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1.
BMC Infect Dis ; 21(1): 130, 2021 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-33516196

RESUMEN

Knowledge among the rural parents about the vaccinations and vaccination coverage of children in the first year of life in Papua New Guinea - analysis of data provided by Christian Health Services. BACKGROUND: This analysis aimed to assess rural parents' knowledge about the diseases prevented by vaccinations and establish vaccination coverage in PNG. METHODS: Knowledge of vaccinations was checked through a standard questionnaire (five closed questions). We analyzed data on vaccination coverage from 2016 to 2018 from all Catholic health facilities. Analyzed vaccinations were the pentavalent vaccine (DTaP-HiB-HepB) and measles vaccine given in the first year of life. Coverage was calculated based on the number of vaccines used compared to the number of eligible children. Analyzed vaccinations were the pentavalent vaccine (DTaP-HiB-HepB) and measles vaccine given in the first year of life. RESULTS: Fifty-six parents, including 52 mothers and four fathers, participated in the interview. Many parents (46%) understood that the vaccine prevents diseases. During the analyzed period, 25,502 doses of measles vaccine were given, 31,428 children were vaccinated with the pentavalent vaccine. In 2016, the measles vaccine coverage rate was 26.6 and 33.4% for the pentavalent vaccine. In 2017, measles and pentavalent vaccines' coverage rate was 12.5 and 16.6%, respectively. There were significant differences in immunization coverage between provinces. A decreasing trend in the number of administered vaccinations was observed. CONCLUSION: The results of this analysis demonstrate that in PNG, the majority of children are not fully immunized. There are significant differences in the vaccination coverage between provinces. As protection from diseases is low, there is a very high risk of an outbreak of the vaccine-preventable disease in the community. Delivery of vaccinations in PNG encounters many barriers, from access to healthcare services to natural disasters and inter-tribial conflicts.


Asunto(s)
Conocimiento , Padres , Población Rural , Cobertura de Vacunación/estadística & datos numéricos , Vacunación , Adulto , Redes Comunitarias , Femenino , Humanos , Inmunización/psicología , Inmunización/estadística & datos numéricos , Programas de Inmunización/estadística & datos numéricos , Lactante , Recién Nacido , Masculino , Vacuna Antisarampión/uso terapéutico , Papúa Nueva Guinea/epidemiología , Padres/educación , Padres/psicología , Población Rural/estadística & datos numéricos , Encuestas y Cuestionarios , Vacunación/psicología , Vacunación/estadística & datos numéricos , Vacunas Combinadas/uso terapéutico
2.
Med Sci (Paris) ; 36(11): 1034-1037, 2020 Nov.
Artículo en Francés | MEDLINE | ID: mdl-33151866

RESUMEN

Coronavirus disease (COVID)-19 is an emerging pandemic infection whose significant ability to spread in a naïve population is well established. The first response of states to the COVID-19 outbreak was to impose lock-down and social barrier measures, such as wearing a surgical mask or social distancing. One of the consequences of this pandemic in terms of public health was the suspension or slowdown of infant vaccination campaigns, in almost all countries. The indirect effects of COVID-19 may therefore weigh on mortality from measles and polio in developing countries. In this pandemic chaos, the only hope lies in the rapid development of an effective vaccine against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). However, acceptance of this vaccine has not yet been won, as beyond the many unknowns that will inevitably weigh around such rapid development, skepticism among vaccine hesitants is growing.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Programas de Inmunización/estadística & datos numéricos , Pandemias , Neumonía Viral/epidemiología , Salud Pública/estadística & datos numéricos , Vacunación/estadística & datos numéricos , Betacoronavirus/fisiología , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/prevención & control , Brotes de Enfermedades/prevención & control , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Programas de Inmunización/organización & administración , Programas de Inmunización/normas , Programas de Inmunización/tendencias , Sarampión/epidemiología , Sarampión/prevención & control , Pandemias/prevención & control , Participación del Paciente/estadística & datos numéricos , Participación del Paciente/tendencias , Neumonía Viral/inmunología , Neumonía Viral/prevención & control , Poliomielitis/epidemiología , Poliomielitis/prevención & control , Salud Pública/normas , Salud Pública/tendencias , Cobertura de Vacunación/organización & administración , Cobertura de Vacunación/estadística & datos numéricos , Vacunas Virales/uso terapéutico
3.
Obstet Gynecol ; 136(5): 1006-1015, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33030866

