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Wagner AL, Gordon A, Tallo VL, Simaku A, Porter RM, Edwards LJ, Duka E, Abu-Khader I, Gresh L, Sciuto C, Azziz-Baumgartner E, Bino S, Sanchez F, Kuan G, de Jesus JN, Simões EAF, Hunt DR, Arbaji AK, Thompson MG. Intent to obtain pediatric influenza vaccine among mothers in four middle income countries. Vaccine 2020; 38:4325-4335. [PMID: 32387013 DOI: 10.1016/j.vaccine.2020.04.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 04/10/2020] [Accepted: 04/12/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Despite a large burden of influenza in middle income countries, pediatric vaccination coverage remains low. The aims of this study were to (1) describe mothers' knowledge and attitudes about influenza illnesses and vaccination, and (2) identify characteristics associated with mothers' intent to vaccinate their child. METHODS From 2015 to 2017, infants 0-11 months old in Nicaragua, Philippines, Jordan, and Albania were enrolled from community settings and hospitals. Interviewers administered a questionnaire to their mothers. Mothers of infants aged 6-11 months rated their intention (small-to-moderate vs. large chance) to accept pediatric vaccination if it was offered at no-cost. The importance of knowledge, attitudes, and sociodemographic characteristics in predicting influenza vaccination intention was measured as the mean decrease in Gini index when that factor was excluded from 1000 decision trees in a random forest analysis. RESULTS In total, 1,308 mothers were enrolled from the community setting and 3,286 from the hospital setting. Prevalence of at least some knowledge of influenza illness ranged from 34% in Philippines to 88% in Albania (in the community sample), and between 23% in Philippines to 88% in Jordan (in the hospital sample). In the community sample, most mothers in Albania (69%) and Philippines (58%) would accept the influenza vaccine, and these proportions were higher in the hospital sample for all countries except Albania (48%) (P < 0.0001). Perceived vaccine safety (mean decrease in Gini index = 61) and effectiveness (55), and perceived knowledge of influenza vaccine (45) were the most important predictors of influenza vaccination intention in models that also included country and community versus hospital sample. CONCLUSION Intent to vaccinate infants aged 6-11 months in four middle income countries was tied primarily to knowledge of the vaccine and perceptions of vaccine safety and effectiveness. These findings were noted among mothers interviewed in the community and mothers of recently hospitalized infants.
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Affiliation(s)
- Abram L Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Veronica L Tallo
- Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines
| | - Artan Simaku
- Department of Epidemiology & Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Rachael M Porter
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Enkeleda Duka
- Department of Epidemiology & Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Ilham Abu-Khader
- The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan
| | - Lionel Gresh
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | | | - Silvia Bino
- Department of Epidemiology & Control of Infectious Diseases, Institute of Public Health, Tirana, Albania
| | - Felix Sanchez
- Hospital Infantil Manuel de Jesús Rivera, Ministry of Health, Managua, Nicaragua
| | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua; Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Joanne N de Jesus
- Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines
| | - Eric A F Simões
- Section of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA; Center for Global Health, Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | | | - Ali K Arbaji
- The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan
| | - Mark G Thompson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Al Nsour M, Bashier H, Al Serouri A, Malik E, Khader Y, Saeed K, Ikram A, Abdalla AM, Belalia A, Assarag B, Baig MA, Almudarra S, Arqoub K, Osman S, Abu-Khader I, Shalabi D, Majeed Y. The Role of the Global Health Development/Eastern Mediterranean Public Health Network and the Eastern Mediterranean Field Epidemiology Training Programs in Preparedness for COVID-19. JMIR Public Health Surveill 2020; 6:e18503. [PMID: 32217506 PMCID: PMC7104707 DOI: 10.2196/18503] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 03/19/2020] [Accepted: 03/19/2020] [Indexed: 01/22/2023] Open
Abstract
The World Health Organization (WHO) declared the current COVID-19 a public health emergency of international concern on January 30, 2020. Countries in the Eastern Mediterranean Region (EMR) have a high vulnerability and variable capacity to respond to outbreaks. Many of these countries addressed the need for increasing capacity in the areas of surveillance and rapid response to public health threats. Moreover, countries addressed the need for communication strategies that direct the public to actions for self- and community protection. This viewpoint article aims to highlight the contribution of the Global Health Development (GHD)/Eastern Mediterranean Public Health Network (EMPHNET) and the EMR’s Field Epidemiology Training Program (FETPs) to prepare for and respond to the current COVID-19 threat. GHD/EMPHNET has the scientific expertise to contribute to elevating the level of country alert and preparedness in the EMR and to provide technical support through health promotion, training and training materials, guidelines, coordination, and communication. The FETPs are currently actively participating in surveillance and screening at the ports of entry, development of communication materials and guidelines, and sharing information to health professionals and the public. However, some countries remain ill-equipped, have poor diagnostic capacity, and are in need of further capacity development in response to public health threats. It is essential that GHD/EMPHNET and FETPs continue building the capacity to respond to COVID-19 and intensify support for preparedness and response to public health emergencies.
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Affiliation(s)
- Mohannad Al Nsour
- Global Health Development/Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Haitham Bashier
- Global Health Development/Eastern Mediterranean Public Health Network, Amman, Jordan
| | | | | | - Yousef Khader
- Jordan University of Science and Technology, Irbid, Jordan
| | - Khwaja Saeed
- Afghanistan Field Epidemiology Training Program, Kabul, Afghanistan
| | - Aamer Ikram
- National Institute of Health, Islamabad, Pakistan
| | | | | | | | - Mirza Amir Baig
- Pakistan Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan
| | - Sami Almudarra
- Saudi Field Epidemiology Training Program, Riyadh, Saudi Arabia
| | - Kamal Arqoub
- Jordan Field Epidemiology Training Program, Amman, Jordan
| | - Shahd Osman
- Sudan Field Epidemiology Training Program, Khartoum, Sudan
| | | | - Dana Shalabi
- Eastern Mediterranean Public Health Network, Amman, Jordan
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