha Alebel GebreEyesus
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Tadesse Tsehay Tarekegn
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Baye Tsegaye Amlak
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Bisrat Zeleke Shiferaw
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Mamo Solomon Emeria
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Omega Tolessa Geleta
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Agerie Aynalem Mewahegn
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Dejen Getaneh Feleke
- Department of Pediatrics and Neonatal Nursing, College of Health Sciences, Debre Tabor University, DebreTabor, Ethiopia
| | - Ermias Sisay Chanie
- Department of Pediatrics and Neonatal Nursing, College of Health Sciences, Debre Tabor University, DebreTabor, Ethiopia
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Fahriani M, Anwar S, Yufika A, Bakhtiar B, Wardani E, Winardi W, Akel KB, Wagner AL, Harapan H. Disruption of childhood vaccination during the COVID-19 pandemic in Indonesia. NARRA J 2021; 1:e7. [PMID: 38449777 PMCID: PMC10914023 DOI: 10.52225/narraj.v1i1.7] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/24/2021] [Indexed: 03/08/2024]
Abstract
The aim of this study was to assess the magnitude of childhood vaccination disruption and to determine the predictors of delaying childhood vaccinations during the coronavirus disease 2019 (COVID-19) pandemic among Indonesian parents. We conducted a nationwide, online, cross-sectional study. A set of questionnaires assessed the disruption of childhood vaccinations and possible explanatory variables, including demographic characteristics, current underlying disease, exposure to and confidence in COVID-19 information, perceived risk, attitude and practice on vaccination, and COVID-19 prevention practice. A multivariable linear regression was used to characterize the relationship between explanatory variables and delayed childhood vaccination. We included 1137 respondents for analysis, of which 52.6% were males and 58.4% participants aged between 31 and 50-years old. Disruption of childhood vaccination service in local health facilities was reported in 42.2% (480/1137) of respondents and 13.3% (193/1137) of respondents explained that their children could not be vaccinated because a healthcare facility temporary stopped the vaccination service. Of all respondents, 312 (27.4%) delayed vaccinating their children for a compulsory vaccination shot. Factors associated with higher odds of delaying compulsory vaccinations for children were employment and chronic disease status, flu vaccination status in the past year, and prior COVID-19 infection. In conclusion, there was a significant disruption of childhood vaccination practices in Indonesia during the COVID-19 pandemic. This is not only due to healthcare closures but also due to parents' practice - delaying the compulsory childhood vaccination for their children. We urge the government to strengthen strategies to ensure childhood vaccination services are available to all children in the country during a pandemic.
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Affiliation(s)
- Marhami Fahriani
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Samsul Anwar
- Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Amanda Yufika
- Department of Family Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Bakhtiar Bakhtiar
- Department of Pediatric, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Elly Wardani
- Department of Nursing Leadership and Management, Faculty of Nursing, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Wira Winardi
- Department of Pulmonology and Respiratory Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Kaitlyn B. Akel
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Abram L. Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
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Klassen AC, Milliron BJ, Reynolds L, Bakhtibekova Z, Mamadraimov S, Bahruddinov M, Shokamolova S, Shuster M, Mukhtar S, Gafurova M, Iskandari M, Majidian R, Job-Johnson B. Formative research to address vaccine hesitancy in Tajikistan. Vaccine 2021; 39:1516-1527. [PMID: 33487469 DOI: 10.1016/j.vaccine.2021.01.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Incomplete childhood vaccination is associated with caregiver vaccine hesitancy, conceptualized by "3 Cs": high complacency, low confidence, and low convenience. To expand on existing evidence drawn primarily from the Americas and Europe, and develop culturally appropriate interventions, this research explored drivers of vaccine hesitancy in the Central Asian country of Tajikistan. METHODS In twelve diverse districts, clinic-based immunization record abstraction identified purposive samples of children who were up-to-date (N = 300) or not (N = 300) on all first year vaccines. Using a modified case-control design, the structured face-to-face in-home survey of 600 caregivers compared knowledge, attitudes and practices regarding childhood vaccination by up-to-date status. Socio-demographic and psychological factors associated with hesitancy were identified, using a 22-item vaccine hesitancy scale, with subscales measuring complacency, confidence, and convenience. Overall contribution of vaccine hesitancy to up-to-date status was modeled, adjusting for other significant covariates. RESULTS Caregivers of not up-to-date children were more likely to report their child's health as poor, and report many logistical barriers to vaccination. Knowledge of vaccine-preventable illnesses was low, and complacency regarding vaccination was high among not up-to-date caregivers. In final multivariable models of predisposing, enabling and reinforcing influences on vaccination status, urban children, those with transportation and employed mothers were more likely to be up-to-date, while not up-to-date children included those born at home, seen as having fair or poor health, or reportedly told by clinicians to avoid immunization. Reinforcing factors included having a "vaccine passport", receiving useful information from medical providers, and believing that vaccine-preventable illnesses are serious and that most in their community are vaccinated. Additionally, vaccine hesitancy was negatively associated with up-to-date status (odds ratio 0.15, 95% C.I. 0.08, 0.26). CONCLUSIONS Results confirm that in this traditional culture, there is a strong need for tailored communication campaigns to address vaccine hesitancy, while continuing to address systems-level barriers.
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Affiliation(s)
- Ann Carroll Klassen
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA.
| | - Brandy-Joe Milliron
- Department of Nutrition Sciences, Drexel University College of Nursing and Health Professions, Philadelphia, PA 19101, USA
| | - Leslie Reynolds
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA
| | | | | | | | | | - Michelle Shuster
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA
| | - Sarah Mukhtar
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA
| | - Maftuna Gafurova
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA
| | - Malika Iskandari
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA
| | - Rauf Majidian
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA
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