RESUMEN

OBJECTIVE: To evaluate the result of an inpatient postpartum human papillomavirus (HPV) immunization pilot program in a diverse, low-income patient population from an urban, hospital-based obstetrics and gynecology clinic. METHODS: In this cohort study, we present results from the first 2 years of the inpatient postpartum HPV immunization program, in which vaccine-eligible postpartum women were identified and immunized during their hospital stays. The program was implemented after educational outreach with prenatal and postpartum clinicians and nurses. Associations between receipt of the HPV vaccine as an inpatient and the characteristics of patients, and the likelihood of and missed opportunities for receiving a subsequent dose of the HPV vaccine as an outpatient were determined using logistic regression, time-to-event analyses, chi-squared tests and t-tests. RESULTS: From April 11, 2017, to April 10, 2019, 394 (59.2%) of 666 postpartum women were eligible for the inpatient postpartum HPV immunization program. The majority (265/394, 67.3%) received the immunization pilot program HPV dose; 36 of those 265 (13.6%) completed the series with that dose. Among women due for additional doses after hospital discharge, those who received the inpatient dose were more likely to receive a subsequent outpatient dose (138/229) than were those who did not receive an inpatient dose (39/129; hazard ratio 2.51, 95% CI 1.76-3.58). On average, there were 30.7 fewer (95% CI 5.8-55.6, P<.02) missed opportunities for subsequent outpatient doses for every 100 eligible visits among women who received the inpatient dose, compared with women who did not. By the end of the study, the proportion of women who had completed the vaccine series was higher among women who received the inpatient dose (95/265, 35.8%) than in those who did not (12 out 129, 9.3%; odds ratio 5.45, 95% CI 2.86-10.38). CONCLUSION: The inpatient postpartum HPV immunization program was associated with increased rates of immunization and addressed a previously missed opportunity. Inpatient immunization programs can serve as a critical way to address gaps in vaccine uptake.


Asunto(s)
Programas de Inmunización/estadística & datos numéricos , Pacientes Internos/estadística & datos numéricos , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Atención Posnatal/estadística & datos numéricos , Adulto , Distribución de Chi-Cuadrado , Femenino , Hospitales Urbanos , Humanos , Programas de Inmunización/métodos , Programas de Inmunización/normas , Modelos Logísticos , Aceptación de la Atención de Salud/estadística & datos numéricos , Atención Posnatal/métodos , Atención Posnatal/normas , Pobreza/estadística & datos numéricos , Embarazo , Evaluación de Programas y Proyectos de Salud , Mejoramiento de la Calidad , Adulto Joven
4.
Farm. comunitarios (Internet) ; 12(4): 21-29, oct. 2020.
Artículo en Español | IBECS | ID: ibc-197488

RESUMEN

INTRODUCCIÓN: la vacunación es el modo más eficaz para prevenir la gripe estacional. En España las coberturas son bajas en todos los grupos de población. Nuestro objetivo es comprobar si la intervención del farmacéutico comunitario puede incrementar las tasas de vacunación e identificar las variables que influyen sobre ellas. MATERIAL Y MÉTODOS: estudio cuasi experimental pre-post intervención en tres grupos de riesgo (GR): mayores de 65 años (M), alto riesgo de sufrir complicaciones (C) y que pueden transmitir la infección (T). Se determinan las tasas de vacunación pre y postintervención (dos campañas) y el efecto de diversas variables sobre la posibilidad de vacunarse. RESULTADOS: han sido entrevistados 74 pacientes, 58  % mujeres, entre 33 y 90 años. Tasa de vacunación previa a la intervención: 58  %. Porcentajes por GR: 69  % M, 62  % C y 47  % T. Se identifican 31 pacientes de riesgo sin historial de vacunación. Tasa de vacunación tras la intervención: 74  % en campaña 17/18 y 66  % en 18/19. La vacunación se relaciona con grado de conocimiento del proceso, existencia de historia de vacunación previa y edad superior a 65 años. DISCUSIÓN: las tasas de vacunación antes de la intervención son similares a las publicadas a nivel regional y nacional. Las tasas incrementadas alcanzadas (74  % y 66  %) se aproximan a los niveles propuestos por la Unión Europea (UE) y la Organización Mundial de la Salud (OMS). El mayor aumento en los grupos C y T puede ser relevante en comunidades cerradas donde las medidas higiénicas son de capital importancia


INTRODUCTION: Vaccinating population is the most effective method of preventing flu and its consequences although in Spain coverage rates remain low. Our objective is to assess whether community pharmacist intervention can increase vaccination coverage of risk population and to identify factors influencing rates. MATERIAL AND METHODS: Pre-post cuasi experimental study including three high risk population groups: aged 65 and above (M), having any risk chronic illness (C) or transmitting patients (T). Coverage was measured before and twice (two vaccination campaigns) after intervention and the effect of different factors on having the vaccine were estimated. RESULTS: 74 patients, 58  % women, aged between 33 and 90 were interviewed. Vaccination coverage before intervention: 58  %. Rates found by risk group: 69  % M, 62  % C y 47  % T. 31 risk patients with no vaccination history were identified. Global post-intervention vaccination coverage: 74  % in 17/18 vaccination campaign and 66  % in 18/19. Flu awareness, vaccination in previous seasons and being aged above 65 showed statistically significant effect on vaccination rate. DISCUSSION: Pre-intervention rates were similar to those published for our region and country. Post-intervention rates (74 and 66  %) are close to EU and WHO vaccination goals. The higher coverage increase was achieved for C and T groups: this can be relevant in closed communities where hygiene measures are of importance. CONCLUSIONS: A simple intervention conducted at our community pharmacy resulted in a significant increase of the flu vaccination rate in several population risk groups


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Gripe Humana/prevención & control , Cobertura de Vacunación/estadística & datos numéricos , Farmacias/estadística & datos numéricos , Vacunas contra la Influenza/uso terapéutico , Factores de Riesgo , Comorbilidad , Distribución por Edad y Sexo , Programas de Inmunización/estadística & datos numéricos , España
5.
Vaccine ; 38(45): 7146-7155, 2020 10 21.
Artículo en Inglés | MEDLINE | ID: mdl-32943265

