RESUMEN
This study aimed to evaluate whether measles vaccine uptake can be predicted directly or indirectly by parental perceptions about the availability of measles vaccine services with parental hesitancy towards the measles vaccine as a potential mediator. This was a community-based cross-sectional study conducted at Omdurman locality in Khartoum state, Sudan in February 2019. The study population included parents/guardians having at least one child aged 2-3 years old. Mediation analysis was conducted using two models, the ordinary least squares path analysis and multiple logistic regression. These models considered perceived vaccine accessibility and availability as independent factors, vaccine uptake as dependent factors, and vaccine hesitancy (PACV scores) as a mediator. A total of 495 responded and the mean age of the mothers who participated in the study was 31.1 (SD = 5.73). Half of the respondents (50.1%) completed university education and nearly three-quarters of the respondents (74.7%) were housewives. After controlling for the other factors, including the mother's age and the number of children, parental perception about the accessibility and availability of the measles vaccine influences the uptake of the measles vaccine indirectly through the mediation effect of measles vaccine hesitancy. We suggest that intervening in measles vaccine hesitancy in addition to measles vaccination access issues will have a positive impact on the uptake and coverage of the measles vaccine in Sudan.
RESUMEN
BACKGROUND: The aim of this study was to determine the prevalence and severity of molar-incisor hypomineralization (MIH) in a cohort of school-aged children in Indiana. METHODS: A calibrated examiner screened eligible school-aged children for MIH and other enamel defects. The authors used the integrated Modified Developmental Defects of Enamel Index and the European Academy of Pediatric Dentistry criteria to examine the permanent first molars, permanent incisors, and primary second molars. The authors used descriptive statistics, exact 95% confidence intervals, and χ2 tests for analysis (α = 5%). RESULTS: A total of 337 participants (mean [standard deviation] age, 9.1 (1.7) years; 52% 6 through 8 years; 66% non-Hispanic white) were examined. The prevalence estimate for MIH was 13% as opposed to a 52% prevalence estimate for any enamel defect (AED) of any of the index teeth. Living in an area with water fluoridation levels greater than 0.7 parts per million or being non-Hispanic black was significantly associated with higher prevalence of AED (P < .05) but not with the prevalence of MIH. Demarcated opacities were the most prevalent defects (43%), followed by atypical restorations (32%). Higher age and higher number of MIH-affected surfaces were associated with larger MIH defect extension (P < .05). CONCLUSIONS: Nearly 1 in 6 children in Indiana had at least 1 permanent first molar with MIH. Water fluoridation levels and race or ethnicity were associated with the prevalence of AED but not with MIH prevalence. PRACTICAL IMPLICATIONS: US dental practitioners should be cognizant that MIH is a common finding. Children with a high number of MIH-affected surfaces would benefit the most from early identification and management as the extension of the defects tends to worsen with age.