RESUMEN

BACKGROUND: COVID-19 pandemic has affected routine immunization globally. Impact will likely be higher in low and middle-income countries with limited healthcare resources and fragile health systems. We quantified the impact, spatial heterogeneity, and determinants for childhood immunizations of 48 million population affected in the Sindh province of Pakistan. METHODS: We extracted individual immunization records from real-time provincial Electronic Immunization Registry from September 23, 2019, to July 11, 2020. Comparing baseline (6 months preceding the lockdown) and the COVID-19 lockdown period, we analyzed the impact on daily immunization coverage rate for each antigen by geographical area. We used multivariable logistic regression to explore the predictors associated with immunizations during the lockdown. RESULTS: There was a 52.5% decline in the daily average total number of vaccinations administered during lockdown compared to baseline. The highest decline was seen for Bacille Cal-mette Guérin (BCG) (40.6% (958/2360) immunization at fixed sites. Around 8438 children/day were missing immunization during the lockdown. Enrollments declined furthest in rural districts, urban sub-districts with large slums, and polio-endemic super high-risk sub-districts. Pentavalent-3 (penta-3) immunization rates were higher in infants born in hospitals (RR: 1.09; 95% CI: 1.04-1.15) and those with mothers having higher education (RR: 1.19-1.50; 95% CI: 1.13-1.65). Likelihood of penta-3 immunization was reduced by 5% for each week of delayed enrollment into the immunization program. CONCLUSION: One out of every two children in Sindh province has missed their routine vaccinations during the provincial COVID-19 lockdown. The pool of un-immunized children is expanding during lockdown, leaving them susceptible to vaccine-preventable diseases. There is a need for tailored interventions to promote immunization visits and safe service delivery. Higher maternal education, facility-based births, and early enrollment into the immunization program continue to show a positive association with immunization uptake, even during a challenging lockdown.


Asunto(s)
Infecciones por Coronavirus/psicología , Sarampión/prevención & control , Pandemias , Neumonía Viral/psicología , Cuarentena , Infecciones por Rotavirus/prevención & control , Tuberculosis Pulmonar/prevención & control , Vacunación/estadística & datos numéricos , Vacuna BCG/administración & dosificación , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/inmunología , Procesamiento Automatizado de Datos , Femenino , Humanos , Programas de Inmunización/estadística & datos numéricos , Lactante , Recién Nacido , Masculino , Sarampión/epidemiología , Sarampión/inmunología , Vacuna Antisarampión/administración & dosificación , Pakistán/epidemiología , Neumonía Viral/epidemiología , Neumonía Viral/inmunología , Sistema de Registros , Infecciones por Rotavirus/epidemiología , Infecciones por Rotavirus/inmunología , Vacunas contra Rotavirus/administración & dosificación , Población Rural , Tuberculosis Pulmonar/epidemiología , Tuberculosis Pulmonar/inmunología , Población Urbana , Vacunación/psicología , Cobertura de Vacunación/estadística & datos numéricos , Vacunas Atenuadas/administración & dosificación
6.
Am J Trop Med Hyg ; 103(4): 1367-1369, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32861265

RESUMEN

Polio is a deadly viral disease that has been paralyzing many children in Afghanistan. Despite fundamental efforts, primarily vaccination, to reduce the number of cases in Afghanistan, there are still many children who are deprived of the vaccine every year. Afghanistan is one of the two remaining countries endemic for polio, and the country has undergone various challenges that have hampered the eradication of this disease. The underlying challenges include inaccessibility of unsecured areas, illiteracy, refusal, and, most recently, COVID-19. The country is in the midst of a battle against COVID-19, and polio has almost entirely been neglected. Sadly, polio cases are increasing in the country, particularly in polio-free provinces. After an initial lockdown, many businesses have been allowed to resume, but the mass polio vaccination campaign has not restarted. New cases of polio will surge if endemic regions remain unvaccinated or inaccessible. To curb the further spread of polio, Afghanistan needs to resume nationwide house-to-house vaccination as restrictions due to COVID-19 are loosened.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades , Programas de Inmunización/estadística & datos numéricos , Neumonía Viral/epidemiología , Poliomielitis/epidemiología , Poliomielitis/prevención & control , Vacunas contra Poliovirus/administración & dosificación , Vacunación/estadística & datos numéricos , Afganistán/epidemiología , Betacoronavirus/patogenicidad , Preescolar , Coinfección , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/virología , Enfermedades Endémicas/economía , Femenino , Humanos , Incidencia , Lactante , Alfabetización/estadística & datos numéricos , Masculino , Pandemias/economía , Neumonía Viral/economía , Neumonía Viral/inmunología , Neumonía Viral/virología , Poliomielitis/economía , Poliomielitis/inmunología , Poliovirus/patogenicidad , Pobreza/estadística & datos numéricos , Salud Pública/ética , Terrorismo/estadística & datos numéricos
7.
PLoS One ; 15(8): e0237525, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32776972

RESUMEN

Hepatitis B is a global epidemic that requires carefully orchestrated vaccination initiatives in geographical regions of medium to high endemicity to reach the World Health Organization's elimination targets by 2030. This study compares two widely-used deterministic hepatitis B models-the Imperial HBV model and the CDA Foundation's PRoGReSs-based on their predicted outcomes in four countries. The impact of scaling up of the timely birth dose of the hepatitis B vaccine is also investigated. The two models predicted largely similar outcomes for the impact of vaccination programmes on the projected numbers of new cases and deaths under high levels of the infant hepatitis B vaccine series. However, scenarios for the scaling up of the infant hepatitis B vaccine series had a larger impact in the PRoGReSs model than in the Imperial model due to the infant vaccine series directly leading to the reduction of perinatal transmission in the PRoGReSs model, but not in the Imperial model. Meanwhile, scaling up of the timely birth dose vaccine had a greater impact on the outcomes of the Imperial hepatitis B model than in the PRoGReSs model due to the greater protection that the birth dose vaccine confers to infants in the Imperial model compared to the PRoGReSs model. These differences underlie the differences in projections made by the models under some circumstances. Both sets of assumptions are consistent with available data and reveal a structural uncertainty that was not apparent in either model in isolation. Those relying on projections from models should consider outputs from both models and this analysis provides further evidence of the benefits of systematic model comparison for enhancing modelling analyses.


Asunto(s)
Vacunas contra Hepatitis B/administración & dosificación , Virus de la Hepatitis B/efectos de los fármacos , Hepatitis B/prevención & control , Programas de Inmunización/estadística & datos numéricos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Modelos Estadísticos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Salud Global , Hepatitis B/epidemiología , Hepatitis B/virología , Humanos , Lactante , Recién Nacido , Persona de Mediana Edad , Embarazo , Organización Mundial de la Salud , Adulto Joven
8.
PLoS One ; 15(8): e0236955, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32764770

RESUMEN

BACKGROUND: Childhood vaccination plays a key role in reducing morbidity and mortality from vaccine-preventable diseases. Numerous studies have assessed the influence of demographic and socioeconomic factors on child immunization around the world. There are few such studies in Afghanistan, however. Therefore, this study aimed to identify factors influencing vaccination status among children age 12-23 months in Afghanistan. MATERIALS AND METHODS: Nationally representative data from the 2015 Afghanistan Demographic and Health Survey were used for this study. A sample of 5,708 children age 12-23 months with a vaccine card and immunization history was analyzed. Multinomial logistic regression was used to identify significant relationships between cofactors and vaccination status. RESULTS: In the study, 51% the subjects were boys, 48% were born at home, and 76% were residents of rural areas. Background characteristics positively associated with vaccination status included delivery in a health facility (RRR = 2.5, 95% CI = 1.9-3.3), maternal age of 30-39 years (RRR = 2.2, 95% CI = 1.2-4.1), attending at least four visits for antenatal care (RRR = 2.7, 95% CI = 1.7-4.5), health facility visit in the past 12 months (RRR = 1.9, 95% CI = 1.4-2.5), paternal professional occupation (RRR = 4.9, 95% CI = 2.0-12.3), family with richer wealth index (RRR = 2.4, 95% CI = 1.4-4.1), and living in the northeast region (RRR = 2.2, 95% CI = 1.2-3.9)were positively associated with vaccination status. Living in the southern region (RRR = 0.3, 95% CI = 0.2-0.5) was negatively associated with vaccination status. CONCLUSION: This study identified maternal age, ANC visits, place of delivery, health facility visits in past 12 months, paternal occupation, wealth quintile, and geographic region as the factors influencing child's vaccination status in Afghanistan.


Asunto(s)
Cobertura de Vacunación/estadística & datos numéricos , Adulto , Afganistán , Estudios Transversales , Demografía , Femenino , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Programas de Inmunización/estadística & datos numéricos , Lactante , Modelos Logísticos , Masculino , Edad Materna , Persona de Mediana Edad , Factores Socioeconómicos , Vacunación/estadística & datos numéricos , Adulto Joven
9.
Tex Med ; 116(5): 47, 2020 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-32645186

RESUMEN

In 2003, the Texas Legislature allowed parents to opt their children out of getting mandatory public school vaccines. Since then, exemptions have jumped more than 3,000%, to 72,743 statewide, according to the Texas Department of State Health Services. That number of exemptions threatens "herd" or "community" immunity for vaccine-preventable diseases.


Asunto(s)
Programas de Inmunización/legislación & jurisprudencia , Programas de Inmunización/estadística & datos numéricos , Educación del Paciente como Asunto , Instituciones Académicas , Negativa a la Vacunación/legislación & jurisprudencia , Negativa a la Vacunación/estadística & datos numéricos , Vacunación/legislación & jurisprudencia , Enfermedades Prevenibles por Vacunación/prevención & control , Vacunas , Niño , Humanos , Texas/epidemiología
10.
BMC Public Health ; 20(1): 1086, 2020 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-32652969

RESUMEN

BACKGROUND: Inability to track children's vaccination history coupled with parents' lack of awareness of vaccination due dates compounds the problem of low immunization coverage and timeliness in developing countries. We evaluated the impact of two types of silicone immunization reminder bracelets for children in improving immunization coverage and timeliness of Pentavalent-3 and the Measles-1 vaccines. METHODS: Children < 3 months were enrolled in either of the 2 intervention groups (Alma Sana Bracelet Group and Star Bracelet Group) or the Control group. Children in the intervention groups were provided the two different bracelets at the time of recruitment. Each time the child visited the immunization center, a hole was perforated in the silicone bracelet to denote vaccine administration. Each child was followed up till administration of Measles-1 vaccine or till 12 months of age (if they did not come to the center for vaccination). Data was analyzed using the intention-to-treat population between groups. The unadjusted and adjusted Risk Ratios (RR) and 95% confidence interval (CI) for Pentavalent-3 and Measles-1 coverage at 12 months of age were estimated through bivariate and multivariate analysis. Time-to-Pentavalent-3 and Measles-1 immunization curves were calculated using the Kaplan-Meier method. RESULTS: A total of 1,445 children were enrolled in the study between July 19, 2017 and October 10, 2017. Baseline characteristics among the three groups were similar. Up-to-date coverage for the Pentavalent-3 /Measles-1 vaccine at 12 months of age was 84.6%/72.0%, 85.4%/70.5% and 83.0%/68.5% in Alma Sana Bracelet group, Star Bracelet group and Control group respectively but the differences were not statistically significant. In the multivariate analysis, neither the Alma Sana bracelet (adjusted RR = 1.01; 95% CI: 0.96-1.06), (adjusted RR: 1.05; 95% CI: 0.97-1.13) nor the Star bracelet (adjusted RR = 1.01; 95% CI: 0.96-1.06) (adjusted RR: 1.03; 95% CI: 0.95-1.11) was significantly associated with Pentavalent-3 vaccination or Measles-1 vaccination. CONCLUSION: Although we did not observe any significant impact of the bracelets on improved immunization coverage and timeliness, our findings add to the existing literature on innovative, low cost reminders for health and make several suggestions for enhancing practical implementation of these tools. TRIAL REGISTRATION: ClinicalTrials.gov NCT03310762 . Retrospectively Registered on October 16, 2017.


Asunto(s)
Promoción de la Salud/estadística & datos numéricos , Programas de Inmunización/estadística & datos numéricos , Vacuna Antisarampión/administración & dosificación , Cooperación del Paciente/estadística & datos numéricos , Sistemas Recordatorios/estadística & datos numéricos , Niño , Preescolar , Femenino , Humanos , Inmunización , Lactante , Masculino , Sarampión/prevención & control , Pakistán , Proyectos de Investigación , Vacunación/estadística & datos numéricos , Cobertura de Vacunación
11.
BMC Public Health ; 20(1): 1108, 2020 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-32664849

RESUMEN

BACKGROUND: Immunization to prevent infectious diseases is a core strategy to improve childhood health as well as survival. It remains a challenge for some African countries to attain the required childhood immunization coverage. We aim at identifying individual barriers confronting parents/caretakers, providers, and health systems that hinder childhood immunization coverage in Sub-Saharan Africa. METHOD: This systematic review searched PubMed/MEDLINE, Web of Science and EMBASE. We restricted to published articles in English that focused on childhood immunization barriers in sub-Saharan Africa from January 1988 to December 2019. We excluded studies if: focused on barriers to immunization for children in other regions of the world, studied adult immunization barriers; studies not available on the university library, they were editorial, reports, reviews, supplement, and bulletins. Study designs included were cross-sectional, second-hand data analysis; and case control. RESULTS: Of the 2652 items identified, 48 met inclusion criteria. Parents/caretakers were the most common subjects. Nine articles were of moderate and 39 were of high methodological quality. Nine studies analyzed secondary data; 36 used cross-sectional designs and three employed case control method. Thirty studies reported national immunization coverage of key vaccines for children under one, eighteen did not. When reported, national immunization coverage of childhood vaccines is reported to be low. Parents/caretaker' barriers included lack of knowledge of immunization, distance to access point, financial deprivation, lack of partners support, and distrust in vaccines and immunization programs. Other associated factors for low vaccine rates included the number of off-springs, lifestyle, migration, occupation and parent's forgetfulness, inconvenient time and language barrier. Barriers at health system level cited by healthcare providers included limited human resources and inadequate infrastructures to maintain the cold chain and adequate supply of vaccines. CONCLUSION: In this review we identified more thoroughly the parents/caretakers' barriers than those of providers and health systems. Factors that influenced decisions to get children vaccinated were mainly their gender, beliefs, socio-culture factors in the communities in which they live. Thus it is vital that immunization programs consider these barriers and address the people and societies in their communities across sub-Saharan Africa.


Asunto(s)
Cuidadores/psicología , Personal de Salud/psicología , Programas de Inmunización/organización & administración , Programas de Inmunización/estadística & datos numéricos , Padres/psicología , Cobertura de Vacunación/estadística & datos numéricos , Vacunación/psicología , Adolescente , Adulto , África del Sur del Sahara , Actitud Frente a la Salud , Estudios de Casos y Controles , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Vacunación/estadística & datos numéricos
12.
BMC Public Health ; 20(1): 1110, 2020 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-32664859

RESUMEN

BACKGROUND: In 1988, the 41st World Health Assembly (WHA) marked the launch of the Global Polio Eradication Initiative (GPEI) for the eradication of polio. A key component of the GPEI has been the development and deployment of a skilled workforce to implement eradication activities. In 1989, the Stop Transmission of Polio (STOP) was initiated to address skilled human resource gaps and strengthen poliovirus surveillance. This paper describes the role of the STOP 52 team in technical capacity building and health system strengthening in the implementation of polio eradication strategies in Kenya following the outbreak of Circulating Vaccine-derived Poliovirus type 2 (cVDPV2). METHODS: Overview of the STOP program, deployment, and the modality of support are described. Descriptive analysis was conducted using data collected by the STOP 52 team during integrated supportive supervisory visits conducted from July 2018 to September 2019. Analyses were carried out using Epi-Info statistical software (Version 7.0) and maps were developed using Quantum Geographic Information System (Q-GIS) (version 3.12.0). RESULTS: The STOP 52 team supportively supervised 870 health facilities on Expanded Program on Immunization (EPI), and Acute Flaccid Paralysis (AFP) and other Vaccine-Preventable Diseases (VPDs) surveillance in 16 (34.1%) of the 47 counties during the study period. AFP surveillance was conducted in all health facilities supervised leading to the detection and investigation of 11 unreported AFP cases. The STOP 52 team, as part of the outbreak response, provided technical support to five successive rounds of polio Supplementary Immunization Activities (SIAs) conducted during the study period. Moreover, in addressing programmatic data needs, the STOP 52 Data Manager played a valuable role in enhancing the quality and use of data for evidence-based planning and decision-making. The STOP 52 team contributed to the development of operational plans, guidelines and training manuals, and participated in the delivery of various Training of Trainers (TOT) and On-the-Job Training (OJT) on EPI, AFP and other VPDs surveillance including data management. CONCLUSION: The STOP 52 team has contributed to polio eradication efforts in Kenya by enhancing AFP and other VPDs surveillance, supporting polio SIAs, strengthening EPI, use of quality EPI, AFP and other VPDs data, and capacity building of Frontline Health Workers (FLWs). The use of Open Data Kit (ODK) technology during supportive supervision, and AFP and other VPDs surveillance was found to be advantageous. A national STOP program should be modeled to produce a homegrown workforce to ensure the availability of more sustainable technical support for polio eradication efforts in Kenya and possibly other polio-affected countries.


Asunto(s)
Erradicación de la Enfermedad/organización & administración , Brotes de Enfermedades/prevención & control , Promoción de la Salud/métodos , Programas de Inmunización/organización & administración , Programas de Inmunización/estadística & datos numéricos , Poliomielitis/prevención & control , Vacunación/estadística & datos numéricos , Países en Desarrollo , Erradicación de la Enfermedad/estadística & datos numéricos , Promoción de la Salud/estadística & datos numéricos , Humanos , Kenia , Vigilancia de la Población
13.
Niger Postgrad Med J ; 27(3): 209-214, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32687121

RESUMEN

Introduction: Immunisation and vaccination programmes are preventive and cost-effective child health interventions for reducing childhood mortality and disability from infectious diseases. Timely administration of these vaccines is important to ensure their effectiveness in disease prevention. Aim: The aim was to determine the timeliness, barriers and predictors of at-birth vaccinations. Materials and Methods: This was a cross-sectional study of 355 mother-newborn pairs using simple random sampling technique by balloting. SPSS version 23.0 was used for data analysis. Crude and adjusted odds ratios (AORs) were used as point estimates in the binary logistic regression model, while 95% confidence interval (CI) was used as the interval estimate. A P < 0.05 was considered statistically significant for the study. Results: The mean age of the mothers was 31.0 ± 6 years. The median age of newborns at vaccination was 18 h (IQR = 1 - 17) h. About 185 (52.1%) of the newborns studied were males. Only 191 (53.8%) newborns received at-birth vaccination within 24 h of life. Weekend delivery, birth outside vaccination days, delivery during public holidays and vaccine stock-outs were barriers to timely vaccinations. Private hospital delivery was an independent predictor of delayed at-birth vaccinations (AOR = 2.616; 95% CI = 1.382-4.951). Conclusions: Our study has identified weekend delivery, preterm birth, delivery outside vaccination days and vaccines stock-outs as barriers to timely at-birth vaccinations. Private hospital delivery is a significant predictor of delayed at-birth vaccinations.


Asunto(s)
Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/administración & dosificación , Programas de Inmunización/estadística & datos numéricos , Vacuna contra el Sarampión-Parotiditis-Rubéola/administración & dosificación , Madres/psicología , Cobertura de Vacunación/estadística & datos numéricos , Vacunación/estadística & datos numéricos , Adulto , Control de Enfermedades Transmisibles , Enfermedades Transmisibles , Estudios Transversales , Femenino , Humanos , Esquemas de Inmunización , Recién Nacido , Masculino , Nigeria , Vigilancia en Salud Pública , Factores de Tiempo
14.
Infect Dis Poverty ; 9(1): 62, 2020 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-32503667

RESUMEN

BACKGROUND: Rabies is a fatal but preventable viral disease, which causes an estimated 59 000 human deaths globally every year. The vast majority of human rabies cases are attributable to bites from infected domestic dogs and consequently control of rabies in the dog population through mass vaccination campaigns is considered the most effective method of eliminating the disease. Achieving the WHO target of 70% vaccination coverage has proven challenging in low-resource settings such as Sub Saharan Africa, and lack of public awareness about rabies vaccination campaigns is a major barrier to their success. In this study we surveyed communities in three districts in Southern Malawi to assess the extent of and socio-economic factors associated with mobile phone ownership and explore the attitudes of communities towards the use of short message service (SMS) to inform them of upcoming rabies vaccination clinics. METHODS: This study was carried out between 1 October-3 December 2018 during the post-vaccination assessment of the annual dog rabies campaign in Blantyre, Zomba and Chiradzulu districts, Malawi. 1882 questionnaires were administered to households in 90 vaccination zones. The surveys gathered data on mobile phone ownership and use, and barriers to mobile phone access. A multivariable regression model was used to understand factors related to mobile phone ownership. RESULTS: Most survey respondents owned or had use of a mobile phone, however there was evidence of an inequality of access, with higher education level, living in Blantyre district and being male positively associated with mobile phone ownership. The principal barrier to mobile phone ownership was the cost of the phone itself. Basic feature phones were most common and few owned smartphones. SMS was commonly used and the main reason for not using SMS was illiteracy. Attitudes to receiving SMS reminders about future rabies vaccination campaigns were positive. CONCLUSIONS: The study showed a majority of those surveyed have the use of a mobile phone and most mobile phone owners indicated they would like to receive SMS messages about future rabies vaccination campaigns. This study provides insight into the feasibility of distributing information about rabies vaccination campaigns using mobile phones in Malawi.


Asunto(s)
Actitud , Teléfono Celular/estadística & datos numéricos , Programas de Inmunización/estadística & datos numéricos , Propiedad/estadística & datos numéricos , Rabia/prevención & control , Factores Socioeconómicos , Vacunación/psicología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Malaui , Masculino , Persona de Mediana Edad , Adulto Joven
16.
BMC Public Health ; 20(1): 691, 2020 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-32460747

RESUMEN

BACKGROUND: The quadrivalent human papillomavirus (HPV) vaccine has been assumed to give protection against genital warts (GW) as well as cervical cancer. Our main question was whether HPV vaccine has any effects on the prevention of GW reported in randomised controlled clinical trials (RCTs) and time-trend analyses. METHODS: This meta-analysis was performed according to the PRISMA guidelines using the PICO format. We searched in three electronic databases (PubMed, Embase, Cochrane Trials), and assessed heterogeneity using the Q-test and I-squared statistics, meta-regression was also performed. Odds ratios (OR) and their confidence intervals (CI) were calculated. The sensitivity was tested by leave-one-out method. We evaluated the presence of publication bias using the funnel plot graph and the Copas selection model. The strength of evidence was assessed using the GRADE approach. RESULTS: Eight RCTs (per-protocol populations) and eight time-trend ecological studies were included in this meta-analysis. A significant reduction (pooled OR = 0.03, 95% CI: 0.01-0.09; I-squared = 53.6%) of GW in young women was recorded in RCTs, and in time-trend analyses both in young women (pooled OR = 0.36, CI 95% = 0.26-0.51; I-squared = 98.2%), and in young men (pooled OR = 0.69, 95% CI = 0.61-0.78; I-squared = 92.7%). In subgroup analysis, a significant reduction of the number of GW events was observed especially in women under 21 years (pooled OR = 0.33, 95% CI = 0.17-0.63). Leave-one-out analysis showed that similar results could be obtained after excluding one study, meta-regression did not show significant difference. CONCLUSIONS: Prophylactic, quadrivalent HPV vaccination can prevent GW in healthy women and men, therefore, it should be included in routine immunization programme.


Asunto(s)
Condiloma Acuminado/prevención & control , Programas de Inmunización/estadística & datos numéricos , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/administración & dosificación , Neoplasias del Cuello Uterino/prevención & control , Vacunación/estadística & datos numéricos , Adolescente , Adulto , Niño , Condiloma Acuminado/epidemiología , Femenino , Humanos , Masculino , Infecciones por Papillomavirus/epidemiología , Vacunas contra Papillomavirus/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto , Neoplasias del Cuello Uterino/epidemiología , Adulto Joven
18.
Am J Public Health ; 110(7): 1092-1097, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32437281

RESUMEN

Objectives. To describe the ongoing collaboration of the Centers for Disease Control and Prevention's (CDC's) school vaccination assessment with state, local, and territorial immunization programs to provide data to monitor school entry vaccination.Methods. Departments of health and education partner to collect data from public school, private school, and homeschooled kindergartners in the 50 US states, the District of Columbia, 2 cities, and the US territories. Immunization programs submit vaccination coverage and exemption data to the CDC, and the CDC reports these data annually via multiple sources.Results. Among the 50 states and the District of Columbia, the number of programs using a census for vaccination coverage data increased from 39 to 41 during the school years 2012-2013 to 2017-2018 (which for most states was August or September through May or June), and the number using a census to collect exemption data increased from 40 to 46. The number of states that reported sharing their local-level vaccination coverage data online increased from 11 in 2012-2013 to 31 in 2017-2018.Conclusions. Coverage data can be used to address undervaccination among kindergartners to work with communities and schools that are susceptible to vaccine-preventable diseases. As more states publish local-level data online, access to improved data provides the public more valuable information.


Asunto(s)
Centers for Disease Control and Prevention, U.S./organización & administración , Programas de Inmunización/organización & administración , Cobertura de Vacunación/organización & administración , Vacunación/estadística & datos numéricos , Preescolar , Recolección de Datos , Humanos , Programas de Inmunización/estadística & datos numéricos , Instituciones Académicas , Estados Unidos
19.
Proc Natl Acad Sci U S A ; 117(23): 13138-13144, 2020 06 09.
Artículo en Inglés | MEDLINE | ID: mdl-32457142

RESUMEN

Regions with insufficient vaccination have hindered worldwide poliomyelitis eradication, as they are vulnerable to sporadic outbreaks through reintroduction of the disease. Despite Israel's having been declared polio-free in 1988, a routine sewage surveillance program detected polio in 2013. To curtail transmission, the Israel Ministry of Health launched a vaccine campaign to vaccinate children-who had only received the inactivated polio vaccine-with the oral polio vaccine (OPV). Determining the degree of prosocial motivation in vaccination behavior is challenging because vaccination typically provides direct benefits to the individual as well as indirect benefits to the community by curtailing transmission. However, the Israel OPV campaign provides a unique and excellent opportunity to quantify and model prosocial vaccination as its primary objective was to avert transmission. Using primary survey data and a game-theoretical model, we examine and quantify prosocial behavior during the OPV campaign. We found that the observed vaccination behavior in the Israeli OPV campaign is attributable to prosocial behavior and heterogeneous perceived risk of paralysis based on the individual's comprehension of the prosocial nature of the campaign. We also found that the benefit of increasing comprehension of the prosocial nature of the campaign would be limited if even 24% of the population acts primarily from self-interest, as greater vaccination coverage provides no personal utility to them. Our results suggest that to improve coverage, communication efforts should also focus on alleviating perceived fears surrounding the vaccine.


Asunto(s)
Altruismo , Brotes de Enfermedades/prevención & control , Vacunación Masiva/psicología , Poliomielitis/prevención & control , Vacuna Antipolio Oral/uso terapéutico , Adolescente , Adulto , Anciano , Niño , Teoría del Juego , Humanos , Programas de Inmunización/métodos , Programas de Inmunización/estadística & datos numéricos , Israel/epidemiología , Vacunación Masiva/estadística & datos numéricos , Persona de Mediana Edad , Modelos Neurológicos , Poliomielitis/epidemiología , Poliomielitis/virología , Poliovirus/aislamiento & purificación , Vacuna Antipolio de Virus Inactivados/uso terapéutico , Aguas del Alcantarillado/virología , Encuestas y Cuestionarios , Cobertura de Vacunación/estadística & datos numéricos , Adulto Joven
20.
Pan Afr Med J ; 35(Suppl 1): 5, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32373256

RESUMEN

Introduction: Malawi's National Immunization Program introduced a second routine dose of measles containing vaccine (MCV2) in 2015 but found coverage lagging. We assessed data quality and gaps in service delivery. Methods: Investigators used a modified data quality audit in 6 low performing districts accompanied by questionnaires for health facilities (HF) and households with children with >1 vaccination. Results: MCV2 doses administered according to source were: 733 in registers, 2364 in reports, 1655 in district reports, 2761 in the electronic database. There was 77% agreement regarding status for MCV2 between the register and the home-based record (HBR). Drop-out differences were found between HF according to the practice of waiting for a minimum number of children to open an MCV vial, canceling sessions due to stock-out and requesting payment for a home-based record. Eighty one percent (81%) of children whose caregivers knew 2 doses were needed had received MCV2 vs fifty eight (58%) of children whose caregivers didn't know. Sixty two (62%) of children who were charged for HBR received MCV2 vs 78% reporting no charge. Conclusion: The drop-out between the first and second doses of MCV was high and inconsistent with elimination goals. The quality of administrative data in these 6 districts was found to be poor. This investigation found that session cancelation, charging for HBR and lack of caregiver knowledge affected completion of the vaccination series. The authors recommend program improvements in these areas to increase uptake of MCV2 and improved reporting practices at all levels of the system.


Asunto(s)
Barreras de Comunicación , Vacuna Antisarampión/administración & dosificación , Sarampión/prevención & control , Aceptación de la Atención de Salud/estadística & datos numéricos , Participación del Paciente/estadística & datos numéricos , Cobertura de Vacunación/estadística & datos numéricos , Niño , Preescolar , Exactitud de los Datos , Erradicación de la Enfermedad/métodos , Erradicación de la Enfermedad/organización & administración , Erradicación de la Enfermedad/normas , Erradicación de la Enfermedad/estadística & datos numéricos , Relación Dosis-Respuesta Inmunológica , Humanos , Programas de Inmunización/métodos , Programas de Inmunización/organización & administración , Programas de Inmunización/normas , Programas de Inmunización/estadística & datos numéricos , Esquemas de Inmunización , Lactante , Recién Nacido , Malaui/epidemiología , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Vigilancia de la Población/métodos , Mejoramiento de la Calidad/organización & administración , Mejoramiento de la Calidad/normas , Proyectos de Investigación , Encuestas y Cuestionarios/normas , Encuestas y Cuestionarios/estadística & datos numéricos , Vacunación/estadística & datos numéricos , Cobertura de Vacunación/métodos , Cobertura de Vacunación/organización & administración
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